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Sample records for british medical response

  1. A "crutch to assist in gaining an honest living": dispensary shopkeeping by Scottish general practitioners and the responses of the British medical elite, ca. 1852-1911.

    PubMed

    Jenkinson, Jacqueline

    2012-01-01

    This article examines the practice among general practitioners in Scotland of keeping shops for dispensary and retail purposes in the late nineteenth century. It demonstrates that while doctors kept such open shops in these areas in order to subsidize their income in a crowded medical market, they argued that shopkeeping allowed them to provide medical care in communities where the population was otherwise too poor to pay for such care. The article compares shopkeeping to medical "covering" and assesses the medical hierarchy's reactions to shopkeeping doctors via disciplinary actions taken against some of these doctors by the General Medical Council (GMC). These actions provoked an organized protest among hundreds of doctors (some of it channeled through the British Medical Association), which challenged the methods of the GMC in determining acceptable professional medical standards.

  2. Systemic Medication and Intraocular Pressure in a British Population

    PubMed Central

    Khawaja, Anthony P.; Chan, Michelle P.Y.; Broadway, David C.; Garway-Heath, David F.; Luben, Robert; Yip, Jennifer L.Y.; Hayat, Shabina; Wareham, Nicholas J.; Khaw, Kay-Tee; Foster, Paul J.

    2014-01-01

    Objective To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women. Design Population-based, cross-sectional study. Participants We included 7093 participants from the European Prospective Investigation into Cancer–Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48–92) and 56% were women. Methods We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels. Main Outcome Measures Mean IOP of the right and left eyes. Results Use of systemic β-blockers (−0.92 mmHg; 95% CI, −1.19, −0.65; P<0.001) and nitrates (−0.63 mmHg; 95% CI, −1.12, −0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use. Conclusions This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic

  3. 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.

  4. To what extent did the 1858 Medical Act bring unity to the British medical profession?

    PubMed

    Beard, John A S

    2013-05-01

    The Medical Act of 1858 was the culmination of medical, political and social wrangling for several decades before its passage. This essay looks to place the Act in its correct historical context and will specifically consider whether it brought about unity to what was a disparate and factional profession. That it was an important piece of legislation in the history of British healthcare is unquestioned, but the extent to which it directly brought about change is more uncertain. In order to understand the background, content and repercussions of the Act, one must recognize the structure of the medical system at that time. One reason for doing this, as argued by some, is that the Medical Act, like the Apothecaries Act of 1815, was the result of changes to the profession and not the cause of them. Reformists hoped that the Medical Act would unify the profession, yet significant historical, hierarchical and political barriers stood in the way of reform.

  5. 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

  6. Modernising medical careers and the British surgeons of the future.

    PubMed

    Chand, Manish; Faruque, Mohammed; Dabbas, Natalie; Nash, Guy F

    2010-05-01

    The Modernising Medical Careers reforms in medical training have led to significant changes in the way junior doctors are trained. However, not all these changes have been welcomed by both trainees and trainers. This article seeks to examine some of the issues regarding training in surgery.

  7. 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.

  8. 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.

  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. 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.

  11. Negotiation strategies and patient empowerment in Spanish and British medical consultations.

    PubMed

    Hernández-López, María de la O

    2011-01-01

    Making a decision is not only one of the physician's most important responsibilities but also one of patients' most sensitive moments in medical encounters. Drawing from pragmatics studies, this paper explores rapport maintenance and/or enhancement (Spencer-Oatey 2000, 2008) in the decision-making strategies that General Practitioners (GPs) and patients employ in 80 encounters in various areas of England and Spain. The results show that such strategies are context-bound and subject to role specifications: while patients may make use of (dis)agreement strategies and initiate decisions and/or self-diagnosis, doctors give options, show empathy, expand explanations or show explicit or implicit (dis) agreement. In relation to this, notable findings were revealed: first, these communicative strategies may vary not only in terms of frequency but also quality and distribution; second, the Spanish interlocutors in the data gathered tend to negotiate through the explicit expression of opinions, while the British interlocutors prefer the discussion of different alternatives and value the other's freedom to act. Third, there is higher tolerance of disagreement in the Spanish data. Fourth, negotiation may be undertaken on the basis of either self-affirmation or consensus-seeking beliefs. Finally, patient empowerment is displayed in divergent ways in both sets of data. In short, the decision-making processes examined are subject to social and psychological factors with a direct impact on communicative styles.

  12. 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

  13. Opinions and preferences of British Columbia pharmacists and physicians on medication management services

    PubMed Central

    Tsao, Nicole W.; Khakban, Amir; Gastonguay, Louise; Zafari, Zafar; Lynd, Larry D.; Marra, Carlo A.

    2016-01-01

    Background: Medication management (MM) services are being provided by pharmacists across Canada in various forms, but pharmacist-physician collaboration is still not a routine practice in most jurisdictions. This survey aimed to gather pharmacists’ and physicians’ opinions and preferences for MM provision. Methods: Two parallel, cross-sectional online surveys, including best-worst scaling tasks, were designed for pharmacists and physicians in British Columbia to capture and compare their preferences for a number of attributes of MM. Results: Surveys were completed by 119 pharmacists and 146 physicians. Results indicate that pharmacists and physicians had similar opinions on many aspects of MM. Ninety-five percent of pharmacists and 69% of physicians believed that additional health services are needed to help patients optimize the use of their medications. However, the majority of each group felt that they were the most important health care professional in providing this service. Most pharmacists (79%) and some physicians (25%) thought that optimizing use of medications would result in both decreased costs and utilization to the health care system. Both pharmacists and physicians felt that the best attribute of an MM service would be if the services resulted in improved health and medication use for patients. Both groups were motivated by increased remuneration for MM; however, the relative strength of preference for this was higher among physicians. Interestingly, physicians valued improved medication adherence as a result of MM more highly than pharmacists did. Discussion and Conclusion: Most pharmacists and physicians agreed that improving patients’ health and medication use would be the best attribute of MM and that there is a need for such services. However, physicians also had strong preferences for being remunerated for participating in MM provision. PMID:28286592

  14. 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

  15. (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.

  16. Patients' responsibilities in medical ethics.

    PubMed

    Draper, Heather; Sorell, Tom

    2002-08-01

    Patients have not been entirely ignored in medical ethics. There has been a shift from the general presumption that 'doctor knows best' to a heightened respect for patient autonomy. Medical ethics remains one-sided, however. It tends (incorrectly) to interpret patient autonomy as mere participation in decisions, rather than a willingness to take the consequences. In this respect, medical ethics remains largely paternalistic, requiring doctors to protect patients from the consequences of their decisions. This is reflected in a one-sided account of duties in medical ethics. Duties fall mainly on doctors and only exceptionally on patients. Medical ethics may exempt patient from obligations because they are the weaker or more vulnerable party in the doctor-patient relationship. We argue that vulnerability does not exclude obligation. We also look at other ways in which patient responsibilities flow from general ethics: for instance, from responsibilities to others and to the self, from duties of citizens, and from the responsibilities of those who solicit advice. Finally, we argue that certain duties of patients counterbalance an otherwise unfair capacity of doctors as helpers.

  17. Has open data arrived at the British Medical Journal (BMJ)? An observational study

    PubMed Central

    Rowhani-Farid, Anisa

    2016-01-01

    Objective To quantify data sharing trends and data sharing policy compliance at the British Medical Journal (BMJ) by analysing the rate of data sharing practices, and investigate attitudes and examine barriers towards data sharing. Design Observational study. Setting The BMJ research archive. Participants 160 randomly sampled BMJ research articles from 2009 to 2015, excluding meta-analysis and systematic reviews. Main outcome measures Percentages of research articles that indicated the availability of their raw data sets in their data sharing statements, and those that easily made their data sets available on request. Results 3 articles contained the data in the article. 50 out of 157 (32%) remaining articles indicated the availability of their data sets. 12 used publicly available data and the remaining 38 were sent email requests to access their data sets. Only 1 publicly available data set could be accessed and only 6 out of 38 shared their data via email. So only 7/157 research articles shared their data sets, 4.5% (95% CI 1.8% to 9%). For 21 clinical trials bound by the BMJ data sharing policy, the per cent shared was 24% (8% to 47%). Conclusions Despite the BMJ's strong data sharing policy, sharing rates are low. Possible explanations for low data sharing rates could be: the wording of the BMJ data sharing policy, which leaves room for individual interpretation and possible loopholes; that our email requests ended up in researchers spam folders; and that researchers are not rewarded for sharing their data. It might be time for a more effective data sharing policy and better incentives for health and medical researchers to share their data. PMID:27737882

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

    PubMed

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

    2002-02-01

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

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

    PubMed

    Paugh, Katherine

    2014-01-01

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

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

    PubMed Central

    MacCarthy, Dan; Hollander, Marcus J

    2014-01-01

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

  1. 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.

  2. 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.

