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Sample records for british medical response

  1. British Contributions to Medical Libraries Overseas

    PubMed Central

    Clark, Hilda M.

    1965-01-01

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

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

    PubMed

    Mackie, Isobel

    2015-12-01

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

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

    PubMed

    Mackie, Isobel

    2015-12-01

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

  4. A short history of providing medical history within the British medical undergraduate curriculum.

    PubMed

    Metcalfe, N H; Stuart, E

    2014-06-01

    This article aims to discuss the history of medical history in the British medical undergraduate curriculum and it reviews the main characters and organisations that have attempted to earn it a place in the curriculum. It also reviews the arguments for and against the study of the subject that have been used over the last 160 years.

  5. British Universities' Responses to Financial Reductions.

    ERIC Educational Resources Information Center

    Sizer, John

    1987-01-01

    The impact on nine British universities' of substantial financial reductions in 1980-81 and the policy implications for national funding agencies are examined. Implementation of institutional retrenchment plans and the role of high-level administrators are discussed. (MSE)

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

    PubMed Central

    Weindling, Paul

    2015-01-01

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

  7. As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas

    PubMed Central

    Gordon, P N; Williamson, S; Lawler, P G

    1998-01-01

    Objective: To determine the frequency and accuracy with which cardiopulmonary resuscitation is portrayed in British television medical dramas. Design: Observational study. Subjects: 64 episodes of three major British television medical dramas: Casualty, Cardiac Arrest, and Medics. Main outcome measures: Frequency of cardiopulmonary resuscitation shown on television; age, sex, and diagnosis of the patients undergoing resuscitation; rate of survival through resuscitation. Results: Overall 52 patients had a cardiorespiratory arrest on screen and 3 had a respiratory arrest alone, all the arrests occurring in 40 of the 64 episodes. Of the 52 patients having cardiorespiratory arrest, 32 (62%) underwent an attempt at cardiopulmonary resuscitation; 8 attempts were successful. All 3 of the patients having respiratory arrests alone received ventilatory support and survived. On 48% of occasions, victims of cardiac arrest seemed to be less than 35 years old. Conclusions: Cardiorespiratory resuscitation is often depicted in British television medical dramas. Patients portrayed receiving resuscitation are likely to be in a younger age group than in real life. Though the reasons for resuscitation are more varied and more often associated with trauma than in reality, the overall success rate is nevertheless realistic. Widespread overoptimism of patients for survival after resuscitation cannot necessarily be blamed on British television medical dramas. Key messagesA quarter of patients in British television medical dramas who received cardiopulmonary resuscitation on screen seemed to surviveThis figure is comparable to initial survival rates in a series of patients in real lifePatients on television are more likely to suffer cardiac arrest as a result of trauma than in real life, and patients undergoing resuscitation are likely to be younger than patients in real lifeThe overall survival rate of patients after cardiopulmonary resuscitation in British television medical drama seems

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

    PubMed Central

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

    2013-01-01

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

  9. Dispensers, obeah and quackery: medical rivalries in post-slavery British Guiana.

    PubMed

    De Barros, Juanita

    2007-08-01

    This paper examines the ambiguous place of medical assistants-dispensers-in a post-slavery British Caribbean colony, British Guiana, from the end of slavery in the 1830s to the early twentieth century. Although the latter were crucial to the functioning of the colonial medical system, local physicians resented them, complaining about the economic threat they posed and at times condemning them as quacks. These attacks were part of a wider discussion about the composition of the medical profession and the role of medical auxiliaries in colonial society, and to an extent, they echoed debates conducted in other jurisdictions in this period. But in the British Caribbean, this discussion was significantly different. There, long-standing views about obeah-an Afro-Creole medico-religious practice-as a particularly dangerous and uncivilised type of quackery was part of the discursive context. That those participating in this debate included African-descended physicians whose arrival in the medical profession was recent and contested demonstrates the vexed and complex nature of professionalisation in a post-slavery society.

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

    SciTech Connect

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

    1983-03-01

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

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

    NASA Astrophysics Data System (ADS)

    Foster, Bryan R.; Rahs, Engel Y.

    1983-03-01

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

  12. 40 years of the British Medical Association film competition.

    PubMed

    Last, M; Robertson, F

    1998-06-01

    Since its inception in 1957 the BMA's annual film competition has fulfilled three roles--promoting the effective use of film and video in medical education, encouraging the production of high quality audiovisual material, and helping to increase the holdings of its film library. The BMA awards recognise programmes for their clinical accuracy, educational value and creative use of the medium.

  13. Rescue of the remnants: the British emergency medical relief operation in Belsen Camp 1945.

    PubMed

    Trepman, E

    2001-10-01

    The British Army liberated the German concentration camp at Belsen on April 15, 1945. The thousands of inmates (estimates range from 60,000 to 78,900 inmates), mostly Jews from eastern Europe, were dying at a rate of 500-600 per day from disease, and many more were being killed by the German guards and co-workers. Diseases prevalent included typhus, tuberculosis, nutritional and infective diarrhoea, severe malnutrition and starvation, and others. Despite huge obstacles including the ongoing war effort, shortages of supplies, and limited numbers of workers, a relief operation was rapidly organized to control the typhus epidemic and salvage as many inmates as possible. The 10,000 emaciated corpses which had been lying all over the camp were collected and buried in mass graves. Inmates were disinfected with D.D.T., scrubbed in a "human laundry," and evacuated from the typhus-ridden Horror Camp (Camp 1) to a hospital organized in the barracks of the Panzer Training School (Camp 2). Feeding of the inmates was carefully regulated, and some basic medical treatment organized. The relief operation was performed by British Army units, detachments of the British Red Cross, British and Belgian medical students, and other volunteers including those from among the less debilitated inmates. Although 13,000 inmates died after the liberation despite the relief operation, thousands of others were rescued.

  14. [Margot Jefferys: the British voice of medical sociology].

    PubMed

    Nunes, Everardo Duarte

    2011-03-01

    Margot Jefferys (1916-1999) was not only the person who introduced medical sociology into Great Britain, but also the researcher and professor who, during thirty years, exerted the most deep influence on the teaching of health social sciences either in undergraduate or especially graduate studies, since the beginning of her career, in 1953, at the London School of Hygiene and Tropical Medicine. In addition to create a global panorama concerning the Jefferys' works, this study highlights two texts, which are situated into the field we are researching: the history of health sociology. The first one, published in 1991, discusses the relationships between epidemiology and sociology; and the second, published in 1996, discusses the field of medical sociology. Both texts are a series of considerations regarding the Jefferys' thought and the more recent questions of the field in Great Britain.

  15. Dutch perspectives on the British Medical Association's critique of euthanasia in the Netherlands.

    PubMed

    Cohen-Almagor, R

    2001-01-01

    During the summer of 1999, extensive interviews with some of the leading authorities on the euthanasia policy were conducted in the Netherlands. They were asked: The British Medical Association, in its memorandum before the House of Lords, held that in regard to Holland, "all seem to agree that the so-called rules of careful conduct (official guidelines for euthanasia) are disregarded in some cases. Breaches of rules range from the practice of involuntary euthanasia to failure to consult another practitioner before carrying out euthanasia and to certifying the cause of death as natural". What do you think? Most of the interviewees conceded that this assertion is, indeed, correct. Two interviewees didn't pay much notice to the issue and three others said that the British critique is both true and untrue. PMID:11817393

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

    PubMed

    Parker, P C; Harrison, G

    2015-11-01

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

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

    PubMed

    Parker, P C; Harrison, G

    2015-11-01

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

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

    PubMed Central

    Tansey, E.M.

    2008-01-01

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

  19. Private medical insurance and saving: evidence from the British Household Panel Survey.

    PubMed

    Guariglia, Alessandra; Rossi, Mariacristina

    2004-07-01

    This paper uses the British Household Panel Survey for the years 1996-2000 to investigate the relationship between saving and private medical insurance in the UK. Because the National Health Service (NHS) gives comprehensive health coverage and is generally free at source, one would not expect private medical insurance to crowd-out saving. However, the NHS being characterised by long waiting lists and generally poor quality, many people prefer to use private health services. In such circumstances, those individuals who are not covered by private medical insurance, and who are therefore more exposed to facing unexpected out-of-pocket private health care expenditures or income losses while waiting for public treatment might save more for precautionary reasons than those who are covered. According to our findings, which are based on a wide range of econometric specifications, there is a positive association between insurance coverage and saving, suggesting that private medical insurance does not generally crowd-out private saving. However, we found some evidence of crowding-out in those areas where the quality of medical facilities is perceived as poor, and in rural areas, characterised by fewer NHS providers.

  20. National survey of British public's views on use of identifiable medical data by the National Cancer Registry

    PubMed Central

    Barrett, Geraldine; Cassell, Jackie A; Peacock, Janet L; Coleman, Michel P

    2006-01-01

    Objectives To describe the views of the British public on the use of personal medical data by the National Cancer Registry without individual consent, and to assess the relative importance attached by the public to personal privacy in relation to public health uses of identifiable health data. Design Cross sectional, face to face interview survey. Setting England, Wales, and Scotland. Participants 2872 respondents, 97% of those who took part in the Office for National Statistics' omnibus survey, a national multistage probability sample, in March and April 2005 (response rates 62% and 69%, respectively). Results 72% (95% confidence interval 70% to 74%) of all respondents did not consider any of the following to be an invasion of their privacy by the National Cancer Registry: inclusion of postcode, inclusion of name and address, and the receipt of a letter inviting them to a research study on the basis of inclusion in the registry. Only 2% (2% to 3%) of the sample considered all of these to amount to an invasion of privacy. Logistic regression analysis showed that the proportions not concerned about invasion of privacy varied significantly by country, ethnicity, socioeconomic status, and housing tenure, although in all subgroups examined most respondents had no concerns. 81% (79% to 83%) of all respondents said that they would support a law making cancer registration statutory. Conclusions Most of the British public considers the confidential use of personal, identifiable patient information by the National Cancer Registry for the purposes of public health research and surveillance not to be an invasion of privacy. PMID:16648132

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Dwyer, Diane C.

    1995-01-01

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

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

    PubMed

    Lisner, Wiebke

    2009-01-01

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

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

    PubMed

    Jones, Claire L

    2012-01-01

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

  5. Medical responsibility and thermonuclear war.

    PubMed

    Cassel, C; Jameton, A

    1982-09-01

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

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

    PubMed Central

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

    2013-01-01

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

  7. Measuring Maturity of Use for Electronic Medical Records (EMRs) in British Columbia: The Physician Information Technology Office (PITO).

    PubMed

    Rimmer, Carol; Hagens, Simon; Baldwin, Anne; Anderson, Carol J

    2014-01-01

    This article examines British Columbia (BC)'s Physician Information Technology Office's efforts to measure and improve the use of electronic medical records (EMRs) by select practices in BC with an assessment of their progress using a maturity model, and targeted support. The follow-up assessments showed substantial increases in the physicians' scores resulting from action plans that comprised a series of tailored support activities. Specifically, there was an increase from 21% to 83% of physicians who could demonstrate that they used their EMRs as the principal method of record-keeping.

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

    PubMed

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

    2002-02-01

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

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

    PubMed

    Paugh, Katherine

    2014-01-01

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

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

    PubMed

    Paugh, Katherine

    2014-01-01

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

  11. RISQy business (Relationships, Incentives, Supports, and Quality): evolution of the British Columbia Model of Primary Care (patient-centered medical home).

    PubMed

    MacCarthy, Dan; Hollander, Marcus J

    2014-01-01

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

  12. Risk and reproductive decisions: British Pakistani couples’ responses to genetic counselling

    PubMed Central

    Shaw, Alison

    2011-01-01

    How far does ethnicity/culture/religion mediate couples’ responses to genetic risk? This paper examines the responses of 51 British Pakistani couples referred to a genetics clinic in southern England to counselling about recurrence risks for genetic problems in children. It is based on fieldwork conducted between 2000 and 2004 that combined participant observation of genetics consultations with interviews in respondents’ homes. Interviews were conducted with 62 adults in connection with these 51 cases, of which 32 were followed through two or more clinical consultations and 12 through more than one pregnancy. Risk responses were categorized as: taking the risk; postponing; exploring risk management or dismissing the risk as irrelevant to current circumstances. Responses were cross-referenced for associations with the severity of the condition, number of affected and unaffected children, availability of a prenatal test, age, gender, and migration history. I found that most couples were initially risk-takers who already had an unaffected child or children. Couples caring for living children with severe conditions were more likely to postpone. However, the risk responses of 15 couples changed over time, most towards and some away from risk management, reflecting changes in couples’ appreciation of the severity of the condition and their subsequent reproductive experiences. The study highlights the diversity and dynamism of responses within one ethnic group and challenges stereotypes about cultural and religious responses to genetic risk. PMID:21641705

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

    PubMed

    Harrison, M

    2000-03-01

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

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

    PubMed

    Harrison, M

    2000-03-01

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

  15. [Nuclear arms and medical responsibility].

    PubMed

    Firket, H

    1999-01-01

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

  16. The use of medical evidence in British trials of suspected Japanese war criminals.

    PubMed

    Roland, Charles G

    2010-01-01

    War crimes trial records are a little-used but fertile source of medical-historical information. They are, however, especially useful when investigating conditions affecting incarcerated Allied servicemen in the Far East because almost all cases are supported by a substantial volume of testimony and depositions by medical personnel. Many national archives contain such material and their holdings are discussed briefly.

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

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2014-03-01

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

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

    ERIC Educational Resources Information Center

    Maxwell, James H.; Weiner, Sanford L.

    1993-01-01

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

  19. "Mended or ended?" Football injuries and the British and American medical press, 1870-1910.

    PubMed

    Park, R J

    2001-01-01

    'Playing Hurt/Playing Tough', a dominant ideology in today's football (soccer, rugby, American 'gridiron'), is by no means new. Many books, monographs, and articles have examined the historical development of these games, but the attention given to them in the medical press during the late 1800s/early 1900s has been overlooked. The Lancet, Journal of the American Medical Association, and other turn-of-the-century medical publications regularly included accounts and descriptions of injuries and deaths. More telling were the many editorials in which physicians in both Britain and the United States expressed enthusiasm while also lamenting the games' physical and morale effects upon players, asking whether 'football' should be mended or ended.

  20. Medical responsibility in the United Arab Emirates.

    PubMed

    Benomran, Fawzi

    2010-05-01

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

  1. Medical responsibility in the United Arab Emirates.

    PubMed

    Benomran, Fawzi

    2010-05-01

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

  2. Medical ethics and education for social responsibility.

    PubMed Central

    Roemer, M. I.

    1980-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Fountain, Reg

    2016-01-01

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

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

    PubMed

    Fountain, Reg

    2016-01-01

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

  6. NASA Medical Response to Human Spacecraft Accidents

    NASA Technical Reports Server (NTRS)

    Patlach, Robert

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  8. Multinational Corporations and British Labour: A Review of Attitudes and Responses.

    ERIC Educational Resources Information Center

    Gennard, John

    Multinational corporations operating in Great Britain, specifically American industry, are arousing fears on the part of British labor, which can be grouped into these categories: (1) a threat to the job security of union members, (2) a change in the balance of power at the collective bargaining table in favor of the employers, (3) a clash of…

  9. "The English disease" or "Asian rickets"? Medical responses to postcolonial immigration.

    PubMed

    Bivins, Roberta

    2007-01-01

    Do the former colonizing powers, like their former colonies, have "postcolonial medicine," and if so, where does it take place, who practices it, and upon whom? How has British medicine in particular responded to the huge cultural shifts represented by the rise of the New Commonwealth and associated postcolonial immigration? I address these questions through a case study of the medical and political responses to vitamin D deficiency among Britain's South Asian communities since the 1960s. My research suggests that in these contexts, diet frequently became a proxy or shorthand for culture (and religion, and race), while disease justified pressure to assimilate.

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

    PubMed

    Rossiter, Kate

    2012-03-01

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

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

    PubMed Central

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Tonkin, Roger S.; And Others

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

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

    PubMed Central

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

    2006-01-01

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

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

    PubMed

    Barraclough, Simon; Morrow, Martha

    2008-04-01

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

  15. The progressive effect of the individualistic response of species to Quaternary climate change: an analysis of British mammalian faunas

    NASA Astrophysics Data System (ADS)

    Stewart, John R.

    2008-12-01

    The individualistic response of species to climate change is accepted by many although how this process works across several climate oscillations has not been widely considered. A cluster analysis using the Bray-Curtis metric with single linkage to show relative faunal similarity was performed on successively older British mammalian faunas to investigate whether they become progressively different compared to the present day (Holocene). British mammalian faunas from MIS 3, 5, 11, 13 and 17 were compared with the Holocene revealing that the last glaciation (MIS 3) is more different than are any of the interglacials (MIS 5, 11, 13, 17). Furthermore, the interglacials generally become more distinct from the Holocene with age. This difference relates to the fact that interglacial faunas have greater proportions of extinct and extirpated species with increased age. The increase in extirpated taxa in turn relates to faunas becoming more non-analogue with greater age. The increase in extirpated elements with age probably relates to the individualistic response to climate change which appears to be progressing with time. The implications of this progressive process are considered in relation to refugia, extinction and evolution.

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

    PubMed

    Barraclough, Simon; Morrow, Martha

    2008-04-01

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

  17. Repeatability of Response to Asthma Medications

    PubMed Central

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

    2010-01-01

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

  18. Medical Director Responsibilities to the ESRD Network

    PubMed Central

    DeOreo, Peter B.

    2015-01-01

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

  19. Medical Director Responsibilities to the ESRD Network.

    PubMed

    DeOreo, Peter B; Wish, Jay B

    2015-10-01

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

  20. Medical Director Responsibilities to the ESRD Network.

    PubMed

    DeOreo, Peter B; Wish, Jay B

    2015-10-01

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

  1. NASA Medical Response to Human Spacecraft Accidents

    NASA Technical Reports Server (NTRS)

    Patlach, Robert

    2011-01-01

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

  2. Poor response to treatment: beyond medication

    PubMed Central

    Carvajal, César

    2004-01-01

    In psychiatry, one of the main factors contributing to poor response to pharmacological treatment is adherence. Noncompliance with maintenance treatments for chronic illnesses such as schizophrenia and affective disorders can exceed 50%, Poor adherence can be due to drug-related factors (tolerance, complexity of prescription, side effects, or cost), patient-related variables (illness symptoms, comorbidity, insight capacity, belief system, or sociocultural environment), and physician-related factors (communication or psychoeducational style). Psychosocial treatments must be used in conjunction with medication during the maintenance phase to improve adherence to treatment and to achieve - through the management of psychological variables - better social, work, and family functioning. This article reviews the concepts of adherence and noncompliance, and their impact on maintenance treatments, as well as the effect of dealing with psychosocial factors in psychiatric treatment. PMID:22034452

  3. Persons found 'not criminally responsible on account of mental disorder': a comparison of British Columbia, Canada and Hunan, China.

    PubMed

    Wang, Xiaoping; Livingston, James D; Brink, Johann; Murphy, Emlene

    2006-12-20

    Current research literature contains very few international, cross-cultural comparison studies of persons adjudicated 'Not Criminally Responsible on Account of Mental Disorder' (NCRMD). This study explores and compares the demographic differences between persons found NCRMD in British Columbia, Canada and Hunan, China. Eight variables such as sex, age, education level, marital status, conviction history, psychiatric history, and index offence are compared between the Canadian and Chinese cohorts. The Canadian and Chinese cohorts were similar in sex and psychiatric history. The divorce rate, educational level, and conviction histories were significantly higher, and the age was significantly older in the Canadian cohort. The Chinese cohort had higher levels of murder and attempted murder index offences. Differences between the two cohorts can be explained in terms of legislative and cultural differences.

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

    PubMed

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

    2014-01-01

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

  5. River response to rapid Holocene environmental change: evidence and explanation in British catchments

    NASA Astrophysics Data System (ADS)

    Macklin, Mark G.; Jones, Anna F.; Lewin, John

    2010-07-01

    Since the late 1980s our understanding of the relationship between climate, land-use and Holocene river development in Britain has changed radically. Conceptually simplistic and data-poor models of people-river environment interaction, many of which considered human activity alone to be the control of Holocene flooding and alluviation, have been replaced by more data-rich models that explain river behaviour in terms of a continuum of climate and anthropogenic drivers, individually operating over a range of temporal and spatial scales. One of the key factors in this paradigm shift has been the significant increase in the number of 14C-dated fluvial units that has itself recently facilitated the application of meta-analysis techniques to large fluvial data sets. These analyses have produced the first probability-based national and regional reconstructions of Holocene flooding in the British Isles that can be correlated with independent, high-resolution hydro-climate records. This paper critically reviews the major findings of this new research focusing on process-based causality relationships in fluvial systems and quantifying how environmental signals are propagated in river basins and preserved in landform and sedimentary sequences. By using cumulative probability density function (CPDF) plots of fluvial 14C dates that have been classified on the basis of sedimentary environment and evidence for changing depositional regime, 17 multi-centennial length periods of flooding and river instability during the Holocene are identified in the UK. The scale and timing of these episodes vary regionally and correlations can be made with a range of climate proxy records, including the North Atlantic drift-ice index, glacier variations in Europe, and mire surface wetness and water-table reconstructions. A new analysis of overbank floodplain sedimentation rates points to an acceleration after ca 1000 cal. BP, which can be related to the agricultural revolution of the Middle Ages

  6. British psychiatry and its discontents

    PubMed Central

    Cooper, Brian

    2010-01-01

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

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

    PubMed

    Kim, Jang Han

    2015-03-01

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

  8. Hazardous materials. Disaster medical planning and response.

    PubMed

    Levitin, H W; Siegelson, H J

    1996-05-01

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

  9. Hazardous materials. Disaster medical planning and response.

    PubMed

    Levitin, H W; Siegelson, H J

    1996-05-01

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

  10. Sensitometric responses of selected medical radiographic films.

    PubMed

    Kofler, J M; Gray, J E

    1991-12-01

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

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

    PubMed Central

    Cunningham, Colleen

    2011-01-01

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

  12. [Delegation of medical responsibilities to non-medical personnel. Options and limits from a legal viewpoint].

    PubMed

    Ulsenheimer, K

    2009-05-01

    Increasing specialization and growing mechanization in medicine have strongly supported the transfer of originally medical responsibilities to non-medical personnel. The enormous pressure of costs as a result of limited financial resources in the health system make the delegation of previously medical functions to cheaper non-medical ancillary staff expedient and the sometimes obvious lack of physicians also gains importance by the delegation of many activities away from medical staff. In the German health system there is no legal norm which clearly and definitively describes the field of activity of a medical doctor. Fundamental for a reform of the areas of responsibility between physicians and non-medical personnel is a terminological differentiation between instruction-dependent, subordinate, non-independent assistance and the delegation of medical responsibilities which are transferred to non-medical personnel for independent and self-determined completion under the supervision and control of a physician. The inclination towards risk of medical activities, the need of protection of the patient and the intellectual prerequisites required for carrying out the necessary measures define the limitations for the delegation of medical responsibilities to non-medical ancillary staff. These criteria demarcate by expert assessment the exclusively medical field of activity in a sufficiently exact and convincing manner.

  13. [Delegation of medical responsibilities to non-medical personnel. Options and limits from a legal viewpoint].

    PubMed

    Ulsenheimer, K

    2009-11-01

    Increasing specialization and growing mechanization in medicine have strongly supported the transfer of originally medical responsibilities to non-medical personnel. The enormous pressure of costs as a result of limited financial resources in the health system make the delegation of previously medical functions to cheaper non-medical ancillary staff expedient and the sometimes obvious lack of physicians also gains importance by the delegation of many activities away from medical staff. In the German health system there is no legal norm which clearly and definitively describes the field of activity of a medical doctor. Fundamental for a reform of the areas of responsibility between physicians and non-medical personnel is a terminological differentiation between instruction-dependent, subordinate, non-independent assistance and the delegation of medical responsibilities which are transferred to non-medical personnel for independent and self-determined completion under the supervision and control of a physician. The inclination towards risk of medical activities, the need of protection of the patient and the intellectual prerequisites required for carrying out the necessary measures define the limitations for the delegation of medical responsibilities to non-medical ancillary staff. These criteria demarcate by expert assessment the exclusively medical field of activity in a sufficiently exact and convincing manner.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    1989-01-01

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

  16. British Columbia

    ERIC Educational Resources Information Center

    Walton, Gerald

    2006-01-01

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

  17. [Medical civil responsibility in the year 2000].

    PubMed

    Rougé-Maillart, C; Pessaux, P; Gosset, D; Penneau, M

    2001-10-01

    In France, during the last year, important jurisprudence was established by the French Supreme Court of Appeal concerning the physician's civil responsibility. On october 7, 1998, the Court decided that "the physician is not exempted for the obligation to provide information by the simple fact that these risks only materialize exceptionally". This means that from now, the physician must inform the patient of all risks that might influence the patient's decision, particularly information concerning life-threatening or severe consequences, but also, as in the past, concerning frequent even benign consequences. The limits of this jurisprudence and the completeness of the information, as established in 1998, are emergency, patient refusal and impossibility to inform the patient. In the decree of May 23, 2000, the Court gave its definition of impossibility to inform the patient, thus establishing the "therapeutic limits". But the judges recognized that the requirement for information delivery is independent of the necessary or unnecessary nature of the therapeutic act. However, in the decree of June 20, 2000, the Court established the conditions for awarding indemnities for defective information delivery. Defective information delivery is not sufficient in itself to constitute a civil offense. Real damage is also necessary. To be awarded with an indemnity, the patient must prove that the lack of information affected his/her decision to consent. If it appears that even if he/she had been well informed, the patient had consented to the care given, the physician would not be obliged to provide the patient with an indemnity. The judges want to find a compensation and make the proof easier for the patient. They accept the potential fault when an organ was injured in the course of an operation. But, these decisions concern the proof and they don't modify the medical responsibility. The physicians have got a duty to use reasonable skill and care and they don't have any

  18. The Medical Response to Sex Trafficking of Minors in Wisconsin.

    PubMed

    Rabbitt, Angela

    2015-04-01

    Medical professionals are in a unique position to identify and assist pediatric victims of sex trafficking, who experience a high prevalence of physical, mental, and sexual health problems. However, providers report a need for education and guidelines for medical care of this population. A literature review was conducted on the nature and scope of pediatric sex trafficking in Wisconsin, the medical and mental health needs of victims, and existing guidelines for medical management. Few existing medical guidelines for the care of trafficking victims are specific to pediatrics or include specific recommendations for the forensic medical evaluation. Because of legislation and resources specific to Wisconsin, national guidelines may not apply locally. Based on the literature review, as well as input from community partners and medical professionals who frequently provide services to victims, guidelines for the medical care of pediatric sex trafficking victims in Wisconsin were developed. Additional community barriers that may prevent an effective medical response also are discussed. PMID:26756057

  19. Medical aid provided by American, Canadian and British Nationals to the Spanish Republic during the Civil War, 1936-1939.

    PubMed

    Shapiro, M F

    1983-01-01

    During international or civil wars, private citizens of noncombatant nations often provide medical aid to one of the contending factions, particularly when they support a participant not favored by their own government. This paper details and analyzes the prominent campaign in the United States, Canada and Great Britain to provide medical aid to the Republicans during the Spanish Civil War (1936 to 1939). The substantial medical aid that was provided clearly alleviated some suffering, but one of the major objectives of the campaign was to arouse public opinion sufficiently to end the boycott of military aid to Republicans; this objective was never achieved. Whether it be in Republican Spain, Vietnam or El Salvador, even a successful medical aid campaign to people in a military conflict may save some lives but may not affect substantially the course of the conflict. Those who are primarily interested in influencing political or military developments, hoping to advance the cause of a particular contending faction, may find tactics other than medical aid campaigns more useful in accomplishing their goals.

  20. The Clicker Challenge: Using a Reader Response System in the (British) History Classroom

    ERIC Educational Resources Information Center

    Dean, David

    2013-01-01

    Most people are familiar with television quiz shows that use such technologies as Audience Response Systems (ARS) and keypads known as "clickers." A similar technology has been available for teachers. Inserting questions into a PowerPoint presentation or running free-standing software, the class is asked to consider a question and select…

  1. An analysis of the skin conductance orienting response in samples of American, British, and German schizophrenics.

    PubMed

    Bernstein, A S; Frith, C D; Gruzelier, J H; Patterson, T; Straube, E; Venables, P H; Zahn, T P

    1982-01-01

    The existing literature dealing with the phasic orienting response (OR) in schizophrenia, examining, for the most part, the skin conductance component (SCOR), reports conflicting results with divergent implications for the nature of the attentional dysfunction in these patients. The present authors have contributed to that literature and to its divergencies. The present report addresses this issue by applying a common set of response definitions and uniform statistical-analytic procedures to the previously gathered electrodermal data obtained independently in each author's laboratory. A total of 14 studies is involved, drawn from six laboratories in the U.S.A., the U.K., and West Germany. Collectively, these studies examine chronic and acute schizophrenics, males and females, those receiving neuroleptic drugs and those not receiving them, recording SCOR from either (or both) hands using a variety of instruments and somewhat differing instructions and conditions, to both auditory and visual stimuli of different intensities and rise-time properties. The authors' purpose is two-fold. First, to determine whether some 'universal' dysfunction can be demonstrated across laboratories, conditions, and samples. Given the heterogeneous origins of these data such a finding would offer fairly strong evidence of 'real' dysfunction in schizophrenia. Second, where disagreement exists, to describe the scope and nature of the disagreement, and to articulate more clearly the findings on each side of a disputed area. One such 'universal' dysfunction emerged. Consistently, schizophrenics displayed an abnormally high incidence of nonresponsiveness, involving nearly 50% of the schizophrenic sample on average. The next most common finding is that many of the schizophrenics who display an SCOR often habituate faster than do nonschizophrenic responders. This was seen in a majority of the studies and laboratories, but conflicting evidence was presented by a minority. Evidence for a

  2. [Disaster medical response concerns us all].

    PubMed

    Schächinger, U; Nerlich, M

    2005-09-01

    The flood disaster in the region of the Oder and Elbe Rivers or the disaster in Eschede, Kaprun, or Ramstein make us aware that disasters not only occur in distant regions of the world but also in our latitudes. They do not follow any rules; no one can predict the location, time, or type of a disaster. However, this lack of concrete predictability should not lead to our being unprepared to respond to catastrophic events. Detailed examination and analysis of medical and organizational activities involved in past disasters reveal that these types of incidents always entail similar medical and logistic consequences. Dealing with disasters necessitates cooperation between numerous organizations and people. This requires clearly structured facilities for information, communication, and decision making as well as a well-defined process flow. In addition to basic planning and practicing of these processes for medical management of catastrophes-such as searching for and rescuing victims, triage, performing life-saving emergency procedures, definitive medical treatment, and transfer of patients-establishing structures for disaster preparedness is indispensable to meet the demands of mass cases of ill or wounded individuals.

  3. Teaching medical students social responsibility: the right thing to do.

    PubMed

    Faulkner, L R; McCurdy, R L

    2000-04-01

    As academic medicine has become more focused on the economic pressures of the marketplace, some educators have expressed concern about whether appropriate attention is being given to the character development and moral education of medical students. The authors conclude that medical schools do indeed have a duty to teach their medical students to be socially responsible. They define a socially responsible individual as a person who takes part in activities that contribute to the happiness, health, and prosperity of a community and its members. They suggest that medical students should participate in carefully designed, socially responsible activities in order to (1) practice and have reinforced such qualities as reliability, trustworthiness, dependability, altruism, and compassion; (2) partially reimburse society for the cost of their medical education; (3) increase their exposure to a population-based approach to health care; and (4) help medical schools fulfill their social contract with the public. The authors outline the process for developing a curriculum to teach social responsibility to medical students and list some of the key questions faculty and administrators must address in the processes of development and implementation. They conclude that while faculty responsible for implementing a curriculum in social responsibility must be highly committed and prepared to address numerous difficult questions concerning the curriculum's philosophy, structure, and function, the potential benefits of such a curriculum are well worth the effort.

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

    PubMed

    Broer, Tineke; Pickersgill, Martyn

    2015-05-01

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

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

    PubMed

    Broer, Tineke; Pickersgill, Martyn

    2015-05-01

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

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

    ERIC Educational Resources Information Center

    DeGraffenreid, Jeff Gordon

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

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

    ERIC Educational Resources Information Center

    Lum, Gifford; And Others

    1982-01-01

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

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

    PubMed

    Noone, Michael

    2015-10-01

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

  9. [The insurance of professional responsibility of medical professionals in Russia].

    PubMed

    2011-01-01

    The article deals with the characteristics of implementation of mandatory insurance of professional risk of medical professionals. The possible directions in resolving actual problems are proposed in the elaboration of normative legal act on insurance of their professional responsibility.

  10. The landslide response of alpine basins to post-Little Ice Age glacial thinning and retreat in southwestern British Columbia

    NASA Astrophysics Data System (ADS)

    Holm, Kris; Bovis, Michael; Jakob, Matthias

    2004-02-01

    The role of post-Little Ice Age (LIA) Neoglacial retreat on landslide activity is investigated in 19 alpine basins along the upper Lillooet River Valley, British Columbia. We examine how Neoglacial scouring and glacial recession have modified hillslope form and slope stability, and construct a decision-making flowchart to identify landslide hazards associated with glacial retreat. This work is based on field mapping, GIS analysis, statistical associations between landslides and terrain attributes, and a comparison between Neoglaciated and non-Neoglaciated terrain within each basin. The bedrock landslide response to glacial retreat varies appreciably according to lithology and the extent of glacial scour below the LIA trimline. Valleys carved in weak Quaternary volcanics show significant erosional oversteepening and contain deep-seated slope movement features, active rock fall, rock slides, and rock avalanches near glacial trimlines. Basins in stronger granitic rock rarely show increased bedrock instability resulting from post-LIA retreat, except for shallow-seated rock slides along some trimlines and failures on previously unstable slopes. In surficial materials, landslides associated with post-LIA retreat originate in till or colluvium, as debris slides or debris avalanches, and are concentrated along lateral moraines or glacial trimlines. Significant spatial association was also observed between recent catastrophic failures, gravitational slope deformation, and slopes that were oversteepened then debuttressed by glacial erosion. Eight out of nine catastrophic rock slope failures occurred just above glacial trimlines and all occurred in areas with a previous history of deep-seated gravitational slope movement, implying that this type of deformation is a precursor to catastrophic detachment.

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  12. Medically Significant Infections Are Increased in Patients With Juvenile Idiopathic Arthritis Treated With Etanercept: Results From the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study

    PubMed Central

    Davies, Rebecca; Southwood, Taunton R.; Kearsley‐Fleet, Lianne; Lunt, Mark

    2015-01-01

    Objective The association between anti–tumor necrosis factor therapy and increased rates of infection is widely documented in adults with rheumatoid arthritis. Findings in children with juvenile idiopathic arthritis (JIA) have been less well documented. The aims of this analysis were to compare the rates of medically significant infections (MSIs) in children with JIA treated with etanercept (ETN) versus methotrexate (MTX) and to compare the rates between combination therapy with ETN plus MTX and monotherapy with ETN. Methods A total of 852 ETN‐treated children and 260 MTX‐treated children had been recruited to the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR‐ETN). MSIs included infections that resulted in death or hospitalization or were deemed medically significant by the clinician. This on‐drug analysis followed the patients until the first MSI, treatment discontinuation, the last followup, or death. Cox proportional hazards models, which were adjusted using propensity deciles, were used to compare rates of MSI between cohorts. Sensitivity analyses were conducted specifically with regard to serious infections (SIs), which were defined as those requiring hospitalization or treatment with intravenous antibiotics/antivirals. Results The ETN‐treated cohort was older and had a longer disease duration, but the disease activity was similar between the cohorts. A total of 133 first MSIs were reported (109 with ETN and 24 with MTX). Patients receiving ETN had higher rates of MSI than did the controls (propensity decile adjusted hazard ratio 2.13 [95% confidence interval 1.22–3.74]). The risk of MSI was higher whether patients were receiving combination or monotherapy. Sensitivity analysis showed no between‐group difference in the rate of SIs, which were much less common. Conclusion ETN therapy is associated with an increased risk of MSI; however, this increased risk disappears when considering only SIs, which

  13. Review on emergency medical response against terrorist attack.

    PubMed

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

    2014-01-01

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

  14. Responsibly managing the medical school--teaching hospital power relationship.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2005-07-01

    The relationship between medical schools and their teaching hospitals involves a complex and variable mixture of monopoly and monopsony power, which has not been previously been ethically analyzed. As a consequence, there is currently no ethical framework to guide leaders of both institutions in the responsible management of this complex power relationship. The authors define these two forms of power and, using economic concepts, analyze the nature of such power in the medical school-teaching hospital relationship, emphasizing the potential for exploitation. Using concepts from both business ethics and medical ethics, the authors analyze the nature of transparency and co-fiduciary responsibility in this relationship. On the basis of both rational self-interest, drawn from business ethics, and co-fiduciary responsibility, drawn from medical ethics, they argue for the centrality of transparency in the medical school-teaching hospital relationship. Understanding the ethics of monopoly and monopsony power is essential for the responsible management of the complex relationship between medical schools and their teaching hospitals and can assist the leadership of academic health centers in carrying out one of their major responsibilities: to prevent the exploitation of monopoly power and monopsony power in this relationship.

  15. The medical-legal responsibilities of a dialysis unit medical director.

    PubMed

    Vaqar, Sarosh; Murray, Brian; Panesar, Mandip

    2014-01-01

    The specialty of Nephrology, by virtue of its relationship with the dialysis procedure, is highly vulnerable to litigation. As is the case with all nephrologists, a dialysis unit medical director is not immune to medical malpractice suits, and can be held liable for any act of perceived or potential harm to any dialysis patient, regardless of the director's level of involvement. The medical director, per the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation, accepts the responsibilities, accountability, and consequent legal liabilities of the quality of the medical care provided to every dialysis patient in the unit. This review is a synopsis of lawsuits filed against medical directors of dialysis units in the past forty years. Six categories of legal actions were noted; medical malpractice, fraudulent claims, self-referral and Stark Law, discrimination, negligence, and violation of patient autonomy and dignity.

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

    PubMed

    McErlain-Burns, T L; Thomson, R

    1999-08-01

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

  17. Tropical skin diseases in British military personnel.

    PubMed

    Bailey, Mark S

    2013-09-01

    Skin complaints are common in travellers to foreign countries and are responsible for up to 25% of medical consultations by military personnel during deployments in the tropics. They also have relatively high rates of field hospital admission, medical evacuation and referral to UK Role 4 healthcare facilities. Non-infectious tropical skin diseases include sunburn, heat rash, arthropod bites, venomous bites, contact dermatitis and phytophotodermatitis. During tropical deployments skin infections that commonly occur in military personnel may become more frequent, severe and difficult to treat. Several systemic tropical infections have cutaneous features that can be useful in making early diagnoses. Tropical skin infections such as cutaneous larva migrans, cutaneous myiasis, cutaneous leishmaniasis and leprosy do occur in British troops and require specialist clinical management. This illustrated review focuses on the most significant tropical skin diseases that have occurred in British military personnel in recent years. Clinical management of these conditions on deployments would be improved and medical evacuations could be reduced if a military dermatology 'reach-back' service (including a telemedicine facility) was available.

  18. Medical responsibility and global environmental change.

    PubMed

    McCally, M; Cassel, C K

    1990-09-15

    Global environmental change threatens the habitability of the planet and the health of its inhabitants. Toxic pollution of air and water, acid rain, destruction of stratospheric ozone, waste, species extinction and, potentially, global warming are produced by the growing numbers and activities of human beings. Progression of these environmental changes could lead to unprecedented human suffering. Physicians can treat persons experiencing the consequences of environmental change but cannot individually prevent the cause of their suffering. Physicians have information and expertise about environmental change that can contribute to its slowing or prevention. Work to prevent global environmental change is consistent with the social responsibility of physicians and other health professionals.

  19. Stress response in medically important Mucorales.

    PubMed

    Singh, Pankaj; Paul, Saikat; Shivaprakash, M Rudramurthy; Chakrabarti, Arunaloke; Ghosh, Anup K

    2016-10-01

    Mucorales are saprobes, ubiquitously distributed and able to infect a heterogeneous population of human hosts. The fungi require robust stress responses to survive in human host. We tested the growth of Mucorales in the presence of different abiotic stress. Eight pathogenic species of Mucorales, including Rhizopus arrhizus, Rhizopus microsporus, Rhizomucor pusillus, Apophysomyces elegans, Licthemia corymbifera, Cunninghamella bertholletiae, Syncephalastrum racemosum and Mucor racemosus, were exposed to different stress inducers: osmotic (sodium chloride and d-sorbitol), oxidative (hydrogen peroxide and menadione), pH, cell wall and metal ions (Cu, Zn, Fe and Mg). Wide variation in stress responses was noted: R. arrhizus showed maximum resistance to both osmotic and oxidative stresses, whereas R. pusillus and M. indicus were relatively sensitive. Rhizopus arrhizus and R. microsporus showed maximum resistance to alkaline pH, whereas C. bertholletiae, L. corymbifera, M. racemosus and A. elegans were resistant to acidic pH. Maximum tolerance was noted in R. microsporus to Cu, R. microsporus and R. arrhizus to Fe and C. bertholletiae to Zn. In contrast, L. corymbifera, A. elegans and M. indicus were sensitive to Cu, Zn and Fe respectively. In conclusion, R. arrhizus showed high stress tolerance in comparison to other species of Mucorales, and this could be the possible reason for high pathogenic potential of this fungi. PMID:27292160

  20. Trench foot: the medical response in the first World War 1914-18.

    PubMed

    Atenstaedt, Robert L

    2006-01-01

    The approaching 90-year anniversary of United States entry into the Great War is an apt time to examine the response to trench foot (now called nonfreezing cold injury [NFCI]) in this conflict. Trench foot appeared in the winter of 1914, characterized by pedal swelling, numbness, and pain. It was quickly recognized by military-medical authorities. There was little debate over whether it was frostbite or new condition, and it was quickly accepted as a specific disease. The major etiologies proposed were exposure, diet, and infection. The opinion emerged that it was caused by circulatory changes in the foot caused by cold, wet, and pressure. Predisposing factors included dietary inadequacy and fatigue. A number of labels were first given to the disease. However, the name "trench foot" was eventually officially sanctioned. Trench foot became a serious problem for the Allies, leading to 75 000 casualties in the British and 2000 in the American forces. Therapy for trench foot involved a number of conventional, tried-and-tested, and conservative methods. Some more innovative techniques were used. Amputation was only used as a last resort. Prevention involved general measures to improve the trench environment; modification of the footwear worn by the men; and the provision of greases to protect them from moisture. The medical reaction to this condition seems to have been relatively effective. The causation was identified, and prophylactic measures were introduced to fit this model; these seem to have been successful in reducing the prevalence of the condition by 1917-18.

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

    PubMed

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

    2014-09-01

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

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

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

    2006-01-01

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

  4. The Canadian Armed Forces medical response to Typhoon Haiyan

    PubMed Central

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

    2015-01-01

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

  5. British Communicator Occupations.

    ERIC Educational Resources Information Center

    Tunstall, Jeremy

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

  6. Houston's medical disaster response to Hurricane Katrina: part 1: the initial medical response from Trauma Service Area Q.

    PubMed

    Hamilton, Douglas R; Gavagan, Thomas F; Smart, Kieran T; Upton, Lori A; Havron, Douglas A; Weller, Nancy F; Shah, Umair A; Fishkind, Avrim; Persse, David; Shank, Paul; Mattox, Kenneth

    2009-04-01

    After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid construction of a 65-examination-room medical facility within the Reliant Center. A plan for triage of arriving evacuees was quickly developed and the Astrodome/Reliant Center Complex mega-shelter was created. Herein, we discuss major elements of the regional disaster response, including regional coordination, triage and emergency medical service transfers into the region's medical centers, medical care in population shelters, and community health challenges.

  7. [Hospital response and medical management in toxic chemical substance disasters].

    PubMed

    Yeh, I-Jeng; Lin, Tzeng-Jih

    2010-06-01

    A hazardous material is defined as any item or agent which has the potential to cause harm to humans, animals, or the environment, either by itself or through interaction with other factors. Toxic chemical substance events are increasingly common events in our modern world. The numerous variables and special equipment involved make effective response to toxic chemical events an especially critical test of hospital emergency response and patient rescue mechanisms. Inadequacies in management could result in disaster - even when only a simple event and minimal error are involved. This article introduces the general medical management algorithm for toxic chemical substance injury and the hospital incident command systems (HICS) developed and currently used by Taiwanese hospitals. Important steps and frequent mistakes made during medical management procedures are further described. The goal of medical care response and emergency units is to prevent catastrophic disasters in the emergency room and their subsequent results. This article further emphasizes correct patient management not only in terms of medical unit effort, but also in terms of cooperation between various relevant organizations including factory-based industrial health and safety systems, multi-factory union defense systems, coordination centers, fire protection and disaster rescue systems, the Environmental Protection Administration and national defense system in order to achieve the most appropriate management. Such coordination, in particular, requires reinforcement in order to ensure readiness for future response needs. PMID:20535674

  8. Chicago medical response to the 2010 earthquake in Haiti: translating academic collaboration into direct humanitarian response.

    PubMed

    Babcock, Christine; Baer, Carolyn; Bayram, Jamil D; Chamberlain, Stacey; Chan, Jennifer L; Galvin, Shannon; Kim, Jimin; Kinet, Melodie; Kysia, Rashid F; Lin, Janet; Malik, Mamta; Murphy, Robert L; Olopade, C Sola; Theodosis, Christian

    2010-06-01

    On January 12, 2010, a major earthquake in Haiti resulted in approximately 212 000 deaths, 300 000 injuries, and more than 1.2 million internally displaced people, making it the most devastating disaster in Haiti's recorded history. Six academic medical centers from the city of Chicago established an interinstitutional collaborative initiative, the Chicago Medical Response, in partnership with nongovernmental organizations (NGOs) in Haiti that provided a sustainable response, sending medical teams to Haiti on a weekly basis for several months. More than 475 medical volunteers were identified, of whom 158 were deployed to Haiti by April 1, 2010. This article presents the shared experiences, observations, and lessons learned by all of the participating institutions. Specifically, it describes the factors that provided the framework for the collaborative initiative, the communication networks that contributed to the ongoing response, the operational aspects of deploying successive medical teams, and the benefits to the institutions as well as to the NGOs and Haitian medical system, along with the challenges facing those institutions individually and collectively. Academic medical institutions can provide a major reservoir of highly qualified volunteer medical personnel that complement the needs of NGOs in disasters for a sustainable medical response. Support of such collaborative initiatives is required to ensure generalizability and sustainability.

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

    PubMed

    Hanlon, Neil; Rosenberg, Mark; Clasby, Rachael

    2007-07-01

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

  10. The civil and military medical response to natural disasters.

    PubMed

    Dowlen, H; Nicol, E; Mozumder, A

    2008-09-01

    This article explores the topic of military involvement in disaster response. This was debated during a conference held at the Royal Society of Medicine, through presentations on experiences and procedures within both the military and civilian roles. The conference was run jointly by the Haywood Club Tri-Service Medical Society and the Catastrophes & Conflict Forum of the Royal Society of Medicine on 20th April 2007. Issues of collaboration and accountability are seen as key themes of disaster response, within which the military can have a role, but which needs to be carefully administered in order to avoid an inappropriate response with an associated political fallout. PMID:19202828

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

    PubMed

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

    2013-02-01

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

  12. Best of British: British Information Online.

    ERIC Educational Resources Information Center

    Ojala, Marydee

    1988-01-01

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

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

    PubMed

    Baker, David

    2004-01-01

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

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

    PubMed

    Peabody, J W

    1999-08-01

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

  15. Responses and concerns of healthcare providers to medication errors.

    PubMed

    Wolf, Z R; Serembus, J F; Smetzer, J; Cohen, H; Cohen, M

    2000-11-01

    This descriptive, correlational study examined the responses and concerns of healthcare professionals about making medication errors and estimated patient harm from such errors. A systematic random sample of nurses, pharmacists, and physicians (N = 402) completed a self-report survey about a medication error they judged to be serious. Respondents were guilty, nervous, and worried about the error. They feared for the safety of the patient, disciplinary action, and punishment. A few subjects indicated that they never reported the errors. The most frequent symptoms associated with errors were neurologically based. The injury suffered by patients was not severe overall according to the harm scales. Weak correlations were found for the harm scales and responses and concerns. The authors suggest a supportive environment for the provider following an error and continuous quality improvement efforts to eliminate system-based errors.

  16. British Sign Name Customs

    ERIC Educational Resources Information Center

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  18. Medical ethos and social responsibility in clinical medicine.

    PubMed

    Francis, C K

    2001-03-01

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

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

    PubMed

    Francis, C K

    2001-05-01

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

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

    PubMed Central

    Francis, C. K.

    2001-01-01

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

  1. Are British psychiatrists racist?

    PubMed

    Lewis, G; Croft-Jeffreys, C; David, A

    1990-09-01

    Out of a sample of 220 British psychiatrists, 139 completed a questionnaire regarding a case vignette of psychotic illness. The sex and 'race' of the vignette were varied and the responses compared. The Afro-Caribbean case was regarded as that of an illness of shorter duration, and requiring less neuroleptics than the white case. Respondents judged the Afro-Caribbean case as potentially more violent and thought criminal proceedings were more appropriate. The female vignette was perceived as less violent, less criminal, and less likely to need neuroleptics. Cannabis psychosis and acute reactive psychosis tended to be diagnosed more often and schizophrenia less often in Afro-Caribbean cases, refuting the claim that psychiatrists tend to overdiagnose schizophrenia in this group. Such 'race thinking' (a form of stereotyping which is distinct from ideological racism) could lead to inappropriate management.

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

    PubMed

    Mathews, Ben; Bismark, Marie M

    2015-08-17

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

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

    PubMed

    Mathews, Ben; Bismark, Marie M

    2015-08-17

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

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

    PubMed Central

    2011-01-01

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

  5. Recurrent hypersomnia: Report of medication-responsive cases

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2013-01-01

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

  7. Characterization of Statin Dose-response within Electronic Medical Records

    PubMed Central

    Wei, Wei-Qi; Feng, Qiping; Jiang, Lan; Waitara, Magarya S.; Iwuchukwu, Otito F.; Roden, Dan M.; Jiang, Min; Xu, Hua; Krauss, Ronald M.; Rotter, Jerome I.; Nickerson, Deborah A.; Davis, Robert L.; Berg, Richard L.; Peissig, Peggy L.; McCarty, Catherine A.; Wilke, Russell A.; Denny, Joshua C.

    2013-01-01

    Efforts to define the genetic architecture underlying variable statin response have met with limited success possibly because previous studies were limited to effect based on one-single-dose. We leveraged electronic medical records (EMRs) to extract potency (ED50) and efficacy (Emax) of statin dose-response curves and tested them for association with 144 pre-selected variants. Two large biobanks were used to construct dose-response curves for 2,026 (simvastatin) and 2,252 subjects (atorvastatin). Atorvastatin was more efficacious, more potent, and demonstrated less inter-individual variability than simvastatin. A pharmacodynamic variant emerging from randomized trials (PRDM16) was associated with Emax for both. For atorvastatin, Emax was 51.7 mg/dl in homozygous for the minor allele versus 75.0 mg/dl for those homozygous for the major allele. We also identified several loci associated with ED50. The extraction of rigorously defined traits from EMRs for pharmacogenetic studies represents a promising approach to further understand of genetic factors contributing to drug response. PMID:24096969

  8. Problem Gambling Treatment within the British National Health Service

    ERIC Educational Resources Information Center

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

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

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

    PubMed

    Decker, Karola

    2003-01-01

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

  10. An occupational medical physician in the Haiti disaster response.

    PubMed

    Parmet, Allen

    2010-05-01

    Overall, the occupational medicine role was essential in the conduct and completion of the NDMS mission. The Public Health Service had anticipated much of the preventive medicine role, and pre- and postdeployment medical concerns were well addressed. The operational role on scene, however, was not fully appreciated by the management of IMSURT, which was not familiar with the DMAT role and provided only limited support. The DMAT teams, however, fully understood the issues, and in the opinion of the author, if the DMAT had been placed in operational control with the IMSURT as an embedded surgical hospital, many of the occupational and logistical problems could have been solved. Without preventive medicine and occupational health, the success of any disaster response team is in jeopardy.

  11. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Medical Review Officer, Substance Abuse... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The...

  12. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Medical Review Officer, Substance Abuse... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The...

  13. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Medical Review Officer, Substance Abuse... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The...

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Medical Review Officer, Substance Abuse... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The...

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

    PubMed

    Kyriakides, Christopher; Virdee, Satnam

    2003-11-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  2. Muted response of fine-grained sediment to a wildfire in British Columbia: the role of landscape disturbances and driving forces

    NASA Astrophysics Data System (ADS)

    Owens, P. N.; Giles, T. R.; Blake, W. H.; Petticrew, E. L.; Bol, R.

    2012-04-01

    In August 2003 a severe wildfire burnt the majority of Fishtrap Creek, a 170 km2 watershed near the city of Kamloops in central British Columbia. The objective of this study was to determine the influence of the wildfire on the amount and composition of fine sediment delivery and transport in the system and to see if the wildfire altered the main sources of sediment. In addition, the findings are compared with that of a nearby watershed, Jamieson Creek, with similar characteristics that was unburnt. In both watersheds, suspended sediment concentrations and fluxes were determined using ISCO automatic water samplers. Changes in sediment sources were determined by collecting bulk sediment and source material samples, and by analysing these samples for a range of properties, including environmental radionuclides and C and N isotopes. Results suggest that following the wildfire there was no major response in fine sediment delivery and transport in Fishtrap Creek, when compared to Jamieson Creek, although there were noticeable differences in the composition of the fine sediment transported and stored in the channel bed. This muted response may be due to the fairly low rainfall amounts in the period immediately following the wildfire. Environmental fallout radionuclides (caesium-137 and unsupported lead-210) showed that there was limited increase (<10%) in the relative contribution from hillslope (vs subsoil and channel bank) sources of sediment. Recent changes in sediment fluxes and sediment sources relate more to bank erosion processes, probably due to loss of root strength and cohesion. The results suggest that in some situations wildfire may not produce the dramatic increases in hillslope erosion and sediment transport often documented in other watersheds. In Fishtrap Creek, channel bank erosion appears to be important in supplying fine material to the channel and this suggests that attention should be directed at managing the riparian zone in watersheds affected by

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

    PubMed Central

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

    1992-01-01

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

  4. Standards for British Libraries.

    ERIC Educational Resources Information Center

    Vaughan, Anthony

    1982-01-01

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

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

    PubMed

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

    2014-10-01

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

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

    PubMed

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

    2014-10-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  12. Academic, Behavioral, and Psychological Responses of Hyperactive Children to Stimulant Medication.

    ERIC Educational Resources Information Center

    Bradley, Eunice

    The paper reviews educational, medical, and psychopharmacological research concerning the academic, behavioral, and psychological responses of hyperactive children to stimulant medication. In Chapter 1 on the problem and plan of study, brief sections are included on the educational community's lack of knowledge regarding stimulant medication, the…

  13. Op Patwin Part 2: HMS illustrious' medical response to typhoon Haiyan.

    PubMed

    Dew, A

    2014-01-01

    Operation PATWIN was the United Kingdom's (UK) response to the disaster caused by Typhoon Haiyan. The UK deployed a force including HMS DARING and HMS ILLUSTRIOUS and this article describes the medical response including the deployment of a Role 2 medical team and the hosting of a UK civilian medical team UK Med. The deployment followed humanitarian guidelines in UK doctrine and contained in the Oslo guidelines, but demonstrated a unique example of a civilian team supported by the military.

  14. Medical ethics and child psychiatry.

    PubMed

    Black, D; Subotsky, F

    1982-03-01

    Two child psychiatrists discuss some ethical issues in child psychiatric practice in relation to the guidelines in the British Medical Association's Handbook of Medical Ethics. Many of their concerns about confidentiality, consent, and the role of the psychiatrist as the child's advocate are seen as arising from the undefined working relationships between the child psychiatrist and nonmedical professionals responsible to agencies outside the health service. At issue is whether the psychiatrist's primary responsibility to patients and their general practitioners is tenable in a nonmedical setting.

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

    ERIC Educational Resources Information Center

    Stetson, Dorothy M.

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

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

    PubMed

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

    2012-10-01

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

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

    PubMed

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

    2015-03-01

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

  18. The Responsibility of Social Work in Medical Education

    PubMed Central

    Elliott, Valerie

    1973-01-01

    This article is a plea for education toward a greater understanding of each other's disciplines for both physicians and social workers. It describes the 1971 summer experience of two medical students, whose perceptions changed over the course of the summer, not only towards social workers, but towards their own treatment approach. Sociology is too generalized and abstract for inclusion in medical education. Social work is more clinical, and should therefore be included. PMID:20468923

  19. British military forensic psychiatry.

    PubMed

    Turner, Mark A; Neal, Leigh A

    2004-04-01

    Military psychiatry has recently generated a lot of interest. In contrast there is virtually no literature on military forensic psychiatry. The first section of the paper is a brief review of British military psychiatric services and recent data on the prevalence of mental illness in British armed forces personnel. The second section summarizes the relevant aspects of the British military judicial and penal systems including the practice of summary justice, the court martial system, and sentencing and corrective training. The third section of the paper addresses issues which are particular to forensic psychiatry, including mental defences in relation to the military, the military offences of malingering and impersonation, risk assessment in military contexts and the notion of 'temperamental unsuitability' to military service. PMID:15176622

  20. The mixed management of patients' medical records: responsibility sharing between the patient and the physician.

    PubMed

    Quantin, Catherine; Fassa, Maniane; Benzenine, Eric; Jaquet-Chiffelle, David-Olivier; Coatrieux, Gouenou; Allaert, François-André

    2010-01-01

    Through this article, we propose a mixed management of patients' medical records, so as to share responsibilities between the patient and the Medical Practitioner by making Patients responsible for the validation of their administrative information, and MPs responsible for the validation of their Patients' medical information. Our proposal can be considered a solution to the main problem faced by patients, health practitioners and the authorities, namely the gathering and updating of administrative and medical data belonging to the patient in order to accurately reconstitute a patient's medical history. This method is based on two processes. The aim of the first process is to provide a patient's administrative data, in order to know where and when the patient received care (name of the health structure or health practitioner, type of care: out patient or inpatient). The aim of the second process is to provide a patient's medical information and to validate it under the accountability of the Medical Practitioner with the help of the patient if needed. During these two processes, the patient's privacy will be ensured through cryptographic hash functions like the Secure Hash Algorithm, which allows pseudonymisation of a patient's identity. The proposed Medical Record Search Engines will be able to retrieve and to provide upon a request formulated by the Medical Practitioner all the available information concerning a patient who has received care in different health structures without divulging the patient's identity. Our method can lead to improved efficiency of personal medical record management under the mixed responsibilities of the patient and the MP.

  1. African Centered Knowledge: A British Perspective.

    ERIC Educational Resources Information Center

    Christian, Mark

    2001-01-01

    Considers the impact of African centered knowledge within the United Kingdom. Recent development of African Diaspora studies has forged links between various black Atlantic communities. The United Kingdom has experienced positive grassroots community response to the work of noted African centered scholars, yet within the British academy,…

  2. 1927: a British eclipse

    NASA Astrophysics Data System (ADS)

    Marriott, R. A.

    1999-06-01

    The total solar eclipse of 1927 June 29 was the first to be seen over the British mainland for 203 years. It caused nationwide excitement, induced mass population movement to the towns, villages, moorlands and offshore waters of Wales and the north of England, and severely tested the country's transport and communication systems.

  3. Chronocentrism and British criminology.

    PubMed

    Rock, Paul

    2005-09-01

    Criminologists display a largely unexamined propensity to ignore writings that are more than fifteen or so years old, with evident consequences for the public presentation and validation of expert knowledge. A citation study was combined with detailed observations from British criminologists to ascertain quite how that disavowal of the past was accomplished.

  4. Prevent and "British Values"

    ERIC Educational Resources Information Center

    Kenny, Alex; Ghale, Baljeet

    2015-01-01

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

  5. British nuclear policymaking

    SciTech Connect

    Bowie, C.J.; Platt, A.

    1984-01-01

    This study analyzes the domestic political, economic, and bureaucratic factors that affect the nuclear policymaking process in Great Britain. Its major conclusion is that, although there have been changes in that process in recent years (notably the current involvement of a segment of the British public in the debate about the deployment of intermediate-range nuclear forces), future British nuclear policymaking will remain much what it has been in the past. Three ideas are central to understanding British thinking on the subject: (1) Britain's long-standing resolve to have her own national nuclear force is largely traceable to her desire to maintain first-rank standing among the nations of the world in spite of loss of empire. (2) Financial considerations have always been important--so much so that they have usually dominated issues of nuclear policy. (3) The executive branch of government dominates the nuclear policymaking process but does not always present a united front. The United States heavily influences British nuclear policy through having supplied Britain since the late 1950s with nuclear data and components of nuclear weapon systems such as Polaris and Trident. The relationship works both ways since the U.S. depends on Britain as a base for deployment of both conventional and nuclear systems.

  6. The Medical Reserve Corps as part of the federal medical and public health response in disaster settings.

    PubMed

    Frasca, Dominic R

    2010-09-01

    The Secretary of the Department of Health and Human Services (HHS), through the Office of the Assistant Secretary for Preparedness and Response (ASPR), coordinates federal Emergency Support Function (ESF) #8 preparedness, response, and recovery actions. To address these needs, the ASPR can draw on trained personnel from a variety of sources, both from within and outside HHS. Among the resources under the domain of HHS is the Medical Reserve Corps (MRC), directed by the Office of the Civilian Volunteer Medical Reserve Corps (OCVMRC) in the Office of the Surgeon General. MRC units are community based and function as a way to locally organize and utilize medical and public health professionals, such as physicians, nurses, pharmacists, dentists, veterinarians, and epidemiologists. Nonclinical volunteers, such as interpreters, chaplains, office workers, legal advisors, and others, can fill logistical and support roles in MRC units. This article discusses locally controlled (Hurricanes Gustav and Ike) and federalized (Hurricanes Katrina and Rita) MRC activations, and it describes the advantages of using medical volunteers in a large-scale disaster response setting.

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

    PubMed

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

    2009-01-01

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

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

    PubMed

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

    2009-01-01

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

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

    PubMed

    Hall, Wayne

    2015-09-01

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

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

    PubMed Central

    Hall, Wayne

    2015-01-01

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

  11. Infectious medical waste management. A home care responsibility.

    PubMed

    Ralph, I G

    1993-01-01

    With the proliferation of bloodborne diseases in the United States, more attention is being focused on the issues of infectious medical waste and its disposal. Home care organizations must be aware of the potential risks involved in handling infectious wastes, and adhere to industry standards of disposal and transport. Education of staff, patients, and community about the management of infectious waste is crucial in today's healthcare arena.

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

    PubMed

    Grayman, Jesse Hession

    2014-11-01

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

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

    PubMed

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

    2000-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

    Kaufman, A

    1999-08-01

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

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

    PubMed Central

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

    2012-01-01

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

  17. British "Programme" Teaches Computer Literacy in U.S.

    ERIC Educational Resources Information Center

    Radcliffe, John

    1983-01-01

    Describes the 1979 conception and subsequent development of "The Computer Programme," a British television series introducing adults to computers and computing. Discusses the positive response to the program. (DMM)

  18. Origins of British geriatrics.

    PubMed Central

    Howell, T. H.

    1976-01-01

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

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

    PubMed Central

    Smith, Saxon D

    2008-01-01

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

  20. Thalassaemia in the British

    PubMed Central

    Knox-Macaulay, H. H. M.; Weatherall, D. J.; Clegg, J. B.; Pembrey, M. E.

    1973-01-01

    Different forms of thalassaemia or related disorders were found in 116 people of apparently pure British stock. Among them were one family with a child homozygous for β-thalassaemia and eight heterozygous relatives, 16 families with 83 persons heterozygous for β-thalassaemia, two families with three persons with Hb H disease and three heterozygous for α-thalassaemia 1, one family with a child apparently homozygous for the “silent β-thalassaemia gene,” one family with six members heterozygous for a form of β-thalassaemia intermedia, and three families with 11 members heterozygous for different types of hereditary persistence of fetal haemoglobin. The clinical, haematological, and haemoglobin biosynthetic findings in these persons were similar to those of patients with thalassaemia from other racial groups. The heterozygous state for β-thalassaemia is overlooked in British patients, particularly during pregnancy, because it is not considered in the differential diagnosis of refractory anaemia. In many cases this leads to much unnecessary investigation and potentially harmful treatment. There seem to be several varieties of hereditary persistence of fetal haemoglobin production among British people. These conditions, while not causing anaemia, may cause difficulties during examination of maternal blood for fetal cells and may, if inherited with a β-thalassaemia gene, produce an unusually high level of Hb F in a person heterozygous for β-thalassaemia. PMID:4124395

  1. Beyond sun, sand, and stitches: assigning responsibility for the harms of medical tourism.

    PubMed

    Snyder, Jeremy; Crooks, Valorie; Johnston, Rory; Kingsbury, Paul

    2013-06-01

    Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists’ home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argument of how responsibility for the harms of this practice should be assigned. This paper addresses this gap by describing both backward looking liability and forward looking political responsibility for stakeholders in MT. We use a political responsibility model to develop a decision-making process for individual medical tourists and conclude that more information on the effects of MT must be developed to help patients engage in ethical MT. PMID:23814800

  2. Beyond sun, sand, and stitches: assigning responsibility for the harms of medical tourism.

    PubMed

    Snyder, Jeremy; Crooks, Valorie; Johnston, Rory; Kingsbury, Paul

    2013-06-01

    Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists’ home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argument of how responsibility for the harms of this practice should be assigned. This paper addresses this gap by describing both backward looking liability and forward looking political responsibility for stakeholders in MT. We use a political responsibility model to develop a decision-making process for individual medical tourists and conclude that more information on the effects of MT must be developed to help patients engage in ethical MT.

  3. Response of mountain pine beetle,Dendroctonus ponderosae Hopkins, and pine engraver,Ips pint (SAY), to ipsdienol in southwestern British Columbia.

    PubMed

    Hunt, D W; Borden, J H

    1988-01-01

    In bioassays conducted with walking beetles in the laboratory (S)-(+)-, (R)-(-)-, and (±)-ipsdienol were attractive alone, but reduced the attraction of both sexes of the mountain pine beetle,Dendroctonus ponderosae Hopkins, to extracts of female frass. Field trapping studies indicated that attraction ofD. ponderosae to a stimulus composed of myrcene +trans-verbenol +exo-brevicomin was significantly reduced with the addition of (±)- and sometimes (S)-(±)-ipsdienol. Thus, (S)-(+)-ipsdienol produced by males of this species may act as an antiaggregation pheromone. (S)-(+)-Ips-dienol is thought to function as a repellent allomone against the pine engraver,Ips pini (Say), in regions whereI. pini utilizes (R)-(-)-ipsdienol as an aggregation pheromone. However, in southwestern British ColumbiaI. pini was attracted to the (±)-ipsdienol used in field bioassays ofD. ponderosae, a finding consistent with the production of both enantiomers byI. pini in this region. When presented with the ternary semiochemical bait forD. ponderosae, (±)-ipsdienol was not attractive toI. pini. Thus, the activity of (S)-(+)-ipsdienol as a repellent allomone againstI. pini seems to be replaced in southwestern British Columbia by the inhibitory effects of myrcene,trans-verbenol,exo-brevicomin, or some combination thereof.

  4. Methods for Measuring Student Response to Stimulant Medication: A Meta-Analytic Review

    ERIC Educational Resources Information Center

    Someki, Fumio; Burns, Matthew K.

    2009-01-01

    Measuring student response to interventions has become an important role for school psychologists. Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are frequently treated with stimulant medication, but the response to the treatment is rarely adequately assessed. The current study examined the sensitivity of measures used to assess the…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  7. The sense of responsibility in the context of professional activities in Medical Genetics.

    PubMed

    Oliva-Teles, Natália

    2011-11-01

    Medical Genetics is a relatively new field of scientific work that involves a lot of enthusiastic professionals, both in routine (clinical) and research (scientific projects). In either field, different geneticists feel different responsibilities for their work, either because they are different people (personal responsibility) or because they have a different rank in the respective departments (professional responsibility). This paper presents the philosophical views of several authors on the sense of responsibility from the Classical times until the present and reveals the practical, daily responsibilities that are met by these professionals, in four areas of responsibility: personal, professional, scientific and sociatal framework.

  8. Doctors' attitudes, medical philosophy, and political views.

    PubMed

    Wakeford, R E; Allery, L

    1986-04-12

    A survey of 507 British physicians in different specialties was conducted to investigate their attitudes on various medico-moral and practice issues. There were few substantial differences among the specialty groups in their responses to questions concerning specific bioethical and practical issues. However, the groups differed substantially in political outlook and general medical philosophy. Ranged from the most right wing and technological to the most left wing and humanistic were the following groups: surgeons, hospital physicians, women physicians, general practitioners, and psychiatrists.

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

    PubMed

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

    2004-01-01

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

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

    PubMed

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

    2004-01-01

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

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

    PubMed

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

    2012-01-01

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

  12. Hurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex.

    PubMed

    Gavagan, Thomas F; Smart, Kieran; Palacio, Herminia; Dyer, Carmel; Greenberg, Stephen; Sirbaugh, Paul; Fishkind, Avrim; Hamilton, Douglas; Shah, Umair; Masi, George; Ivey, R Todd; Jones, Julie; Chiou-Tan, Faye Y; Bloodworth, Donna; Hyman, David; Whigham, Cliff; Pavlik, Valory; Feigin, Ralph D; Mattox, Kenneth

    2006-09-01

    On September 1, 2005, with only 12 hours notice, various collaborators established a medical facility--the Katrina Clinic--at the Astrodome/Reliant Center Complex in Houston. By the time the facility closed roughly two weeks later, the Katrina Clinic medical staff had seen over 11,000 of the estimated 27,000 Hurricane Katrina evacuees who sought shelter in the Complex. Herein, we describe the scope of this medical response, citing our major challenges, successes, and recommendations for conducting similar efforts in the future.