  3. Different responses of influenza epidemic to weather factors among Shanghai, Hong Kong, and British Columbia.

    PubMed

    Wang, Xi-Ling; Yang, Lin; He, Dai-Hai; Chiu, Alice Py; Chan, Kwok-Hung; Chan, King-Pan; Zhou, Maigeng; Wong, Chit-Ming; Guo, Qing; Hu, Wenbiao

    2017-02-08

    Weather factors have long been considered as key sources for regional heterogeneity of influenza seasonal patterns. As influenza peaks coincide with both high and low temperature in subtropical cities, weather factors may nonlinearly or interactively affect influenza activity. This study aims to assess the nonlinear and interactive effects of weather factors with influenza activity and compare the responses of influenza epidemic to weather factors in two subtropical regions of southern China (Shanghai and Hong Kong) and one temperate province of Canada (British Columbia). Weekly data on influenza activity and weather factors (i.e., mean temperature and relative humidity (RH)) were obtained from pertinent government departments for the three regions. Absolute humidity (AH) was measured by vapor pressure (VP), which could be converted from temperature and RH. Generalized additive models were used to assess the exposure-response relationship between weather factors and influenza virus activity. Interactions of weather factors were further assessed by bivariate response models and stratification analyses. The exposure-response curves of temperature and VP, but not RH, were consistent among three regions/cities. Bivariate response model revealed a significant interactive effect between temperature (or VP) and RH (P < 0.05). Influenza peaked at low temperature or high temperature with high RH. Temperature and VP are important weather factors in developing a universal model to explain seasonal outbreaks of influenza. However, further research is needed to assess the association between weather factors and influenza activity in a wider context of social and environmental conditions.

  4. Different responses of influenza epidemic to weather factors among Shanghai, Hong Kong, and British Columbia

    NASA Astrophysics Data System (ADS)

    Wang, Xi-Ling; Yang, Lin; He, Dai-Hai; Chiu, Alice PY; Chan, Kwok-Hung; Chan, King-Pan; Zhou, Maigeng; Wong, Chit-Ming; Guo, Qing; Hu, Wenbiao

    2017-02-01

    Weather factors have long been considered as key sources for regional heterogeneity of influenza seasonal patterns. As influenza peaks coincide with both high and low temperature in subtropical cities, weather factors may nonlinearly or interactively affect influenza activity. This study aims to assess the nonlinear and interactive effects of weather factors with influenza activity and compare the responses of influenza epidemic to weather factors in two subtropical regions of southern China (Shanghai and Hong Kong) and one temperate province of Canada (British Columbia). Weekly data on influenza activity and weather factors (i.e., mean temperature and relative humidity (RH)) were obtained from pertinent government departments for the three regions. Absolute humidity (AH) was measured by vapor pressure (VP), which could be converted from temperature and RH. Generalized additive models were used to assess the exposure-response relationship between weather factors and influenza virus activity. Interactions of weather factors were further assessed by bivariate response models and stratification analyses. The exposure-response curves of temperature and VP, but not RH, were consistent among three regions/cities. Bivariate response model revealed a significant interactive effect between temperature (or VP) and RH (P < 0.05). Influenza peaked at low temperature or high temperature with high RH. Temperature and VP are important weather factors in developing a universal model to explain seasonal outbreaks of influenza. However, further research is needed to assess the association between weather factors and influenza activity in a wider context of social and environmental conditions.

  5. 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.

  6. The medical response to trench nephritis in World War One.

    PubMed

    Atenstaedt, R L

    2006-08-01

    Around the 90-year anniversary of the Battle of the Somme, it is important to remember the international effort that went into responding to the new diseases, which appeared during the First World War, such as trench nephritis. This condition arose among soldiers in spring 1915, characterized by breathlessness, swelling of the face or legs, headache, sore throat, and the presence of albumin and renal casts in urine. It was speedily investigated by the military-medical authorities. There was debate over whether it was new condition or streptococcal nephritis, and the experts agreed that it was a new condition. The major etiologies proposed were infection, exposure, and diet (including poisons). Research pointed to the origin of the disease as being infective rather than toxic, but no definite cause was discovered. A number of labels were given to the disease, including war nephritis. However, trench nephritis was the one used most widely. Trench nephritis was a serious problem for the Allies, leading to 35 000 casualties in the British and 2000 in the American forces. There were also hundreds of deaths. The condition was treated in line with pre-war regimens designed for acute nephritis. No significant preventative methods were implemented for trench nephritis, as there was no consensus regarding causation. The medical response to trench nephritis was largely ineffective, with medical commentators recognizing that there had been a lack of medical progress.

  7. 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.

  8. 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)

  9. "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.

  10. Personality, lifestyles, alcohol and drug consumption in a sample of British medical students.

    PubMed

    Ashton, C H; Kamali, F

    1995-05-01

    Personality characteristics and lifestyle variables were assessed in two cohorts of second-year medical students at the University of Newcastle upon Tyne, UK as part of a psychopharmacology 'teach-in' in 1993 and 1994. The pooled sample included 186 students: 77 men, 109 women, mean age 20.4 +/- 1.8 years. Measures included the Eysenck Personality Questionnaire, the Hospital Anxiety Depression Scale, and a questionnaire concerning consumption of alcohol, tobacco, cannabis and other illicit drugs, and physical exercise. The results were compared, where possible, with a similar survey in Newcastle upon Tyne medical students in 1983 and 1984. Personality variables, prevalence of cigarette smoking, levels of caffeine consumption and participation in sports had not changed significantly over the decade. There appeared to be a modest overall increase in alcohol consumption and in the 1993 and 1994 cohorts of students, 25.5% of those who drank alcohol exceeded recommended low risk levels (comparable data not available for 1983 and 1984). Reported use of cannabis and other illicit drugs had more than doubled, and in the present survey 49.2% of students recorded using cannabis and 22% had tried other illicit drugs. Corresponding figures for 1983 and 1984 were 20.9% for cannabis and 3.3% for other illicit drugs. Anxiety levels were not measured in 1983 and 1984 but in the present survey 39.3% of the students had anxiety ratings within the clinically significant range. The high levels of alcohol consumption and illicit drug use, and the high anxiety ratings, in this sample of medical students are a cause for concern.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    PubMed

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

    2014-05-01

    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.

  12. 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

  13. 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

  14. 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.

  15. [Medical response to precariousness and poverty].

    PubMed

    Hassin, J

    1996-10-01

    If there is a medical response to precariousness and extreme poverty, there is no illness that is specific of the poor. Diseases that are commonly found here result from the state of being homeless and often addicted. One possible medical response to the problem is to establish specialized institutions as, in Paris, the Nanterre hospital, the Social SAMU (Service d'aide médicale urgente) medical dormitories, and several outpatient clinics for precarious people. The present debate on a "two-tiers medicine" must be considered with pragmatism. Specific structures have to be imagined like places for reception and orientation that allow these patients to get access to general rights for protection and assistance.

  16. 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.

  17. 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

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

    PubMed

    Meyer, Jessica

    2015-05-01

    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.

  19. 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…

  20. 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

  1. 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.

  2. Twenty years of ecosystem response after clearcutting and slashburning in conifer forests of central British Columbia, Canada

    PubMed Central

    Feller, Michael; Bradfield, Gary

    2017-01-01

    Forests are being clearcut over extensive areas of western North America, but plant community response to harvesting and slashburning under varying climatic conditions in central British Columbia, Canada is still largely unknown. Evaluation of resilience is hampered by the short history of logging, lack of long-term experiments and methodological limitations. To test the effect of clearcut logging, prescribed burning and reforestation on forest resilience, we recorded vascular plant cover repeatedly after treatment between 1981 and 2008 in 16 permanent research installations in three biogeoclimatic zones: Engelmann Spruce-Subalpine Fir, Interior Cedar-Hemlock and Sub-Boreal Spruce. We created a plant-trait dataset for the 181 recorded species to define plant functional types representing groups of plants that behave in similar ways and/or produce similar ecological outcomes. These plant functional types, along with taxonomic analysis of diagnostic and indicator species, were then used to evaluate plant community response to disturbance. Twenty years post-treatment, species diversity increased in all zones and plant abundance was greatest in the Interior Cedar-Hemlock. Cover of understory plant functional types associated with mature conifer forests increased in all zones, constituting a significant proportion (> 40%) of the vegetation community by year 20. Response patterns varied by zone and with time. Understory species diagnostic of mature forests were present in all zones by year 20, but we identified indicator species sensitive to slashburning or requiring more time for recovery, including white-flowered rhododendron (Rhododendron albiflorum) and devil's club (Oplopanax horridus). Overall, loss of compositional or functional diversity following harvest and site remediation was not detected, suggesting that montane and subalpine forests in British Columbia are resilient to this treatment. However, because these forests can be slow to recover from disturbance

  3. Twenty years of ecosystem response after clearcutting and slashburning in conifer forests of central British Columbia, Canada.