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

    PubMed

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

    2013-06-01

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

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

    PubMed

    Sirisup, N

    1999-08-01

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

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

    PubMed

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

    2013-06-01

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

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

    PubMed

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

    2008-12-01

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

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

    PubMed

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

    2008-12-01

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

  18. Standards, attitudes and accountability in the medical profession.

    PubMed

    Simanowitz, A

    1985-09-01

    As a spokesperson for a British patient advocacy group, Action for the Victims of Medical Accidents (AVMA), the author outlines the aims of the organization and the factors contributing to unsatisfactory resolution of cases involving such accidents. He points out that 70% of the clients of AVMA seek a good explanation of what happened rather than compensation. Accountability in the medical profession is inadequate, and care often comes to a halt when something goes wrong because no one wants to take responsibility. Disclosure of medical records is sometimes resisted because the records will reveal negligence. In the author's opinion, frank disclosure is the only reasonable policy in the wake of a medical accident.

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

    PubMed Central

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

    2016-01-01

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

  20. Indians Repulse British With Rocket

    NASA Technical Reports Server (NTRS)

    2004-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Cappon, P; Watson, D

    1999-08-01

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

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

    PubMed

    Cappon, P; Watson, D

    1999-08-01

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

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

    PubMed

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

    2014-12-01

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

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

    PubMed

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

    2014-12-01

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

  6. An Intelligent 802.11 Triage Tag For Medical Response to Disasters

    PubMed Central

    Lenert, Leslie A.; Palmer, Douglas A.; Chan, Theodore C; Rao, Ramesh

    2005-01-01

    When medical care is initiated at a mass casualty event, the first activity is the triage of victims, which is the grouping by victims severity of injury. Paper triage tags are often used to mark victims’ triage status and to record information on injuries and treatments administered in the field. In this paper we describe the design and development of an“Intelligent Triage Tag” (ITT), an electronic device to coordinate patient field care. ITTs combine the basic functionality of a paper triage tag with sensors, nonvolatile memory, a microprocessor and 802.11 wireless transmission capabilities. ITTs not only display victims' triage status but also signal alerts, and mark patients for transport or immediate medical attention. ITTs record medical data for later access offsite and help organize care by relaying information on the location of the victims during field treatment. ITTs are a part of the Wireless Information System for Medical Response in Disasters (WIISARD) architecture. PMID:16779078

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

    PubMed

    Tucker, J B

    1997-08-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Responsibilities of the medical director. 494.150 Section 494.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE...

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  10. Basal ganglia volume in unmedicated patients with schizophrenia is associated with treatment response to antipsychotic medication.

    PubMed

    Hutcheson, Nathan L; Clark, David G; Bolding, Mark S; White, David M; Lahti, Adrienne C

    2014-01-30

    We investigated the relationship between basal ganglia volume and treatment response to the atypical antipsychotic medication risperidone in unmedicated patients with schizophrenia. Basal ganglia volumes included the bilateral caudate, putamen, and pallidum and were measured using the Freesurfer automated segmentation pipeline in 23 subjects. Also, baseline symptom severity, duration of illness, age, gender, time off medication, and exposure to previous antipsychotic were measured. Treatment response was significantly correlated with all three regions of the bilateral basal ganglia (caudate, putamen, and pallidum), baseline symptom severity, duration of illness, and age but not gender, time off antipsychotic medication, or exposure to previous antipsychotic medication. The caudate volume was the basal ganglia region that demonstrated the strongest correlation with treatment response and was significantly negatively correlated with patient age. Caudate volume was not significantly correlated with any other measure. We demonstrated a novel finding that the caudate volume explains a significant amount of the variance in treatment response over the course of 6 weeks of risperidone pharmacotherapy even when controlling for baseline symptom severity and duration of illness.

  11. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part... CFR part 40 and shall perform the functions set forth in 49 CFR part 40 and this subpart. If the... must perform the functions set forth in subpart G of 49 CFR part 40, and subpart E of this part....

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2016-08-01

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

  14. Growth Hormone Tumor Histological Subtypes Predict Response to Surgical and Medical Therapy

    PubMed Central

    Kiseljak-Vassiliades, Katja; Carlson, Nichole E.; Borges, Manuel T.; Kleinschmidt-DeMasters, B.K.; Lillehei, Kevin O.; Kerr, Janice M.; Wierman, Margaret E.

    2014-01-01

    Purpose Growth hormone (GH) pituitary tumors are associated with significant morbidity and mortality. Current treatments, including surgery and medical therapy with somatostatin analogues (SSA), dopamine agonists and/or a GH receptor antagonist, result in disease remission in approximately half of patients. Predictors of GH tumor response to different therapies have been incompletely defined based on histologic subtype, particularly densely (DG) versus sparsely (SG) granulated adenomas. The aim of this study was to examine our own institutional experience with GH adenomas and correlate how subtype related to clinical parameters as well as response to surgery and medical therapies. Methods A retrospective chart review of 101 acromegalic patients operated by a single neurosurgeon was performed. Clinical data were correlated with histologic subtype and disease control, as defined by IGF-1 levels, and random growth hormone levels in response to surgery and/or medical therapies. Results SG tumors, compared to DG, occurred in younger patients (p=0.0010), were 3-fold larger (p=0.0030), but showed no differences in tumor-invasion characteristics (p=0.12). DG tumors had a higher rate of remission in response to surgery compared to SG, 65.7% vs. 14.3% (p<0.0001), as well as to medical therapy with SSAs (68.8% for DG vs. 28.6% for SG tumors; p=0.028). SG tumors not controlled with SSAs consistently responded to a switch to, or addition of, a GH receptor antagonist. Conclusions Histological GH tumor subtyping implicates a different clinical phenotype and biologic behavior, and provides prognostic significance for surgical success and response to medical therapies. PMID:25129651

  15. History of British Space Science

    NASA Astrophysics Data System (ADS)

    Massie, Harrie; Robins, M. O.

    2009-12-01

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

  16. A study on the disaster medical response during the Mauna Ocean Resort gymnasium collapse

    PubMed Central

    Cha, Myeong-il; Kim, Gi Woon; Kim, Chu Hyun; Choa, Minhong; Choi, Dai Hai; Kim, Inbyung; Wang, Soon Joo; Yoo, In Sool; Yoon, Han Deok; Lee, Kang Hyun; Cho, Suck Ju; Heo, Tag; Hong, Eun Seog

    2016-01-01

    Objective To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. Methods Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. Results One hundred fifty-five accident victims treated at 12 hospitals, mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of collapse was disseminated in 4 minutes, dispatch of 4 disaster medical assistance teams took at least 69 minutes to take the decision of dispatch. Four point five percent were treated at the accident site, 56.7% were transferred to 2 hospitals that were nearest to the collapse site, and 42.6% were transferred to hospitals that were poorly prepared to handle disaster victims. Conclusion In the Gyeongju Mauna Ocean Resort gymnasium collapse, the initial triage and distribution of patients was inefficient and medical assistance arrived late. These problems had also been noted in prior mass casualty incidents. PMID:27752635

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

    PubMed Central

    Zakariassen, Erik; Hunskaar, Steinar

    2016-01-01

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

  18. PG medical training and accreditation: responsibility of the government for the adequate health service delivery.

    PubMed

    Bhattarai, M D

    2012-09-01

    On one hand there is obvious inadequate health coverage to the rural population and on the other hand the densely populated urban area is facing the triple burden of increasing non-communicable and communicable health problems and the rising health cost. The postgraduate medical training is closely interrelated with the adequate health service delivery and health economics. In relation to the prevailing situation, the modern medical education trend indicates the five vital issues. These are i). Opportunity needs to be given to all MBBS graduates for General Specialist and Sub-Specialist Training inside the country to complete their medical education, ii). Urgent need for review of PG residential training criteria including appropriate bed and teacher criteria as well as entry criteria and eligibility criteria, iii). Involvement of all available units of hospitals fulfilling the requirements of the residential PG training criteria, iv). PG residential trainings involve doing the required work in the hospitals entitling them full pay and continuation of the service without any training fee or tuition fee, and v). Planning of the proportions of General Specialty and Sub-Specialty Training fields, particularly General Practice (GP) including its career and female participation. With increased number of medical graduates, now it seems possible to plan for optimal health coverage to the populations with appropriate postgraduate medical training. The medical professionals and public health workers must make the Government aware of the vital responsibility and the holistic approach required.

  19. An overview of the roles and responsibilities of Chinese medical colleges in body donation programs.

    PubMed

    Zhang, Luqing; Xiao, Ming; Gu, Mufeng; Zhang, Yongjie; Jin, Jianliang; Ding, Jiong

    2014-01-01

    The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low and fraught with a number of difficulties. In the past, traditional Chinese culture focused on preserving the human body intact, which often limited body donation. In recent years, the public has become more open toward body donation. At Nanjing Medical University, only 20 bodies were donated in 2001. After the university became involved in an organized body donation program, this number increased to 70 donated bodies per year (2007 to 2012). This article describes and reviews Chinese medical colleges as a special case study among body donation programs, particularly in terms of the multiple responsibilities and roles that such institutions must assume in the course of adopting these programs. Medical colleges in China must serve as advocates, coordinators, builders, managers, educators, and beneficiaries in undertaking body donation programs. It is important for medical colleges to recognize these pluripotent roles and educate the public in order to promote body donation programs. This case study may also effectively guide and encourage Chinese medical colleges in refining their own body donation programs in the future.

  20. The humanising power of medical history: responses to biomedicine in the 20th century United States.

    PubMed

    Warner, John Harley

    2011-12-01

    Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to 'humanism' were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative 'dehumanisation' of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency-a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.

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

    PubMed

    Kraushar, Matthew L; Rosenberg, Rebecca E

    2015-08-01

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

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

    PubMed Central

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

    2009-01-01

    A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate-to-severely depressed outpatients. In this article, we seek to identify the variables that were associated with response across both treatments as well as variables that predicted superior response in one treatment over the other. The sample consisted of 180 depressed outpatients: 60 of whom were randomly assigned to cognitive therapy; 120 were assigned to antidepressant medications. Treatment was provided for 16 weeks. Chronic depression, older age, and lower intelligence each predicted relatively poor response across both treatments. Three prescriptive variables were identified: marriage, unemployment, and having experienced a greater number of recent life events predicted superior response to cognitive therapy compared to antidepressant medications. Thus, six markers of treatment outcome were identified, each of which might be expected to carry considerable clinical utility. The three prognostic variables identify subgroups that might benefit from alternative treatment strategies; the three prescriptive variables identify groups who appear to respond particularly well to cognitive therapy. PMID:19634969

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

    PubMed

    Chakrabarti, Pratik

    2009-01-01

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

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

    PubMed

    Chakrabarti, Pratik

    2009-01-01

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

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

    PubMed

    Stover, Alyson D

    2016-01-01

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

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

    PubMed

    Stover, Alyson D

    2016-01-01

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

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

    PubMed

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

    2015-10-01

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

  8. British Association of Clinical Anatomists

    PubMed Central

    1983-01-01

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

  9. Halting the 'sad degenerationist parade': medical concerns about heredity and racial degeneracy in New Zealand psychiatry, 1853-99.

    PubMed

    Dawson, Maree

    2012-01-01

    Historians have focused on early twentieth-century positive eugenics in New Zealand In this article, I argue that the response came from a tradition of concern about heredity and white racial degeneracy, which extended beyond the British Empire. This article focuses on concerns about heredity at the Auckland Mental Hospital between 1850 and 1899, and contextualises these concerns in New Zealand mental hospital statistics from the late-nineteenth century. This article also considers Australasian, British, North and South American medical and immigration legislation history, and contrasts this with the legislation and medical discourses which formed part of a fear of heredity, racial degeneracy, immigration and mental illness in New Zealand.

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

    PubMed

    Bochicchio, Daniel

    2010-01-01

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

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

    PubMed

    Bochicchio, Daniel

    2010-01-01

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

  12. Anger control in response to verbal provocation: effects of stimulant medication for boys with ADHD.

    PubMed

    Hinshaw, S P; Buhrmester, D; Heller, T

    1989-08-01

    Although stimulant medication reduces hyperactive children's aggression in naturalistic settings, stimulant effects on anger control have not been demonstrated. We therefore assessed the role of methylphenidate in enhancing response to verbal provocation from familiar peers and from role-playing adults. Twenty-four boys with attention deficit-hyperactivity disorder (ADHD), aged 6-12, received small-group cognitive-behavioral intervention in anger management skills. During posttraining assessments, the children were randomly assigned to placebo versus .6 mg/kg of methylphenidate. In the peer provocations, methylphenidate enhanced self-control, decreased physical retaliation, and marginally increased the display of coping strategies. Medication and prompting were minimally beneficial in the delayed, adult-administered generalization assessments. Among the issues discussed are (a) differences between peer and adult provocation and (b) the roles of medication dosage and multimodality intervention for promoting socially competent behavior in children with ADHD.

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

    PubMed

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

    2015-09-01

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

  14. Medical response to hurricanes Katrina and Rita: local public health preparedness in action.

    PubMed

    Pierce, J Rush; Pittard, Alicia E I; West, Theresa A; Richardson, J Matthew

    2007-01-01

    Like more than 150 communities in Texas, our community participated in disaster response for Gulf coast citizens evacuated from hurricanes Katrina and Rita. We implemented and adjusted emergency operations plans that were designed to respond to a local disaster. Lessons learned will strengthen our disaster preparedness in the future, including the importance of a robust medical presence at evacuation shelters; the value of an accurate and timely database of medical needs for shelter occupants; the usefulness of brief paperwork; the need for a preidentified and pretrained group of healthcare workers; the necessity of timely and accurate communications with medical partners in the community; the requirement that our local city government plan, open, and operate disaster shelters in our community; and the impact of ease of travel, frequent and honest communication, and sincere appreciation on maintaining morale in our volunteers.

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

    Psihogios, Alexandra M.; Kolbuck, Victoria

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

  18. Comparison of British and French expatriate doctors’ characteristics and motivations

    PubMed Central

    Quantin, Catherine; Abbas, Rachid; Hagi, Mathieu; Breton, Gwenaelle Le; Romestaing, M; Carnet, Dider

    2012-01-01

    Objective The aim of this study was to analyse the migration of doctors between the UK and France, in an attempt to identify the reasons for these migrations. Design This was a cross-sectional study conducted using a self-completed questionnaire. Setting The questionnaire was sent to all British doctors practising in France and to all French doctors practising in the UK. Participants The doctors were identified, thanks to official data of the National Medical Councils. There were 244 French doctors practising in the UK and 86 British doctors practising in France. Outcome measures A questionnaire was specifically developed for the study to determine the reasons why doctors moved to the other country and their level of satisfaction with regard to their expatriation. Results A total of 98 French doctors (of 244) and 40 British doctors (of 86) returned the questionnaire. The motivations of the two studied populations were different: French doctors were attracted by the conditions offered by the National Health Service, whereas British doctors were more interested in opportunities for career advancement, moved to join a husband or wife or to benefit from favourable environmental conditions. Overall, the doctors who responded considered the expatriation a satisfactory experience. After expatriation, 84% of French doctors were satisfied with their new professional situation compared with only 58% of British doctors. Conclusions This study, which is the first of its kind and based on representative samples, has led to a clearer understanding of the migration of doctors between France and the UK. PMID:23192244

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

    PubMed

    Chalwin, R P; Flabouris, A

    2013-09-01

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

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

    PubMed

    Benson, Blaine E

    2011-11-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  2. Emergency response and medical rescue in the worst hit Mianyang areas after the Wenchuan earthquake.

    PubMed

    Lei, Bai Ling; Zhou, Yun; Zhu, Ying; Huang, Xuan Yin; Han, Si Run; Ma, Qiang; He, Jing; Li, Yong Qing

    2008-11-01

    The 12 May 2008 earthquake caused damage to 88% of the health systems in the worst hit areas of Mianyang with 326 casualties and the direct economic loss of RMB 3124 billion. Within 30 minutes of the earthquake, the Mianyang headquarters for earthquake disaster relief and the Mianyang public health headquarters for medical rescue and treatment were organized. Five medical teams were sent to Beichuang County, the worst hit Mianyang area, four hours after the earthquake. A total of 22,947 wounded and sick people were delivered to local hospitals after simple triage and rapid treatment through three stations. By 30 June, the Mianyang medical organization had received 379,600 people and admitted 21,628 inpatients. These 2772 severely wounded (including 146 with limbs amputated and 846 who died in hospital). Since 17 May, 3381 wounded had been transferred to 14 provincial and city-level hospitals across China. On 20 June, the Mianyang Rehabilitation Center for wounded and sick people was established and received 156 rehabilitation inpatients. Together with the medical team for psychological intervention, they provided psychological support for over 70,000 people. Within two hours of the earthquake, the Mianyang Organization for Health and Epidemic Control and Prevention launched the emergency response plan for major natural disasters. The organization sent emergency teams for disease prevention and control and completed disinfection and burial of corpses and disposal of carcasses, monitoring of water quality and epidemics, disinfection of environmental ruins, epidemic control in resettled areas, precautions against secondary disasters caused by the earthquake, and large-scale health education. The emergency command system for medical rescue and disease control and prevention in the Mianyang areas integrated resources, carried out unified command, and responded rapidly. Furthermore, the headquarters of medical relief co-ordinated and united the governmental and

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

    PubMed Central

    2012-01-01

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

  4. Integrating medical ethics with normative theory: patient advocacy and social responsibility.

    PubMed

    Jecker, N S

    1990-06-01

    It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as largely unwarranted; and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others. PMID:2203177

  5. University of Texas Medical Branch telemedicine disaster response and recovery: lessons learned from hurricane Ike.

    PubMed

    Vo, Alexander H; Brooks, George B; Bourdeau, Michael; Farr, Ralph; Raimer, Ben G

    2010-06-01

    Despite previous efforts and expenditure of tremendous resources on creating and simulating disaster response scenarios, true disaster response, specifically for healthcare, has been inadequate. In addition, none of the >200 local and statewide telemedicine programs in the United States has ever responded to a large-scale disaster, let alone, experienced one directly. Based on its experience with hurricanes Rita and, most recently, Ike, the University of Texas Medical Branch (UTMB) experienced its most challenging trials. Although there were significant disruptions to a majority of UTMB's physical and operational infrastructures, its telemedicine services were able to resume near normal activities within the first week of the post-Ike recovery period, an unimaginable feat in the face of such remarkable devastation. This was primarily due in part to the flexibility of its data network, the rapid response, and plasticity of its telemedicine program. UTMB's experiences in providing rapid and effective medical services in the face of such a disaster offer valuable lessons for local, state, and national disaster preparations, policy, and remote medical delivery models and programs.

  6. Integrating medical ethics with normative theory: patient advocacy and social responsibility.

    PubMed

    Jecker, N S

    1990-06-01

    It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as largely unwarranted; and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others.

  7. Medical response to a nuclear detonation: creating a playbook for state and local planners and responders.

    PubMed

    Murrain-Hill, Paula; Coleman, C Norman; Hick, John L; Redlener, Irwin; Weinstock, David M; Koerner, John F; Black, Delaine; Sanders, Melissa; Bader, Judith L; Forsha, Joseph; Knebel, Ann R

    2011-03-01

    For efficient and effective medical responses to mass casualty events, detailed advanced planning is required. For federal responders, this is an ongoing responsibility. The US Department of Health and Human Services (DHHS) prepares playbooks with formal, written plans that are reviewed, updated, and exercised regularly. Recognizing that state and local responders with fewer resources may be helped in creating their own event-specific response plans, subject matter experts from the range of sectors comprising the Scarce Resources for a Nuclear Detonation Project, provided for this first time a state and local planner's playbook template for responding to a nuclear detonation. The playbook elements are adapted from DHHS playbooks with appropriate modification for state and local planners. Individualization by venue is expected, reflecting specific assets, populations, geography, preferences, and expertise. This playbook template is designed to be a practical tool with sufficient background information and options for step-by-step individualized planning and response. PMID:21402817

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

    PubMed Central

    2011-01-01

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

  9. Courses in Physics in Medical Colleges

    ERIC Educational Resources Information Center

    Physics Education, 1975

    1975-01-01

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

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

    ERIC Educational Resources Information Center

    Corby, Richard A.

    1990-01-01

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

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

    SciTech Connect

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

    1994-09-01

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

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

    PubMed

    Hanfling, Dan; Bouri, Nidhi

    2013-12-01

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

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

    PubMed

    Hosseini, Seyed Alireza

    2013-12-01

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

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

    PubMed

    Hosseini, Seyed Alireza

    2013-12-01

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

  15. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director

    PubMed Central

    Jones, Edward R.; Goldman, Richard S.

    2015-01-01

    The Centers for Medicare & Medicaid Services’ Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician. PMID:25403921

  16. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director.

    PubMed

    Jones, Edward R; Goldman, Richard S

    2015-08-01

    The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician.

  17. [Organisational responsibility versus individual responsibility: safety culture? About the relationship between patient safety and medical malpractice law].

    PubMed

    Hart, Dieter

    2009-01-01

    The contribution is concerned with the correlations between risk information, patient safety, responsibility and liability, in particular in terms of liability law. These correlations have an impact on safety culture in healthcare, which can be evaluated positively if--in addition to good quality of medical care--as many sources of error as possible can be identified, analysed, and minimised or eliminated by corresponding measures (safety or risk management). Liability influences the conduct of individuals and enterprises; safety is (probably) also a function of liability; this should also apply to safety culture. The standard of safety culture does not only depend on individual liability for damages, but first of all on strict enterprise liability (system responsibility) and its preventive effects. Patient safety through quality and risk management is therefore also an organisational programme of considerable relevance in terms of liability law.

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2007-01-01

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

  20. An 802.11 Wireless Blood Pulse-Oximetry System for Medical Response to Disasters

    PubMed Central

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

    2005-01-01

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

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

    PubMed Central

    Caldorera-Moore, Mary; Peppas, Nicholas A.

    2009-01-01

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

  2. Telemedicine in the British Antarctic survey.

    PubMed

    Grant, Iain C

    2004-12-01

    Medicine in the Antarctic is probably the most isolated situation in which a doctor can practise, differing in degree of severity even from that of the Arctic region. The increasing use of Telemedicine has helped to reduce this isolation and to improve access to secondary healthcare for those who live in the most remote bases in the world. The article describes the way in which Antarctic Telemedicine has evolved in the British Antarctic survey, outlining the use of low cost and low technology systems to improve the availability of emergency advice, both to the doctor and to isolated field parties, specialist consultation, medical education, and healthcare records. The Antarctic is a useful proving ground for technologies which may have applications in space and other extreme and isolated environments.

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

    PubMed

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

    2011-01-01

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

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

    PubMed

    Moore, J

    1992-01-01

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

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

    ERIC Educational Resources Information Center

    Halbert, Judy; Kaser, Linda

    2015-01-01

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

  6. Directions and opportunities in health informatics in British Columbia.

    PubMed

    Thornton, K

    1994-06-01

    The social changes, and changes in perceptions of the effectiveness of health care in British Columbia have resulted in a large number of recommendations in the report of the British Columbia Royal Commission on Health Care and Costs. Many of these recommendations have implications for health informatics. The British Columbia Government, in outlining a response, foresees a major change in the emphases of health care, which will involve four major areas of health informatics: network evolution, automation of the patient record, outcome- and other quality-related databases, and consumer health education. These themes are discussed, in the light of the opinions of academics, health care providers, and the health-informatics industry. The themes must be intercalated into the health informatics curriculum, to equip graduates for the challenges of B.C.'s changing health care system.

  7. British Industrial Libraries Before 1939

    ERIC Educational Resources Information Center

    Marshall, Margaret R.

    1972-01-01

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

  8. Tides of the British Seas

    ERIC Educational Resources Information Center

    Sandon, Frank

    1975-01-01

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

  9. Instructor Training on British Railways

    ERIC Educational Resources Information Center

    Gibson, J. D.

    1970-01-01

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

  10. Rapid assessment of health needs and medical response after the tsunami in Thailand, 2004-2005.

    PubMed

    Güereña-Burgueño, Fernando; Jongsakul, Krisada; Smith, Bryan L; Ittiverakul, Mali; Chiravaratanond, Orapan

    2006-10-01

    On December 26, 2004, an earthquake triggered a massive tsunami in the Indian Ocean, causing an estimated 183,172 deaths and 40,320 missing in 12 countries. In Thailand, six provinces (Krabi, Phang-Nga, Phuket, Ranong, Satun, and Trang) were affected. U.S. government agencies delivered emergency medical assistance from December 30, 2004, to January 6, 2005. A team from the Armed Forces Research Institute of Medical Sciences conducted a rapid health and needs assessment in southern Thailand. Twelve hospitals were referral centers for tsunami-related medical care. None of the hospitals had been damaged during the tsunami; all activated mass casualty plans. As of October 2005, 5,395 deaths were confirmed and 2,817 individuals were missing. The response of the Thai government to the tsunami was rapid and effective in mitigating the health consequences among survivors and helped prioritize public health interventions and the diversion of U.S. assistance to areas with greater need for international emergency humanitarian assistance. PMID:17447613

  11. Loss of appetite in acutely ill medical inpatients: physiological response or therapeutic target?

    PubMed

    Schütz, Philipp; Bally, Martina; Stanga, Zeno; Keller, Ulrich

    2014-01-01

    Loss of appetite and ensuing weight loss is a key feature of severe illnesses. Protein-energy malnutrition (PEM) contributes significantly to the adverse outcome of these conditions. Pharmacological interventions to target appetite stimulation have little efficacy but considerable side effects. Therefore nutritional therapy appears to be the logical step to combat inadequate nutrition. However, clinical trial data demonstrating benefits are sparse and there is no current established standard algorithm for use of nutritional support in malnourished, acutely ill medical inpatients. Recent high-quality evidence from critical care demonstrating harmful effects when parenteral nutritional support is used indiscriminately has led to speculation that loss of appetite in the acute phase of illness is indeed an adaptive, protective response that improves cell recycling (autophagy) and detoxification. Outside critical care, there is an important gap in high quality clinical trial data shedding further light on these important issues. The selection, timing, and doses of nutrition should be evaluated as carefully as with any other therapeutic intervention, with the aim of maximising efficacy and minimising adverse effects and costs. In light of the current controversy, a reappraisal of how nutritional support should be used in acutely ill medical inpatients outside critical care is urgently required. The aim of this review is to discuss current pathophysiological concepts of PEM and to review the current evidence for the efficacy of nutritional support regarding patient outcomes when used in an acutely ill medical patient population outside critical care. PMID:24782139

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

    PubMed

    Ling, K A

    2003-07-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Bailey, Mark S

    2013-09-01

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

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

    PubMed Central

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

    2014-01-01

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

  17. British Telecom and Project Universe

    NASA Astrophysics Data System (ADS)

    Childs, G. H. L.; Morrow, G.

    1983-07-01

    Factors influencing the emergence of local area network (LANs) are covered along with British Telecom's involvement in Project Universe, an experiment to produce high-speed data links between several LANs in the United Kingdom with the Orbital Test Satellite (OTS). Other functions of Project Universe include measuring the network components performance, developing procedures for using the system for computer-computer and terminal-computer operations, and investigating the use of LAN satellites for business and computer communications. British Telecom has been involved with Project Universe since its inception. A standard Videotex system has been connected to the Cambridge Ring, consequently providing Videotex terminals attached to the ring access to a special Universe Prestel system. Future goals include replacing the OTS with a new satellite with a terminal operating at 8-10 Mbit/s. Block diagrams are provided.

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

    PubMed

    Ballantyne, Angela J

    2016-01-01

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

  19. Committee opinion no. 500: Professional responsibilities in obstetric-gynecologic medical education and training.

    PubMed

    2011-08-01

    The education of health care professionals is essential to maintaining standards of medical competence and access to care by patients. Inherent in the education of health care professionals is the problem of disparity in power and authority, including the power of teachers over learners and the power of practitioners over patients. Although there is a continuum of supervision levels and independence from student to resident to fellow, the ethical issues that arise during interactions among all teachers, learners, and their patients are similar. In this Committee Opinion, the Committee on Ethics of the American College of Obstetricians and Gynecologists discusses and offers recommendations regarding the professional conduct and ethical responsibilities of practitioners toward patients and participants in research in educational settings; of learners and teachers toward one another; and of institutions toward patients, learners, and teachers.

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

    PubMed

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

    2005-01-01

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

  1. Houston's medical disaster response to Hurricane Katrina: part 2: transitioning from emergency evacuee care to community health care.

    PubMed

    Hamilton, Douglas R; Gavagan, Thomas; Smart, Kieran; Weller, Nancy; Upton, Lori A; Havron, Douglas A; Fishkind, Avrim; Persse, David; Shank, Paul; Shah, Umair A; Mattox, Kenneth

    2009-04-01

    After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid construction of a 65-examination-room medical facility within the Reliant Center. A plan for triage of arriving evacuees was quickly developed and the Astrodome/Reliant Center Complex mega-shelter was created. Herein, we discuss major elements of the regional disaster response, including regional coordination, triage and emergency medical service transfers into the region's medical centers, medical care in population shelters, and community health challenges.

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

    PubMed Central

    Masters, Ken

    2012-01-01

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

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

    PubMed

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

    2016-01-01

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

  4. Checklist of British and Irish Hymenoptera - Platygastroidea

    PubMed Central

    Buhl, Peter N.; Notton, David G.

    2016-01-01

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

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

    SciTech Connect

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

    2014-11-07

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

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

    PubMed

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

    2010-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

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

    PubMed

    Samardzic, Josip; Hreckovski, Boris; Hasukic, Ismar

    2015-06-01

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

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

    PubMed

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

    2010-01-01

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

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

    PubMed Central

    Samardzic, Josip; Hreckovski, Boris; Hasukic, Ismar

    2015-01-01

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

  11. Children in Care: A Report to the Representative for Children and Youth from the British Columbia Teachers' Federation

    ERIC Educational Resources Information Center

    British Columbia Teachers' Federation, 2009

    2009-01-01

    Teachers in the public schools of British Columbia have a special responsibility to help ensure that the aesthetic, emotional, intellectual, physical, and social development of children in care is met. Representatives of the British Columbia Teachers' Federation (BCTF) from the Aboriginal Education Advisory Committee, the Committee for Action on…

  12. [Physician-patient relations: right or self determination. Path across the Atlantic regarding medical responsibility].

    PubMed

    Hervé, C; Wolf, M

    1998-09-19

    In France, patients have a fundamental right to health care, specifically declared in the Public Health Code. Licensed physicians are endowed by law with the mission of providing such care. The patient-physician relationship thus operates in an atmosphere of mutual trust. This situation, derived from roman law, is much different from that in countries where Habeas Corpus is the founding principle. In the United States for example, in virtue of the right to autonomy or self-determination, a patient has to decide to receive health care. In both situations, patient consent is mandatory, but in France consent is a condition, and not the fundamental principle of health care. A recent court decision (Cour de Cassation, February 25, 1997) has however had considerable impact on the health care climate in France. According to this decision, the physician is charged with the responsibility of informing the patient of all possible risks inherent in a proposed treatment. In addition, the physician must be able to prove the patient has received such information. The danger is that health care in France depart from the notion of a medical mission, moving onto the unstable grounds of an open marketplace. If the physician becomes a salesperson meeting the desires of a client-patient, what will happen to the climate of mutual patient-physician trust so strong in France? There is an urgent need to preserve the fundamental right to medical care in France, a mission performed by legally designated physicians and other health carers, for the benefit of consenting patients. PMID:9793058

  13. British atomic tests in Australia.

    PubMed

    Suter, K

    1994-01-01

    The United Kingdom and Australia have reached agreement on the British payment for cleaning up the Maralinga (South Australia) site at which the UK tested some of its atomic weapons in the 1960s. The tests were conducted amid great secrecy and only in recent years has the truth about the health hazards fully emerged. The peace movement opposed the tests and its stand has been vindicated. Also vindicated have been the claims by Aborigines that more damage was done by the tests than was earlier admitted.

  14. Predicting the long-term effects of human-robot interaction: a reflection on responsibility in medical robotics.

    PubMed

    Datteri, Edoardo

    2013-03-01

    This article addresses prospective and retrospective responsibility issues connected with medical robotics. It will be suggested that extant conceptual and legal frameworks are sufficient to address and properly settle most retrospective responsibility problems arising in connection with injuries caused by robot behaviours (which will be exemplified here by reference to harms occurred in surgical interventions supported by the Da Vinci robot, reported in the scientific literature and in the press). In addition, it will be pointed out that many prospective responsibility issues connected with medical robotics are nothing but well-known robotics engineering problems in disguise, which are routinely addressed by roboticists as part of their research and development activities: for this reason they do not raise particularly novel ethical issues. In contrast with this, it will be pointed out that novel and challenging prospective responsibility issues may emerge in connection with harmful events caused by normal robot behaviours. This point will be illustrated here in connection with the rehabilitation robot Lokomat.

  15. Rural mass casualty preparedness and response: the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events.

    PubMed

    Viswanathan, Kristin P; Bass, Robert; Wijetunge, Gamunu; Altevogt, Bruce M

    2012-10-01

    The Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a workshop at the request of the Federal Interagency Committee on Emergency Medical Services (FICEMS) that brought together a range of stakeholders to broadly identify and confront gaps in rural infrastructure that challenge mass casualty incident (MCI) response and potential mechanisms to fill them. This report summarizes the presentations and discussions around 6 major issues specific to rural MCI preparedness and response: (1) improving rural response to MCI through improving daily capacity and capability, (2) leveraging current and emerging technology to overcome infrastructure deficits, (3) sustaining and strengthening relationships, (4) developing and sharing best practices across jurisdictions and sectors, (5) establishing metrics research and development, and (6) fostering the need for federal leadership to expand and integrate EMS into a broader rural response framework. PMID:23077273

  16. Immunization delivery in British Columbia

    PubMed Central

    Omura, John; Buxton, Jane; Kaczorowski, Janusz; Catterson, Jason; Li, Jane; Derban, Andrea; Hasselback, Paul; Machin, Shelagh; Linekin, Michelle; Morgana, Tamsin; O’Briain, Barra; Scheifele, David; Dawar, Meena

    2014-01-01

    Abstract Objective To explore the experiences of family physicians and pediatricians delivering immunizations, including perceived barriers and supports. Design Qualitative study using focus groups. Setting Ten cities throughout British Columbia. Participants A total of 46 family physicians or general practitioners, 10 pediatricians, and 2 residents. Methods A semistructured dialogue guide was used by a trained facilitator to explore participants’ experiences and views related to immunization delivery in British Columbia. Verbatim transcriptions were independently coded by 2 researchers. Key themes were analyzed and identified in an iterative manner using interpretive description. Main findings Physicians highly valued vaccine delivery. Factors facilitating physician-delivered immunizations included strong beliefs in the value of vaccines and having adequate information. Identified barriers included the large time commitment and insufficient communication about program changes, new vaccines, and the adult immunization program in general. Some physicians reported good relationships with local public health, while others reported the opposite experience, and this varied by geographic location. Conclusion These findings suggest that physicians are supportive of delivering vaccines. However, there are opportunities to improve the sustainability of physician-delivered immunizations. While compensation schemes remain under the purview of the provincial governments, local public health authorities can address the information needs of physicians. PMID:24627403

  17. An exploratory study on the elements that might affect medical students' and residents' responsibility during clinical training.

    PubMed

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

    2014-01-01

    We are now more or less confronting a "challenge of responsibility" among both undergraduate and postgraduate medical students and some recent alumni from medical schools in Iran. This ethical problem calls for urgent etiologic and pathologic investigations into the problem itself and the issues involved. This study aimed to develop a thematic conceptual framework to study factors that might affect medical trainees' (MTs) observance of responsibility during clinical training. A qualitative descriptive methodology involving fifteen in-depth semi-structured interviews was used to collect the data. Interviews were conducted with both undergraduate and postgraduate MTs as well as clinical experts and experienced nurses. Interviews were audio-recorded and then transcribed. The data was analyzed using thematic content analysis. The framework derived from the data included two main themes, namely "contextual conditions" and "intervening conditions". Within each theme, participants recurrently described "individual" and "non-individual or system" based factors that played a role in medical trainees' observance of responsibility. Overall, contextual conditions provide MTs with a "primary or basic responsibility" which is then transformed into a "secondary or observed responsibility" under the influence of intervening conditions. In conclusion three measures were demonstrated to be very important in enhancing Iranian MTs' observance of responsibility: a) to make and implement stricter and more exact admission policies for medical colleges, b) to improve and revise the education system in its different dimensions such as management, structure, etc. based on regular and systematic evaluations, and c) to establish, apply and sustain higher standards throughout the educational environment. PMID:25512829

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  20. John Gregory (1724-1773) and his lectures on the duties and qualifications of a physician establishing modern medical ethics on the base of the moral philosophy and the theory of science of the empiric British Enlightenment.

    PubMed

    Strätling, M

    1997-01-01

    In 1769/70 the Scottish physician and philosopher John Gregory (1724-1773) published Lectures On the Duties and Qualifications of a Physician. Gregory developed a truely ethical - in the sense of (moral) philosophically based - system of conduct in a physician. His concept of practising and teaching ethics in medicine and science is established on a very broad footing: combining Bacon's (1561-1626) general philosophy of nature and science with both, the general, likewise empirically based moral philosophy of his personal friend David Hume (1711-1776), and with the principles upheld by the so-called Common-Sense Philosophy. His Lectures had - particularly via the famous Code of Medical Ethics of Thomas Percival (1740-1804) - a decisive influence on our contemporary concepts of ethics in medicine and science. John Gregory is, without doubt, one of the most important and certainly the most comprehensive among the founders of what is known today as modern Bioethics.

  1. Request Strategies in British English and Japanese.

    ERIC Educational Resources Information Center

    Fukushima, Saeko

    1996-01-01

    Tests request strategies used by speakers of Japanese and British English in two culturally neutral situations likely to trigger a request. Concludes that the degree of imposition goes on a par with the number of politeness strategies but that there are differences in the types of strategies used: the British use conventional forms and supportive…

  2. British Support for English Studies in Europe.

    ERIC Educational Resources Information Center

    British Council, London (England). English-Teaching Information Centre.

    This survey attempts to document British support for English Studies in Europe. "English Studies" is interpreted as covering English language, British literature in English, and appropriate background studies. The first part consists of short descriptions of the activities of the principal organizations active in this field: Association of…

  3. Psychology and homosexuality: the British Sexological Society.

    PubMed

    Weigle, D C

    1995-04-01

    The British Sexological Society was a largely unknown society composed of influential people of the early twentieth century in Great Britain. The present research is an archival study of the Society and its work concerning homosexuality. Issues addressed by the British Sexological Society are relevant to the early development of sexual emancipation movements as well as to issues of sexuality today.

  4. The Making of a Moral British Bangladeshi

    ERIC Educational Resources Information Center

    Zeitlyn, Benjamin

    2014-01-01

    This article traces changing notions of a moral upbringing among British Bangladesh families in London. It reviews ideas of the making of a moral person ("manush corano") in Bangladesh and contrasts those with contemporary practices and ideas about the good child in London. It argues that in London, British Bangladeshis have embraced a…

  5. Providing a Background for British Literature.

    ERIC Educational Resources Information Center

    DeLuca, Diana Macintyre

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

  6. The Contemporaneity of the British Survey.

    ERIC Educational Resources Information Center

    Dodson, Charles Brooks

    The seeming remoteness of material studied in a British literature survey course can be frustrating for the teacher. Students may find little relevance in the story of Beowulf or the descriptions of Gulliver's voyages. However, instructors can highlight the contemporaneity of British literary texts by drawing parallels to modern times. For…

  7. Integrated Curriculum Programs in British Columbia

    ERIC Educational Resources Information Center

    Johnston, Julie

    2011-01-01

    In this article, the author discusses British Columbia's integrated curriculum programs (ICPs). In this province of sea and mountains, outdoor adventures figure prominently in its ICPs--with a healthy dose of environmental and sustainability education mixed in. The author presents five examples from British Columbia's ICPs: (1) Earthquest Outdoor…

  8. British African Caribbean Women and Depression

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  9. The Current Canon in British Romantics Studies.

    ERIC Educational Resources Information Center

    Linkin, Harriet Kramer

    1991-01-01

    Describes and reports on a survey of 164 U.S. universities to ascertain what is taught as the current canon of British Romantic literature. Asserts that the canon may now include Mary Shelley with the former standard six major male Romantic poets, indicating a significant emergence of a feminist perspective on British Romanticism in the classroom.…

  10. Accounting for medical communication: parents' perceptions of communicative roles and responsibilities in the pediatric intensive care unit.

    PubMed

    Gordon, Cynthia; Barton, Ellen; Meert, Kathleen L; Eggly, Susan; Pollacks, Murray; Zimmerman, Jerry; Anand, K J S; Carcillo, Joseph; Newth, Christopher J L; Dean, J Michael; Willson, Douglas F; Nicholson, Carol

    2009-01-01

    Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents' perceptions of clinicians' and their own communicative roles and responsibilities in the context of team-based care. We examine parents' descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they report (n = 47). Findings indicate that parental perceptions of communicative responsibilities are more nuanced than assumed in previous research: Parents identified their own responsibilities as participating as part of the team of care, gathering information, interacting with appropriate affect, and working to understand complex and uncertain medical information. Complementarily, parents identified clinician responsibilities as communicating professionally, providing medical information clearly, managing parents' hope responsibly, and communicating with appropriate affect. Through the accounts they provide, parents evaluate both parental and clinician role-responsibilities as fulfilled and unfulfilled. Clinicians' management of prognostic uncertainty and parents' struggles to understand that uncertainty emerged as key, complementary themes with practical implications for incorporating parents into the PICU care team. The study also highlights insights retrospective interview data bring to the examination of medical communication.

  11. Assessment of biodosimetry methods for a mass-casualty radiological incident: medical response and management considerations.

    PubMed

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

    2013-12-01

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

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

    PubMed Central

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

    2013-01-01

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

  13. Criminal law as a response to medical malpractice: pluses and minuses--comparing Italian and U.S. experiences.

    PubMed

    Di Landro, Andrea R

    2012-06-01

    The paper is divided into three parts. The first part sets out the comparative differences between the tort of malpractice in common law and the criminal negligence in civil law: while the common law takes for mens rea only the "gross" negligence, and rarely medical negligence, other law systems instead (and particularly Italian law) criminalize also ordinary negligence, frequently in medical malpractice cases. The second part of the paper addresses the pluses of using criminal law as response to medical malpractice: inadequate medical self-policing and "repeat offenders" problems are analysed, in the perspective of the patient, of the doctor, of the insurance company, and of the community. The third part addresses the minuses of the criminal law as response: medical "shame and blame" mentality, criminal stigma and culture of fear are disincentives to incident reporting and to system analysis (the most important means of prevention); "defensive medicine" and "courts-abiding medicine" are managed not yet in the patient's exclusive interest, but in the egoistic/utilitarian aim to avoid denunciations; finally, the uncertainty of the medicine, the accusatory system and the proof "beyond a reasonable doubt" seem hardly compatible with each other.

  14. Sir Charles Ballance: pioneer British neurological surgeon.

    PubMed

    Stone, J L

    1999-03-01

    Sir Charles A. Ballance (1856-1936) began his medical career at St. Thomas's Hospital the University College, London, England, in 1875, receiving honors in every subject and a gold medal in surgery. Victor Horsley (1857-1916) and Ballance were classmates at the University and in the later 1880s began work together at the Brown Institute and the National Hospital, Queen Square. In addition to important studies on vascular surgery, Ballance was involved in primate work on cerebral localization with lifelong friends Charles Beevor, Charles Sherrington, David Ferrier, and others. In June of 1887, Ballance assisted Horsley at Queen Square in the successful removal of an extramedullary spinal cord tumor. Horsley was about to abandon the operation, but his friend urged the removal of one lamina higher and the tumor was discovered. Ballance, a demonstrator in anatomy, realized the spinal cord segments lay higher in relation to the vertebral bodies than was generally appreciated. Ballance popularized the operation of radical mastoidectomy for advanced middle ear infection (1890), standardized an approach to drain or excise temporal brain abscesses, and was the first to clearly understand the neurological signs of cerebellar abscess (1894). Ballance also devised cranial base approaches to attack infectious thrombophlebitis of the lateral, petrosal, and cavernous sinuses. He was the first to completely remove an acoustic tumor (1894); 18 years later, the patient remained well. Ballance also drained a posterior fossa subdural hematoma (1906) and successfully sectioned the auditory nerve for Meniere's syndrome (1908). Ballance's operative experience with both supra- and infratentorial brain lesions included approximately 400 cases, which are detailed in his 1907 book, Some Points in the Surgery of the Brain and Its Membranes. His two-volume set, Essays on the Surgery of the Temporal Bone (1919), remains a brilliantly written and illustrated classic. Ballance was an expert on

  15. From Stress to Distress: Conceptualizing the British Family Farming Patriarchal Way of Life

    ERIC Educational Resources Information Center

    Price, Linda; Evans, Nick

    2009-01-01

    "Rural stress" and "farming stress" are terms that have become commonly appropriated by British health-based academic disciplines, the medical profession and social support networks, especially since the agricultural "crises" of B.S.E. and Foot and Mouth disease. Looking beyond the media headlines, it is apparent that the terms in fact are…

  16. The british military hospitals in macedonia during the first world war.

    PubMed

    Cvetkovski, Vladimir

    2016-01-01

    The paper focusses its attention to the medical work of the British Military hospitals stationed in Macedonia during the First World War, the surgical work carried out under very heavy conditions in improvised operating theatres as well as the treatment of the wounded and sick solders brought from the battlefields on the Macedonian Front.

  17. Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to Internet searches for medical information.

    PubMed

    Fergus, Thomas A

    2013-10-01

    Individuals frequently use the Internet to search for medical information. However, for some individuals, searching for medical information on the Internet is associated with an exacerbation of health anxiety. Researchers have termed this phenomenon as cyberchondria. The present research sought to shed further light onto the phenomenology of cyberchondria. In particular, the moderating effect of intolerance of uncertainty (IU) on the relationship between the frequency of Internet searches for medical information and health anxiety was examined using a large sample of medically healthy community adults located in the United States (N=512). The purported moderating effect of IU was supported. More specifically, the relationship between the frequency of Internet searches for medical information and health anxiety grew increasingly stronger as IU increased. This moderating effect of IU was not attributable to general distress. These results suggest that IU is important for better understanding the exacerbation of health anxiety in response to Internet searches for medical information. Conceptual and therapeutic implications of these results are discussed. PMID:23992476

  18. Audience responses to television news coverage of medical advances: The mediating role of audience emotions and identification.

    PubMed

    Hong, Hyehyun

    2015-08-01

    Exemplifying a real person in news stories has become a popular journalistic technique to describe an event or issue. With the frequent appearance of medical news reports in local television in recent years, this news presentation style is widely believed to help audiences better engage in and understand complex medical information and to influence their perceptions and judgments. In terms of television news coverage of medical advances, this study investigates how audiences respond to embedded human examples (mainly patients who experience benefits from the advances) and to overall news stories, and how such responses are related to their perception of portrayed medical advances. The experimental results indicate that news stories with a human example were more likely to intensify the audience's positive emotions than those without, which in turn influenced favorable perceptions of the described medical advance. In addition, the extent to which the audience identified with a human example (in particular, sympathy) mediated the relationship between the audience's involvement in the news story and its perception of the portrayed medical advance.

  19. Human values in medical education.

    PubMed

    Ellis, J R

    1976-11-01

    Attitudes and values in medicine vary with the nature of the individual, his education and training, and the circumstances of his professional life. Comparisons are drawn between medical education in Britain 40 years ago and today. Though education has changed, British students are still mainly motivated by a desire to care for sick people. The impact of personal medicine on a country that has long accepted the need for some kind of national health service is described. It is postulated that as government and public become increasingly involved in health care, it is of paramount importance that medical education should provide a clear understanding of what a profession is and inculcate a determination to maintain true professional status. New responsibilities of the profession, to the public at large and to society, are suggested. The ability of medical education to exert a good influence on concern for human values in medicine depends in the final analysis on the ability to show excellence to medical students.

  20. 2005 Distinguished Academician Lecture: Evolution of postgraduate medical education in Singapore--role of professional associations.

    PubMed

    Shanmugaratnam, K

    2005-12-01

    From 1910 to 1945, doctors in Singapore received postgraduate training through apprenticeship. During the early post-war period, some doctors in the public service were given scholarships to study in Britain and to obtain higher professional qualifications from the British Royal Colleges. The events that most influenced subsequent development of postgraduate education in Singapore occurred between 1956 and 1969: the formation of the Academy of Medicine and the Singapore Medical Association (SMA); organisation of courses for candidates preparing for examinations of the Royal Australasian and British Colleges; competition between the Academy and the University over responsibility for postgraduate medical education; the inauguration of the School of Postgraduate Medical Studies (SPMS); and the introduction of Master of Medicine (M Med) degrees in various medical specialties. From 1970 to 1999, there was expansion in several aspects of postgraduate medical education: SPMS awarded more than 2000 M Med degrees; the Singapore Medical Council (SMC) established a Register of Specialists and formed a Specialist Accreditation Board; the Academy formed Chapters in 10 specialties and developed Advanced Specialty Training programmes leading to Fellowship of the Academy of Medicine Singapore (FAMS); the SMA formed Societies in some 20 specialties; and a College of Family Physicians was inaugurated. There have been more developments from 2000 to 2005: the University restructured SPMS as a Division of Graduate Medical Studies within the Faculty of Medicine; the SMC implemented compulsory Continuing Medical Education; and the Academy converted 6 of its 10 Chapters into Colleges. PMID:16453040

  1. Mortality among British Columbia pilots.

    PubMed

    Salisbury, D A; Band, P R; Threlfall, W J; Gallagher, R P

    1991-04-01

    We studied the mortality experience of all pilots who died in the province of British Columbia between 1950 and 1984, using proportional mortality ratios (PMR) and proportional cancer mortality ratios (PCMR). There were 341 deaths during that time in males whose usual occupation was listed as pilot. The PMR for aircraft accidents was significantly elevated (PMR = 3196, 95% C.I. 2810, 3634), and the PMR for atherosclerotic heart disease was significantly depressed (PMR = 47, 95% C.I. 30, 70). Although based on small numbers of deaths, and not statistically significant, elevated PCMRs were seen for cancers of the colon, brain, and nervous system, as well as for Hodgkin's disease. These findings suggest the need for further epidemiologic studies of commercial airline pilots. PMID:2031640

  2. Some Effects of Stimulant Medication on Response Allocation: A Double-Blind Analysis

    ERIC Educational Resources Information Center

    Kelley, Michael E.; Fisher, Wayne W.; Lomas, Joanna E.; Sanders, Roy Q.

    2006-01-01

    Children who are diagnosed with attention deficit hyperactivity disorder (or who engage in behavior consistent with such a diagnosis) are often prescribed stimulant medications for hyperactive or inattentive behaviors. However, the mechanisms by which stimulant medications affect individuals' behavior are rarely evaluated. The purpose of the…

  3. A proposal for field-level medical assistance in an international humanitarian response to chemical, biological, radiological or nuclear events.

    PubMed

    Malich, Gregor; Coupland, Robin; Donnelly, Steve; Baker, David

    2013-10-01

    A capacity for field-level medical assistance for people exposed to chemical, biological, radiological or nuclear (CBRN) agents or medical support for people potentially exposed to these agents is intrinsically linked to the overall risk management approach adopted by the International Committee of the Red Cross (ICRC) for an international humanitarian response to a CBRN event. This medical assistance articulates: ▸the characteristics of the agent concerned (if known) ▸the need for immediate care particularly for people exposed to agents with high toxicity and short latency ▸the imperative for those responding to be protected from exposure to the same agents. This article proposes two distinct capacities for medical assistance--CBRN field medical care and CBRN first aid--that take the above into account and the realities of a CBRN event including the likelihood that qualified medical staff may not be present with the right equipment. These capacities are equally pertinent whether in support of ICRC staff or for assistance of victims of a CBRN event. Training of those who will undertake CBRN field medical care and CBRN first aid must include: ▸knowledge of CBRN agents, their impact on health and the corresponding toxidromes ▸skills to use appropriate equipment ▸use of appropriate means of self-protection ▸an understanding of the additional complexities brought by the need for and interaction of triage, transfer and decontamination. The development of CBRN field medical care and CBRN first aid continues within the ICRC while acknowledging that the opportunities for learning in real situations are extremely limited. Comments from others who work in this domain are welcome.

  4. An ethical framework for the responsible management of pregnant patients in a medical disaster.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2011-01-01

    The ethics of managing obstetric patients in medical disasters poses ethical challenges that are unique in comparison to other disaster patients, because the medical needs of two patients--the pregnant patient and the fetal patient--must be considered. We provide an ethical framework for doing so. We base the framework on the justice-based prevention of exploitation of populations of patients, both obstetric and non-obstetric, in medical disasters. We use the concept of exploitation to identify a spectrum from ethically acceptable, to ethically challenging, to ethically unacceptable, management of obstetric patients in medical disasters. We also address the ethics of the care of obstetric and neonatal patients when the resources of a hospital are completely overwhelmed in a large-scale medical disaster.

  5. The misconstruction of critical medical anthropology: a response to a cultural constructivist critique.

    PubMed

    Baer, H A

    1997-05-01

    Since its emergence over a decade ago as a distinct theoretical framework, critical medical anthropology (CMA) has engaged in debate and dialogue with various other perspectives within medical anthropology, particularly clinical anthropology, medical ecology, and, to a lesser degree, postmodernism. While at least two genres of CMA have emerged, both of which are involved in a dialogue with each other, proponents of other perspectives often misread or "misconstruct" the agenda of CMA as both a theoretical framework and a strategy for health activism. This essay in particular critiques this process among proponents of the interpretative or cultural constructivist perspective. On a positive note, however, I urge critical medical anthropologists and cultural constructivists within medical anthropology to enter into a dialogue with each other because their two perspectives, despite the presence of obvious epistemological differences, share commonalities.

  6. Circulating hormones and pituitary responsiveness in young epileptic men receiving long-term antiepileptic medication.

    PubMed

    Macphee, G J; Larkin, J G; Butler, E; Beastall, G H; Brodie, M J

    1988-01-01

    Impairment of libido and sexual potency are commonly reported by male epileptic patients. This may be partly a consequence of medication. Circulating hormones were measured in 53 postpubertal male epileptic patients less than 45 years of age and in an age-matched control group (n = 40), consisting of 14 untreated epileptic patients and 26 unmedicated healthy subjects. A subgroup also underwent a combined gonadotrophin- and thyrotrophin-releasing hormone (LH-RH/TRH) pituitary stimulation test. Untreated patients did not differ from healthy subjects for any parameter, and their data were combined for comparison with the treated epileptic patients. Total testosterone (T), androstenedione, and basal follicle-stimulating hormone concentrations were similar in all patient groups. Patients receiving more than one drug had higher sex hormone binding globulin (SHBG) (p less than 0.01) and lower free T and dehydroepiandrosterone sulphate (DHAS) levels (both p less than 0.001) than controls. Carbamazepine (CBZ) monotherapy also reduced free T (p less than 0.05) and DHAS (p less than 0.001) and increased basal prolactin (p less than 0.01). In these two groups of patients, basal luteinising hormone (LH) was elevated (p less than 0.01), presumably as a pituitary response to increased T catabolism. There was a negative correlation between free T and circulating CBZ (r = -0.54, p less than 0.05) in the monotherapy patients. Phenytoin (PHT) was associated with a rise in SHBG (p less than 0.01) and a fall in DHAS (p less than 0.001). Basal LH was also elevated, but this just failed to reach statistical significance (p less than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Student Project in Anatomy (SPA) – Making the First Year Medical Students Responsible and Creative

    PubMed Central

    Mishra, Snigdha; George, Bincy M; Kumar, Naveen

    2016-01-01

    Introduction Creativity is a combination of ones’ capacity to think outside the box, the gained knowledge and the passion for creating something. It very easily and effectively provides the creator a chance to be responsible for his/her creation and acts as a confidence booster for him/her. Creativity is inherent, but needs to be polished and nurtured. If nurtured well through proper motivation, the creator excels leaps and bounds. It develops an empathetic behaviour in the creator, when he allows his creations to be used by others. Aim The study was done to generate learning resources through academically good students and make them available for the entire class. Materials and Methods Academically, top 16 students were involved in a project of their choice. The projects included preparation of question answers, powerpoint presentations, cross-word puzzles, videos, models, atlases and wall hangers etc., ten weeks were given to finish the project. The project was guided and monitored by teachers. The end product of the project was given to the entire class for use. The perception of users of the end products of the projects was recorded through mini interviews. Results All the students who took part in the project liked working on the project. They felt motivated, rewarded and had mastery on the topic which they used in the project. The students who did not do the project but used the end product of the project also liked the project work. They felt that the end products of the projects were simple, informative and creative. Conclusion By participating in Student Project in Anatomy (SPA), the students get to show their total potential through these creative ways. It provides a fresh and welcome change from the common routine followed otherwise in medical schools. The outcome of the projects can help the entire class. This type of projects can be easily tailored into existing curriculum and in disciplines other than anatomy too. PMID:27790469

  8. Primary, secondary and tertiary effects of eco-climatic change: the medical response.

    PubMed

    Butler, Colin D; Harley, David

    2010-04-01

    Climatic and ecological change threaten human health globally. Manifestations include lost species, vanishing glaciers and more frequent heavy rain. In the second half of this century, accelerating sea level rise is likely to cause crop loss, and population dislocation. These problems may be magnified by dysfunctional human responses, including conflict. The population health consequences of these events can be classified as primary, secondary and tertiary. Primary signs include the acute and chronic stress of heat waves, and trauma from increased bush fires and flooding. Secondary signs are indirect, such as an altered distribution of arthropod vectors, intermediate hosts and pathogens that will produce changes in the epidemiology of many infectious diseases. More severe future health consequences of climate change are classified here as tertiary effects. If moderate or severe climate change scenarios prove accurate then these manifestations will occur over large areas, and could include famine, war and significant population displacement. Such effects would threaten governance and health. The health professions must respond to these challenges, especially the task of recognising and seeking to minimise tertiary health consequences. The gap between what we know and what we need to know concerning these issues can be narrowed by a new field of medical practice. The framework for this emerging discipline includes climate change, ecology and global health. Combined, these dimensions may be called ecomedicine. Actions to reduce individual emissions, to promote active transport (with its 'co-benefit' of preventing chronic disease), and involvement in group action to protect the environment and to prevent war, informed by understanding of the health of individual patients and populations, will be central to the practice of ecomedicine.

  9. Haemodynamic Responses to Selective Vagal Nerve Stimulation under Enalapril Medication in Rats

    PubMed Central

    Gierthmuehlen, Mortimer; Stieglitz, Thomas; Zentner, Josef; Plachta, Dennis T. T.

    2016-01-01

    Selective vagal nerve stimulation (sVNS) has been demonstrated to lower blood pressure (BP) in rats without causing major side effects. This method might be adapted for the treatment of therapy-resistant hypertension in patients. Converting enzyme inhibitors (CEIs) are among the first drugs that are administered for arterial hypertension and prominently reduce BP primarily by interacting with the renin-angiotensin system of the kidneys. Beyond the reduction of BP, CEI have a positive effect on the survival rate after myocardial infarction; they reduce the rates of stroke and improve the neurohormonal status in heart-failure patients. If sVNS might be introduced as a therapy against resistant hypertension, patients will at least partially stay on their CEI medication. It is therefore the aim of this study to investigate the influence of the CEI enalapril on the haemodynamic and respiratory effects of sVNS. In 10 male Wistar rats, a polyimide-based multichannel-cuff-electrode was placed around the vagal nerve bundle to selectively stimulate the aortic depressor nerve fibres. Stimulation parameters were adapted to the thresholds of the individual animals and included repetition frequencies between 30 and 50 Hz, amplitudes of 0.5 to 1.5 mA and pulse widths between 0.4 ms and 1.0 ms. BP responses were detected with a microtip transducer in the left carotid artery, and electrocardiography was recorded with subcutaneous electrodes. After intravenous administration of enalapril (2 mg/kg bodyweight), the animals’ mean arterial blood pressures (MAPs) decreased significantly, while the heart rates (HRs) were not significantly influenced. The effects of sVNS on BP and HR were attenuated by enalapril but were still present. We conclude that sVNS can lower the MAP during enalapril treatment without relevant side effects. PMID:26766419

  10. Haemodynamic Responses to Selective Vagal Nerve Stimulation under Enalapril Medication in Rats.

    PubMed

    Gierthmuehlen, Mortimer; Stieglitz, Thomas; Zentner, Josef; Plachta, Dennis T T

    2016-01-01

    Selective vagal nerve stimulation (sVNS) has been demonstrated to lower blood pressure (BP) in rats without causing major side effects. This method might be adapted for the treatment of therapy-resistant hypertension in patients. Converting enzyme inhibitors (CEIs) are among the first drugs that are administered for arterial hypertension and prominently reduce BP primarily by interacting with the renin-angiotensin system of the kidneys. Beyond the reduction of BP, CEI have a positive effect on the survival rate after myocardial infarction; they reduce the rates of stroke and improve the neurohormonal status in heart-failure patients. If sVNS might be introduced as a therapy against resistant hypertension, patients will at least partially stay on their CEI medication. It is therefore the aim of this study to investigate the influence of the CEI enalapril on the haemodynamic and respiratory effects of sVNS. In 10 male Wistar rats, a polyimide-based multichannel-cuff-electrode was placed around the vagal nerve bundle to selectively stimulate the aortic depressor nerve fibres. Stimulation parameters were adapted to the thresholds of the individual animals and included repetition frequencies between 30 and 50 Hz, amplitudes of 0.5 to 1.5 mA and pulse widths between 0.4 ms and 1.0 ms. BP responses were detected with a microtip transducer in the left carotid artery, and electrocardiography was recorded with subcutaneous electrodes. After intravenous administration of enalapril (2 mg/kg bodyweight), the animals' mean arterial blood pressures (MAPs) decreased significantly, while the heart rates (HRs) were not significantly influenced. The effects of sVNS on BP and HR were attenuated by enalapril but were still present. We conclude that sVNS can lower the MAP during enalapril treatment without relevant side effects.

  11. Medical Renaissance.

    PubMed

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology. PMID:26065591

  12. Medical Renaissance.

    PubMed

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology.

  13. Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making

    PubMed Central

    Brandeau, Margaret L.; McCoy, Jessica H.; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M.

    2013-01-01

    Purpose Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. We examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. Methods We reviewed a spectrum of published disaster response models addressing public health or healthcare delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. We developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. Results We propose six recommendations for model construction and reporting, inspired by the most exemplary models: Health sector disaster response models should address real-world problems; be designed for maximum usability by response planners; strike the appropriate balance between simplicity and complexity; include appropriate outcomes, which extend beyond those considered in traditional cost-effectiveness analyses; and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. Conclusions Quantitative models are critical tools for planning effective health sector responses to disasters. The recommendations we propose can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response. PMID:19605887

  14. Moderating effects of salivary testosterone levels on associations between job demand and psychological stress response in Japanese medical workers.

    PubMed

    Hirokawa, Kumi; Miwa, Machiko; Taniguchi, Toshiyo; Tsuchiya, Masao; Kawakami, Norito

    2016-06-10

    Levels of job stress have been shown to be inversely associated with testosterone levels, but some inconsistent results have been documented. We investigated the moderating effects of testosterone levels on associations between job stress-factors and psychological stress responses in Japanese medical workers. The participants were 63 medical staff (20 males and 43 women; mean age: 30.6 years; SD=7.3) in Okayama, Japan. Their job-stress levels and psychological stress responses were evaluated using self-administered questionnaires, and their salivary testosterone collected. Multiple regression analyses showed that job demand was positively associated with stress responses in men and women. An interaction between testosterone and support from colleagues had a significant effect on depression and anxiety for women. In women with lower testosterone levels, a reducing effect of support from colleagues on depression and anxiety was intensified. In women with higher testosterone levels, depression and anxiety levels were identical regardless of support from colleagues. Testosterone may function as a moderator between perceived work environment and psychological stress responses for female medical workers.

  15. Inflight Pharmacokinetic and Pharmacodynamic Responses to Medications Commonly Used in Spaceflight

    NASA Technical Reports Server (NTRS)

    Wotring, V. E.; Derendorf, H.; Kast, J.; Barger, L.; Basner, M.

    2016-01-01

    INTRODUCTION: Researchers do not know if medications act the same in the spaceflight environment as they do on Earth. Aspects of the spaceflight environment (low gravity, radiation exposure, closed environment, stress) have been shown to alter human physiology. Some of these physiological changes could be expected to alter either pharmacokinetics (PK, how the body absorbs, distributes, metabolizes and excretes administered medications) or pharmacodynamics (PD, receptors or signaling systems that are the targets of medication action). Anecdotal data has suggested that, at least for certain medications or indications, inflight medication efficacy is poor. In order to prepare for exploration missions where speedy evacuation to Earth may not be a possibility, the likelihood of unexpected medication action must be determined. METHODS: This protocol was approved by the JSC IRB. This study will include administration of an antibiotic medication, either alone or in combination with sleep aid. Both study medications are FDA-approved prescription drugs and available for use on the ISS. After (double-blind) drug administration, blood samples will be collected over a period of 8 hours. These samples will be analyzed for content of the administered drug(s) and their metabolites, and pharmacokinetic analyses conducted. At the same time points when blood samples are collected, several measures of sleep/wakefulness and cognitive performance will be collected, including actigraphy, electroencephalography, and the psychomotor vigilance test (with the Cognition [1] suite of tests at certain, key, time points). This protocol will be conducted on crewmember volunteers pre-flight, during flight (post FD42), and post-flight so that flight-ground comparisons can be made for each individual. RESULTS: Results from the "Rx Metabolism" study will provide unique information on pharmacokinetics and pharmacodynamics in a microgravity environment. This information will allow the medical community

  16. Checklist of British and Irish Hymenoptera - Proctotrupoidea

    PubMed Central

    2016-01-01

    Abstract Background A revised checklist of the British and Irish Heloridae and Proctotrupidae (Proctotrupoidea) substantially updates the previous comprehensive checklist, dating from 1978. Country level data (i.e. occurrence in England, Scotland, Wales, Ireland and the Isle of Man) is reported where known. New information A total of three Heloridae and 39 Proctotrupidae (including only certainly recorded species) represents a 27% increase in the British list since 1978. Most species are still poorly known and there has been a dearth of taxonomic and faunistic work on the British and Irish fauna. PMID:27226750

  17. Telemedicine and international disaster response: Medical consultation to Armenia and Russia via a telemedicine spacebridge

    NASA Technical Reports Server (NTRS)

    Houtchens, Bruce A.; Clemmer, Terry P.; Holloway, Harry C.; Kiselev, Alexander A.; Logan, James S.; Merrell, Ronald C.; Nicogossian, Arnauld E.; Nikogossian, Haik A.; Rayman, Russell B.; Sarkisian, Ashot E.

    1991-01-01

    The Telemedicine Spacebridge, a satellite mediated audio-video-fax link between four U.S. and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several U.S. medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to onsite physicians and favorably influence clinical decisions in the aftermath of major disasters.

  18. The view from the trenches: part 1-emergency medical response plans and the need for EPR screening.

    PubMed

    Gougelet, Robert M; Rea, Michael E; Nicolalde, Roberto J; Geiling, James A; Swartz, Harold M

    2010-02-01

    Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a "dirty bomb," hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, the authors propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities List (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provide a solid framework for this response. The effective screening of potentially-exposed victims directly following a nuclear attack could decrease the number of patients seeking immediate medical care by greater than 90%. PMID:20065673

  19. The View from the Trenches Part 1: Emergency Medical Response Plans and the Need for EPR Screening

    PubMed Central

    Gougelet, Robert M.; Rea, Michael E.; Nicolalde, Roberto J.; Geiling, James A.; Swartz, Harold M.

    2014-01-01

    Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a “dirty bomb,” hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, we propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities list (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provides a solid framework for this response. The effective screening of potentially exposed victims directly following a nuclear attack could potentially decrease the number of patients seeking immediate medical care by greater than 90%. PMID:20065673

  20. Operation GRITROCK: the Defence Medical Services' story and emerging lessons from supporting the UK response to the Ebola crisis.

    PubMed

    Bricknell, Martin; Hodgetts, T; Beaton, K; McCourt, A

    2016-06-01

    This paper is a record of the UK Defence Medical Services (DMS) contribution to the UK response to the Ebola crisis in West Africa from the start of planning in July 2014 to the closure of the Ministry of Defence Ebola Virus Disease Treatment Unit at the end of June 2015. The context and wider UK government decisions are summarised. This paper describes the decisions and processes that resulted in the deployment of a DMS delivered Ebola Treatment Unit in conjunction with the Department for International Development and Save the Children. It covers arrangements for medical care for disease and non-battle injury, the Air Transportable Isolator and Force Health Protection policy, and finally, considers the medical lessons from this deployment. The core message is that the UK DMS are the only part of the UK health sector that is trained, equipped, manned and available to rapidly deploy and operate a complete medical unit as part of an international response to a health crisis. PMID:26487710

  1. The ecology and evolution of animal medication: genetically fixed response versus phenotypic plasticity.

    PubMed

    Choisy, Marc; de Roode, Jacobus C

    2014-08-01

    Animal medication against parasites can occur either as a genetically fixed (constitutive) or phenotypically plastic (induced) behavior. Taking the tritrophic interaction between the monarch butterfly Danaus plexippus, its protozoan parasite Ophryocystis elektroscirrha, and its food plant Asclepias spp. as a test case, we develop a game-theory model to identify the epidemiological (parasite prevalence and virulence) and environmental (plant toxicity and abundance) conditions that predict the evolution of genetically fixed versus phenotypically plastic forms of medication. Our model shows that the relative benefits (the antiparasitic properties of medicinal food) and costs (side effects of medicine, the costs of searching for medicine, and the costs of plasticity itself) crucially determine whether medication is genetically fixed or phenotypically plastic. Our model suggests that animals evolve phenotypic plasticity when parasite risk (a combination of virulence and prevalence and thus a measure of the strength of parasite-mediated selection) is relatively low to moderately high and genetically fixed medication when parasite risk becomes very high. The latter occurs because at high parasite risk, the costs of plasticity are outweighed by the benefits of medication. Our model provides a simple and general framework to study the conditions that drive the evolution of alternative forms of animal medication.