    PubMed

    Chandler, Julia R; Haeussler, Sybille; Hamilton, Evelyn H; Feller, Michael; Bradfield, Gary; Simard, Suzanne W

    2017-01-01

    Forests are being clearcut over extensive areas of western North America, but plant community response to harvesting and slashburning under varying climatic conditions in central British Columbia, Canada is still largely unknown. Evaluation of resilience is hampered by the short history of logging, lack of long-term experiments and methodological limitations. To test the effect of clearcut logging, prescribed burning and reforestation on forest resilience, we recorded vascular plant cover repeatedly after treatment between 1981 and 2008 in 16 permanent research installations in three biogeoclimatic zones: Engelmann Spruce-Subalpine Fir, Interior Cedar-Hemlock and Sub-Boreal Spruce. We created a plant-trait dataset for the 181 recorded species to define plant functional types representing groups of plants that behave in similar ways and/or produce similar ecological outcomes. These plant functional types, along with taxonomic analysis of diagnostic and indicator species, were then used to evaluate plant community response to disturbance. Twenty years post-treatment, species diversity increased in all zones and plant abundance was greatest in the Interior Cedar-Hemlock. Cover of understory plant functional types associated with mature conifer forests increased in all zones, constituting a significant proportion (> 40%) of the vegetation community by year 20. Response patterns varied by zone and with time. Understory species diagnostic of mature forests were present in all zones by year 20, but we identified indicator species sensitive to slashburning or requiring more time for recovery, including white-flowered rhododendron (Rhododendron albiflorum) and devil's club (Oplopanax horridus). Overall, loss of compositional or functional diversity following harvest and site remediation was not detected, suggesting that montane and subalpine forests in British Columbia are resilient to this treatment. However, because these forests can be slow to recover from disturbance

  4. 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

  5. Commentary: the 1944 patulin trial: the first properly controlled multicentre trial conducted under the aegis of the British Medical Research Council.

    PubMed

    Chalmers, Iain; Clarke, Mike

    2004-04-01

    The 1948 report of the British Medical Research Council's randomized trial of streptomycin for pulmonary tuberculosis is widely regarded as marking the beginning of the modern history of controlled clinical trials. Four years earlier, however, a methodologically sophisticated multicentre trial conducted under the aegis of the Medical Research Council was reported, which assessed the effects of the antibiotic patulin on the course of common colds. Philip D'Arcy Hart and Joan Faulkner (later Joan Doll) were the secretary and assistant secretary, respectively, to the committee overseeing the trial, and they clearly recognized the importance of preventing foreknowledge of allocations from those admitting patients to the study. To do this and to 'muddle people up', they and Ruth D'Arcy Hart devised a scheme involving the use of two patulin groups and two placebo groups, allocating patients to one of these four groups using strict rotation. Philip D'Arcy Hart believes that this study has been overshadowed by the celebrated streptomycin trial (for which he was also secretary to the oversight committee) because no beneficial effect of patulin was detected, and because the report of the streptomycin trial referred to the use of random sampling numbers to generate the allocation schedule. This article makes clear why we agree with Philip D'Arcy Hart that the 1944 patulin trial deserves wider recognition as the first well controlled, multicentre clinical trial to have been conducted under the aegis of the British Medical Research Council. This status is reflected in the International Journal of Epidemiology's reproduction of the full text of the trial report in this issue of the journal.

  6. 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.

  7. 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…

  8. Canadian Medical Education Journal Survey evaluations of University of British Columbia residents’ education and attitudes regarding palliative care and physician assisted death

    PubMed Central

    Spicer, David; Paul, Sonia; Tang, Tom; Chen, Charlie; Chase, Jocelyn

    2017-01-01

    Background Little prior research has been conducted regarding resident physicians’ opinions on the subject of Physician Assisted Death (PAD), despite past surveys ascertaining the attitudes of practicing physicians towards PAD in Canada. We solicited British Columbia residents’ opinions on the amount of education they receive about palliative care and physician assisted death, and their attitudes towards the implementation of PAD. Methods We conducted a cross sectional, anonymous online survey with the resident physicians of British Columbia, Canada. Questions included: close-ended questions, graded Likert scale questions, and comments. Results Among the respondents (n=299, response rate 24%), 44% received ≥5 hours of education in palliative care, 40% received between zero and four hours of education, and 16% reported zero hours. Of all respondents, 75% had received no education about PAD and the majority agreed that there should be more education about palliative care (74%) and PAD (85%). Only 35% of residents felt their program provided them with enough education to make an informed decision about PAD, yet 59% would provide a consenting patient with PAD. Half of the respondents believed PAD would ultimately be provided by palliative care physicians. Interpretation Residents desire further education about palliative care and PAD. Training programs should consider conducting a thorough needs assessment and implementing structured education to meet this need. PMID:28344712

  9. 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

  10. Hydrologic response of soils to precipitation at Carnation Creek, British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Fannin, R. J.; Jaakkola, J.; Wilkinson, J. M. T.; Hetherington, E. D.

    2000-02-01

    The extreme hydrologic response of gravelly, sandy soils in the Carnation Creek watershed is examined from observations at 12 standpipe piezometers. The nearly continuous piezometric data are reported as a time series of monthly maximum readings. Ten locations of measurement appear to exhibit an upper limit to the pore water pressure head that is independent of rainfall intensity and duration. Two locations exhibit artesian pressures that appear directly influenced by rainfall characteristics and may last for several hours. We found the impact of individual storms to be highly variable. The spatial variation in hydrologic response is attributed to the influence of preferential flow paths in the soil matrix.

  11. [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

  12. 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.

  13. 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.

  14. Do emergency medical system response times matter for health outcomes?

    PubMed

    Wilde, Elizabeth Ty

    2013-07-01

    The introduction of technology aimed at reducing the response times of emergency medical services has been one of the principal innovations in crisis care over the last several decades. These substantial investments have typically been justified by an assumed link between shorter response times and improved health outcomes. However, current medical research does not generally show a relationship between response time and mortality. In this study, we explain the discrepancy between conventional wisdom and mortality; existing medical research fails to account for the endogeneity of incident severity and response times. Analyzing detailed call-level information from the state of Utah's Bureau of Emergency Medical Services, we measure the impact of response time on mortality and hospital utilization using the distance of the incident from the nearest EMS agency headquarters as an instrument for response time. We find that response times significantly affect mortality and the likelihood of being admitted to the hospital, but not procedures or utilization within the hospital.

  15. 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).

  16. Biologic treatment response among adults with juvenile idiopathic arthritis: results from the British Society for Rheumatology Biologics Register

    PubMed Central

    McErlane, Flora; Foster, Helen E.; Davies, Rebecca; Lunt, Mark; Watson, Kath D.; Symmons, Deborah P. M.

    2013-01-01

    Objective. To describe the use of and response to biologic therapies commenced in adults with JIA. Methods. Patients with arthritis onset <16 years were identified from the British Society for Rheumatology Biologics Register for rheumatoid arthritis (BSRBR-RA) and stratified into ILAR JIA subtypes. Patterns of biologic use and treatment persistence were explored, with disability levels (HAQ) and remission rates [28-Joint Disease Activity Score (DAS28)] evaluated at 6 and 12 months. Results. Arthritis with an onset of <16 years was confirmed in 225 patients and the ILAR subtype was determined in 154 (68%). Only 58 (26%) patients had a diagnosis of JIA recorded in the BSRBR-RA. The median age at biologic commencement was 31 years [interquartile range (IQR) 23–39] and 76% were female. The biologic therapies were etanercept (49%), infliximab (28%), adalimumab (22%) and anakinra (1%). Fifty per cent of patients received more than one biologic during follow-up (2 agents, n = 64; ≥3 agents, n = 49). Treatment persistence at 1 year was 78% (95% CI 71%, 82%), falling to 42% (95% CI 34%, 49%) at 5 years. Both the HAQ and DAS28 improved significantly at 6 months, with 21% and 28% of patients in remission (DAS28 < 2.6) at 6 and 12 months, respectively. Conclusion. This study describes patterns and identifies outcomes of biologic use in a national cohort of adults with JIA. With no national guidance currently available in this area, the choice of first biologic was inconsistent, although treatment outcomes were good. These data confirm that biologic therapies are an important treatment option in adults with active JIA in adulthood. PMID:23873820

  17. 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.

  18. 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.

  19. Oil and the British economy

    SciTech Connect

    Atkinson, F.; Hall, S.

    1983-01-01

    Despite the 1976 discovery of North Sea oil, the British economy has floundered in the early 1980s. To uncover the reasons behind this predicament, the authors examine the North Sea oil sector, show the impact of its recent development on the British economy, and analyze the automatic responses of an economy to the development of such a new sector, the ''Kay debate,'' and the experience of six other countries with oil and the manufacturing industry.

  20. S(p)O(2) values in acute medical admissions breathing air--implications for the British Thoracic Society guideline for emergency oxygen use in adult patients?