  2. Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era--a Conference at Harvard Medical School.

    PubMed

    Knipe, David M; Whelan, Sean P

    2015-08-01

    Harvard Medical School convened a meeting of biomedical and clinical experts on 5 March 2015 on the topic of "Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era," with the goals of discussing the lessons from the recent Ebola outbreak and using those lessons as a case study to aid preparations for future emerging infections. The speakers and audience discussed the special challenges in combatting an infectious agent that causes sporadic outbreaks in resource-poor countries. The meeting led to a call for improved basic medical care for all and continued support of basic discovery research to provide the foundation for preparedness for future outbreaks in addition to the targeted emergency response to outbreaks and targeted research programs against Ebola virus and other specific emerging pathogens.

  3. Libraries in British Columbia: MedlinePlus

    MedlinePlus

    ... this page: https://medlineplus.gov/libraries/britishcolumbia.html Libraries in British Columbia To use the sharing features ... George University Hospital of Northern BC Northern Health Library Services / ILL Learning & Development Centre 1475 Edmonton Street ...

  4. Retrenchment in British Universities: Lessons Learned.

    ERIC Educational Resources Information Center

    Simpson, William A.

    1985-01-01

    A study of 14 British universities that underwent severe retrenchment in 1981-1984 is reported, and successful policies, procedures, philosophies, and techniques that may be applicable to institutions in many countries are outlined. (MSE)

  5. Why British GPs use computers and hospital doctors do not.

    PubMed

    Benson, T

    2001-01-01

    Almost all general medical practitioners (GPs) in the UK use computers, compared with less than one in ten of hospital doctors. This paper explains how this unexpected situation came about over a thirty-year period, identifying some of the successes and failures of British medical computing along the way. Twelve separate factors are considered. The major determinants have not been technical, but rather a strong tide of political backing for general practice and leadership from the profession at the highest level, which have combined to build an appropriate regulatory framework and financial incentives that have encouraged GPs to embrace computers. Hospital computing has some difficulties not met by GPs, but the main factor preventing progress has been the lack of any real incentive positive (carrot) or negative (stick), for hospital doctors to use computers.

  6. GADL1 variant and medication adherence in predicting response to lithium maintenance treatment in bipolar I disorder

    PubMed Central

    Chen, Chih-Ken; Lee, Chau-Shoun; Chen, Hsuan-Yu; Wu, Lawrence Shih-Hsin; Chang, Jung-Chen; Liu, Chia-Yih

    2016-01-01

    Background Genetic variants and medication adherence have been identified to be the main factors contributing to lithium treatment response in bipolar disorders. Aims To simultaneously examine effects of variant glutamate decarboxylase-like protein 1 (GADL1) and medication adherence on response to lithium maintenance treatment in Han Chinese patients with bipolar I (BPI) disorder. Method Frequencies of manic and depressive episodes between carriers and non-carriers of the effective GADL1 rs17026688 T allele during the cumulative periods of off-lithium, poor adherence to lithium treatment and good adherence to lithium treatment were compared in Han Chinese patients with BPI disorder (n=215). Results GADL1 rs17026688 T carriers had significantly lower frequencies of recurrent affective episodes than non-T carriers during the cumulative period of good adherence, but not during those of poor adherence. Conclusions GADL1 rs17026688 and medication adherence jointly predict response to lithium maintenance treatment in Han Chinese BPI patients. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27703793

  7. Differential clinical characteristics, medication usage, and treatment response of bipolar disorder in the US versus The Netherlands and Germany.

    PubMed

    Post, Robert M; Leverich, Gabriele S; Altshuler, Lori L; Frye, Mark A; Suppes, Trisha; Keck, Paul E; McElroy, Susan L; Nolen, Willem A; Kupka, Ralph; Grunze, Heinz; Walden, Joerg; Rowe, Mike

    2011-03-01

    Increased early-onset bipolar illness was seen in the US compared with the Netherlands and Germany (abbreviated here as Europe), but other clinical characteristics, medication use, and treatment response have not been systematically explored. Outpatients with bipolar disorder were treated naturalistically and followed prospectively at four sites in the US and three in Europe. Data and clinical characteristics were collected from patient questionnaires, and medication usage and good-to-excellent response to treatment for at least 6 months ascertained from daily clinician ratings on the National Institutes of Mental Health-Life Chart Method. Almost all clinical characteristics earlier associated with a poor treatment response were more prevalent in the US than in Europe, including early onset, environmental adversity, rapid cycling, more than 20 prior episodes, comorbid anxiety and substance abuse disorders, and a positive parental history for an affective disorder. Lithium was used more frequently in Europe than in the US and had a higher rate of success, whereas valproate was used more in the US, with a trend toward higher success in Europe. Antidepressants were used more in the US, but had extremely low success rates. Many other agents were deployed differently on the two continents, but success rates were consistently lower in the US than in Europe. In conclusion, clinical characteristics and patterns of medication usage and effectiveness differed markedly in the two continents suggesting the need for uncovering explanations and considering the two populations as heterogeneous in the future pharmacological studies.

  8. Qualitative assessment of the emotional and behavioural responses of haemophilia A carriers to negative experiences in their medical care.

    PubMed

    Renault, N K; Howell, R E; Robinson, K S; Greer, W L

    2011-03-01

    Previous discussions with haemophilia A (HA) carriers suggested that carriers may experience inappropriate care, resulting in poor relationships with healthcare providers (HCPs; principally physicians and nurses), and unfortunate and extreme emotional and behavioural responses. This was a qualitative study to explore medical experiences of HA carriers and their emotional and behavioural responses. Eleven HA carriers and five Haemophilia Treatment Centre nurses were interviewed. Themes were identified using QSR NVivo 8.0. Carriers and nurses reported HA-related bleeding symptoms in carriers, including life-threatening haemorrhage following injury or medical intervention. Menorrhagia was common and distressing. Negative carrier experiences were related in the determination of genotypic and phenotypic status, management, precautions and HCP attitude, including dismissing carriers' symptoms, concerns or requests for care. Carriers responded with mistrust, lost confidence, disappointment, fear, anxiety, doubt of self or child, discussing experiences, avoidance of healthcare and self-treatment. Dismissive HCP attitudes, ignorance about bleeding disorders in women and unique aspects of the carrier population appear to make errors more likely. This study indicates that carriers experience inappropriate care and encounter dismissive attitudes, and respond emotionally and behaviourally. Our model suggests that systematic medical errors aggravate a negative feedback loop leading to negative emotional and behavioural responses and worsening carrier care. Improved carrier care policies and increased awareness of women's bleeding disorders may improve this situation. Further research is needed to determine whether the themes identified in this study accurately reflect the experiences of carriers in general.

  9. Medical malpractice and the professional legal responsibility of the sports physician.

    PubMed

    Verzeletti, Andrea

    2013-09-01

    As with other medical specialties, litigation in sports medicine appears to be on the increase. In most countries, the applicable legal standard is "good medical practice" as identified with reference to the physician's own field of specialisation: what is commonly done by physicians in the same specialty generally serves as the standard by which a physician's conduct is measured. To enhance the quality of sports medicine practice, medical societies have been issuing guidelines for use by sports physicians, and a number of courts have recognised guidelines as evidence of good medical practice. One potential field of malpractice in sports medicine relates to privacy issues: an athlete should be asked to fill in a consent form if the medical information needs to be shared with other parties. Another relevant field is doping: for any act of drug prescription to be legally sound, sports physicians have to be aware of the requirements of the World Anti-Doping Agency Code and its international standards. Ultimately, the best way for sports physicians to avoid sources of liability is for them to keep up to date with the latest research and to act in a careful and diligent manner.

  10. PERSONALIZED HYPOTHESIS TESTS FOR DETECTING MEDICATION RESPONSE IN PARKINSON DISEASE PATIENTS USING iPHONE SENSOR DATA.

    PubMed

    Chaibub Neto, Elias; Bot, Brian M; Perumal, Thanneer; Omberg, Larsson; Guinney, Justin; Kellen, Mike; Klein, Arno; Friend, Stephen H; Trister, Andrew D

    2016-01-01

    We propose hypothesis tests for detecting dopaminergic medication response in Parkinson disease patients, using longitudinal sensor data collected by smartphones. The processed data is composed of multiple features extracted from active tapping tasks performed by the participant on a daily basis, before and after medication, over several months. Each extracted feature corresponds to a time series of measurements annotated according to whether the measurement was taken before or after the patient has taken his/her medication. Even though the data is longitudinal in nature, we show that simple hypothesis tests for detecting medication response, which ignore the serial correlation structure of the data, are still statistically valid, showing type I error rates at the nominal level. We propose two distinct personalized testing approaches. In the first, we combine multiple feature-specific tests into a single union-intersection test. In the second, we construct personalized classifiers of the before/after medication labels using all the extracted features of a given participant, and test the null hypothesis that the area under the receiver operating characteristic curve of the classifier is equal to 1/2. We compare the statistical power of the personalized classifier tests and personalized union-intersection tests in a simulation study, and illustrate the performance of the proposed tests using data from mPower Parkinsons disease study, recently launched as part of Apples ResearchKit mobile platform. Our results suggest that the personalized tests, which ignore the longitudinal aspect of the data, can perform well in real data analyses, suggesting they might be used as a sound baseline approach, to which more sophisticated methods can be compared to.

  11. PERSONALIZED HYPOTHESIS TESTS FOR DETECTING MEDICATION RESPONSE IN PARKINSON DISEASE PATIENTS USING iPHONE SENSOR DATA.

    PubMed

    Chaibub Neto, Elias; Bot, Brian M; Perumal, Thanneer; Omberg, Larsson; Guinney, Justin; Kellen, Mike; Klein, Arno; Friend, Stephen H; Trister, Andrew D

    2016-01-01

    We propose hypothesis tests for detecting dopaminergic medication response in Parkinson disease patients, using longitudinal sensor data collected by smartphones. The processed data is composed of multiple features extracted from active tapping tasks performed by the participant on a daily basis, before and after medication, over several months. Each extracted feature corresponds to a time series of measurements annotated according to whether the measurement was taken before or after the patient has taken his/her medication. Even though the data is longitudinal in nature, we show that simple hypothesis tests for detecting medication response, which ignore the serial correlation structure of the data, are still statistically valid, showing type I error rates at the nominal level. We propose two distinct personalized testing approaches. In the first, we combine multiple feature-specific tests into a single union-intersection test. In the second, we construct personalized classifiers of the before/after medication labels using all the extracted features of a given participant, and test the null hypothesis that the area under the receiver operating characteristic curve of the classifier is equal to 1/2. We compare the statistical power of the personalized classifier tests and personalized union-intersection tests in a simulation study, and illustrate the performance of the proposed tests using data from mPower Parkinsons disease study, recently launched as part of Apples ResearchKit mobile platform. Our results suggest that the personalized tests, which ignore the longitudinal aspect of the data, can perform well in real data analyses, suggesting they might be used as a sound baseline approach, to which more sophisticated methods can be compared to. PMID:26776193

  12. Attitudes towards people with intellectual disabilities: a comparison of young people from British South Asian and White British backgrounds.

    PubMed

    Sheridan, Joel; Scior, Katrina

    2013-04-01

    Research with South Asian families of individuals with intellectual disabilities (ID) suggests an increased fear of stigma and isolation from the community. Evidence on attitudes towards ID among the wider community is very limited and was the focus of the present study. Responses were collected from 737 college students aged 16-19 using the Community Living Attitudes Scale-ID version. Results indicated that British South Asians (n=355) were less in favour of the social inclusion of people with ID than White British young people (n=382). British South Asian adolescents were more likely to hold the view that people with ID should be sheltered and not empowered. It is proposed that future inclusion policies integrate ethnic minority views whose religious and cultural values do not always conform to the core values of social inclusion policies. It is also proposed that culturally specific school based interventions could be introduced with the aims of decreasing stigma and fostering attitudes in line with the aims of normalisation.

  13. Medical politics and Canadian Medicare: professional response to the Canada Health Act.

    PubMed

    Stevenson, H M; Williams, A P; Vayda, E

    1988-01-01

    The Canada Health Act of 1984 served as a lightning rod for profession/government conflict, culminating in a 25-day doctors' strike in Ontario. The act was perceived as threatening medical dominance and professional autonomy in its prohibition of user fees and extra billing. A post-strike survey of 2,397 physicians across the provinces, however, reveals important limits to physicians' ideological support for an unregulated medical market place. Rather, there are divisions within the profession on how to translate commitment to autonomy into appropriate policy objectives and political strategies.

  14. Specific serum and local antibody responses against Cryptosporidium parvum during medication of calves with halofuginone lactate.

    PubMed Central

    Peeters, J E; Villacorta, I; Naciri, M; Vanopdenbosch, E

    1993-01-01

    Fecal and serum anti-Cryptosporidium parvum immunoglobulin A (IgA), IgM, and IgG were monitored by an enzyme immunoassay in C. parvum-infected calves after medication with halofuginone lactate. In a first experiment, four groups of five 1-day-old colostrum-fed calves were inoculated with 10(6) oocysts of C. parvum. They were medicated with 0, 30, 60, or 120 micrograms of halofuginone lactate per kg from days 2 to 8 postinfection (p.i.). Unmedicated calves passed large numbers of oocysts between 3 and 14 days p.i. Treatment with 30 micrograms/kg did not completely inhibit oocyst output during medication, whereas 60 and 120 micrograms/kg did. The latter groups passed only a reduced number of oocysts when the drug was withdrawn. In a second experiment, 3- to 6-day-old colostrum-fed calves were divided into three groups of 16 or 17 animals each. All animals had acquired C. parvum infection before arrival at the fattening unit. They were medicated with 0, 60, or 120 micrograms/kg for 7 days beginning on the day of arrival. Unmedicated calves passed large numbers of oocysts from 0 to 21 days. Medication stopped oocyst output at day 7, but some of the calves again passed low numbers of oocysts 7 days after withdrawal of the drug. Experimental infection of unmedicated calves was followed by a rise in local anti-C. parvum IgA and IgM titers. Rising coproantibody levels coincided with falling oocyst output. In halofuginone-medicated and experimentally infected calves, only specific anti-C. parvum IgM levels rose during the first 5 days p.i. Specific IgA levels increased in association with oocyst output after withdrawal of the drug in the 60- and 120-micrograms/kg groups. In naturally infected calves, on the other hand, both specific IgA and IgM levels rose further during medication. Although titers were lower than in unmedicated controls, no significant differences were observed. Both medicated and unmedicated calves were equally protected from a challenge with 10

  15. Students' responses to scenarios depicting ethical dilemmas: a study of pharmacy and medical students in New Zealand.

    PubMed

    Henning, Marcus A; Malpas, Phillipa; Ram, Sanya; Rajput, Vijay; Krstić, Vladimir; Boyd, Matt; Hawken, Susan J

    2016-07-01

    One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the 'four principles' determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in 'real' settings and this information may help educators prepare students for these clinical ethical dilemmas. PMID:27154898

  16. Classification of childhood asthma phenotypes and long-term clinical responses to inhaled anti-inflammatory medications

    PubMed Central

    Howrylak, Judie A.; Fuhlbrigge, Anne L.; Strunk, Robert C.; Zeiger, Robert S.; Weiss, Scott T.; Raby, Benjamin A.

    2014-01-01

    Background Although recent studies have identified the presence of phenotypic clusters in asthmatic patients, the clinical significance and temporal stability of these clusters have not been explored. Objective Our aim was to examine the clinical relevance and temporal stability of phenotypic clusters in children with asthma. Methods We applied spectral clustering to clinical data from 1041 children with asthma participating in the Childhood Asthma Management Program. Posttreatment randomization follow-up data collected over 48 months were used to determine the effect of these clusters on pulmonary function and treatment response to inhaled anti-inflammatory medication. Results We found 5 reproducible patient clusters that could be differentiated on the basis of 3 groups of features: atopic burden, degree of airway obstruction, and history of exacerbation. Cluster grouping predicted long-term asthma control, as measured by the need for oral prednisone (P < .0001) or additional controller medications (P = .001), as well as longitudinal differences in pulmonary function (P < .0001). We also found that the 2 clusters with the highest rates of exacerbation had different responses to inhaled corticosteroids when compared with the other clusters. One cluster demonstrated a positive response to both budesonide (P = .02) and nedocromil (P = .01) compared with placebo, whereas the other cluster demonstrated minimal responses to both budesonide (P = .12) and nedocromil (P = .56) compared with placebo. Conclusion Phenotypic clustering can be used to identify longitudinally consistent and clinically relevant patient subgroups, with implications for targeted therapeutic strategies and clinical trials design. PMID:24892144

  17. An Overview of the Roles and Responsibilities of Chinese Medical Colleges in Body Donation Programs

    ERIC Educational Resources Information Center

    Zhang, Luqing; Xiao, Ming; Gu, Mufeng; Zhang, Yongjie; Jin, Jianliang; Ding, Jiong

    2014-01-01

    The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low…

  18. Effects of the Clinical Environment on Physicians' Response to Postgraduate Medical Education.

    ERIC Educational Resources Information Center

    Mazzuca, Steven A.; And Others

    1990-01-01

    Effects of a medical education program about diabetes mellitus were studied as a function of the extent to which participants' clinical environments were made to facilitate recommended practices. Subjects were 99 internal medicine residents and 15 internists staffing a general medicine clinic who attended a 3.5-hour diabetes seminar. (SLD)

  19. State and Church in British Honduran Education, 1931-39: A British Colonial Perspective.

    ERIC Educational Resources Information Center

    Hitchen, Peter

    2000-01-01

    Offers an analysis of church and state influences on the development of education in British Honduras (now Belize). Focuses on the British neglect of education in the colony; the emergence of tensions between the church and state, exploring issues related to Roman Catholic and Protestant rivalry; and church-state issues. (CMK)

  20. Medical education in Malaysia.

    PubMed

    Lim, Victor K E

    2008-01-01

    Malaysia has a long history of medical education, with Singapore becoming the first medical school to serve the region after its foundation in 1905. The first school to be established in Kuala Lumpur after independence from the British was the Faculty of Medicine at the University of Malaya in 1963. Whilst today there are 21 public and private medical schools, all offering a 5 year undergraduate programme, some private schools have diversified by developing international collaboration and conduct twinning or credit-transfer programmes. All medical schools require accreditation by the National Accreditation Board and the Malaysian Medical Council. Although the criteria for accreditation is comprehensive and covers a broad range of areas of assessment, it is debatable whether it always matches the needs of the country. The dramatic increase in medical schools in the last two decades has posed challenges in terms of maintenance of quality, physical infrastructure and suitably qualified faculty.

  1. A New Paradigm for Teaching Histology Laboratories in Canada's First Distributed Medical School

    ERIC Educational Resources Information Center

    Pinder, Karen E.; Ford, Jason C.; Ovalle, William K.

    2008-01-01

    To address the critical problem of inadequate physician supply in rural British Columbia, The University of British Columbia (UBC) launched an innovative, expanded and distributed medical program in 2004-2005. Medical students engage in a common curriculum at three geographically distinct sites across B.C.: in Vancouver, Prince George and…

  2. Circulating biomarker responses to medical management vs. mechanical circulatory support in severe inotrope‐dependent acute heart failure

    PubMed Central

    Meredith, Anna J.; Dai, Darlene L. Y.; Chen, Virginia; Hollander, Zsuzsanna; Ng, Raymond; Kaan, Annemarie; Tebbutt, Scott; Ramanathan, Krishnan; Cheung, Anson

    2015-01-01

    Abstract Background Severe inotrope‐dependent acute heart failure (AHF) is associated with poor clinical outcomes. There are currently no well‐defined blood biomarkers of response to treatment that can guide management or identify recovery in this patient population. In the present study, we characterized the levels of novel and emerging circulating biomarkers of heart failure in patients with AHF over the first 30 days of medical management or mechanical circulatory support (MCS). We hypothesized a shared a plasma proteomic treatment response would be identifiable in both patient groups, representing reversal of the AHF phenotype. Methods and results Time course plasma samples of the first 30 days of therapy, obtained from patients managed medically (n = 8) or with implantable MCS (n = 5), underwent semi‐targeted and candidate biomarker analyses, using multiple reaction monitoring (MRM) mass spectrometry, antibody arrays, and enzyme‐linked immunosorbent assays. Differentially expressed proteins were identified using robust limma for MRM and antibody array data. Patients managed medically or with implantable MCS had a shared proteomic signature of six plasma proteins: circulating cardiotrophin 1, cardiac troponin T, clusterin, and dickopff 1 increased, while levels of C‐reactive protein and growth differentiation factor 15 decreased in both groups over the 30 day time course. Conclusions We have characterized the temporal proteomic signature of clinical recovery in AHF patients managed medically or with MCS, over the first 30 days of treatment. Changes in biomarker expression over the time course of treatment may provide a basis for understanding the biological basis of AHF, potentially identifying novel markers and pathophysiologic mechanisms of recovery.

  3. U.S. Complicity and Japan's Wartime Medical Atrocities: Time for a Response.

    PubMed

    Devolder, Katrien

    2015-01-01

    Shortly before and during the Second World War, Japanese doctors and medical researchers conducted large-scale human experiments in occupied China that were at least as gruesome as those conducted by Nazi doctors. Japan never officially acknowledged the occurrence of the experiments, never tried any of the perpetrators, and never provided compensation to the victims or issued an apology. Building on work by Jing-Bao Nie, this article argues that the U.S. government is heavily complicit in this grave injustice, and should respond in an appropriate way in order to reduce this complicity, as well as to avoid complicity in future unethical medical experiments. It also calls on other U.S. institutions, in particular the Presidential Commission for the Study of Bioethical Issues, to urge the government to respond, or to at least inform the public and initiate a debate about this dark page of American and Japanese history.

  4. [World Health Organization strategies "Towards Unity for Health" and the social responsibility of medical schools].

    PubMed

    Boelen, C

    2003-04-01

    One may wonder why multiple endeavours conducted worldwide over the last five decades to reform health systems have not achieved their expected outcomes. In light of increasing fragmentation, the current health system must be substituted by a true systems vision along with political will to create a unity of action between the five main stakeholders, namely: policy-makers, health care service managers, professionals and professional associations, academic institutions including medical schools, and civil society. Such synergy can only be established if the partners share the same commitment to core values such as quality, equity, relevance and cost-effectiveness in the health care field. Through its functions of providing education, training, research, and services, the medical school has the potential to induce reflection and stimulate action leading to a more coherent, effective, and equitable health system and policies.

  5. U.S. Complicity and Japan's Wartime Medical Atrocities: Time for a Response.

    PubMed

    Devolder, Katrien

    2015-01-01

    Shortly before and during the Second World War, Japanese doctors and medical researchers conducted large-scale human experiments in occupied China that were at least as gruesome as those conducted by Nazi doctors. Japan never officially acknowledged the occurrence of the experiments, never tried any of the perpetrators, and never provided compensation to the victims or issued an apology. Building on work by Jing-Bao Nie, this article argues that the U.S. government is heavily complicit in this grave injustice, and should respond in an appropriate way in order to reduce this complicity, as well as to avoid complicity in future unethical medical experiments. It also calls on other U.S. institutions, in particular the Presidential Commission for the Study of Bioethical Issues, to urge the government to respond, or to at least inform the public and initiate a debate about this dark page of American and Japanese history. PMID:26030498

  6. Medical Response, Search and Recovery during the Space Shuttle Columbia Accident Investigation

    NASA Technical Reports Server (NTRS)

    Stepaniak, Philip C.

    2010-01-01

    On February 1, 2003, the Space Shuttle Columbia broke apart during atmospheric re-entry on mission STS-107. After an event such as this, with high visibility and international interest, the operational challenge of recovering the crewmembers could not be underestimated. The Space Shuttle Program is organized to respond to a vehicle mishap using the resources of the Mishap Investigation Team (MIT). On the afternoon of Feb. 1, 2003, the MIT deployed to Barksdale Air Force Base (AFB), Louisiana. This location became the investigative center and interim storage location for crewmembers received from the Lufkin, Texas Disaster Field Office (DFO). The Lufkin DFO served as the primary area for all operations, including staging assets and deploying field teams for search, recovery and security of crewmember remains. More than 2,000 people from numerous organizations were involved with the recovery of the crew. All seven crewmembers of STS-107 were recovered and ceremonial last rights were administered. Astronaut and military personnel escorted the crew with honor to the MIT at Barksdale AFB, Louisiana. At Barksdale AFB a temporary morgue was established in an aircraft hangar and operated for approximately two weeks during which time coordination with the DFO field recovery teams, Armed Forces Institute of Pathology (AFIP) medical personnel, and the crew surgeons was on going. Families of crewmembers and NASA management were notified daily of the current findings. Working under the leadership of the MIT Lead, the medical team developed and executed a short-term plan to identify and relocate the crew with a military honor guard and protocol to the medical examiner at the Armed Forces Port Mortuary, Dover AFB, Delaware. After operations at Barksdale AFB were concluded the medical team transitioned back to Houston and a long-term plan was developed and implemented which involved the Air Force Mortuary Affairs at Randolph AFB, Texas. This plan was coordinated with search teams

  7. The ethics of cardiopulmonary resuscitation. II. Medical logistics and the potential for good response.

    PubMed Central

    Davies, J M; Reynolds, B M

    1992-01-01

    Mismatches between provision of paediatric cardiopulmonary resuscitation (CPR) and potential to benefit are examined. Deficiencies are most likely to occur in peripheral maternity units but futile CPR is more common in emergency departments where the child is unknown. Decision making in individual cases is best retained by the medical profession for the sake of the child and family. American style intervention by the legislature is likely to dissipate scarce resources and perhaps harm infants not capable of benefiting. PMID:1489234

  8. Addressing the role of medical students using community mobilization and social media in the Ebola response.

    PubMed

    Chapman, Helena J; Animasahun, Victor J; Tade, Adesoji E; Naveed, Asad

    2016-06-01

    Health professions education in the 21st century should incorporate both community mobilization and social media strategies. First, community mobilization facilitates change by educating community members with evidence-based, high-quality and up-to-date health information and empowering their active participation in target health initiatives. Second, advancements in technology and globalization foster the development of innovative communication technologies used as a key tool in the 'roll out' of community health initiatives during epidemics such as Ebola virus disease. In August 2014, medical students of Sierra Leone and Guinea used these dual health promotional strategies in the Kick Ebola Out campaign to educate community members about transmission of the Ebola virus and preventive measures, as well as to reduce perceptions related to stigma or fear of disease transmission. In this report, we describe how medical students, who are trained in basic and clinical sciences, evidence-based practices, and social determinants of health, can serve as human resources for health and facilitate dynamic communication strategies to educate and empower both medical students and community members for local or national health initiatives. PMID:27216169

  9. Internal conflict: undergraduate nursing students' response to inadequate supervision during the administration of medication.

    PubMed

    Reid-Searl, Kerry; Moxham, Lorna; Walker, Sandra; Happell, Brenda

    2009-01-01

    Current legislation in Queensland requires that undergraduate nursing students are personally supervised when administering restricted medication in the clinical setting. Previous research suggests this is not always the case. Exploration of the experiences of undergraduate nursing students was undertaken using grounded theory as the methodological framework. In-depth, semi-structured interviews were conducted with 28 students during their final year clinical placements. Data were analysed using a constant comparative approach. The focus of this paper is to examine the emergent theme of internal conflict, which is experienced by the participants as a consequence of the theory-practice gap. This conflict is reflected by the divergent requirements and expectations between the university and the registered nurses providing supervision in light of the role both play in student assessment. In addition, the participants voiced concerns about patient safety due to the potential for medication error. Internal conflict was identified by participants as the cause of considerable fear and anxiety about passing the course, getting a job and avoiding harm to patients. These findings raise serious concerns about the adequacy of the supervision for nursing students and highlighted the need for a more concerted approach to the theoretical and clinical education of students in relation to medication administration.

  10. Effects of meal composition on postprandial incretin, glucose and insulin responses after surgical and medical weight loss

    PubMed Central

    Brown, T. T.; Cheskin, L. J.; Choi, P.; Moran, T. H.; Peterson, L.; Matuk, R.; Steele, K. E.

    2015-01-01

    Summary Background Meal tolerance tests are frequently used to study dynamic incretin and insulin responses in the postprandial state; however, the optimal meal that is best tolerated and suited for hormonal response following surgical and medical weight loss has yet to be determined. Objective To evaluate the tolerability and effectiveness of different test meals in inducing detectable changes in markers of glucose metabolism in individuals who have undergone a weight loss intervention. Methods Six individuals who underwent surgical or medical weight loss (two Roux‐en‐Y gastric bypass, two sleeve gastrectomy and two medical weight loss) each completed three meal tolerance tests using liquid‐mixed, solid‐mixed and high‐fat test meals. The tolerability of each test meal, as determined by the total amount consumed and palatability, as well as fasting and meal‐stimulated glucagon‐like peptide, glucose‐dependent insulinotropic polypeptide, insulin and glucose were measured. Results Among the six individuals, the liquid‐mixed meal was better and more uniformly tolerated with a median meal completion rate of 99%. Among the four bariatric surgical patients, liquid‐mixed meal stimulated on average a higher glucagon‐like peptide (percent difference: 83.7, 89), insulin secretion (percent difference: 155.1, 158.7) and glucose‐dependent insulinotropic polypeptide (percent difference: 113.5, 34.3) compared with solid‐mixed and high‐fat meals. Conclusions The liquid‐mixed meal was better tolerated with higher incretin and insulin response compared with the high‐fat and solid‐mixed meals and is best suited for the evaluation of stimulated glucose homeostasis. PMID:27774253

  11. Local, Regional and National Responses for Medical Management of a Radiological/Nuclear Incident

    PubMed Central

    Dainiak, Nicholas; Skudlarska, Beata; Albanese, Joseph

    2013-01-01

    Radiological and nuclear devices may be used by terrorists or may be the source of accidental exposure. A tiered approach has been recommended for response to a terrorist event wherein local, regional, state and federal assets become involved sequentially, as the magnitude in severity of the incident increases. State-wide hospital plans have been developed and published for Connecticut, New York and California. These plans address delineation of responsibilities of various categories of health professionals, protection of healthcare providers, identification and classification of individuals who might have been exposed to and/or contaminated by radiation and, in the case of Connecticut response plan, early management of victims. Regional response programs such as the New England Regional Health Compact (consisting of 6 member states) have been developed to manage consequences of radiation injury. The Department of Homeland Security is ultimately responsible for managing both health consequences and the crisis. Multiple US national response assets may be called upon for use in radiological incidents. These include agencies and programs that have been developed by the Department of Energy, the Environmental Protection Agency and the Department of Defense. Coordination of national, regional and state assets with local response efforts is necessary to provide a timely and efficient response. PMID:23447742

  12. Where are we now in British health economics?

    PubMed

    Blaug, M

    1998-08-01

    Health economics took off in 1970 or thereabouts, just after the take-off date for the economics of education. Although early health economics made use of human capital theory as did the economics of education, it soon took a different route inspired by Arrow's work on medical insurance. The economics of education failed to live up to its promising start in the 1960s and gradually ran out of steam. The economics of health, however, has made steady theoretical and empirical progress since 1970, principally in coming to grips with the implications of supplier-induced demand and the difficulties of evaluating health care outcomes. Some of the best work on British health economics has been in the area of normative welfare economics, defining more precisely what is meant by equity in the delivery of health care and measuring the degree of success in achieving equity. Recent efforts to reform the NHS by the introduction of 'quasi markets' have improved the quantity and quality of health care in Britain. In short, British health economics has been characterised by the use of Pigovian piecemeal rather than Paretian global welfare economics, retaining a distinctive style that sets it apart from American health economics.

  13. British Aerospace Cryogenic Coolers For Infrared Detectors

    NASA Astrophysics Data System (ADS)

    Groves, Harry W.

    1988-10-01

    The British Aerospace Dynamics Division has been active in the infrared field since the early 1950's. Originally infrared sensors were, and in many cases still are, cooled with Joule-Thomson coolers associated with rechargeable gas-bottles. Today, there is also a need for zero maintenance systems. To meet this need British Aerospace has productionised a range of viable Stirling Cycle cryogenic coolers. This paper summarises the intensive development programme which has taken place over the last seven years on such applications as the British Aerospace infrared linescan system for the Tornado and their suitability for further applications; both infrared and other sensors where signal-to-noise improvements at low temperatures are beneficial.

  14. Medical innovation then and now: perspectives of innovators responsible for transformative drugs.

    PubMed

    Xu, Shuai; Kesselheim, Aaron S

    2014-01-01

    Effective medical innovation is a common goal of policymakers, physicians, researchers, and patients both in the private and public sectors. With the recent slowdown in approval of new transformative prescription drugs, many have looked back to the "golden years" of the 1980s and 1990s when numerous breakthrough products emerged. We conducted a qualitative study of innovators (n=127) directly involved in creation of groundbreaking drugs during that era to determine what made their work successful and how the process of conducting medical innovation has changed over the past 3 decades. Transcripts were analyzed using standard coding techniques and the constant comparative method of qualitative data analysis to identify the positive features of and challenges posed by the past and present therapeutic innovation environments (70 of the 127 interviewees explicitly addressed these issues). Interviewees emphasized the continued central role played by individuals and the institutions they were a part of in driving innovation. In addition, respondents discussed the importance of collaboration between individuals and institutions to share resources and expertise. Strong underlying basic science was also cited to be a major contributing factor to the success of an innovation. The climate for modern-day medical innovation involves a greater emphasis on patenting in academia, difficulty negotiating the technology transfer process, and funding constraints. Regulatory demands or reimbursement concerns were not commonly cited as factors that influenced transformative innovation. This study suggests that generating future transformative innovation will require a simplification of the current technology transfer process, continued commitment to basic science research, and policy changes that promote meaningful collaboration between individuals from disparate institutions.

  15. The expanded scope of emergency medical practice necessary for initial disaster response: lessons from Haiti.

    PubMed

    Menon, Anil S; Norris, Robert L; Racciopi, Julie; Tilson, Heather; Gardner, Jonathan; McAdoo, Gaby; Brown, Ian P; Auerbach, Paul S

    2012-01-01

    A team of emergency physicians and nurses from Stanford University responded to the devastating January 2010 earthquake in Haiti. Because of the extreme nature of the situation, combined with limited resources, the team provided not only acute medical and surgical care to critically injured and ill victims, but was required to uniquely expand its scope of practice. Using a narrative format and discussion, it is the purpose of this paper to highlight our experience in Haiti and use these to estimate some of the skills and capabilities that will be useful for physicians who respond to similar future disasters.

  16. Psychological Stress In First Year Medical Students In Response To The Dissection Of A Human Corpse

    PubMed Central

    Bernhardt, Veronika; Rothkötter, Hermann Josef; Kasten, Erich

    2012-01-01

    Objectives: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students. Methods: The study was carried out with a group of 155 first year medical students (112 female, 43 male, 21.4±2.9 years). Self-composed questionnaires were used to distinguish between concerns related to dissection and individual experiences and anxiety because of deceasing or death. In order to detect the changes of attitudes towards the dissection course, one questionnaire was answered by participants in the beginning of the course and one in the end (n=94, 66 female, 28 male). Additionally, personality traits of the students were analyzed using two scales of the “Freiburger Persönlichkeitsinventar (FPI-R)”. Results: The self-composed questionnaires showed high reliability. For some students dissection was emotional stress; about 50% became anxious when coping the first confrontation, however, only 12% to large extent. Concerning the anxiety of dissection of individual body parts it was less for limbs, internal organs and skin and increased for head and genitals. Although hypothesized before, the correlation between age, extraversion, emotionality and the extent of anxiety were small. Almost 90% of the students approve the early beginning of the gross anatomy course. The follow-up study showed a marked decline of anxiety. Conclusion: Our results show that about 50% of the students started the course with emotional stress and about one-tenth of them were very worried about

  17. Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites.

    PubMed

    McClelland, Alastair; Khanam, Shopnara; Furnham, Adrian

    2014-03-01

    This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towards depression with increasing age amongst British Bangladeshis. Older British Bangladeshis believed depression was an illness that brought a sense of shame and loss of dignity to the individual and his or her family, and they also favoured a lay referral system for sufferers. They also had more superstitious beliefs about depression than both younger British Bangladeshis and British Whites. A pattern of increasing negativity with increasing age was not evident amongst the British Whites, but older individuals in both groups tended to believe that depression was not helped by psychological intervention. The attitudes towards depression in the young was similar (and generally positive) in both ethnic groups. These findings highlight the necessity to provide more culturally sensitive and accessible services for migrant communities - particularly amongst older individuals.

  18. Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites.

    PubMed

    McClelland, Alastair; Khanam, Shopnara; Furnham, Adrian

    2014-03-01

    This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towards depression with increasing age amongst British Bangladeshis. Older British Bangladeshis believed depression was an illness that brought a sense of shame and loss of dignity to the individual and his or her family, and they also favoured a lay referral system for sufferers. They also had more superstitious beliefs about depression than both younger British Bangladeshis and British Whites. A pattern of increasing negativity with increasing age was not evident amongst the British Whites, but older individuals in both groups tended to believe that depression was not helped by psychological intervention. The attitudes towards depression in the young was similar (and generally positive) in both ethnic groups. These findings highlight the necessity to provide more culturally sensitive and accessible services for migrant communities - particularly amongst older individuals. PMID:25076835

  19. Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites

    PubMed Central

    McClelland, Alastair; Khanam, Shopnara; Furnham, Adrian

    2013-01-01

    This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towards depression with increasing age amongst British Bangladeshis. Older British Bangladeshis believed depression was an illness that brought a sense of shame and loss of dignity to the individual and his or her family, and they also favoured a lay referral system for sufferers. They also had more superstitious beliefs about depression than both younger British Bangladeshis and British Whites. A pattern of increasing negativity with increasing age was not evident amongst the British Whites, but older individuals in both groups tended to believe that depression was not helped by psychological intervention. The attitudes towards depression in the young was similar (and generally positive) in both ethnic groups. These findings highlight the necessity to provide more culturally sensitive and accessible services for migrant communities – particularly amongst older individuals. PMID:25076835

  20. Ambient Noise Tomography of the British Isles

    NASA Astrophysics Data System (ADS)

    Nicolson, H. J.; Curtis, A.; Baptie, B.

    2009-12-01

    In recent years, surface wave tomography using empirical Green’s functions computed via the ambient noise interferometry method has become an established approach to lithospheric imaging problems. To date, ambient noise tomography has been successfully applied to seismometer arrays in the United States, Australia, Iceland, China, South Africa, Europe and the Tibetan Plateau. The basis of the ambient seismic interferometry method is that, by cross-correlating noise data between two seismic stations and stacking over a long enough time period, one can approximate the Green’s Function that would have been recorded at one of the stations if the other had actually been a source. Consequently, one of the main advantages of ambient noise interferometry is that traditional seismic sources such as earthquakes or ballistics are not required; therefore it is ideal for application to seismically quiescent areas such as the British Isles. The British Isles are an archipelago located adjacent to the Eurasian continental shelf in a typically intra-plate setting, formed by a complex amalgamation of several terranes. These range from Laurentian north of the Highland Boundary fault to Avalonian south of the Iapetus Suture and evidence of the regions turbulent geological past can be inferred from its lithospheric structure. Previous studies of the structure of the British Isles considered relatively few seismic stations and/or were limited to using offshore shots, quarry blasts or teleseismic earthquakes as seismic energy sources. We have applied the ambient noise tomography method to noise data recorded on approximately 100 broadband and short period seismometers, including many new stations, in the British Isles and mainland Europe. This dense coverage of the British Isles allows us to image the crust and upper mantle velocity structure with a horizontal resolution in the region of 100km across the North Sea and 30km in the mainland United Kingdom. Here we present the first

  1. Reactions of Medical Students Affected by Disasters.

    ERIC Educational Resources Information Center

    Kent, Gerry

    1991-01-01

    A study of concerns and reactions of medical students affected by a disaster at a British football game found feelings of guilt, doubts about competence, concern about coping with stresses of being a physician, and difficult relationships with fellow students. Formal medical school teaching about posttraumatic stress disorder is recommended.…

  2. Checklist of British and Irish Hymenoptera - Braconidae

    PubMed Central

    Shaw, Mark R.; Godfray, H. Charles J.

    2016-01-01

    Abstract Background The checklist of British and Irish Braconidae is revised, based in large part on the collections of the National Museums of Scotland, Edinburgh, and the Natural History Museum, London. Distribution records are provided at the country level together with extensive synonymy and bibliography. New information Of the 1,338 species regarded as valid, presumed native and certainly identified, 83 are here recorded for the first time from the British Isles. One new synonym is established (Dyscritus suffolciensis Morley, 1933 = Syntretus splendidus (Marshall, 1887) syn. nov.) PMID:27226759

  3. Checklist of British and Irish Hymenoptera - Ichneumonidae

    PubMed Central

    2016-01-01

    Abstract Background The checklist of British and Irish Ichneumonidae is revised, based in large part on the collections of the Natural History Museum, London and the National Museums of Scotland, Edinburgh. Distribution records are provided at the country level. New information Of the 2,447 species regarded as valid and certainly identified, 214 are here recorded for the first time from the British Isles. Neorhacodinae is considered to be a separate subfamily rather than a synonym of Tersilochinae. Echthrini is treated as a junior synonym of the tribe Cryptini, not Hemigastrini. Echthrus Gravenhorst and Helcostizus Förster are classified in Cryptini rather than, respectively, Hemigastrini and Phygadeuontini. PMID:27733812

  4. Updated posters to help manage medical emergencies in the dental practice.

    PubMed

    Jevon, P

    2015-09-11

    Medical emergencies can occur in the dental practice. Medical Emergencies in the Dental Practice and Emergency Drugs in the Dental Practice posters have been designed to help dental practitioners to respond effectively and safely to a medical emergency. These posters, endorsed by the British Dental Association, are included with this issue of the British Dental Journal. Further copies can be downloaded from: https://www.walsallhealthcare.nhs.uk/medical-education.aspx.

  5. A Look at Some British Performing Arts Libraries

    ERIC Educational Resources Information Center

    Jones, John Frank

    1974-01-01

    Highlights of four special collections: British Broadcasting Company Reference Library; National Film Archives and Book Library of the British Film Institute; Theatre Section of the Victoria and Albert Museum; and the Shakespeare Collection of the Birmingham Municipal Reference Library. (LS)

  6. Characterization of a medical X-ray machine for testing the response of electronic dosimeters in pulsed radiation fields

    NASA Astrophysics Data System (ADS)

    Guimarães, Margarete C.; Da Silva, Teógenes A.

    2014-11-01

    Electronic personal dosimeters (EPD) based on solid state detectors have been used for personnel monitoring for radiation protection purpose; their use has been extended to practices with pulsed radiation beams although their performance is not well known. Deficiencies in the EPD response in pulsed radiation fields have been reported; they were not detected before since type tests and calibrations of EPDs were established in terms of continuous X and gamma reference radiations. An ISO working group was formed to elaborate a standard for test conditions and performance requirements of EPDs in pulsed beams; the PTB/Germany implemented a special X-ray facility for generating the reference pulsed radiation beams. In this work, an 800 Plus VMI medical X-ray machine of the Dosimeter Calibration Laboratory of CDTN/CNEN was characterized to verify its feasibility to perform EPD tests. Characterization of the x-ray beam was done in terms of practical peak voltage, half-value layer, mean energy and air kerma rate. Reference dosimeters used for air kerma measurements were verified as far their metrological coherence and a procedure for testing EDPs was established. Electronic personal dosimeters (EPD) have been used for personnel monitoring. EPD use has been extended to pulsed radiation beams. Deficiencies in the EPD response in pulsed beams have been reported. The feasibility of using a medical X-ray machine to perform EPD tests was studied. Reference dosimeters were verified and EPD testing procedure was established.

  7. British Romantic Generalism in the Age of Specialism, 1870–1990

    PubMed Central

    Casper, Stephen T.; Welsh, Rick

    2016-01-01

    This essay explores the impact of ‘generalism’ and ‘general practice’ on the specialisation of British medicine using the case of neurology in Britain to reveal characteristics of British ‘generalist medical culture’ from 1870 to 1990. It argues that ‘generalism’ represented a particular epistemological position in Victorian medicine, one that then created a natural bridge between science and medicine over which almost all physicians and scientists were comfortable walking. The legacies of that Victorian ‘generalist preference’ exerted an enduring impact on the specialisation process as physicians experienced it in the twentieth century and as this case of neurology reveals so clearly. Neurologists and general physicians would still be arguing about the relative merits of a general medical education into the 1980s. By then, however, the emergence of government bodies promoting specialist labour conditions would have rendered the process seemingly inexorable. PMID:26858515

  8. The history of British gynaecological pathology.

    PubMed

    Young, Robert H

    2009-01-01

    The venerable tradition of British gynaecological pathology is honoured by brief comments on those who have pioneered work in this arena, using as the starting point the remarkable Scottish physician Dr Matthew Baillie who, with his uncles, the legendary William and John Hunter, can arguably be considered the founders of medicine in Great Britain. The impact of Baillie's great work 'The Morbid Anatomy of Some of the Most Important Parts of the Human Body' is noted. Because of the fame they achieved in working in other areas, the contributions to gynaecological pathology of Thomas Hodgkin and Richard Bright, particularly the former, are often overlooked and are noted herein as is a remarkable book on the ovary by Charles G. Ritchie, published in 1865. The middle years of the 19th century were notable because of the activities of pioneering surgeons such as Sir Spencer Wells and Lawson Tait which gradually led to a greater emphasis on pathologic examination of specimens removed at operation, as opposed to autopsy evaluation. The closing years of the 19th century and early years of the 20th century were dominated by five individuals, Alban Doran, John Bland-Sutton, Cuthbert Lockyer, Elizabeth Hurdon and John Hammond Teacher. Doran wrote an early study of tubal carcinoma and a book on that organ and the ovary. Bland-Sutton was a remarkably influential surgeon with a significant interest in pathology and also contributed a book on the ovary and fallopian tube as well as one of the early good papers on metastatic tumours to the ovary. Lockyer wrote an outstanding book on uterine fibroids and established, and funded, a museum at Charing Cross Hospital. Hurdon can be considered the first female gynaecological pathologist. She spent much of her active career in the United States working at Johns Hopkins Hospital. She co-authored a monumental book on the appendix, likely never to be equalled. Teacher worked in Glasgow for many years and was almost single-handedly responsible

  9. The media and intellectuals' response to medical publications: the antidepressants' case

    PubMed Central

    2013-01-01

    During the last decade, there was a debate concerning the true efficacy of antidepressants. Several papers were published in scientific journals, but many articles were also published in the lay press and the internet both by medical scientists and academics from other disciplines or representatives of societies or initiatives. The current paper analyzes the articles authored by three representative opinion makers: one academic in medicine, one academic in philosophical studies, and a representative of an activists' group against the use of antidepressants. All three articles share similar gaps in knowledge and understanding of the scientific data and also are driven by an ‘existential-like’ ideology. In our opinion, these articles have misinterpreted the scientific data, and they as such may misinform or mislead the general public and policy makers, which could have a potential impact upon public health. It seems that this line of thought represents another aspect of the stigma attached to people suffering from mental illness. PMID:23587303

  10. Spontaneous skepticism: the interplay of motivation and expectation in responses to favorable and unfavorable medical diagnoses.

    PubMed

    Ditto, Peter H; Munro, Geoffrey D; Apanovitch, Anne M; Scepansky, James A; Lockhart, Lisa K

    2003-09-01

    The quantity of processing view of motivated reasoning predicts that individuals are more likely to spontaneously question the validity of unfavorable than favorable feedback even when the objective likelihood of the feedback is equivalent. Participants were videotaped self-administering a bogus medical test revealing either a favorable or an unfavorable result. In Studies 1 and 2, unfavorable result participants required more time to accept the validity of the test result and were more likely to spontaneously recheck its validity than were favorable result participants. However, unfavorable results also were perceived as less expected than were favorable results, even though the information supplied about their objective likelihood was identical. Study 3 showed that participants evaluating another student's results perceived favorable and unfavorable outcomes as equally likely, suggesting that the subjective likelihood of positive and negative feedback is also subject to motivational influence. PMID:15189608

  11. A Paramedic-staffed Helicopter Emergency Medical Service's Response to Winch Missions in Victoria, Australia.

    PubMed

    Meadley, Ben; Heschl, Stefan; Andrew, Emily; de Wit, Anthony; Bernard, Stephen A; Smith, Karen

    2016-01-01

    Winching emergency medical care providers from a helicopter to the scene enables treatment of patients in otherwise inaccessible locations, but is not without risks. The objective of this study was to define characteristics of winch missions undertaken by Intensive Care Flight Paramedics (ICFP) in Victoria, Australia with a focus on extraction methods and clinical care delivered at the scene. A retrospective data analysis was performed to identify all winch missions between November 2010 and March 2014. Demographic data, winch characteristics, physiological parameters, and interventions undertaken on scene by the ICFP were extracted. Out of 5,003 missions in the study period, 125 were identified as winch operations. Winter missions were significantly less frequent than those of any other season. Patients were predominantly male (78.4%) and had a mean age of 38 years (±17.6). A total of 109 (87.2%) patients were identified as experiencing trauma with a mean Revised Trauma Score of 7.5288, and isolated limb fractures were the most frequently encountered injury. Falls and vehicle-related trauma were the most common mechanisms of injury. The total median scene duration was 49 minutes (IQR 23-91). Sixty-three patients (50.4%) were extracted using a stretcher, 45 (36.0%) using a hypothermic strop, and 6 (4.8%) via normal rescue strop. Eleven patients (8.8%) were not winched to the helicopter. Vascular access (38.4%), analgesia (44.0%), and anti-emetic administration (28.8%) were the most frequent clinical interventions. Forty-nine patients (39.2%) did not receive any clinical intervention prior to winch extraction. Winch operations in Victoria, Australia consisted predominantly of patients with minor to moderate traumatic injuries. A significant proportion of patients did not require any clinical treatment prior to winching, and among those who did, analgesia was the most frequent intervention. Advanced medical procedures were rarely required prior to winch extraction.

  12. Pharmacists' perceptions of alternative health approaches--a comparison between U.S. and British pharmacists.

    PubMed

    Nelson, M V; Bailie, G R; Areny, H

    1990-04-01

    A survey was sent to 1,000 United States (U.S.) pharmacists (19.7% responded) and 750 British pharmacists (63.0% responded) to assess their perceived knowledge, perceived usefulness, referrals, and utilization of alternative health approaches (AHA). More than 50% of U.S. and British citizens had 'never heard of' or 'only heard of' about half of the 21 AHA assessed. Acupuncture was the AHA felt to be most useful by the majority of pharmacists, both in the U.S. (83.8%) and in Britain (91.0%). Osteopathy (38.6%) and chiropractic (33.5%) were most often referrals by U.S. pharmacists, whereas homeopathy (14.7%) and osteopathy (14.5%) were most often referrals by British pharmacists. The most utilized AHAs were osteopathy (21.8%) and chiropractic (19.3%) by U.S. pharmacists and homeopathy (10.1%) and herbal medicine (6.0%) by British pharmacists. Differences exist in the perceived knowledge, perception of usefulness, referrals, and utilization of AHAs between U.S. and British pharmacists. It is quite likely that the low-response rates, particularly among the U.S. pharmacists, may mask even greater ignorance about AHAs. It may also underestimate the proportion of pharmacists who are of the view that AHAs are useless and not worthy of answering questions about. PMID:2341492

  13. British and Pakistani children's understanding of death: cultural and developmental influences.

    PubMed

    Panagiotaki, Georgia; Nobes, Gavin; Ashraf, Aisha; Aubby, Herjit

    2015-03-01

    This study explored British and Pakistani 4- to 7-year-olds' (N = 188) understanding of death. The aim was to examine possible influences on the acquisition of the subcomponents of the death concept by investigating how they are understood by children of different ages and cultural and religious backgrounds. Three groups of children were compared: White British and British Muslim living in London, and Pakistani Muslim living in rural Pakistan. In line with previous research (Slaughter, 2005, Aust. Psychol., 40(3), 179), irreversibility of death was one of the first subcomponents to be acquired, while causality was the last. The two groups of British children shared many similarities in their understanding of inevitability, applicability, irreversibility, and cessation. Pakistani Muslim children understood irreversibility earlier than did children in both British groups. In all three cultural groups, children's responses demonstrated very limited understanding of causality. Our findings support the view that aspects of a mature understanding of death develop between the ages of 4 and 7 years and that the process of understanding death as a biological event is, to a great extent, universal. They also suggest that aspects of children's reasoning are influenced by culturally specific experiences, particularly those arising from living in rural versus urban settings.

  14. Pharmacists' perceptions of alternative health approaches--a comparison between U.S. and British pharmacists.

    PubMed

    Nelson, M V; Bailie, G R; Areny, H

    1990-04-01

    A survey was sent to 1,000 United States (U.S.) pharmacists (19.7% responded) and 750 British pharmacists (63.0% responded) to assess their perceived knowledge, perceived usefulness, referrals, and utilization of alternative health approaches (AHA). More than 50% of U.S. and British citizens had 'never heard of' or 'only heard of' about half of the 21 AHA assessed. Acupuncture was the AHA felt to be most useful by the majority of pharmacists, both in the U.S. (83.8%) and in Britain (91.0%). Osteopathy (38.6%) and chiropractic (33.5%) were most often referrals by U.S. pharmacists, whereas homeopathy (14.7%) and osteopathy (14.5%) were most often referrals by British pharmacists. The most utilized AHAs were osteopathy (21.8%) and chiropractic (19.3%) by U.S. pharmacists and homeopathy (10.1%) and herbal medicine (6.0%) by British pharmacists. Differences exist in the perceived knowledge, perception of usefulness, referrals, and utilization of AHAs between U.S. and British pharmacists. It is quite likely that the low-response rates, particularly among the U.S. pharmacists, may mask even greater ignorance about AHAs. It may also underestimate the proportion of pharmacists who are of the view that AHAs are useless and not worthy of answering questions about.

  15. The Native Courtworker and Counselling Association of British Columbia. Annual Report, 1980-81.

    ERIC Educational Resources Information Center

    Native Courtworker and Counseling Association of British Columbia, Vancouver.

    The Native Courtworker and Counselling Association of British Columbia, with objectives of providing courtworker services for Native Indians charged with offenses; supplying information on legal rights, responsibilities, and operation of the justice system; and reducing the number of Native people in conflict with the law, handled 4,860 Native…

  16. Contesting the Limond Thesis on British Influence in Irish Education since 1922: A Comparative Perspective

    ERIC Educational Resources Information Center

    O'Donoghue, Tom; Harford, Judith

    2012-01-01

    This paper is a response to David Limond's exposition, "[An] historical culture ... rapidly, universally, and thoroughly restored"? British influence on Irish education since 1922, which appeared in "Comparative Education", Vol. 46, No. 4, November 2010, pp. 449-462. Limond's overall thesis is that "a post-colonial overhang affects Irish…

  17. Continuing Education Activities of the University of British Columbia, 1977/1978.

    ERIC Educational Resources Information Center

    British Columbia Univ., Vancouver.

    The 1977-78 annual report on continuing education activities of the University of British Columbia is presented. The provision of continuing education by the university is decentralized. Several administrative units are responsible for credit and noncredit, general and professional continuing education, and professional development. The following…

  18. A Comparative Study of Moral Development of Korean and British Children.

    ERIC Educational Resources Information Center

    Baek, Hye-Jeong

    2002-01-01

    Explores Lawrence Kohlberg's theory of moral development in relation to Korean and British children. Illustrates cultural differences in moral orientations. Notes it was not possible to match responses from Korean children to Kohlberg's manual. Suggests that interpretation of children's moral reasoning should be based on consideration of cultural…

  19. British Students' Perceptions of Ethical Issues in International Marketing: An Empirical Investigation.

    ERIC Educational Resources Information Center

    Amin, Sammy G.

    1996-01-01

    A survey investigated 122 British business students' perceptions of ethics in international marketing practices, particularly as they are affected by demographic characteristics. In response to 12 specific scenarios, students indicated relatively liberal attitudes. Implications for global marketing specialists and for business education are…

  20. Pilot investigation of the utility of a student response system in medical student lectures.

    PubMed

    Roy, K H

    1996-03-01

    An evaluation of a student response system was undertaken to investigate its effect on lectures. Use of the system in lectures at the University of Wales College of Medicine (UWCM) was observed for a trial period. Analyses of these observations, and the opinions of lecturers and students who used the system suggest that the system improves upon the 'conventional' lecture in various ways. Such benefits, and some limitations, are discussed. It is suggested that student response systems such as the one described may be a step towards making 'the lecture' a more effective medium for teaching.

  1. A Change of Heart? British Policies towards Tubercular Refugees during 1959 World Refugee Year.

    PubMed

    Taylor, Becky

    2015-01-01

    This article looks at Britain's response to the World Refugee Year (1959-60), and in particular the government's decision to allow entry to refugees with tuberculosis and other chronic illnesses. In doing so, it broke the practice established by the 1920 Aliens' Order which had barred entry to immigrants with a range of medical conditions. This article uses the entry of these sick refugees as an opportunity to explore whether government policy represented as much of a shift in attitude and practice as contemporary accounts suggested. It argues for the importance of setting the reception of tubercular and other 'disabled' refugees in 1959-61 in its very particular historical context, showing it was a case less of the government thinking differently about refugees, and more of how, in a post-Suez context, the government felt obliged to take into account international and public opinion. The work builds on and adds to the growing literature surrounding refugees and disease. It also places the episode within the specificity of the post-war changing epidemiological climate; the creation of the National Health Service; and the welfare state more broadly. In looking at the role of refugee organizations in the Year, the article also contributes to debates over the place of voluntary agencies within British society.

  2. A Change of Heart? British Policies towards Tubercular Refugees during 1959 World Refugee Year.

    PubMed

    Taylor, Becky

    2015-01-01

    This article looks at Britain's response to the World Refugee Year (1959-60), and in particular the government's decision to allow entry to refugees with tuberculosis and other chronic illnesses. In doing so, it broke the practice established by the 1920 Aliens' Order which had barred entry to immigrants with a range of medical conditions. This article uses the entry of these sick refugees as an opportunity to explore whether government policy represented as much of a shift in attitude and practice as contemporary accounts suggested. It argues for the importance of setting the reception of tubercular and other 'disabled' refugees in 1959-61 in its very particular historical context, showing it was a case less of the government thinking differently about refugees, and more of how, in a post-Suez context, the government felt obliged to take into account international and public opinion. The work builds on and adds to the growing literature surrounding refugees and disease. It also places the episode within the specificity of the post-war changing epidemiological climate; the creation of the National Health Service; and the welfare state more broadly. In looking at the role of refugee organizations in the Year, the article also contributes to debates over the place of voluntary agencies within British society. PMID:26411063

  3. The response of academic medical centers to the 2010 Haiti earthquake: the Mount Sinai School of Medicine experience.

    PubMed

    Ripp, Jonathan A; Bork, Jacqueline; Koncicki, Holly; Asgary, Ramin

    2012-01-01

    On January 12, 2010, Haiti was struck by a 7.0 earthquake which left the country in a state of devastation. In the aftermath, there was an enormous relief effort in which academic medical centers (AMC) played an important role. We offer a retrospective on the AMC response through the Mount Sinai School of Medicine (MSSM) experience. Over the course of the year that followed the Earthquake, MSSM conducted five service trips in conjunction with two well-established groups which have provided service to the Haitian people for over 15 years. MSSM volunteer personnel included nurses, resident and attending physicians, and specialty fellows who provided expertise in critical care, emergency medicine, wound care, infectious diseases and chronic disease management of adults and children. Challenges faced included stressful and potentially hazardous working conditions, provision of care with limited resources and cultural and language barriers. The success of the MSSM response was due largely to the strength of its human resources and the relationship forged with effective relief organizations. These service missions fulfilled the institution's commitment to social responsibility and provided a valuable training opportunity in advocacy. For other AMCs seeking to respond in future emergencies, we suggest early identification of a partner with field experience, recruitment of administrative and faculty support across the institution, significant pre-departure orientation and utilization of volunteers to fundraise and advocate. Through this process, AMCs can play an important role in disaster response.

  4. Biological response of Sr-containing coating with various surface treatments on titanium substrate for medical applications

    NASA Astrophysics Data System (ADS)

    Yang, Shih-Ping; Lee, Tzer-Min; Lui, Truan-Sheng

    2015-08-01

    An implant requires a suitable surface to trigger osteointegration. The surface characteristics and chemical composition are important factors in this process. Plasma spraying and micro-arc oxidation can be used to fabricate rough and porous structures for medical applications. Strontium (Sr) has been shown to prevent osteoporosis in vitro and in vivo. However, few scientists have evaluated the biological response of Sr-containing coatings on different surface treatments. In this study, a sand-blasted (SB) surface (as the control), plasma-sprayed hydroxyapatite (HA) and Sr-substituted HA coatings (HAPS and SrHAPS, respectively), calcium phosphate and Sr-containing calcium phosphate micro-arc oxidation surface (CPM and SrCPM, respectively) were analyzed in terms of human osteoblastic cell (MG63) response. Sr was confirmed to be incorporated into the surface. SrHAPS and SrCPM specimens had higher cell responses than those of the HAPS and CPM groups, respectively. The cells cultured on SrCPM and SrHAPS specimens exhibited high proliferation and differentiation. However, CPM and SrCPM specimens stimulated more ECM-like structures than other specimens. The results show that Sr-containing coatings have good characteristics that enhance cell response. The SrCPM coating is a suitable implant surface treatment for clinical applications.

  5. Mobile Phones, in Combination with a Computer Locator System, Improve the Response Times of Emergency Medical Services in Central London

    PubMed Central

    Gossage, JA; Frith, DP; Carrell, TWG; Damiani, M; Terris, J; Burnand, KG

    2008-01-01

    INTRODUCTION The aim of this study was to determine whether mobile phones and mobile phone locating devices are associated with improved ambulance response times in central London. PATIENTS AND METHODS All calls from the London Ambulance Service database since 1999 were analysed. In addition, 100 consecutive patients completed a questionnaire on mobile phone use whilst attending the St Thomas's Hospital Emergency Department in central London. RESULTS Mobile phone use for emergencies in central London has increased from 4007 (5% of total) calls in January 1999 to 21,585 (29%) in August 2004. Ambulance response times for mobile phone calls were reduced after the introduction of the mobile phone locating system (mean 469 s versus 444 s; P = 0.0195). The proportion of mobile phone calls made from mobile phones for life-threatening emergencies was higher after injury than for medical emergencies (41% versus 16%, P = 0.0063). Of patients transported to the accident and emergency department by ambulance, 44% contacted the ambulance service by mobile phone. Three-quarters of calls made from outside the home or work-place were by mobile phone and 72% of patients indicated that it would have taken longer to contact the emergency services if they had not used a mobile. CONCLUSIONS Since the introduction of the mobile phone locating system, there has been an improvement in ambulance response times. Mobile locating systems in urban areas across the UK may lead to faster response times and, potentially, improved patient outcomes. PMID:18325208

  6. British International Schools: The Deployment and Training of Teaching Assistants

    ERIC Educational Resources Information Center

    Tarry, Estelle

    2011-01-01

    This article reports on research carried out on behalf of the Council of British International Schools (COBIS) as to the role and deployment of British international school teaching assistants. Through questionnaires and a follow up open discussion with headteachers from British international schools it was found that, due to the differing…

  7. A Firsthand Look at the British Open School.

    ERIC Educational Resources Information Center

    Staley, Gerald J.

    The author of this informal critique of the British Open School spent the 1972-73 academic year as a teacher in London's Battersea School as part of an exchange program in which six British open school teachers exchanged places with six teachers from British Columbia, Canada. After a brief description of the daily and weekly program at Battersea…

  8. Constructions of Racism by British Chinese Pupils and Parents

    ERIC Educational Resources Information Center

    Archer, Louise; Francis, Becky

    2005-01-01

    British Chinese pupils stand out as a high achieving group within the British education system and yet very little theoretical or policy attention has been given to these pupils' identities and experiences of education. In this paper we consider British Chinese pupils' (and parents') reports of their experiences of racism/s and their views on the…

  9. Children with HIV Infection: Collaborative Responsibilities of the Child Welfare and Medical Communities.

    ERIC Educational Resources Information Center

    Boland, Mary G.; And Others

    1988-01-01

    Describes collaborative efforts of New Jersey Department of Human Services child welfare division and the New Jersey Children's Hospital AIDS (Acquired Immune Deficiency Syndrome) Program to care for children with human immunodeficiency virus. Contends child welfare and health care communities have responsibility to provide comprehensive,…

  10. British Chinese Children: Agency and Action

    ERIC Educational Resources Information Center

    Clayton, Carmen Lau

    2013-01-01

    The assumption that Chinese young people are passive beings with little or no agency is a dominant theme within the academic literature. However PhD research findings demonstrate how British Chinese adolescents (aged 11-14) do exhibit varying degrees of agency in their lives. Here, agency is understood as individuals having the capacity to act, to…

  11. Indians of British Columbia (An Historical Review).

    ERIC Educational Resources Information Center

    Department of Indian Affairs and Northern Development, Ottawa (Ontario).

    An historical review is presented of the 6 major groups of Indians of the coastal region of British Columbia: the Coast Salish, Nootka, Kwakiutl, Bella Coola, Tsimshian, and Haida. Characteristics of each tribe are contrasted in the following 7 sections of the review: (1) Introduction--the life style, sociocultural factors, and unique…

  12. Macro and Microenvironments at the British Library.

    ERIC Educational Resources Information Center

    Shenton, Helen

    This paper describes the storage of the 12 million items that have just been moved into the new British Library building. The specifications for the storage and environmental conditions for different types of library and archive material are explained. The varying environmental parameters for storage areas and public areas, including reading rooms…

  13. Martin Trow on British Higher Education

    ERIC Educational Resources Information Center

    Silver, Harold

    2009-01-01

    For almost half a century from the early 1960s Martin Trow was the most persistent American commentator on British higher education. He analysed the main reports from Robbins to Dearing, developed and applied a language for discussing common problems amongst different systems, and focused on the uncertain progress of the UK to mass higher…

  14. Gnathostomiasis Acquired by British Tourists in Botswana

    PubMed Central

    Wall, Emma C.; van Tulleken, Christoffer; Godfrey-Faussett, Peter; Bailey, Robin L.; Chiodini, Peter L.

    2009-01-01

    Infection with Gnathostoma spinigerum has been generally confined to Southeast Asia and Central and South America. However, gnathostomiasis was recently found in British tourists who had visited Botswana. Consequently, travel to Africa should now be considered a risk factor for gnathostomiasis. PMID:19331741

  15. British Columbia water quality guidelines, criteria

    SciTech Connect

    1998-12-31

    This publication contains tables summarizing approved water quality guidelines for various contaminants that may be present in British Columbia water supplies. It begins with a section in question and answer format that explains certain aspects of the guidelines. Contaminants covered by the guidelines include particulate matter, nutrients and algae, aluminium, lead, mercury, nitrogen, dissolved oxygen, copper, chlorine, fluoride, hydrocarbons, pH, and silver.

  16. First Employment of British Pharmacology Graduates

    ERIC Educational Resources Information Center

    Hollingsworth, Michael; Markham, Anthony

    2006-01-01

    A survey was conducted in UK Universities to identify the employment of pharmacology graduates (BSc, MSc and PhD) 6 months after graduation in 2003. The aim was to provide data for the British Pharmacological Society (BPS) so they could offer advice to interested bodies and to University staff for careers information. 85% of 52 Universities…

  17. The British Novel: Conrad to the Present.

    ERIC Educational Resources Information Center

    Wiley, Paul L.

    Intended for advanced undergraduate and graduate students who desire a useful research tool, this bibliography cites the works of and about British novelists, beginning with Joseph Conrad and terminating in 1950. The listings are selective with proper emphasis given to less celebrated but distinctive writers. A preface explaining the numerous…

  18. Drivers of Cousin Marriage among British Pakistanis

    PubMed Central

    Shaw, Alison

    2014-01-01

    Background/Aim Why has the apparently high rate of cousin marriage among Bradford Pakistanis been sustained, 50 years since Pakistani migration to Britain began? Methods A review of the anthropological literature on Pakistani migration and settlement, British Pakistani marriage patterns and the phenomenon of transnational marriage. Results British Pakistanis are diverse in regional origins and social class characteristics, with many Bradford Pakistanis originating from the Mirpur district and northern Punjab. British Pakistani marriages often involve a partner from Pakistan who joins a spouse in the UK. Transnational marriage of first cousins offers relatives in Pakistan opportunities for a ‘better’ life in the West and are important for British Pakistanis for economic, social, cultural and emotional reasons. These processes are also differentially influenced by region of origin and class characteristics in Pakistan as well as by education, employment and locality in Britain. The pattern observed in Bradford may not be applicable nationally. Conclusion Further research examining marital decisions over several generations in families differing by social class, region of origin in Pakistan and locality in Britain is necessary to contextualise the findings from Bradford. PMID:25060267

  19. Representations of St Apollonia in British churches.

    PubMed

    Beal, J F

    1996-05-01

    St Apollonia is the patron saint of sufferers from toothache. Many medieval churches contain pictures of saints. Fifty-five representations of St Apollonia in British churches are listed. A large number of these are in the West Country and East Anglia. The majority are on rood screens or stained glass windows.

  20. Considerations for Education Reform in British Columbia

    ERIC Educational Resources Information Center

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  1. A History of Modern British Adult Education.

    ERIC Educational Resources Information Center

    Fieldhouse, Roger

    The purpose of this book is: to set the historical development of British adult education in its wider policy and ideological context; to examine its various forms and formulations; and to identify what purpose or purposes it has served. The 16 chapters are as follows: "Historical and Political Context" (Roger Fieldhouse); "The Nineteenth Century"…

  2. British Writers; Modules for Teacher Corps.

    ERIC Educational Resources Information Center

    Gilliard, Fred

    This booklet, containing eight instructional modules on works by major British writers, can be used either within a lower-level literature course for non-English majors or in a survey course for English majors. The first four modules focus on works from the early English period through the Elizabethan Age: "Beowulf,""Sir Gawain and the Green…

  3. British Columbia. Reference Series No. 25.

    ERIC Educational Resources Information Center

    Department of External Affairs, Ottawa (Ontario).