    PubMed

    Smith, Gary B; Prytherch, David R; Watson, Duncan; Forde, Val; Windsor, Alastair; Schmidt, Paul E; Featherstone, Peter I; Higgins, Bernie; Meredith, Paul

    2012-10-01

    S(p)O(2) is routinely used to assess the well-being of patients, but it is difficult to find an evidence-based description of its normal range. The British Thoracic Society (BTS) has published guidance for oxygen administration and recommends a target S(p)O(2) of 94-98% for most adult patients. These recommendations rely on consensus opinion and small studies using arterial blood gas measurements of saturation (S(a)O(2)). Using large datasets of routinely collected vital signs from four hospitals, we analysed the S(p)O(2) range of 37,593 acute general medical inpatients (males: 47%) observed to be breathing room air. Age at admission ranged from 16 to 105 years with a mean (SD) of 64 (21) years. 19,642 admissions (52%) were aged <70 years. S(p)O(2) ranged from 70% to 100% with a median (IQR) of 97% (95-98%). S(p)O(2) values for males and females were similar. In-hospital mortality for the study patients was 5.27% (range 4.80-6.27%). Mortality (95% CI) for patients with initial S(p)O(2) values of 97%, 96% and 95% was 3.65% (3.22-4.13); 4.47% (3.99-5.00); and 5.67% (5.03-6.38), respectively. Additional analyses of S(p)O(2) values for 37,299 medical admissions aged ≥18 years provided results that were distinctly different to those upon which the current BTS guidelines based their definition of normality. Our findings suggest that the BTS should consider changing its target saturation for actively treated patients not at risk of hypercapnic respiratory failure to 96-98%.

  1. Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009–2013

    PubMed Central

    Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

    2016-01-01

    Background Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. Objectives To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Methods Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009–2013. Results 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). Conclusions The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. PMID:25717054

  2. 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)

  3. 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.

  4. Children's Responses to the Medical Evaluation for Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Dubowitz, Howard

    1998-01-01

    Addresses three issues: (1) how children respond to the medical evaluation for sexual abuse; (2) how the trauma of the evaluation experienced by some children can be minimized and the benefits maximized; and (3) how children's responses to the medical evaluation for sexual abuse can be interpreted. (DB)

  5. 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…

  6. ADHD: A Psychological Response to an Evolving Concept (Report of a Working Party of the British Psychological Association).

    ERIC Educational Resources Information Center

    Reason, Rea

    1999-01-01

    This article is an abridged version of a British Psychological Society paper that addresses research relevant to current understanding of the notion of attention deficit hyperactivity disorder from an historical, psychological, and biological perspective. Also discusses implications for practice in the light of the information obtained. (Author/CR)

  7. U.S. medical device reporting: who is responsible?

    PubMed

    Donawa, Maria

    2005-04-01

    When various companies are involved in the manufacture and export of medical devices to the United States (U.S.), it is not always easy to understand the reporting responsibilities under the U.S. Medical Device Reporting regulation. A new rule has been published to help companies better understand the requirements. This article discusses the new rule, ways to determine responsibilities and suggestions for compliance.

  8. 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.

  9. Metropolitan Medical Response System Act of 2010

    THOMAS, 111th Congress

    Rep. Markey, Edward J. [D-MA-7

    2010-02-03

    02/24/2010 Referred to the Subcommittee on Emergency Communications, Preparedness, and Response. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. 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.).

  11. Responding to disasters: academic medical centers' responsibilities and opportunities.

    PubMed

    Sklar, David P; Richards, Michael; Shah, Mark; Roth, Paul

    2007-08-01

    Disaster preparedness and disaster response should be a capability of all academic health centers. The authors explore the potential role and impact of academic medical centers (AMC)s in disaster response. The National Disaster Medical System and the evolution of disaster medical assistance teams (DMAT) are described, and the experience at one AMC with DMAT is reviewed. The recent deployment of a DMAT sponsored by an AMC to the Hurricane Katrina disaster is described, and the experience is used to illustrate the opportunities and challenges of future disaster medical training, research, and practice at AMCs. AMCs are encouraged to identify an appropriate academic unit to house and nurture disaster-preparedness activities, participate in education programs for health professionals and the public, and perform research on disaster epidemiology and response. Networks of AMCs offer the potential of acting as a critical resource for those AMCs stricken by a disaster and for communities needing the infusion of highly trained and motivated health care providers. The Association of American Medical Colleges can play a critical role in assisting and coordinating AMC networks through its relationship with all AMCs and the federal government and by increasing the awareness of medical educators and researchers about this important, emerging area of medical knowledge.

  12. 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.

  13. 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.

  14. Tips for using mobile audience response systems in medical education

    PubMed Central

    Gousseau, Michael; Sommerfeld, Connor; Gooi, Adrian

    2016-01-01

    Background With growing evidence on the benefits of active learning, audience response systems (ARSs) have been increasingly used in conferences, business, and education. With the introduction of mobile ARS as an alternative to physical clickers, there are increasing opportunities to use this tool to improve interactivity in medical education. Aim The aim of this study is to provide strategies on using mobile ARS in medical education by discussing steps for implementation and pitfalls to avoid. Method The tips presented reflect our commentary of the literature and our experiences using mobile ARS in medical education. Results This article offers specific strategies for the preparation, implementation, and assessment of medical education teaching sessions using mobile ARS. Conclusion We hope these tips will help instructors use mobile ARS as a tool to improve student interaction, teaching effectiveness, and participant enjoyment in medical education. PMID:27942242

  15. 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

  16. 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.

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

    PubMed

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

    2011-04-01

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

  18. Learning about medical student mistreatment from responses to the medical school graduation questionnaire.

    PubMed

    Mavis, Brian; Sousa, Aron; Lipscomb, Wanda; Rappley, Marsha D

    2014-05-01

    Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future.

  19. 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.

  20. Wireless Distribution Systems To Support Medical Response to Disasters

    PubMed Central

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

    2005-01-01

    We discuss the design of multi-hop access networks with multiple gateways that supports medical response to disasters. We examine and implement protocols to ensure high bandwidth, robust, self-healing and secure wireless multi-hop access networks for extreme conditions. Address management, path setup, gateway discovery and selection protocols are described. Future directions and plans are also considered. PMID:16779171

  1. [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.

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

    ERIC Educational Resources Information Center

    Coppoc, Gordon L.; Stuckey, William J.

    1977-01-01

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

  3. 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…

  4. Medical Response to Haiti Earthquake: Operation Unified Response

    DTIC Science & Technology

    2011-01-24

    struck Haiti at 4:53 pm, Tues, Jan 12, 2010 –230,000 Deaths * –197,000 Injured – 1.1M Displaced People –3,000,000 Affected People –60% of government...15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Magnitude 7.0 Earthquake vic. Port au Prince 6.1 Aftershock COMFORT Arrives BATAAN ARG Arrives AFSOC...RESPONSE Deployment Timeline ( March ) 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 281110986 754321 JTF-H Conducts RIP w/ARSOUTH Final DHHS Treatment

  5. Directing Discipline: State Medical Board Responsiveness to State Legislatures.

    PubMed

    Lillvis, Denise F; McGrath, Robert J

    2017-02-01

    State medical boards are increasingly responsible for regulating medical and osteopathic licensure and professional conduct in the United States. Yet, there is great variation in the extent to which such boards take disciplinary action against physicians, indicating that some boards are more zealous regulators than others. We look to the political roots of such variation and seek to answer a simple, yet important, question: are nominally apolitical state medical boards responsive to political preferences? To address this question, we use panel data on disciplinary actions across sixty-four state medical boards from 1993 through 2006 and control for over-time changes in board characteristics (e.g., composition, independence, budgetary status), regulatory structure, and resources. We show that as state legislatures become more liberal [conservative], state boards increasingly [decreasingly] discipline physicians, especially during unified government and in the presence of highly professional legislatures. Our conclusions join others in emphasizing the importance of state medical boards and the contingent nature of political control of state regulation. In addition, we emphasize the roles that oversight capacity and strategy play in offsetting concerns regarding self-regulation of a powerful organized interest.

  6. 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…

  7. HMO encroachment. The Palm Beach County Medical Society's response.

    PubMed

    Fischer, L A

    1987-03-01

    In 1984, the Palm Beach County (Florida) Medical Society faced the invasion of an HMO which, via an expensive advertising plan, urged Medicare recipients to enroll in a program that promised free health care. As physicians watched more and more of their older patients transfer to the HMO, they turned to their local medical society, which formulated a response. It launched a public information campaign designed to give patients the necessary facts about HMOs so they could make an informed decision about joining. The article describe the specific steps the physicians took to battle the new competition.

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

    PubMed

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

    2002-03-01

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

  9. 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.

  10. Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response

    PubMed Central

    Colizza, Vittoria; Schmitt, Heike; Andrews, Johanna; Balcan, Duygu; Huang, Wei E.; Keller, Virginie D.J.; Vespignani, Alessandro; Williams, Richard J.

    2011-01-01

    Background: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers. Objectives: We assessed the ecotoxicologic risks of a pandemic influenza medical response. Methods: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers. Results: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0–14% and 5–32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0–14% and 0–30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range). Conclusions: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs

  11. 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

  12. 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…

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. Leading articles in medical journals in 1966.