    This booklet, one of a series featuring the Canadian provinces, presents a brief overview of British Columbia and is suitable for teacher reference or student reading. A discussion of the province's history includes the early European explorers, Indian natives, and later fur traders and settlers. The building of the transcontinental railway, entry…

  4. Vocational and Civic Education: Whither British Policy?

    ERIC Educational Resources Information Center

    Winch, Christopher

    2012-01-01

    The current crisis in British VET (Vocational Education and Training) is explained in terms of the decline of opportunities beyond preparation for university for young people after school. The continuing large numbers of "NEETS" (those not in employment, education or training) is but one aspect of this problem: much larger is the decline in good…

  5. British I.T.A. Research.

    ERIC Educational Resources Information Center

    Downing, John

    1968-01-01

    The conclusions and recommendations drawn from a 7-year study of the Initial Teaching Alphabet (i/t/a) made by the Reading Research Unit of London University are reported. The British research showed conclusively that traditional orthography (TO) is a major handicap for teachers and students of reading. Students taught with i/t/a made…

  6. HIV Prevalence among Aboriginal British Columbians

    PubMed Central

    Hogg, Robert S; Strathdee, Steffanie; Kerr, Thomas; Wood, Evan; Remis, Robert

    2005-01-01

    Context There is considerable concern about the spread of HIV disease among Aboriginal peoples in British Columbia. Objective To estimate the number of Aboriginal British Columbians infected with HIV. Design and setting A population-based analysis of Aboriginal men and women in British Columbia, Canada from 1980 to 2001. Participants Epidemic curves were fit for gay and bisexual men, injection drug users, men and women aged 15 to 49 years and persons over 50 years of age. Main outcome measures HIV prevalence for the total Aboriginal population was modeled using the UNAIDS/WHO Estimation and Projection Package (EPP). Monte Carlo simulation was used to estimate potential number infected for select transmission group in 2001. Results A total of 170,025 Aboriginals resided in British Columbia in 2001, of whom 69% were 15 years and older. Of these 1,691 (range 1,479 – 1,955) men and women aged 15 years and over were living with HIV with overall prevalence ranging from 1.26% to 1.66%. The majority of the persons infected were men. Injection drug users (range 1,202 – 1,744) and gay and bisexual men (range 145, 232) contributed the greatest number of infections. Few persons infected were from low risk populations. Conclusion More than 1 in every 100 Aboriginals aged 15 years and over was living with HIV in 2001. Culturally appropriate approaches are needed to tailor effective HIV interventions to this community. PMID:16375771

  7. The British Experience of Reform in Education.

    ERIC Educational Resources Information Center

    Johnes, Geraint

    1996-01-01

    The nature and impact of reforms since 1988 in British education, both compulsory and postsecondary, are examined, focusing on changes in organizational structure and financing mechanisms. The success of these changes in meeting their objectives is assessed, and unresolved issues are identified. (MSE)

  8. Live from Westminster: Broadcasting the British Parliament.

    ERIC Educational Resources Information Center

    Scott, Peter Hardiman

    1978-01-01

    Describes live radio broadcasting from the chambers of the British Parliament. After 55 years of campaigning by broadcasters and Members of Parliament, and following experimental broadcasting by the BBC and Independent Local Radio, service was installed in April 1978. Initial experimentation, current procedures, and implications for television…

  9. The Discourses of British Domestic Sitcom.

    ERIC Educational Resources Information Center

    Bee, Jim

    This analysis of the British domestic situation comedy (sitcom) as a genre begins by noting that it is considered basically taxonomical, using the categories of character, narrative, and theme to develop understanding of its discursive strategies. Considered to be preliminary and tentative, the results of this analysis suggest that: (1) the sitcom…

  10. Earnings Returns to the British Education Expansion

    ERIC Educational Resources Information Center

    Devereux, Paul J.; Fan, Wen

    2011-01-01

    We study the effects of the large expansion in British educational attainment that took place for cohorts born between 1970 and 1975. Using the Quarterly Labour Force Survey, we find that the expansion caused men to increase education by about a year on average and gain about 8% higher wages; women obtained a slightly greater increase in education…

  11. Evaluation of Prescriber Responses to Pharmacist Recommendations Communicated by Fax in a Medication Therapy Management Program (MTMP)

    PubMed Central

    Perera, Prasadini N.; Guy, Mignonne C.; Sweaney, Ashley M.; Boesen, Kevin P.

    2016-01-01

    BACKGROUND As defined by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, medication therapy management programs (MTMPs) must be designed to decrease adverse drug events and improve patient outcomes by promoting appropriate medication use. WellPoint Inc. contracted with the pharmacist-run University of Arizona College of Pharmacy Medication Management Center (UA MMC) to provide a pilot telephone-based MTMP to approximately 5,000 high-risk beneficiaries from among its nearly 2 million Medicare prescription drug plan (PDP) beneficiaries. Eligibility for the program was determined by a minimum of 2 of 6 chronic diseases (dyslipidemia, cardiovascular disease, depression, diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease; at least 1 of the latter 2 diseases must be present), at least 3 Part-D covered medications, and greater than $4,000 per year in predicted drug spending. In addition to these criteria, WellPoint Inc. used the Johns Hopkins adjusted clinical groups (ACG) predictive model to identify the high-risk beneficiaries to be enrolled in the program. Medication therapy reviews were conducted for these patients. If any medication-related problems (MRPs) were identified, the patient’s prescribers were contacted via a fax communication with recommendation(s) to resolve these MRPs. The UA MMC fax interventions were categorized as cost saving, guideline adherence, or safety concerns. OBJECTIVES To (a) determine prescriber responses to pharmacist-initiated recommendations in an MTMP for the 3 intervention categories, (b) compare prescriber responses between intervention categories, and (c) compare prescriber response by prescriber type (primary care physician [PCP] vs. specialist) within each intervention category. METHODS A retrospective analysis of pharmacist-initiated interventions from August through December 2008 was performed using data collected from the UA MMC database. Data were collected on

  12. The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics - A Study of Medical Ethics Using Immersive Virtual Reality

    PubMed Central

    Pan, Xueni; Slater, Mel; Beacco, Alejandro; Navarro, Xavi; Bellido Rivas, Anna I.; Swapp, David; Hale, Joanna; Forbes, Paul Alexander George; Denvir, Catrina; de C. Hamilton, Antonia F.; Delacroix, Sylvie

    2016-01-01

    Background Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner’s daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor’s response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. Experiment Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. Results Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants’ level of presence (together with participants’ feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening. PMID:26889676

  13. [Response of bone metastases to medical treatment: definition of evaluation criteria and classification trials].

    PubMed

    Belpomme, D; Droz, J P; Marie, F N; Namer, M; Tan, T N; Pecking, A; Rouesse, J; Vanel, D; Bock, P; Cappelaere, P

    1989-01-01

    Bone metastases are very frequent. Some are sensitive to the action of anticancer drugs. However, there is as yet an unsolved methodological problem in the evaluation of response to these drugs. The uniquely radiological UICC criteria are quite insufficient, in as much as they appear with a long delay and sometimes give erroneous results. In this work we give a brief review of biological and clinical knowledge about bone metastases, and we attempt to give an array of the possible evaluation criteria and their respective value. We propose as a working hypothesis a classification of responses taking into account the criteria: the urinary hydroxyproline to urinary creatinine ratio, the serum dosage of bone isoenzyme of alkaline phosphatase and propeptide of type III procollagen (P III NP), and as an essential element, an analysis of all available imaging techniques. A visual study of bone scintillation scans must precede that of radiographs and, when possible, it must be associated to computerized scintillation scanning. When metastasis are located to the pelvis, the vertebral column, or the sternum, a CT scan or better, a nuclear magnetic resonance study (IRM), is indispensable in order to have a direct measure of the tumor extension to soft tissues. Furthermore, in the case of isolated metastases, one of these imaging techniques allows a diagnostic biopsy. Finally an analysis of response at the bone level will always be associated with a measure of their duration and an evaluation of metastases to other sites.

  14. Parental Anxiety as a Predictor of Medication and CBT Response for Anxious Youth

    PubMed Central

    Gonzalez, Araceli; Peris, Tara S.; Vreeland, Allison; Kiff, Cara J.; Kendall, Philip C.; Compton, Scott N.; Albano, Anne Marie; Birmaher, Boris; Ginsburg, Golda S.; Keeton, Courtney P.; March, John; McCracken, James; Rynn, Moira; Sherrill, Joel; Walkup, John T.; Piacentini, John

    2014-01-01

    The aim of this investigation was to evaluate how parental anxiety predicted change in pediatric anxiety symptoms across four different interventions: cognitive-behavioral therapy (CBT), medication (sertraline; SRT), their combination (COMB), and pill placebo. Participants were 488 youths (ages 7-17) with separation anxiety disorder, generalized anxiety disorder, and/or social phobia and their primary caregivers. Latent growth curve modeling assessed how pre-treatment parental trait anxiety symptoms predicted trajectories of youth anxiety symptom change across 12 weeks of treatment at four time points. Interactions between parental anxiety and treatment condition were tested. Parental anxiety was not associated with youth’s pre-treatment anxiety symptom severity. Controlling for parental trait anxiety, youth depressive symptoms, and youth age, youths who received COMB benefitted most. Counter to expectations, parental anxiety influenced youth anxiety symptom trajectory only within the SRT condition, whereas parental anxiety was not significantly associated with youth anxiety trajectories in the other treatment conditions. Specifically, within the SRT condition, higher levels of parental anxiety predicted a faster and greater reduction in youth anxiety over the acute treatment period compared to youths in the SRT condition whose parents had lower anxiety levels. While all active treatments produced favorable outcomes, results provide insight regarding the treatment-specific influence of parental anxiety on the time course of symptom change. (ClinicalTrials.gov number NCT00052078.) PMID:24610431

  15. Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

    PubMed Central

    Green, Bonnie L.; Saunders, Pamela A.; Power, Elizabeth; Dass-Brailsford, Priscilla; Schelbert, Kavitha Bhat; Giller, Esther; Wissow, Larry; Hurtado de Mendoza, Alejandra; Mete, Mihriye

    2016-01-01

    Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.

  16. Emergency contraception under attack in Latin America: response of the medical establishment and civil society.

    PubMed

    Faúndes, Aníbal; Távara, Luis; Brache, Vivian; Alvarez, Frank

    2007-05-01

    The concept that it is possible to prevent a pregnancy after coitus is not new, but has gained prominence over the last 10-15 years. It provides a second chance to women who do not want to get pregnant and who, voluntarily or not, have had unprotected intercourse. Emergency contraception has been under strong attack by the Catholic church and anti-choice organisations in Latin America, who claim that the interference with implantation of the fertilised ovum is equivalent to an early abortion. The accumulation of evidence, however, is that the mechanism of action of emergency contraception is to prevent ovulation and that it does not interfere with implantation. This has been ignored by the anti-choice movement. The pattern of opposition to emergency contraception has been the same all over the Latin America region. The medical establishment and civil society, including the International Consortium for Emergency Contraception, have played a key role in defending access to emergency contraception throughout the region. A positive consequence of the public opposition of the Catholic church is that the concept and the method have become better known, and emergency contraception has become widely used. The cases of Peru, Brazil and Chile are described as examples.

  17. Parental anxiety as a predictor of medication and CBT response for anxious youth.

    PubMed

    Gonzalez, Araceli; Peris, Tara S; Vreeland, Allison; Kiff, Cara J; Kendall, Philip C; Compton, Scott N; Albano, Anne Marie; Birmaher, Boris; Ginsburg, Golda S; Keeton, Courtney P; March, John; McCracken, James; Rynn, Moira; Sherrill, Joel; Walkup, John T; Piacentini, John

    2015-02-01

    The aim of this investigation was to evaluate how parental anxiety predicted change in pediatric anxiety symptoms across four different interventions: cognitive-behavioral therapy, medication (sertraline; SRT), their combination (COMB), and pill placebo. Participants were 488 youths (ages 7-17) with separation anxiety disorder, generalized anxiety disorder, and/or social phobia and their primary caregivers. Latent growth curve modeling assessed how pre-treatment parental trait anxiety symptoms predicted trajectories of youth anxiety symptom change across 12 weeks of treatment at four time points. Interactions between parental anxiety and treatment condition were tested. Parental anxiety was not associated with youth's pre-treatment anxiety symptom severity. Controlling for parental trait anxiety, youth depressive symptoms, and youth age, youths who received COMB benefitted most. Counter to expectations, parental anxiety influenced youth anxiety symptom trajectory only within the SRT condition, whereas parental anxiety was not significantly associated with youth anxiety trajectories in the other treatment conditions. Specifically, within the SRT condition, higher levels of parental anxiety predicted a faster and greater reduction in youth anxiety over the acute treatment period compared to youths in the SRT condition whose parents had lower anxiety levels. While all active treatments produced favorable outcomes, results provide insight regarding the treatment-specific influence of parental anxiety on the time course of symptom change.

  18. Emergency contraception under attack in Latin America: response of the medical establishment and civil society.

    PubMed

    Faúndes, Aníbal; Távara, Luis; Brache, Vivian; Alvarez, Frank

    2007-05-01

    The concept that it is possible to prevent a pregnancy after coitus is not new, but has gained prominence over the last 10-15 years. It provides a second chance to women who do not want to get pregnant and who, voluntarily or not, have had unprotected intercourse. Emergency contraception has been under strong attack by the Catholic church and anti-choice organisations in Latin America, who claim that the interference with implantation of the fertilised ovum is equivalent to an early abortion. The accumulation of evidence, however, is that the mechanism of action of emergency contraception is to prevent ovulation and that it does not interfere with implantation. This has been ignored by the anti-choice movement. The pattern of opposition to emergency contraception has been the same all over the Latin America region. The medical establishment and civil society, including the International Consortium for Emergency Contraception, have played a key role in defending access to emergency contraception throughout the region. A positive consequence of the public opposition of the Catholic church is that the concept and the method have become better known, and emergency contraception has become widely used. The cases of Peru, Brazil and Chile are described as examples. PMID:17512384

  19. RealityFlythrough: Enhancing Situational Awareness for Medical Response to Disasters Using Ubiquitous Video

    PubMed Central

    McCurdy, Neil J.; Griswold, William G; Lenert, Leslie A.

    2005-01-01

    The first moments at a disater scene are chaotic. The command center initially operates with little knowledge of hazards, geography and casualties, building up knowledge of the event slowly as information trickles in by voice radio channels. RealityFlythrough is a tele-presence system that stitches together live video feeds in real-time, using the principle of visual closure, to give command center personnel the illusion of being able to explore the scene interactively by moving smoothly between the video feeds. Using RealityFlythrough, medical, fire, law enforcement, hazardous materials, and engineering experts may be able to achieve situational awareness earlier, and better manage scarce resources. The RealityFlythrough system is composed of camera units with off-the-shelf GPS and orientation systems and a server/viewing station that offers access to images collected by the camera units in real time by position/orientation. In initial field testing using an experimental mesh 802.11 wireless network, two camera unit operators were able to create an interactive image of a simulated disaster scene in about five minutes. PMID:16779092

  20. Medication type modifies inflammatory response to traffic exposure in a population with type 2 diabetes.

    PubMed

    Rioux, Christine L; Tucker, Katherine L; Brugge, Doug; Mwamburi, Mkaya

    2015-07-01

    The association between residential traffic exposure and change in C-reactive protein over 2-years was evaluated using multivariate linear regression including interaction models for traffic and diabetes medication use/type (insulin vs. oral hypoglycemic agents (OHAs)). The study population was Puerto Rican adults (n = 356) residing in greater Boston with type 2 diabetes. Traffic was characterized as proximity to roads with >20,000 weekday traffic volumes, and multi-directional traffic density. Increases in CRP concentration were significantly associated with residence ≤100 m of a roadway (p = 0.009) or near multiple roadways (p < 0.001), vs. further away, for individuals using insulin in stratified models, with consistent results in interaction models (p = 0.071 and p = 0.002). CRP was significantly lower with highest traffic density exposure in stratified (p = 0.03) and interaction models (p = 0.024) for individuals using OHAs. Individuals on insulin experienced increased CRP concentrations with traffic exposure over a 2-year study period, while those using OHAs did not experience increases.

  1. RealityFlythrough: enhancing situational awareness for medical response to disasters using ubiquitous video.

    PubMed

    McCurdy, Neil J; Griswold, William G; Lenert, Leslie A

    2005-01-01

    The first moments at a disaster scene are chaotic. The command center initially operates with little knowledge of hazards, geography and casualties, building up knowledge of the event slowly as information trickles in by voice radio channels. RealityFlythrough is a tele-presence system that stitches together live video feeds in real-time, using the principle of visual closure, to give command center personnel the illusion of being able to explore the scene interactively by moving smoothly between the video feeds. Using RealityFlythrough, medical, fire, law enforcement, hazardous materials, and engineering experts may be able to achieve situational awareness earlier, and better manage scarce resources. The RealityFlythrough system is composed of camera units with off-the-shelf GPS and orientation systems and a server/viewing station that offers access to images collected by the camera units in real time by position/orientation. In initial field testing using an experimental mesh 802.11 wireless network, two camera unit operators were able to create an interactive image of a simulated disaster scene in about five minutes. PMID:16779092

  2. An Examination of the Effects of Stimulant Medication on Response Inhibition: A Comparison between Children with and without Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Brackenridge, Rachel; McKenzie, Karen; Murray, George C.; Quigley, April

    2011-01-01

    This study investigated whether methylphenidate is effective in improving response inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD were compared with normally developing children on measures of response inhibition. Participants with ADHD were compared across two conditions--medicated and unmedicated.…

  3. Medical hypophysectomy: I. Dose-response using a gonadotropin-releasing hormone antagonist.

    PubMed

    Kenigsberg, D; Littman, B A; Hodgen, G D

    1984-07-01

    The hypothalamic-pituitary-ovarian axis can be "dissected" in a nonsurgical and reversible fashion by the administration of a potent gonadotropin-releasing hormone (GnRH) antagonist. We created a transient, functional lesion at the level of the pituitary gonadotrope by using a potent GnRH antagonist ([ Ac- pClPhe1 , pClDPhe2 , DTrp3 , DArg6 , DAla10 ]-GnRH). In long-term castrate cynomolgus monkeys, doses of 0.05 to 2.0 mg/kg/day intramuscularly were administered for a total of 32 days. At doses up to 0.2 mg/kg/day, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in circulation were only moderately suppressed; these subjects responded to an estradiol challenge by manifesting an LH elevation or surge within 48 hours. At doses of 0.5 to 1.0 mg/kg/day, FSH and LH secretion was suppressed to or below the limits of assay detection within 7 days, remaining in a severely hypogonadotropic state for the remainder of the treatment interval. Using 2 mg/kg/day, estradiol-positive feedback for midcycle-like LH/FSH surges was fully inhibited. This suppression of gonadotropin secretion was rapidly reversible, in that circulating gonadotropin levels had returned to pretreatment castrate levels within 60 days after termination of GnRH antagonist treatments. These findings suggest that potent GnRH antagonists can effectively create a hypogonadotropic milieu without the initial enhancement of gonadotropin secretion that occurs during initiation of GnRH agonist therapy. "Medical hypophysectomy" through GnRH antagonist administration may permit a more direct and controlled approach to gonadal therapies such as ovulation induction.

  4. Induction of Response to Psychotropic Medications in Depression and Panic After Concurrent Treatment of Diabetes

    PubMed Central

    Srinivasa, Murthy Vasantmeghna; Pradeep, Bombe Abhijeet; Sadashiv, Lokhande Chetan; Bhagwandas, Shah Nilesh

    2014-01-01

    We present a case of depression with panic disorder, which did not respond to adequate psychiatric interventions over a period of several months. However, it improved completely with the diagnosis and treatment of diabetes mellitus. Hence, we infer that comorbid diabetes mellitus can render depression resistant to psychiatric interventions and must always be ruled out when treating patients who show poor response to adequate interventions for an adequate period of time. The role of antidepressants should also be considered in poor glycemic control. PMID:24860227

  5. "Our babies shall not die": a community's response to medical neglect.

    PubMed

    Jacobs, S E

    1979-01-01

    The free neighborhood health center in a Midwest U.S. town was developed in response to a report that indicated that infant mortality rates were higher for the Black community than for the community-at-large. The health center soon took on the full range of health problems brought by clients regardless of client's race, ethnicity, or income. The processes for managing health care problems in an environment where racism was the rule rather than the exception are considered in this study.

  6. Medical education, social responsibility and praxis: Responding to the needs of all children.

    PubMed

    Martimianakis, Maria Athina

    2016-01-01

    While poverty is a recognized risk factor for ill health, directly intervening on the effects of poverty has traditionally been considered to fall outside the realm of a physician's daily practice. Yet, to appropriately respond to the health needs of all children, we have the social responsibility to help our trainees become competent health advocates. Experiential learning approaches can be used to aid students in developing identities and competencies as health advocates. Experiencing illness outside the sterility of the clinic, from the patient's point of view, encourages students to seek the knowledge they need to care for patients who are disenfranchised, socially vulnerable and/or marginalized. PMID:27441019

  7. Medical education, social responsibility and praxis: Responding to the needs of all children.

    PubMed

    Martimianakis, Maria Athina

    2016-01-01

    While poverty is a recognized risk factor for ill health, directly intervening on the effects of poverty has traditionally been considered to fall outside the realm of a physician's daily practice. Yet, to appropriately respond to the health needs of all children, we have the social responsibility to help our trainees become competent health advocates. Experiential learning approaches can be used to aid students in developing identities and competencies as health advocates. Experiencing illness outside the sterility of the clinic, from the patient's point of view, encourages students to seek the knowledge they need to care for patients who are disenfranchised, socially vulnerable and/or marginalized.

  8. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    PubMed

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

  9. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China

    PubMed Central

    Liu, Xu; Tang, Bihan; Yang, Hongyang; Liu, Yuan; Xue, Chen; Zhang, Lulu

    2015-01-01

    Purpose: Performance assessments of earthquake medical rapid response teams (EMRRTs), particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Methods: Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. Results: The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. Conclusions: This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams. PMID:26690182

  10. Influence of Stimulant Medication and Response Speed on Lateralization of Movement-Related Potentials in Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Resch, Franz; Klein, Christoph; Renner, Tobias; Fallgatter, Andreas J.; Weisbrod, Matthias

    2012-01-01

    Background Hyperactivity is one of the core symptoms in attention deficit hyperactivity disorder (ADHD). However, it remains unclear in which way the motor system itself and its development are affected by the disorder. Movement-related potentials (MRP) can separate different stages of movement execution, from the programming of a movement to motor post-processing and memory traces. Pre-movement MRP are absent or positive during early childhood and display a developmental increase of negativity. Methods We examined the influences of response-speed, an indicator of the level of attention, and stimulant medication on lateralized MRP in 16 children with combined type ADHD compared to 20 matched healthy controls. Results We detected a significantly diminished lateralisation of MRP over the pre-motor and primary motor cortex during movement execution (initial motor potential peak, iMP) in patients with ADHD. Fast reactions (indicating increased visuo-motor attention) led to increased lateralized negativity during movement execution only in healthy controls, while in children with ADHD faster reaction times were associated with more positive amplitudes. Even though stimulant medication had some effect on attenuating group differences in lateralized MRP, this effect was insufficient to normalize lateralized iMP amplitudes. Conclusions A reduced focal (lateralized) motor cortex activation during the command to muscle contraction points towards an immature motor system and a maturation delay of the (pre-) motor cortex in children with ADHD. A delayed maturation of the neuronal circuitry, which involves primary motor cortex, may contribute to ADHD pathophysiology. PMID:22720017

  11. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    PubMed

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems. PMID:26642175

  12. [Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology].

    PubMed

    Ferreirós, J; Cabeza, B; Gayete, Á; Sánchez, M; Torres, M I; Cobo, M; Isla, D; Puente, J; Reguart, N; de Castro, J

    2015-01-01

    The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM) have therefore produced a national consensus statement in order to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography (MDCT) as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only Response Evaluation Criteria in Solid Tumours (RECIST 1.1) but also Immune-Related Response Criteria (irRC). PMID:25530188

  13. [Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology].

    PubMed

    Ferreirós, J; Cabeza, B; Gayete, Á; Sánchez, M; Torres, M I; Cobo, M; Isla, D; Puente, J; Reguart, N; de Castro, J

    2015-01-01

    The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM) have therefore produced a national consensus statement in order to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography (MDCT) as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only Response Evaluation Criteria in Solid Tumours (RECIST 1.1) but also Immune-Related Response Criteria (irRC).

  14. Surface response of a viscoelastic medium to subsurface acoustic sources with application to medical diagnosis

    NASA Astrophysics Data System (ADS)

    Royston, Thomas J.; Yazicioglu, Yigit; Loth, Francis

    2003-02-01

    The response at the surface of an isotropic viscoelastic medium to buried fundamental acoustic sources is studied theoretically, computationally and experimentally. Finite and infinitesimal monopole and dipole sources within the low audible frequency range (40-400 Hz) are considered. Analytical and numerical integral solutions that account for compression, shear and surface wave response to the buried sources are formulated and compared with numerical finite element simulations and experimental studies on finite dimension phantom models. It is found that at low audible frequencies, compression and shear wave propagation from point sources can both be significant, with shear wave effects becoming less significant as frequency increases. Additionally, it is shown that simple closed-form analytical approximations based on an infinite medium model agree well with numerically obtained ``exact'' half-space solutions for the frequency range and material of interest in this study. The focus here is on developing a better understanding of how biological soft tissue affects the transmission of vibro-acoustic energy from biological acoustic sources below the skin surface, whose typical spectral content is in the low audible frequency range. Examples include sound radiated from pulmonary, gastro-intestinal and cardiovascular system functions, such as breath sounds, bowel sounds and vascular bruits, respectively.

  15. [Mental state and the criminal responsibility--legal regulations and medical criteria in Poland and other countries].

    PubMed

    Bolechała, Filip

    2009-01-01

    In contemporary civilized legal systems, sanity is a prerequisite for criminal responsibility of the perpetrator. Thus, insanity resulting from certain psychiatric and psychological disorders is a circumstance excluding the guilt. General assumptions of insanity criteria are close and similar in legal systems of the majority of countries; however, certain essential differences appear in details of their interpretation and acceptance. These differences in particular appear among systems of continental European states as opposed to these, in which the judiciary system is derived from the English law. The paper presents and discusses in detail the legal and medical considerations of insanity defense in Poland, as well as outlines the legal foundations of this issue in other countries of Europe, North America and Australia.

  16. [Behaviors in response to the tuberculin skin test conversion in medical students from a university in Lima, Peru].

    PubMed

    Calixto-Aguilar, Lesly; Manrique-Zegarra, Martiel; Gotuzzo-Herencia, Eduardo; Samalvides-Cuba, Frine

    2016-06-01

    The aim of this study was to determine the behaviors in response to tuberculin skin test (PPD) conversion and the reasons for starting or not starting treatment for latent tuberculosis infection (TILT) among medical students at a university in Lima, Peru. A total of 548 participants completed a questionnaire; of them, 6.7% tested positive on university admission and 11.1% were recent converters. A total of 55.7% did not start TILT and had no explanation. Of the recent converters, most students who did start TILT were >22 years old (p = 0.01) and correctly answered general knowledge questions (p = 0.04). It is important to note that the PPD conversion rate was higher than that reported in the literature and that most students did not follow the treatment prophylaxis because of a lack of information. PMID:27656929

  17. Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision model for Managing an Effective, Timely, and Balanced Response

    SciTech Connect

    Coleman, C. Norman; Blumenthal, Daniel J.

    2013-05-01

    Based on experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, a real-time, medical decision model is presented by which to make key health-related decisions given the central role of health and medical issues in such disasters. Focus is on response and recovery activities that are safe, timely, effective, and well-organized. This approach empowers on-site decision makers to make interim decisions without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Key features of this approach include ongoing assessment, consultation, information, and adaption to the changing conditions. This medical decision model presented is compatible with the existing US National Response Framework structure.

  18. We Blame the Parents! a Response to "Cultural Capital as an Explanation of Variation in Participation in Higher Education" by John Noble and Peter Davies ("British Journal of Sociology of Education 30, No. 5")

    ERIC Educational Resources Information Center

    Harrison, Neil; Waller, Richard

    2010-01-01

    This paper offers a response to a recent article where the authors argue cultural capital is the only determinant of the propensity of young people to seek to enter higher education, dismissing other indicators such as social class. This response questions the support the original authors draw from other literature and offers criticism of the…

  19. Humanitarian Medical Response to the Syrian Arab Republic (April 7, 2013 to April 23, 2013).

    PubMed

    Mahomed, Zeyn; Motara, Feroza; Bham, Ahmed

    2016-02-01

    The Syrian Arab Republic is entrenched in a deadly civil war, plunging the country into a state of chaos. With 3.2 million refugees abroad, 7.6 million internally displaced persons, and more than 200,000 killed, humanitarian assistance and international intervention are in dire need. This report outlines the response to the Syrian humanitarian crisis by a South African-based nongovernmental organization (NGO). It describes the experiences of a health care worker, the patient profiles, and the lessons learned in a war zone. Responding to a nation in need is of paramount importance. In order to maximize the benefit conferred, the team should always attempt to implement measures that leave a lasting legacy. PMID:26674667

  20. Toward phase 4 trials in heart failure: A social and corporate responsibility of the medical profession.

    PubMed

    Iyngkaran, Pupalan; Beneby, Glen S

    2015-12-26

    Congestive heart failure (CHF) is a chronic condition, requiring polypharmacy, allied health supports and regular monitoring. All these factors are needed to ensure compliance and to deliver the positive outcomes demonstrated from randomized controlled trials. Unfortunately many centers around the world are unable to match trial level support. The outcomes for many communities are thus unclear. Research design factors in post-marketing surveillance to address this issue. Phase 4 studies is the name given to trials designed to obtain such community level data and thus address issues of external validity. CHF phase 4 studies are relatively underutilized. We feel the onus for this research lies with the health profession. In this commentary we provide arguments as to why phase 4 studies should be viewed as a social and corporate responsibility of health professional that care for clients with CHF.

  1. Toward phase 4 trials in heart failure: A social and corporate responsibility of the medical profession

    PubMed Central

    Iyngkaran, Pupalan; Beneby, Glen S

    2015-01-01

    Congestive heart failure (CHF) is a chronic condition, requiring polypharmacy, allied health supports and regular monitoring. All these factors are needed to ensure compliance and to deliver the positive outcomes demonstrated from randomized controlled trials. Unfortunately many centers around the world are unable to match trial level support. The outcomes for many communities are thus unclear. Research design factors in post-marketing surveillance to address this issue. Phase 4 studies is the name given to trials designed to obtain such community level data and thus address issues of external validity. CHF phase 4 studies are relatively underutilized. We feel the onus for this research lies with the health profession. In this commentary we provide arguments as to why phase 4 studies should be viewed as a social and corporate responsibility of health professional that care for clients with CHF. PMID:26713277

  2. Toward phase 4 trials in heart failure: A social and corporate responsibility of the medical profession.

    PubMed

    Iyngkaran, Pupalan; Beneby, Glen S

    2015-12-26

    Congestive heart failure (CHF) is a chronic condition, requiring polypharmacy, allied health supports and regular monitoring. All these factors are needed to ensure compliance and to deliver the positive outcomes demonstrated from randomized controlled trials. Unfortunately many centers around the world are unable to match trial level support. The outcomes for many communities are thus unclear. Research design factors in post-marketing surveillance to address this issue. Phase 4 studies is the name given to trials designed to obtain such community level data and thus address issues of external validity. CHF phase 4 studies are relatively underutilized. We feel the onus for this research lies with the health profession. In this commentary we provide arguments as to why phase 4 studies should be viewed as a social and corporate responsibility of health professional that care for clients with CHF. PMID:26713277

  3. Negotiating hospital infections: The debate between ecological balance and eradication strategies in British hospitals, 1947-1969

    PubMed Central

    Condrau, Flurin; Kirk, Robert G. W.

    2012-01-01

    This paper reviews and contrasts two strategies of infection control that emerged in response to the growing use of antibiotics within British hospitals, c.1946-1969. At this time, we argue, the hospital became an arena within which representatives of the medical sciences and clinical practices contested not so much the content of knowledge but the way that knowledge translated into practice. Key to our story are the conceptual assumptions about antibiotics put forward by clinicians, on the one hand, and microbiologists on the other. The former embraced antibiotics as the latest weapon in their fight to eradicate disease. For clinicians, the use of antibiotics were utilised within a conceptual frame that prioritised the value of the individual patient before them. Microbiologists, in contrast, understood antibiotics quite differently. They adopted a complex understanding of the way antibiotics functioned within the hospital environment that emphasised the relational and ecological aspects of their use. Despite their broader environmental focus, microbiologists focus on the ways in which bacteria travelled led to ever greater emphasis to be placed on the «healthy» body which, having been exposed to antibiotics, became a dangerous carrier of resistant staphylococcal strains. The surrounding debate regarding the appropriate use of antibiotics reveals the complex relationship between hospital, the medical sciences and clinical practice. We conclude that the history of hospital infections invites a more fundamental reflection on global hospital cultures, antibiotic prescription practices, and the fostering of an interdisciplinary spirit among the professional groups living and working in the hospital. PMID:22332465

  4. Assessment of Medical Reserve Corps Volunteers' Emergency Response Willingness Using a Threat- and Efficacy-Based Model

    PubMed Central

    Barnett, Daniel J.; Thompson, Carol B.; Tosatto, Rob; Austin, Brad; Schaffzin, Samuel; Ansari, Armin; Semon, Natalie L.; Balicer, Ran D.; Links, Jonathan M.

    2013-01-01

    The goal of this study was to investigate the willingness of Medical Reserve Corps (MRC) volunteers to participate in public health emergency–related activities by assessing their attitudes and beliefs. MRC volunteers responded to an online survey organized around the Extended Parallel Process Model (EPPM). Respondents reported agreement with attitude/belief statements representing perceived threat, perceived efficacy, and personal/organizational preparedness in 4 scenarios: a weather-related disaster, a pandemic influenza emergency, a radiological (“dirty bomb”) emergency, and an inhalational anthrax bioterrorism emergency. Logistic regression analyses were used to evaluate predictors of volunteer response willingness. In 2 response contexts (if asked and regardless of severity), self-reported willingness to respond was higher among those with a high perceived self-efficacy than among those with low perceived self-efficacy. Analyses of the association between attitude/belief statements and the EPPM profiles indicated that, under all 4 scenarios and with few exceptions, those with a perceived high threat/high efficacy EPPM profile had statistically higher odds of agreement with the attitude/belief statements than those with a perceived low threat/low efficacy EPPM profile. The radiological emergency consistently received the lowest agreement rates for the attitude/belief statements and response willingness across scenarios. The findings suggest that enrollment with an MRC unit is not automatically predictive of willingness to respond in these types of scenarios. While MRC volunteers' self-reported willingness to respond was found to differ across scenarios and among different attitude and belief statements, the identification of self-efficacy as the primary predictor of willingness to respond regardless of severity and if asked highlights the critical role of efficacy in an organized volunteer response context. PMID:23477632

  5. Improving self-report measures of medication non-adherence using a cheating detection extension of the randomised-response-technique.

    PubMed

    Ostapczuk, Martin; Musch, Jochen; Moshagen, Morten

    2011-10-01

    Medication non-adherence is a serious problem for medical research and clinical practice. Self-reports are only moderately valid, and objective methods are cumbersome and expensive to administer. We sought to improve self-reports of medication non-adherence using a cheating detection extension of the randomised-response-technique (RRT). This RRT variant encourages more honest responses by offering interviewees a higher degree of anonymity while simultaneously allowing us to estimate the proportion of respondents disobeying the RRT instructions. The 597 patients were asked to report their lifetime prevalence of medication non-adherence under one of two different questioning procedures, direct questioning or randomised-response. When questioned directly, only 20.9% of patients admitted to intentional medication non-adherent behaviour, as opposed to 32.7% of patients under RRT conditions. Additionally, the cheating detection extension revealed a significant proportion of patients (47.1%) disobeying the instructions in the RRT condition. Assuming that either none or all of them were non-adherent, a lower and upper bound of 32.7% and 79.8%, respectively, could be estimated for the lifetime prevalence of non-adherent behaviour. The results demonstrate that self-report measures as well as traditional variants of the RRT, which do not take cheating into account, may provide considerably distorted estimates of the prevalence of medication non-adherence.

  6. Response of a viscoelastic halfspace to subsurface distributed acoustic sources with application to medical diagnosis

    NASA Astrophysics Data System (ADS)

    Royston, Thomas J.; Yazicioglu, Yigit; Loth, Francis

    2003-04-01

    The response within and at the surface of an isotropic viscoelastic medium to subsurface distributed low audible frequency acoustic sources is considered. Spherically and cylindrically distributed sources are approximated as arrays of infinitesimal point sources. Analytical approximations for the acoustic field radiating from these sources are then obtained as a summation of tractable point source expressions. These theoretical approximations are compared to computational finite element predictions and experimental studies in selected cases. The objective is to better understand low audible frequency sound propagation in soft biological tissue caused by subsurface sources. Distributed acoustic sources could represent vibratory motion of the vascular wall caused by turbulent blood flow past a constriction (stenosis). Additionally focused vibratory stimulation using a dynamic radiation force caused by interfering ultrasound beams effectively creates a distributed subsurface acoustic source. A dynamic radiation force has been investigated as a means of probing subsurface tissue anomalies, including calcified vascular plaque and tumorous growths. In these cases, there is an interest in relating acoustic measurements at the skin surface and within the medium to the underlying flow/constriction environment or tissue anomaly. [Research supported by NIH NCRR 14250 and Whitaker Foundation BME RG 01-0198.

  7. Thermoluminescence dating of the british coversand deposits

    NASA Astrophysics Data System (ADS)

    Bateman, M. D.

    Coversand deposits, thought to be of Lateglacial age are found in Britain in North Lincolnshire, South-West Lancashire and Central East Anglia. A comprehensive dating study of them, using thermoluminescence (TL) techniques, is currently underway in an attempt to link the British coversand deposits to the European coversand chronology. Initial results from four of the British coversand sites sampled are presented. The 26 TL dates from 14 samples show that in Lincolnshire aeolian deposition took place from 12.5 ka to I1 ka. Cessation of the initial sand deposition was synchronous with this in Lancashire, but sand deposition occurred significantly earlier in East Anglia. The upper layers of aeolian sand in Lancashire are much younger and are attributed to Holocene reworking. On the basis of these dates, Lincolnshire and Lancashire coversand deposition occurred at a similar time to the Younger Coversand II, whilst East Anglian coversand deposition coincided with the Younger Coversand I phase in the European coversand chronology.

  8. Flood Hazard Management: British and International Perspectives

    NASA Astrophysics Data System (ADS)

    James, L. Douglas

    This proceedings of an international workshop at the Flood Hazard Research Centre (Queensway, Enfield, Middlesex, U.K.) begins by noting how past British research on flood problems concentrated on refining techniques to implement established policy. In contrast, research covered in North American and Australian publications involved normative issues on policy alternatives and administrative implementation. The workshop's participants included 16 widely recognized scientists, whose origins were about equally divided between Britain and overseas; from this group the workshop's organizers expertly drew ideas for refining British urban riverine flood hazard management and for cultivating links among researchers everywhere. Such intellectual exchange should be of keen interest to flood hazard program managers around the world, to students of comparative institutional performance, to those who make policy on protecting people from hazards, and to hydrologists and other geophysicists who must communicate descriptive information for bureaucratic, political, and public decision- making.

  9. The British reaction to dementia praecox 1893-1913. Part 1.

    PubMed

    Ion, R M; Beer, M D

    2002-09-01

    Emil Kraepelin introduced the concept of dementia praecox in 1893. The eventual acceptance of the concept brought a degree of clarity and order previously unknown to psychiatric nosology. The pre-Kraepelin era had been dominated by concepts such as mania, melancholia and adolescent insanity. After Kraepelin these ideas were abandoned in favour of the two great concepts of dementia praecox and manic depressive insanity, both of which remain active within modern psychiatry in the form of schizophrenia and bipolar disorder. This two-part study focuses on the early British reaction to Kraepelin's concept, from 1893, when he first introduced it, to 1913 when it gained general recognition. It examines the struggle experienced by the proponents of dementia praecox before the concept's acceptance by most British psychiatrists in 1913. It argues that both clinical/professional and linguistic factors influenced the British response to dementia praecox. Part 1 of this study describes the backdrop to the development of Kraepelin's ideas and examines the response to the concept in the British psychiatric textbooks and journals of the period. Part 2 will explore reaction to the concept in the professional meetings of the period, and will also examine and evaluate the key issues arising from the debate.

  10. Essential key indicators for disaster medical response suggested to be included in a national uniform protocol for documentation of major incidents: a Delphi study

    PubMed Central

    2013-01-01

    Background Registration of data from a major incident or disaster serves several purposes such as to record data for evaluation of response as well as for research. Data needed can often be retrieved after an incident while other must be recorded during the incident. There is a need for a consensus on what is essential to record from a disaster response. The aim of this study was to identify key indicators essential for initial disaster medical response registration. By this is meant nationally accepted processes involved, from the time of the emergency call to the emergency medical communication centre until medical care is provided at the emergency department. Methods A three round Delphi study was conducted. Thirty experts with a broad knowledge in disaster and emergency response and medical management were invited. In this study we estimated 30 experts to be approximately one third of the number in Sweden eligible for recruitment. Process, structure and outcome indicators for the initial disaster medical response were identified. These were based on previous research and expressed as statements and were grouped into eight categories, and presented to the panel of experts. The experts were instructed to score each statement, using a five point Likert scale, and were also invited to include additional statements. Statements reaching a predefined consensus level of 80% were considered as essential to register. Results In total 97 statements were generated, 77 statements reached consensus. The 77 statements covered parts of all relevant aspects involved in the initial disaster medical response. The 20 indicators that did not reach consensus mostly concerned patient related times in hospital, types of support systems and security for health care staff. Conclusions The Delphi technique can be used for reaching consensus of data, comprising process, structure and outcome indicators, identified as essential for recording from major incidents and disasters. PMID

  11. Where is the British national press?

    PubMed

    MacInnes, John; Rosie, Michael; Petersoo, Pille; Condor, Susan; Kennedy, James

    2007-06-01

    Although globalization has highlighted the danger of conflating state, society and nation, sociologists remain insufficiently alert to such banal nationalism. Newspapers offer a strong test case of the extent of diversity in the construction of state, national and social boundaries, since Billig and Anderson have argued they comprise a special case where their orientation to an audience simultaneously located in a state, society and nation allows them to reproduce a sense of national identity. However, despite the commonsense obviousness of the term, it proves remarkably difficult to define what the 'British national press' might comprise. Circulation density of titles varies substantially across different parts of the UK and editorial copy is altered to address diverse 'national' readerships. 'British' newspapers also circulate in other states, especially the Republic of Ireland. After reviewing how newspapers might be defined as 'national' and/or 'British', we conclude that both Anderson and Billig over-estimate the congruence, relevance and obviousness of state, society and national boundaries. If the conceptualization of such boundaries is problematic in the case of the press, it follows that it must be still more so for most other objects of sociological analysis, including that of 'society' itself.

  12. Blast furnace injection developments in British Steel

    SciTech Connect

    Jukes, M.H.

    1996-12-31

    British Steel has four integrated steel works, i.e., Llanwern, Port Talbot, Scunthorpe, Teesside, with a total of ten blast furnaces, nine of which are currently operating. The furnaces range in size from the 14 meters (45 feet 11 inches) hearth diameter Redcar No. 1 furnace at Teesside (a single furnace works) to the 8.33 meters (27 feet 4 inches) hearth Queen Mary and Queen Bess furnaces at Schunthorpe, with a total of four furnaces at that works. All have injection systems installed, those at Scunthorpe being equipped with granular coal injection and all others currently working with oil injection. The driving force behind the development of blast furnace injection has been as a means for introducing reducing agents (British Steel now refers to coke plus hydrocarbon injectants as total reductants) into the process as a part substitute/supplement for top charged coke and the technology is still being developed and used for that purpose. By utilizing practical experience and observing the work of others, British Steel has been assessing blast furnace injection technology experimentally for purposes other than the introduction of reducing agents.

  13. Sustainable development in British land use regulation

    SciTech Connect

    Basiago, A.D.

    1995-12-01

    Sustainable development is a new international theory of development founded on principles of futurity, environment, equity and participation. It is the legacy of twenty years of international environmental law that has established a doctrine of global trusteeship. Sustainable development has entered British land use regulation through the Maastricth Treaty; the EU`s Fifth Environmental Action Program; as well as the British government`s Planning Policy Guidance notes on land use principles, local plans, transport and historic preservation, and its white papers. The Earth Summit accord Agenda 21 is a blueprint on how to make development socially, economically and environmentally sustainable. Under its terms, Britain has prepared a national sustainable development strategy for the UN`s Commission on Sustainable Development. It features Local Agenda 21 strategies in which local authorities develop policies for sustainable development and establish partnerships with other sectors. In this paper, the Local Agenda 21 strategies of seven local authorities are evaluated according to the paradigm introduced in Agenda 21 and elaborated by Kahn that describes sustainable development as a dynamic system of integrated and interlinked economic, social and environmental sustainability. The author concludes that sustainable development in British land use regulation is guided by notions of economic development, social justice and environmental planning and not by the dynamic, integrated model of Agenda 21. 46 refs., 3 figs.

  14. Important developments in northeast British Columbia

    SciTech Connect

    Kedgley, G.H.

    1981-07-01

    Provincial leaders in British Columbia wished to expand the natural resource base in British Columbia's economy. With this in mind, the development of the Peace River coalfield was carefully planned. Planners had to consider infrastructure needs in a virgin area, manpower requirements, and environmental effects. A computer model was developed to estimate the production costs of the various coal projects using different mining technologies. Alternatives for accommodating the increased population and services of the areas were also considered. The impacts of coal dust were investigated, alternative rail routes were identified and studied, and a comprehensive analysis of the supply and demand for manpower, both during construction and operation, was undertaken. Some 87 volumes of reports were prepared. The outcome of all this activity was a decision to build a rail spur line, a town at Tumbler Ridge, a new road south from Chetwynd, power lines, and a port at Prince Rupert. British Columbia had identified Japan as the only market that could accept such a large tonnage in a single purchase. After negotiations, it was agreed that the Japanese would buy 5,000,000 tons of metallurgical coal per year for a minimum 15 years on the understanding that the necessary infrastructure would be set up to ensure that the coal reached the marketplace at competitive prices.

  15. Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists

    PubMed Central

    Billis, Evdokia; McCarthy, Christopher J; Gliatis, John; Matzaroglou, Charalampos; Oldham, Jacqueline A

    2016-01-01

    AIM To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. METHODS Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ2 tests. RESULTS The survey was divided into three subsections; PTs’ attitudes on LBP assessment, patients’ attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low (< 10%) and 8 statements demonstrated high (> 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a “privilege” which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as “executers”, being unable to interfere with treatment plan, possibly implying lack of autonomy. CONCLUSION Although similarities on history taking methods and on patients’ attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy. PMID:27672569

  16. Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists

    PubMed Central

    Billis, Evdokia; McCarthy, Christopher J; Gliatis, John; Matzaroglou, Charalampos; Oldham, Jacqueline A

    2016-01-01

    AIM To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. METHODS Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ2 tests. RESULTS The survey was divided into three subsections; PTs’ attitudes on LBP assessment, patients’ attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low (< 10%) and 8 statements demonstrated high (> 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a “privilege” which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as “executers”, being unable to interfere with treatment plan, possibly implying lack of autonomy. CONCLUSION Although similarities on history taking methods and on patients’ attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.

  17. Response

    ERIC Educational Resources Information Center

    Barton, Len

    2010-01-01

    A special issue of the "British Journal of Sociology of Education" has been devoted to an examination of Disability and Inclusive Education. The authors of the papers in this issue have all made important contributions to the advancement of knowledge and understanding in these fields of study. Overall, they have provided a comprehensive, valuable…

  18. 'Recharge my exhausted batteries': Overbeck's Rejuvenator, Patenting, and Public Medical Consumers, 1924-37.

    PubMed

    Stark, James F

    2014-10-01

    Although historians have shown that there has been a complex and multi-layered relationship between the body, medicine and the force of electricity, many avenues remain to be explored. One of the most prominent of these is the way in which electrotherapy technologies were marketed to a wide variety of different end users and intermediaries. This paper offers the first historical analysis of one such device - the Overbeck Rejuvenator - a 1920s electrotherapy machine designed for use by the general public. Its inventor, Otto Overbeck, was not a medical man and this enabled him to use aggressive strategies of newspaper advertising, using testimonials to market his product alongside appeals to his own scientific authority. He commissioned the prestigious Ediswan Company to manufacture the Rejuvenator on a large scale, and took out patents in eleven countries to persuade users of the efficacy of the device. In response to Overbeck's activities, the British Medical Association enlisted an electrical engineer to examine the Rejuvenator, contacted practitioners whose endorsements were being used in publicity material, and denied Overbeck permission to advertise in the British Medical Journal. Despite this, the Rejuvenator brought its inventor wealth and notoriety, and helped redefine the concept of 'rejuvenation', even if the professional reception of such a device was almost universally hostile. This paper shows how the marketing, patenting and publishing of Overbeck combined to persuade members of the laity to try the Rejuvenator as an alternative form of therapy, bypassing the medical profession in the process. PMID:25284892

  19. 'Recharge my exhausted batteries': Overbeck's Rejuvenator, Patenting, and Public Medical Consumers, 1924-37.

    PubMed

    Stark, James F

    2014-10-01

    Although historians have shown that there has been a complex and multi-layered relationship between the body, medicine and the force of electricity, many avenues remain to be explored. One of the most prominent of these is the way in which electrotherapy technologies were marketed to a wide variety of different end users and intermediaries. This paper offers the first historical analysis of one such device - the Overbeck Rejuvenator - a 1920s electrotherapy machine designed for use by the general public. Its inventor, Otto Overbeck, was not a medical man and this enabled him to use aggressive strategies of newspaper advertising, using testimonials to market his product alongside appeals to his own scientific authority. He commissioned the prestigious Ediswan Company to manufacture the Rejuvenator on a large scale, and took out patents in eleven countries to persuade users of the efficacy of the device. In response to Overbeck's activities, the British Medical Association enlisted an electrical engineer to examine the Rejuvenator, contacted practitioners whose endorsements were being used in publicity material, and denied Overbeck permission to advertise in the British Medical Journal. Despite this, the Rejuvenator brought its inventor wealth and notoriety, and helped redefine the concept of 'rejuvenation', even if the professional reception of such a device was almost universally hostile. This paper shows how the marketing, patenting and publishing of Overbeck combined to persuade members of the laity to try the Rejuvenator as an alternative form of therapy, bypassing the medical profession in the process.

  20. Apparatus for detecting a condition of a medication infusion system and providing an informational signal in response thereto

    NASA Technical Reports Server (NTRS)

    Fischell, Robert E. (Inventor)

    1988-01-01

    A medication infusion system having a means for providing an informational signal when (1) medication in the reservoir falls below a threshold level; (2) a fluid leak occurs in different portions of the system; and (3) the intended medication pumping does not correlate with the pumping actually affected.

  1. Weathering the empire: meteorological research in the early British Straits Settlements.

    PubMed

    Williamson, Fiona

    2015-09-01

    This article explores meteorological interest and experimentation in the early history of the Straits Settlements. It centres on the establishment of an observatory in 1840s Singapore and examines the channels that linked the observatory to a global community of scientists, colonial officers and a reading public. It will argue that, although the value of overseas meteorological investigation was recognized by the British government, investment was piecemeal and progress in the field often relied on the commitment and enthusiasm of individuals. In the Straits Settlements, as elsewhere, these individuals were drawn from military or medical backgrounds, rather than trained as dedicated scientists. Despite this, meteorology was increasingly recognized as of fundamental importance to imperial interests. Thus this article connects meteorology with the history of science and empire more fully and examines how research undertaken in British dependencies is revealing of the operation of transnational networks in the exchange of scientific knowledge.

  2. Predicting Meaningful Outcomes to Medication and Self-Help Treatments for Binge Eating Disorder in Primary Care: The Significance of Early Rapid Response

    PubMed Central

    Grilo, Carlos M.; White, Marney A.; Masheb, Robin M.; Gueorguieva, Ralitza

    2014-01-01

    Objective We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing anti-obesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. Method 104 obese patients with BED were randomly assigned to one of four treatments: sibutramine, placebo, shCBT+sibutramine, or shCBT+placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research-clinicians monthly throughout treatment, post-treatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge-eating by the fourth treatment week, was used to predict outcomes. Results Rapid response characterized 47% of patients. Rapid response was unrelated to demographic and baseline clinical characteristics. Rapid response was significantly associated prospectively with remission from binge eating at post-treatment (51% versus 9% for non-rapid responders), 6-month (53% vs 23.6%), and 12-month (46.9% vs 23.6%) follow-ups. Mixed effects model analyses revealed rapid response was significantly associated with greater decreases in binge-eating, eating-disorder psychopathology, depression, and percent weight loss. Discussion Our findings, based on a diverse obese patient group receiving medication and self-help CBT treatments for BED in primary care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatments. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes even in low intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. Clinical Trial Registration clinicaltrials.gov: NCT00537810 PMID

  3. Lunacy and the 'Islands in the British Seas'.

    PubMed

    Hirst, David

    2007-12-01

    In the mid-nineteenth century the Dependent Territories of Jersey, Guernsey and the Isle of Man all had small, relatively stable populations, many of whom did not speak English as their first language. The response of each to the public asylum movement was very different. Guernsey had an asylum by 1852, but Jersey and the Isle of Man opened permanent asylums only in 1868. This comparative study examines the interactions between British government agencies, the Home Office, Commissioners in Lunacy and Lieutenant Governors, and the autonomous insular legislatures. It discusses the reasons why Jersey and the Isle of Man were reluctant to establish publicly funded asylums, the alternatives considered, and the opportunities afforded to private madhouse proprietors by absent or lax supervisory frameworks.

  4. High-frequency turbidity currents in British Columbia fjords

    NASA Astrophysics Data System (ADS)

    Bornhold, Brian D.; Ren, Ping; Prior, David B.

    1994-12-01

    The frequency of turbidity currents in Bute Inlet and Knight Inlet (British Columbia, Canada) was monitored. A prototype instrument (turbidity event detector) was deployed adjacent to prominent incised sea-floor channels. Approximately 25 30 turbidity currents occur annually. They appear closely correlated to periods of higher river discharge into the heads of the fjords. Two peaks in both discharge and turbidity current fequency occur, one in response to snow melt in late June early July, the other to glacier melt in August. Virtually no turbidity currents were observed in winter. River mouth bars, channel deposits, and other deltaic sediments build up during lower discharge periods and are swept onto the steep delta front and into subaqueous channels, along with bedload, during floods.

  5. Health services and the legitimation of the colonial state: British Malaya 1786-1941.

    PubMed

    Manderson, L

    1987-01-01

    This article is concerned with the establishment and extension of health care and medical services in British colonial Malaya. Initially, medical care was provided for the colonial elite and those in their direct employment. With the expansion of colonial control beyond trade centers into the hinterland and with the growth of agriculture and mining. Western medicine was extended both to labor involved in these export industries and to others whose ill health might jeopardize the welfare of the colonists. Public health programs in the twentieth century continued to focus on medical problems that had direct impact on the colonial economy, but programs were extended to ensure the reproduction as well as the maintenance of the labor force. This article develops the notion of a legitimation vacuum, and the role of the state provision of social services, including medical services, in legitimizing colonial presence and control. PMID:3549590

  6. From international to zonal trials: the origins of the Nuremberg medical trial.

    PubMed

    Weindling, P

    2000-01-01

    This article examines how plans to have a second International Military Tribunal led to the Medical Trial at Nuremberg. While the British opposed a second international trial because of their distrust of the Soviets, they supported a plan for a series of special zonal trials to be conducted by the American authorities at Nuremberg. In December 1945 the British became aware of the extent of medical war crimes committed by the Germans. Their investigation led to an eventual handover to the Americans of a group of German doctors for trial at Nuremberg. At the same time the British and French Supported an International Scientific Commission for the Investigation of Medical War Crimes.

  7. Checklist of British and Irish Hymenoptera - Chalcidoidea and Mymarommatoidea

    PubMed Central

    Dale-Skey, Natalie; Askew, Richard R.; Noyes, John S.; Livermore, Laurence

    2016-01-01

    Abstract Background A revised checklist of the British and Irish Chalcidoidea and Mymarommatoidea substantially updates the previous comprehensive checklist, dating from 1978. Country level data (i.e. occurrence in England, Scotland, Wales, Ireland and the Isle of Man) is reported where known. New information A total of 1754 British and Irish Chalcidoidea species represents a 22% increase on the number of British species known in 1978. PMID:27346954

  8. Large brown seaweeds of the British Isles: Evidence of changes in abundance over four decades

    NASA Astrophysics Data System (ADS)

    Yesson, Chris; Bush, Laura E.; Davies, Andrew J.; Maggs, Christine A.; Brodie, Juliet

    2015-03-01

    The large brown seaweeds (macroalgae) are keystone species in intertidal and shallow subtidal marine ecosystems and are harvested for food and other products. Recently, there have been sporadic, often anecdotal, reports of local abundance declines around the British Isles, but regional surveys have rarely revisited sites to determine possible changes. An assessment was undertaken of changes in the abundance of large brown seaweeds around the British Isles using historical survey data, and determination of whether any changes were linked with climate change. Data were analysed from multiple surveys for 14 habitat-forming and commercially important species of Phaeophyceae, covering orders Laminariales, Fucales and Tilopteridales. Changes in abundance were assessed for sites over the period 1974-2010. Trends in distribution were compared to summer and winter sea surface temperatures (SST). Results revealed regional patterns of both increase and decrease in abundance for multiple species, with significant declines in the south for kelp species and increases in northern and central areas for some kelp and wracks. Abundance patterns of 10 of the 14 species showed a significant association with SSTs, but there was a mixture of positive and negative responses. This is the first British Isles-wide observation of declining abundance of large brown seaweeds. Historical surveys provide useful data to examine trends in abundance, but the ad hoc nature of these studies limit the conclusions that can be drawn. Although the British Isles remains a stronghold for large brown algae, it is imperative that systematic surveys are undertaken to monitor changes.

  9. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population

    PubMed Central

    Kaphingst, Kimberly A.; Stafford, Jewel D.; McGowan, Lucy D’Agostino; Seo, Joann; Lachance, Christina R.; Goodman, Melody S.

    2015-01-01

    Objective Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information [genetic test/family history] and disease condition [diabetes/heart disease] and by race/ethnicity in a medically underserved population. Methods 1057 English-speaking adults completed a survey containing one of four vignettes (two-by-two randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. Results No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR=1.93; p<0.0001); respondents with marginal (OR=1.54; p=0.005) or limited (OR=1.85; p=0.009) health literacy had greater interest than those with adequate health literacy. Blacks (OR=1.78; p=0.001) and Hispanics (OR=1.85; p=0.001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR=1.45; p=0.04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β= −0.41; p<0.001) and Hispanics (β= −0.25; p=0.033) intended to change fewer health habits than Whites; health literacy was negatively associated with number of health habits participants intended to change. Conclusions Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information. PMID:25622080

  10. Medication possession ratio associated with short-term virologic response in individuals initiating antiretroviral therapy in Namibia.

    PubMed

    Hong, Steven Y; Jerger, Logan; Jonas, Anna; Badi, Alfons; Cohen, Steven; Nachega, Jean B; Parienti, Jean-Jacques; Tang, Alice M; Wanke, Christine; Terrin, Norma; Pereko, Dawn; Blom, Abraham; Trotter, Andrew B; Jordan, Michael R

    2013-01-01

    The visual-analogue scale (VAS), Likert item (rating scale), pills identification test (PIT), and medication possession ratio (MPR) provide estimates of antiretroviral therapy (ART) adherence which correlate with HIV viral suppression. These simple adherence measures are inexpensive and easy to administer; however, require validation and adjustment prior to implementation. The objective of this study was to define the optimal adherence assessment measure in Namibia to identify patients at risk for sub-optimal adherence and poor virologic response 6 months after ART initiation. We conducted a cross-sectional survey in HIV-infected adults receiving ART for 6-12 months prior to the adherence assessment. Adherence measures included 30-day VAS, 30-day Likert item, self-reported treatment interruptions, PIT, and MPR. Association of adherence measures with 6-month HIV-1 RNA level was assessed using two thresholds (1000 copies/mL and 5000 copies/mL). Adherence was assessed in 236 patients, mean age 37.3 years, 54% female. Mean adherence was 98.1% by 30-day VAS, 84.7% by 30-day Likert item, 97.0% by self-reported treatment interruptions, 90.6% by PIT, and 98.8% by MPR. Agreement between adherence measures was poor using kappa statistic. 76% had HIV-1 RNA <1000 copies/ml, and 88% had HIV-1 RNA <5000 copies/ml. MPR (continuous) was associated with viral suppression <5000 copies/ml (p = 0.036). MPR <75% was associated with virologic failure at ≥5000 copies/ml with OR 3.89 (1.24, 12.21), p = 0.013. Adherence was high with all measures. Only MPR, was associated with short-term virologic response, suggesting its cross-culturally utility for early identification of patients at high risk for virologic failure.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. A virtual reality patient simulation system for teaching emergency response skills to U.S. Navy medical providers.

    PubMed

    Freeman, K M; Thompson, S F; Allely, E B; Sobel, A L; Stansfield, S A; Pugh, W M

    2001-01-01

    Rapid and effective medical intervention in response to civil and military-related disasters is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties not generally encountered in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multimodal data. In this project, collaborators adapted and merged existing technologies to produce a flexible, modular patient simulation system with both three-dimensional virtual reality and two-dimensional flat screen user interfaces for teaching cognitive assessment and treatment skills. This experiential, problem-based training approach engages the user in a stress-filled, high fidelity world, providing multiple learning opportunities within a compressed period of time and without risk. The system simulates both the dynamic state of the patient and the results of user intervention, enabling trainees to watch the virtual patient deteriorate or stabilize as a result of their decision-making speed and accuracy. Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired. This paper describes the technologies and the process used to develop the trainers, the clinical algorithms, and the incorporation of teaching points. We also characterize aspects of the actual simulation exercise through the lens of the trainee. PMID:11367936

  13. 'I never faced up to being gay': sexual, religious and ethnic identities among British Indian and British Pakistani gay men.

    PubMed

    Jaspal, Rusi

    2012-01-01

    This paper presents the findings from a comparative qualitative study of British Indian and British Pakistani gay men, all of whom self-identified as members of their religious communities. Data were analysed using thematic analysis and identity process theory. Results suggest that the intersection between sexuality and religion is more relevant to British Pakistani participants, while the intersection between sexuality and ethnicity is more relevant to British Indian participants. For British Indian participants in particular, homosexuality seems to be socially problematic, posing potential obstacles for interpersonal and intergroup relations. Conversely, for British Pakistanis, homosexuality is both socially and psychologically problematic, affecting intrapsychic as well as interpersonal levels of human interdependence. Theoretical and practical implications are discussed.

  14. 'I never faced up to being gay': sexual, religious and ethnic identities among British Indian and British Pakistani gay men.

    PubMed

    Jaspal, Rusi

    2012-01-01

    This paper presents the findings from a comparative qualitative study of British Indian and British Pakistani gay men, all of whom self-identified as members of their religious communities. Data were analysed using thematic analysis and identity process theory. Results suggest that the intersection between sexuality and religion is more relevant to British Pakistani participants, while the intersection between sexuality and ethnicity is more relevant to British Indian participants. For British Indian participants in particular, homosexuality seems to be socially problematic, posing potential obstacles for interpersonal and intergroup relations. Conversely, for British Pakistanis, homosexuality is both socially and psychologically problematic, affecting intrapsychic as well as interpersonal levels of human interdependence. Theoretical and practical implications are discussed. PMID:22651130

  15. Using the British National Formulary effectively.

    PubMed

    Bellerby, Ann; Needham, Deborah Susan

    2016-09-21

    Nursing students, nurses and other healthcare professionals involved in prescribing, dispensing, administration and monitoring of medicines should be able to navigate and use the British National Formulary (BNF) effectively. Recent changes to the structure of the BNF have resulted in new symbols, additional sections in drug and drug-class monographs, and a reduction in the amount of cross-referencing between chapters. This article explores how healthcare professionals can access the information in the BNF to ensure that medicines use is optimised, therapeutic effects are maximised, and adverse drug reactions and drug interactions are minimised. PMID:27654562

  16. Lack of association of acute phase response proteins with hormone levels and antidepressant medication in perimenopausal depression

    PubMed Central

    2014-01-01

    Background Major depression is associated with higher plasma levels of positive acute-phase proteins, as well as with lower plasma levels of negative acute-phase proteins. The aim of this study is to examine the levels of acute-phase response proteins and whether these levels are influenced by reproductive hormones and antidepressant medication in the perimenopausal depression. Methods Sixty-five women (age range: 40–58 years old) participated in this study. All women were in the perimenopausal phase. The diagnosis of depression was made through a psychiatric interview and with the aid of Hamilton Depression Rating Scale 17 (HAM-D 17). The acute-phase response proteins, such as haptoglobin (HP), transferrine (TRf), α1-antitrypsin, complement protein 3 (C3), complement protein 4 (C4) and C-reactive protein (CRP) and the reproductive hormones, for example follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), were analyzed using standard laboratory methods. Pearson’s correlations were applied to evaluate the relationship between acute-phase proteins and hormones. Results Perimenopausal women were divided into three groups. The first group consisted of normal controls, the second one involved depressed perimenopausal women, who were taking selective serotonin reuptake inhibitors (SSRIs), and the third one included depressed women that were not treated with SSRIs. Depressed women in perimenopause, when being compared to non-depressed women, did not differ as to serum levels of acute-phase proteins. There was a positive correlation between HP and E2 in depressed perimenopausal women, who were not taking SSRIs. Conclusions The lack of association between acute-phase proteins and depressive mood mentioned in this study does not support previous findings in patients with major depression. This negative finding in perimenopausal depression indicates either the absence or a more complex nature of the interactions between acute-phase proteins

  17. Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control

    PubMed Central

    Malicki, Julian

    2015-01-01

    Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine. PMID:25949219

  18. Exposure to smoking in movies among British adolescents 2001–2006

    PubMed Central

    Anderson, Stacey J; Millett, Christopher; Polansky, Jonathan R

    2010-01-01

    Objective To estimate youth exposure to smoking in movies in the UK and compare the likely effect with the USA. Methods We collected tobacco occurrences data for 572 top-grossing films in the UK screened from 2001 to 2006 and estimated the number of on-screen tobacco impressions delivered to British youths in this time period. Results 91% of films in our sample that contained smoking were youth-rated films (British Board of Film Classification rating ‘15’ and lower), delivering at least 1.10 billion tobacco impressions to British youths during theatrical release. British youths were exposed to 28% more smoking impressions in UK youth-rated movies than American youth-rated movies, because 79% of movies rated for adults in the USA (‘R’) are classified as suitable for youths in the UK (‘15’ or ‘12A’). Conclusion Because there is a dose-response relation between the amount of on-screen exposure to smoking and the likelihood that adolescents will begin smoking, the fact that there is substantially higher exposure to smoking in youth-rated films in the UK than in the USA suggests that the fraction of all youth smoking because of films in the UK is probably larger than in the USA. Other countries with ratings systems that are less conservative (in terms of language and sexuality) than the USA will also be likely to deliver more on-screen tobacco impressions to youths. Assigning an ‘18’ classification to movies that contain smoking would substantially reduce youth exposure to on-screen smoking and, hence, smoking initiation among British youths. PMID:20197360

  19. A comparative analysis of British and Taiwanese students' conceptual and procedural knowledge of fraction addition

    NASA Astrophysics Data System (ADS)

    Li, Hui-Chuan

    2014-10-01

    This study examines students' procedural and conceptual achievement in fraction addition in England and Taiwan. A total of 1209 participants (561 British students and 648 Taiwanese students) at ages 12 and 13 were recruited from England and Taiwan to take part in the study. A quantitative design by means of a self-designed written test is adopted as central to the methodological considerations. The test has two major parts: the concept part and the skill part. The former is concerned with students' conceptual knowledge of fraction addition and the latter is interested in students' procedural competence when adding fractions. There were statistically significant differences both in concept and skill parts between the British and Taiwanese groups with the latter having a higher score. The analysis of the students' responses to the skill section indicates that the superiority of Taiwanese students' procedural achievements over those of their British peers is because most of the former are able to apply algorithms to adding fractions far more successfully than the latter. Earlier, Hart [1] reported that around 30% of the British students in their study used an erroneous strategy (adding tops and bottoms, for example, 2/3 + 1/7 = 3/10) while adding fractions. This study also finds that nearly the same percentage of the British group remained using this erroneous strategy to add fractions as Hart found in 1981. The study also provides evidence to show that students' understanding of fractions is confused and incomplete, even those who are successfully able to perform operations. More research is needed to be done to help students make sense of the operations and eventually attain computational competence with meaningful grounding in the domain of fractions.

  20. Fasting regimens for regional ophthalmic anaesthesia. A survey of members of the British Ophthalmic Anaesthesia Society.

    PubMed

    Steeds, C; Mather, S J

    2001-07-01

    Members of the British Ophthalmic Anaesthesia Society were surveyed using a postal questionnaire. The response rate was 72.3%. Respondents were asked about starvation before regional anaesthesia for cataract surgery, the use of sedation in these patients, monitoring and if oxygen supplementation was given. The results show that most patients are not starved before this type of regional anaesthesia, and that the majority of patients receive no supplementary sedation or intravenous analgesia. Over 70% of patients received oxygen supplementation.