    PubMed

    Stimpson, Philippa J; Marks, Daniel Jb

    2016-10-01

    The British Journal of Hospital Medicine is 50 years old. This article takes a look back at articles published during the year of its inception from the British Medical Journal, the Lancet and the Journal of the American Medical Association.

  18. Executive impairment determines ADHD medication response: implications for academic achievement.

    PubMed

    Hale, James B; Reddy, Linda A; Semrud-Clikeman, Margaret; Hain, Lisa A; Whitaker, James; Morley, Jessica; Lawrence, Kyle; Smith, Alex; Jones, Nicole

    2011-01-01

    Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to indirect informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy. Documenting "cool" executive-working memory (EWM) and "hot" self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type (n = 33)/hyperactive-impulsive type (n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/ SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed.

  19. 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

  20. 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.

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

    PubMed

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

    2015-01-01

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

  3. Improvement in medical consultation responses with a structured request form.

    PubMed

    Geist, Shin-Mey Rose Y; Geist, James R

    2008-05-01

    Physicians often do not provide adequate information regarding patients' medical conditions when presented with consultation requests (CR) generated by dental students and their instructors about the students' patients. We hypothesized that a structured CR form, which requests specific information by providing a checklist and/or closed-ended questions for physicians to answer, would lead to better communication and improved responses. We also hypothesized that providing in-service education to clinical faculty on the conditions that require and don't require CRs would reduce the number of unwarranted CRs sent to physicians. We assessed the responses obtained with the new form and compared them to findings over a similar period using our older, unstructured CR forms. We also evaluated the numbers of CRs written unnecessarily during both time periods. Improvements in the appropriateness of information provided by physicians were noted with the new CR forms for diabetes mellitus, hypertension, heart murmur, and anticoagulant therapy. The number of CRs written for conditions that did not need a consultation was approximately the same after provision of instruction as before. We conclude that structured CR forms improve the flow of information between dentists and physicians and should enhance student knowledge and skills in soliciting relevant information. Greater efforts must be taken to inform clinical faculty about the indications for CRs.

  4. 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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  6. 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.

  7. 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,…

  8. British super-shuttle

    NASA Astrophysics Data System (ADS)

    1984-10-01

    British Aerospace, the nationalized aerospace manufacturer, confirmed that a space shuttle of new design is indeed being studied, and that a model of the craft will be displayed. The British television network ITN had announced that secret plans were being prepared for the construction of a reusable horizontal takeoff super-shuttle, which could breathe atmospheric oxygen to supply its propulsion system. Retracting a first denial according to which the project existed merely as scribbles on the back of an envelope, a British Aerospace spokesperson declared that it was in fact a very serious study. The super-shuttle, called HOTOL (horizontal takeoff and landing), would be placed in orbit as a platform for satellite launching. The spokesperson further indicated that with a certain resemblance to the Concorde, it would be pilotless, remote controlled, and would allow frequent operations at short time intervals.

  9. 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.

  10. Teaching Medical Ethics: Some Persistent Questions and Some Responses.

    ERIC Educational Resources Information Center

    Pellegrino, Edmund D.

    1989-01-01

    Issues in the inclusion of medical ethics in the medical curriculum are discussed, including its relevance, whether or not ethics can be taught, whose ethics should be taught, the contribution of the professional ethicist, and the relevance of humanistic studies outside ethics. (MSE)

  11. Some effects of stimulant medication on response allocation: a double-blind analysis.

    PubMed

    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 current study was to evaluate the effects of stimulant medication on response allocation when antecedents and consequences were held constant and equated. Results indicated that the presence of an amphetamine medication (Adderall) influenced response allocation across two concurrently available responses while all other stimulus conditions were held constant.

  12. The 1985 British Physics Olympiad.

    ERIC Educational Resources Information Center

    Isenberg, Cyril

    1985-01-01

    Presents questions and answers to the 1985 British Physics Olympiad (BPhO) Competition. Comments about the competition (the second year of British participation) and the winners who went to Yugoslavia (and placed second behind the USSR) are included. (JN)

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. Donald E. Francke Medal lecture. The transition from apothecary to pharmacist in British hospitals.

    PubMed

    Whittet, T D

    1979-04-01

    The transition from hospital apothecaries to contemporary hospital pharmacists in Great Britain is reviewed, beginning with the monk-apothecaries associated with the monastic infirmaries as early as the 12th century. Briefly reviewed is the use of the title Apothecary, from about the mid-1500s to about the mid-1800s, at three Royal Hospitals--St. Thomas's Hospital, St. Bartholomew's Hospital and the Bethlehem Hospital. The responsibilities, pharmaceutical and otherwise, of persons who held this title over the years are discussed. Pharmaceutical duties were eventually entrusted to the dispenser (or, at St. Thomas's, the pharmaceutist) and then to the pharmacist. The history of hospital apothecaries is also traced at the voluntary hospitals, University College Hospital, and hospitals in Scotland, Wales and the British provinces. British hospital apothecaries changed from a pharmaceutical orientation to a medical orientation, but they retained control of hospital pharmacies for about 50 years after this change was sanctioned legally.

  18. Response of Faculty Members to Medical Students' Personal Problems.

    ERIC Educational Resources Information Center

    Brown, James C.; Barnett, John M.

    1984-01-01

    A survey of 96 faculty in 12 medical schools showed that faculty average 48.6 minutes a week discussing personal problems with students. The most common problems concern finances, emotional health, and interactions with faculty. Techniques used include listening, questioning, sympathy, and empathy. (MSE)

  19. Norepinephrine and cardiovascular responses to maximal exercise in Parkinson's disease on and off medication.

    PubMed

    DiFrancisco-Donoghue, Joanne; Elokda, Ahmed; Lamberg, Eric M; Bono, Nancy; Werner, William G

    2009-09-15

    The aim of this experiment is to understand how Parkinson's disease (PD) medication affects the autonomic responses of individuals during an acute exercise stress test. Fourteen people with PD and fifteen healthy individuals age-matched between 50 and 80 years performed a modified Bruce protocol. Subjects with PD performed the test once off medication (PD-off) and then 1 week later on medication (PD-on). Heart rate (HR), blood pressure (BP), VO(2), and norepinephrine (NE) levels were taken at rest and at peak exercise. At peak exercise HR, BP, and NE values for the PD-on and PD-off group were all significantly lower than healthy controls, regardless of whether subjects were on their medication. Autonomic abnormalities during exercise in this population appear to be disease manifested and not impacted by medications used to treat PD. We can assume, both on and off medication, this population will show markedly lower BP, HR, and NE responses.

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

    PubMed

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

    2009-12-01

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

  1. British Nuclear Policymaking,

    DTIC Science & Technology

    1984-01-01

    devoted to capital spending.’ This has all Laken place although Britain’s economy has been seriously troubled by inflation, low productivity, and...American support was required to counterbalance Soviet influence in Western.Europe, Iran, Turkey, and Greece. Britain’s exhausted economy loomed as an...for a British deterrent. The simple truth is that when the Empire crumbled and the economy failed to recover, nuclear weapons became-and continue to

  2. Medical response to catastrophic events: California's planning and the Loma Prieta earthquake.

    PubMed

    Haynes, B E; Freeman, C; Rubin, J L; Koehler, G A; Enriquez, S M; Smiley, D R

    1992-04-01

    The threat of a great earthquake has compelled California to develop a disaster plan for catastrophic medical events that calls for local response with state-coordinated mutual aid and casualty evacuation, if necessary. During the 1989 Loma Prieta earthquake that killed 63 people and injured 3,700, local emergency medical services systems were busy but not stressed excessively. The medical mutual aid system delivered medical personnel, supplies, and blood. One hospital suffered severe nonstructural damage, but it was able to treat large numbers of casualties. Our system performed admirably in this limited response, but was hampered by difficulties with disaster intelligence, communications, emergency medical services dispatch, patient care records, hospital damage, and inadequate disaster training. We describe our state's mutual aid system, the Loma Prieta response, and lessons and recommendations for the future.

  3. 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

  4. 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.

  5. 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.

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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 employer...-hour request period or pending receipt of the split specimen test result. (c) Substance...

  7. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Medical Review Officer, Substance Abuse... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The employer...-hour request period or pending receipt of the split specimen test result. (c) Substance...

  8. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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 employer...-hour request period or pending receipt of the split specimen test result. (c) Substance...

  9. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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 employer...-hour request period or pending receipt of the split specimen test result. (c) Substance...

  10. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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 employer...-hour request period or pending receipt of the split specimen test result. (c) Substance...

  11. 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…

  12. Metropolitan Medical Response System Program Act of 2009

    THOMAS, 111th Congress

    Rep. Bilirakis, Gus M. [R-FL-9

    2010-01-21

    01/28/2010 Referred to the Subcommittee on Emergency Communications, Preparedness, and Response. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. 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

  14. Consensus management in the British National Health Service: implications for the United States?

    PubMed

    Schulz, R; Harrison, S

    1984-01-01

    Most operational services within the reorganized British National Health Service are managed by local teams: medical specialist, general practitioner, nurse, administrator, and finance officer. Decision by consensus has worked well to integrate services in a complex and fiscally constrained system. As larger and more formal systems of health care emerge in the United States, the British experience may be relevant.

  15. [Dose-response relationship: relevance for medical practice].

    PubMed

    Klinkhardt, U; Harder, S

    2000-05-01

    Dose-finding studies are performed routinely in patients and--if appropriate surrogate models exist--also in healthy volunteers. Such studies aim at establishing the optimal dose range for further clinical studies on the efficacy and the risk-benefit ratio of a new drug. The dose-response relationship of a drug is most often described by a sigmoidal curve. Its parameters include the mean effective dose, the maximal effect and the steepness. Interpretation of such curves should be done in the context of the intended clinical indications of the drug. The risk-benefit ratio of a drug can be assessed by overlapping the dose-response curve of wanted and unwanted clinical effects, again, any overlapping (which can be described e.g. by the therapeutic index) should be seen in the context of the indication and available therapeutic alternatives.

  16. The Royal Navy and British Security Policy.

    DTIC Science & Technology

    1983-12-01

    SCHOOL December 1983 Author Approved by: Tesis Avisor s" econd R e r Chafrman, Department of National Security Affairs -- and Policy Sciences " Dean of...8217s based on the 14 VULCAN , VICTOR and VALIANT bombers. Although cooperation with the American SAC was envisioned from the begining, the force did...British strategic nuclear deterrent. This responsibility was once the domain of the Royal Air Force and its VULCAN , VICTOR, and VALIANT bombers, but after

  17. [Urologic surgery and risks of complaints in medical responsibility].

    PubMed

    Haillot, O; Haertig, A; Vannier, J; Janin, P; Lanson, Y

    1989-01-01

    The card-index study of specialized insurance companies allowed the analysis of 82 cases concerning urological surgical procedures. Forty-two cases went to the Civil Court, 10 to the Penal Court and 5 to the Administrative Tribunal, while 5 cases were simply declared to insurance companies without judiciary consequences. Sixty-two cases concerned private plaintiffs surgeons and 34 cases concerned non specialist urologic surgeons. Sixteen plaintiffs were compensated, 9 after a conciliatory agreement and 7 after trial. There were no penal condemnations (one case on the waiting list). Impotence was the most frequent cause for complaint which was compensated. Next, came incontinence generally secondary to endoscopic resection. Retrospectively, 19 cases seemed to be unwarranted due to the dishonesty of patients (3 patients were prosecuted for unwarranted procedures). On the other hand, 32 cases seemed to be due to a lack of information given to the patients themselves or to their families, either before of after the incriminated act. The risk of prosecution is relatively low in urology. It could be decreased by careful management of the medical chart, by rapid analysis of complications and by a constant effort to inform the patient and his family.

  18. 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…

  19. 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.

  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. 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.

  2. Medical fee and service advertising: a response from physicians.

    PubMed

    Bussom, R S; Darling, J R

    1978-02-01

    Restrictions on advertising about services performed by professional groups have recently been questioned by the government and consumerists. The purpose of this study was to determine physicians' attitudes about the use of advertising in their profession and also to compare these results with responses from dentists, attorneys, and accountants. While a survey of these groups in three metropolitan areas indicate mild support for advertising in general, there was a definite negative reaction to advertising in the respective professions. Participants also reported their attitudes about the effects of advertising on prices and fees, quality of services, and public expectation and governmental regulations. The concepts of social marketing and informative advertising are suggested as approaches that may meet the requirements of both the government and the professions.

  3. Nurse education in the British armed forces.

    PubMed

    Carter, Chris; Finnegan, Alan P

    2014-10-21

    Defence nurses form the largest registered specialty in the UK defence medical services. Once qualified, defence nurses maintain and develop their nursing and clinical skills in appropriate healthcare settings, and can be deployed in operational environments such as Afghanistan. Workforce planning and staffing establishment levels are defined to meet the needs of British armed forces, allies and, potentially, local populations. Since the workforce is geographically dispersed, deployed or undertaking non-clinical duties, there are constraints on nurses' attempts to maintain basic skills and access continuing professional development. This article explores the concept and the developing role of defence nurse lecturers in improving educational support for defence nurses.

  4. 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.

  5. 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

  6. Accidental Deaths Among British Columbia Indians

    PubMed Central

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

    1966-01-01

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

  7. [THE EVALUATION OF RESPONSIBILITY CITIZEN FOR ONE'S OWN HEALTH FROM THE POSITIONS OF MEDICAL WORKERS].

    PubMed

    Dauletkalieva, J A; Kulov, D B

    2015-01-01

    The article demonstrates necessity of implementing principle of solidary responsibility of citizenfore one's own health with purpose of health promotion and development of health care in country and all over the world. The analysis of national and international literature proved that human health in many ways depends on life style. Nowadays, population places the responsibility for one's own health to state, employers and medical personnel. The article presents main results of anonymous questionnaire survey carried out among 723 workers of municipal polyclinics. The software Statisitka was applied to determine relative frequency of occurrence of characteristic in different groups (percentage) and confidence range. The comparative analysis according the Student criterion was applied among physicians and paramedical personnel. The purpose of survey was to evaluate degree of responsibility of population for one's own health from point of view of medical personnel. It is established that 69.5% of physicians and 79.6% of paramedical personnel consider their patients responsible for implementation of prescribed recommendations. The opposite point of view have 30.5% of physicians and 20.4% of paramedical personnel. According opinion of 42.9% Of physicians and 48.9% of paramedical personnel human age has no impact on degree of one's own health caring. The physicians of polyclinics evaluate responsibility of citizenfor one's own health quite low. So, only 11. 6% of physicians and 28.6% of paramedical personnel of polyclinics provide positive reply to the asked question. The majority of physicians (37.4%) and medical nurses (34.2%) are convinced that to increase responsibility for one's own health the activities infield of health education are to be implemented. The application of the mechanism of co-payments for medical services is supported by 34.6% of physicians and 27.4% of medical nurses. The given question caused difficulties with answer among 20.2% of physicians and

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

    PubMed

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

    2011-09-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. Autonomy, consent and responsibility. Part II. Informed consent in medical care and in the law.

    PubMed

    Mellado, J M

    Legal recognition of patient's rights aspired to change clinical relationship and medical lex artis. However, its implementation has been hampered by the scarcity of resources and the abundance of regulations. For several years, autonomy, consent, and responsibility have formed one of the backbones of the medical profession. However, they have sparked controversy and professional discomfort. In the first part of this article, we examine the conceptual and regulatory limitations of the principle of autonomy as the basis of informed consent. We approach the subject from philosophical, historical, legal, bioethical, deontological, and professional standpoints. In the second part, we cover the viability of informed consent in health care and its relationship with legal responsibility.

  11. 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.

  12. 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.

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

    PubMed Central

    Robinson, T N; Kemby, K M

    2012-01-01

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

  14. "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.

  15. Biotechnology and ethics in medical education of the new millennium: physician roles and responsibilities.

    PubMed

    Gonnella, Joseph S.; Hojat, Mohammadreza

    2001-07-01

    Although the medical education curriculum varies internationally, we suggest that it is desirable for medical educators to share a universal responsibility to prepare physicians to perform three distinct, yet interrelated professional roles. The first is that of a clinician who has the knowledge and technical skills to care for individual patients, as well as the public. The second role can be viewed as that of an educator, a teacher, or a consultant who has the interpersonal skills and personal qualities to teach, advise and counsel patients and the public about their health and illness, risk factors and healthy lifestyle. The third role is that of a resource manager to enable physicians to care for patients and serve the public not only by drawing on available material assets but also by prudent use of the resources for better serving the most number of people at the least expense without compromising the quality of care. The very nature of the medical profession also obligates medical educators through the world to sensitize medical students and physicians to the ethical responsibilities that are implicit to each of the three aforementioned roles. Although the basic ethical responsibilities of do no harm and confidentiality are universal, certain global changes, such as rapid advancements in biotechnology and resource allocation, are now reshaping medical ethics on every continent. Spawned by the rapid advances in the biomedical sciences, biotechnology is revolutionizing human reproduction, sustaining human life, cloning human beings, and mapping the entire human genetic terrain. These advances imply changes in medical education and formal preparation of physicians in performing their roles as clinicians, educators and resource managers. These biotechnological developments, coupled with the increasing cost of healthcare and maldistribution of resources worldwide, present unprecedented ethical-social challenges that need to be addressed in the education of the

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

    PubMed Central

    Ruan, Junhu; Wang, Xuping; Shi, Yan

    2014-01-01

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

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

    PubMed

    Ruan, Junhu; Wang, Xuping; Shi, Yan

    2014-10-27

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

  18. 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…

  19. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 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...

  20. 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...

  1. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 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...

  2. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 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...

  3. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 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...

  4. Medical Students' Responses to an Inpatient Suicide: Opportunities for Education and Support

    ERIC Educational Resources Information Center

    Hamaoka, Derrick A.; Fullerton, Carol S.; Benedek, David M.; Gifford, Robert; Nam, Theodore; Ursano, Robert J.

    2007-01-01

    Objective: The authors review third-year medical students' questionnaires to identify the perceptions, themes, and recommendations following an inpatient suicide. Method: The authors reviewed the needs assessment information collected 1 year after an inpatient suicide. The information, originally gathered through responses to a voluntary e-mail…

  5. 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…

  6. 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.

  7. 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

  8. 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

  9. DNA methylation and clinical response to antidepressant medication in major depressive disorder: A review and recommendations.

    PubMed

    Lisoway, Amanda J; Zai, Clement C; Tiwari, Arun K; Kennedy, James L

    2017-01-04

    Antidepressant medications are the most common treatment for major depression and related disorders. Pharmacogenetic studies have demonstrated that response to these medications is associated with genetic variation. While these studies have been invaluable they have yet to explain why a significant number of patients do not respond to their initial medication. The epigenetic modification known as DNA methylation has recently been studied in the context of antidepressant treatment response. As such, the purpose of this article is to review the advances made in the relatively new field of pharmaco-epigenetics of antidepressant response. We included all published articles examining DNA methylation in association with antidepressant treatment response in Major Depressive Disorder from April 2006 to June 2016 using the PubMed, Medline, PsychInfo and Web of Science databases. At the present time, although original articles are limited, epigenetic modifications of SLC6A4, BDNF, and IL11 genes are showing promising results as biomarkers for prediction of antidepressant response. However, research methods and results are heterogeneous and additional studies are required before results are generalizable. At the end of this review we provide recommendations for study design and analytic approaches.

  10. 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.

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

    PubMed

    Kraushar, Matthew L; Rosenberg, Rebecca E

    2015-08-01

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

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

    PubMed

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

    2016-04-01

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

  13. 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.

  14. 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.

  15. A next generation electronic triage to aid mass casualty emergency medical response.

    PubMed

    Gao, Tia; White, D

    2006-01-01

    For years, emergency medical response communities have relied upon paper triage tags, clipboards of notes, and voice communications to share information during medical emergencies. This workflow, however, has proven labor intensive, time consuming, and prone to human error [1]. In collaboration with three EMS groups in the Washington, DC Metropolitan area, we have developed a next generation triage system to improve the effectiveness of emergency response. This system includes: 1) electronic triage tags, 2) wearable vital sign sensors, 3) base stations laptops to monitor and manage patients, 4) pervasive tracking software to locate patients at all stages of the disaster response process, and 5) PDAs to support documentation and communication. Our system has evolved through three iterations of rapid-development, field-studies, usability reviews, and focus-group interview. This paper summarizes engineering considerations for technologies that must operate under constraints of medical emergencies. It is our hope that the lessons reported in this paper will help technologists in developing future emergency response systems.

  16. 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.

  17. Validation of self-reported diagnosis of diabetes in the 1946 British birth cohort.

    PubMed

    Pastorino, Silvia; Richards, Marcus; Hardy, Rebecca; Abington, Jane; Wills, Andrew; Kuh, Diana; Pierce, Mary

    2015-10-01

    The aim of this study was to validate self-reported diabetes and age at diagnosis among a sample of the British population, using general practitioners (GPs) as the reference standard. Using data from the Medical Research Council National Survey of Health and Development (NSHD), self-reported diabetes was determined either in response to a direct question at five follow-ups between 1977 and 2010, or from other self-reported medical information. A validation questionnaire was sent to the GP for all participants who reported a diagnosis of diabetes and gave permission to contact their GP (172). The validity of self-reported diabetes was assessed by calculating the percentage of self-reported diabetes cases that were confirmed by their GP, i.e. the positive predictive value (PPV). The difference between self-reported and GP-confirmed age at diagnosis was analysed with a Bland-Altman plot. Completed questionnaires were obtained from 157 GPs (91.2%). Of these, 149 confirmed their patient self-reported diabetes diagnosis (PPV=94.9%). Results were similar when self-reported diabetes was assessed by responses to direct questions only (PPV=95.4%). The average difference between self-reported and GP-reported age at diagnosis was 0.6 years (95% CI 0.2-1.1). We conclude that among the British population questionnaires are a valid method to assess GP-diagnosed diabetes, as measured by responses to a direct question or by patient-reported medical information.

  18. 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.

  19. Response to depression treatment in the Aging Brain Care Medical Home model

    PubMed Central

    LaMantia, Michael A; Perkins, Anthony J; Gao, Sujuan; Austrom, Mary G; Alder, Cathy A; French, Dustin D; Litzelman, Debra K; Cottingham, Ann H; Boustani, Malaz A

    2016-01-01

    Objective To evaluate the effect of the Aging Brain Care (ABC) Medical Home program’s depression module on patients’ depression severity measurement over time. Design Retrospective chart review. Setting Public hospital system. Participants Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014. Methods The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9) scores recorded in the ABC Medical Home program’s depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept. Results Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P<0.001); however, the effect differed by gender (P=0.015). On average, women’s scores (4.5 point drop at 1 month) improved faster than men’s scores (1 point drop at 1 month). Moreover, both men and women had a predicted drop of 7 points (>50% decline from baseline) on the PHQ-9 at 6 months. Conclusion These analyses demonstrate evidence for the sustained effectiveness of the ABC Medical Home program at inducing depression remission outcomes while employing clinical staff who required less formal training than earlier clinical trials. PMID:27826188

  20. 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.

  1. Alcohol and other drugs: the response of the political and medical institutions.

    PubMed

    Pittman, D J; Staudenmeier, W J; Kaplan, A

    1991-08-01

    Formal and informal social control in shaping individual behaviors toward the use of alcohol and other drugs is discussed. Emphasis is placed on formal social control as it occurs in two major institutions. The state, which embodies the political and legal structures of the society is discussed in terms of the social control of some of the consequences of drinking, such as public drunkenness, alcoholism, operating vehicles with specific blood alcohol levels, and crime and alcohol use. The medical institution's involvement in alcohol and drug control is discussed in terms of the physician's role in diagnosing alcohol and drug dependent individuals. Two contemporary cases, those of pregnant addicts and alcohol-related organ transplant patients, illustrate the significant interactions between the responses of the political and medical institutions, and the broader influences that help shape these responses.

  2. A conflict of responsibilities: a grounded theory study of clinical psychologists' experience of client non-attendance within the British National Health Service.

    PubMed

    Tweed, A E; Salter, D P

    2000-12-01

    Within psychotherapy process research, the effects of client non-attendance upon therapists has been neglected. The present study interviewed six clinical psychologists concerning their experiences of client non-attendance in health service practice in the UK. Their accounts were analysed using a grounded theory method. A core category was identified and termed 'responsibility'. This highlighted conflicting relationships between participants' responsibilities in several areas. A process model pertaining to non-attendance was also developed. Client non-attendance was seen to produce a level of disruption, experienced as an affective reaction and often experienced in terms of negative affect. In response, re-organizational strategies were used to restore equilibrium. Reasons are suggested as to why negative affective reactions were experienced. These include factors concerning therapeutic competency, but also reflect upon the profession's espousal of an 'all-knowing' expert identity. This is seen to be incongruent to the complexities of clinical practice.

  3. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    DTIC Science & Technology

    2012-10-31

    information is estimated to average 1 hour per response, including the time for reviewing instructions, searching data sources, gathering and...maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of...2012 through September 30, 2012 5 of 17 • RITN participated in the BARDA Medical Countermeasures Capacity review in the National Capital Region

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

    PubMed

    Benson, Blaine E

    2011-11-01

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

  5. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    DTIC Science & Technology

    2014-10-30

    MD Anderson Cancer Center BCPeX Business Continuity Plan Exercise MDS Myelodysplastic Syndrome BMCC Bone Marrow Coordinating Center MHC Major...Histocompatibility Complex BMDW Bone Marrow Donors Worldwide MICA MHC Class I-Like Molecule, Chain A BMT Bone Marrow Transplantation MICB MHC Class I-Like...1 of 16 Grant Award N00014-13-1-0039 DEVELOPMENT OF MEDICAL TECHNOLOGY FOR CONTINGENCY RESPONSE TO MARROW TOXIC AGENTS QUARTERLY

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  7. 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.

  8. 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.

  9. 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.

  10. Comment: The People's Law School of British Columbia.

    ERIC Educational Resources Information Center

    Sprowls, David

    1980-01-01

    The People's Law School of British Columbia is a nonprofit organization informing laymen of their legal rights and responsibilities. The program features free evening courses cosponsored by community groups in 60 centers around the province. (Journal availability: Canada-United States Law Journal, 11075 East Blvd., Cleveland, OH 44106.) (MSE)

  11. 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…

  12. [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.

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

    PubMed

    Jones, Edward R; Goldman, Richard S

    2015-08-07

    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.

  15. 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)

  16. 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)

  17. 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.

  18. Proper oxygen use can help save lives in initial medical emergency response.

    PubMed

    Starr, L M

    1993-03-01

    For many people who deal with medical emergencies--some human resource managers, emergency team administrators, CPR and first aid instructors, EMTs, nurses and physicians--the topic of oxygen use by nonmedical responders at the workplace is poorly understood. Workplace emergency response administrators may find it helpful to become familiar with the current emergency medical literature and learn that the previous literature may no longer apply. Furthermore, fear that use of emergency oxygen by nonmedical responders is "playing doctor," and will lead to some imagined uncontrollable catastrophe is based on statistically and medically unfounded misinformation. As is the case with many uncertain events, the perception of risk is unrelated to the actual risk. Refusing to allow appropriately trained nonmedical responders to use reliable emergency oxygen when it is available is a potentially grave error and makes emergency care in the workplace less efficient and valuable. There are many cases of workplace injury or illness in which oxygen use is not only appropriate but may help save a patient's life. Ensuring that the proper emergency oxygen equipment is available where appropriate and properly training personnel are responsible for first aid can, in some cases, lessen the severity of workplace illness and injury incidents.

  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. Medical ozone increases methotrexate clinical response and improves cellular redox balance in patients with rheumatoid arthritis.

    PubMed

    León Fernández, Olga Sonia; Viebahn-Haensler, Renate; Cabreja, Gilberto López; Espinosa, Irainis Serrano; Matos, Yanet Hernández; Roche, Liván Delgado; Santos, Beatriz Tamargo; Oru, Gabriel Takon; Polo Vega, Juan Carlos

    2016-10-15

    Medical ozone reduced inflammation, IL-1β, TNF-α mRNA levels and oxidative stress in PG/PS-induced arthritis in rats. The aim of this study was to investigate the medical ozone effects in patients with rheumatoid arthritis treated with methotrexate and methotrexate+ozone, and to compare between them. A randomized clinical study with 60 patients was performed, who were divided into two groups: one (n=30) treated with methotrexate (MTX), folic acid and Ibuprophen (MTX group) and the second group (n=30) received the same as the MTX group+medical ozone by rectal insufflation of the gas (MTX+ozone group). The clinical response of the patients was evaluated by comparing Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), Anti-Cyclic Citrullinated (Anti-CCP) levels, reactants of acute phase and biochemical markers of oxidative stress before and after 20 days of treatment. MTX+ozone reduced the activity of the disease while MTX merely showed a tendency to decrease the variables. Reactants of acute phase displayed a similar picture. MTX+ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. Glutathione correlated with all clinical variables just after MTX+ozone. MTX+ozone increased the MTX clinical response in patients with rheumatoid arthritis. No side effects were observed. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets. Medical ozone treatment is capable of being a complementary therapy in the treatment of rheumatoid arthritis.

  2. Family Experiences with Pediatric Antiretroviral Therapy: Responsibilities, Barriers, and Strategies for Remembering Medications

    PubMed Central

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

    2008-01-01

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

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

    PubMed

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

    2012-12-01

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

  4. Use of a geographic information system (GIS) in the medical response to the Fukushima nuclear disaster in Japan.

    PubMed

    Nagata, Takashi; Kimura, Yoshinari; Ishii, Masami

    2012-04-01

    The Great East Japan Earthquake occurred on March 11, 2011. In the first 10 days after the event, information about radiation risks from the Fukushima Daiichi nuclear plant was unavailable, and the disaster response, including deployment of disaster teams, was delayed. Beginning on March 17, 2011, the Japan Medical Association used a geographic information system (GIS) to visualize the risk of radiation exposure in Fukushima. This information facilitated the decision to deploy disaster medical response teams on March 18, 2011.

  5. 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.

  6. 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.

  7. Speciality preferences in Dutch medical students influenced by their anticipation on family responsibilities.

    PubMed

    Alers, Margret; Pepping, Tess; Bor, Hans; Verdonk, Petra; Hamberg, Katarina; Lagro-Janssen, Antoine

    2014-12-01

    Physician gender is associated with differences in the male-to-female ratio between specialities and with preferred working hours. We explored how graduating students' sex or full-time or part-time preference influences their speciality choice, taking work-life issues into account. Graduating medical students at Radboud University Medical Centre, the Netherlands participated in a survey (2008-2012) on career considerations. Logistic regression tested the influence of sex or working hour preference on speciality choice and whether work-life issues mediate. Of the responding students (N = 1,050, response rate 83, 73.3 % women), men preferred full-time work, whereas women equally opted for part time. More men chose surgery, more women family medicine. A full-time preference was associated with a preference for surgery, internal medicine and neurology, a part-time preference with psychiatry and family medicine. Both male and female students anticipated that foremost the career of women will be negatively influenced by family life. A full-time preference was associated with an expectation of equality in career opportunities or with a less ambitious partner whose career would affect family life. This increased the likelihood of a choice for surgery and reduced the preference for family medicine among female students. Gender specifically plays an important role in female graduates' speciality choice making, through considerations on career prospects and family responsibilities.

  8. EEG connectivity between the subgenual anterior cingulate and prefrontal cortices in response to antidepressant medication.

    PubMed

    Iseger, Tabitha A; Korgaonkar, Mayuresh S; Kenemans, J Leon; Grieve, Stuart M; Baeken, Chris; Fitzgerald, Paul B; Arns, Martijn

    2017-02-22

    Antidepressant medication is the most common treatment for major depressive disorder (MDD), however, the precise working mechanism underlying these treatments remains unclear. Recent neuromodulation treatments demonstrate that direct stimulation of the dorsolateral prefrontal cortex (DLPFC), dorsomedial prefrontal cortex (DMPFC), and subgenual anterior cingulate (sgACC) relate to clinical improvement, suggesting connectivity alterations of the DLPFC-DMPFC-sgACC network to mediate antidepressant response. The international Study to Predict Optimized Treatment in Depression (iSPOT-D) is an international multicentre study that collected EEG data for 1008 MDD patients, randomized to 3 different antidepressant medications (N=447 MDD with complete pre- and post-treatment data and N=336 non-MDD). Treatment response was defined by a decline of >50% on the Hamilton Rating Score for Depression (HRSD17). We investigated whether connectivity in alpha and theta frequencies of the DLPFC-DMPFC-sgACC network changed from pre- to post-treatment between: (i) patients and controls, and (ii) responders (R) and non-responders (NR). Women exhibited higher alpha and theta connectivity compared to males, both pre- and post-treatment. Furthermore, theta, but not alpha, hypo-connectivity was found for MDD patients. A decreased alpha connectivity after treatment was found only for male responders, while non-responders and females exhibited no changes in alpha connectivity. Decreasing alpha connectivity could potentially serve as a treatment emergent biomarker, in males only. Furthermore, it could be useful to a priori stratify by gender for future MDD studies.

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

    PubMed

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

    2009-02-01

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

  10. 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. PMID:27775101

  11. 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.

  12. Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital.

    PubMed

    Al-Hashar, Amna; Al-Zakwani, Ibrahim; Eriksson, Tommy; Al Za'abi, Mohammed

    2017-01-01

    Background: Medication errors occur frequently at transitions in care and can result in morbidity and mortality. Medication reconciliation is a recognized hospital accreditation requirement and designed to limit errors in transitions in care. Objectives: To identify beliefs, perceived roles and responsibilities of physicians, pharmacists and nurses prior to the implementation of a standardized medication reconciliation process. Methods: A survey was distributed to the three professions: pharmacists in the pharmacy and physicians and nurses in hospital in-patient units. It contained questions about the current level of medication reconciliation practices, as well as perceived roles and responsibilities of each profession when a standardized process is implemented. Value, barriers to implementing medication reconciliation and the role of information technology were also assessed. Analyses were performed using univariate statistics. Results: There was a lack of clarity of current medication reconciliation practices as well as lack of agreement between the three professions. Physicians and pharmacists considered their professions as the main providers while nurses considered physicians followed by themselves as the main providers with limited roles for pharmacists. The three professions recognize the values and benefits of medication reconciliation yet pharmacists, more than others, stated limited time to implement reconciliation is a major barrier. Obstacles such as unreliable sources of medication history, patient knowledge and lack of coordination and communication between the three professions were expressed. Conclusions: The three health care professions recognize the value of medication reconciliation and want to see it implemented in the hospital, yet there is a lack of agreement with regard to roles and responsibilities of each profession within the process. This needs to be addressed by the hospital administration to design clear procedures and defined roles

  13. 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

  14. Smoking Response to Health and Medical Spending Changes and the Role of Insurance.

    PubMed

    Marti, Joachim; Richards, Michael R

    2017-03-01

    Severe health shocks provide new information about one's personal health and have been shown to influence smoking behaviors. In this paper, we suggest that they may also convey information about the hard to predict financial consequences of illnesses. Relevant financial risk information is idiosyncratic and unavailable to the consumer preceding illness, and the information search costs are high. However, new and salient information about the health as well as financial consequences of smoking after a health shock may impact smoking responses. Using variation in the timing of health shocks and two features of the US health care system (uninsured spells and aging into the Medicare program at 65), we test for heterogeneity in the post-shock smoking decision according to plausibly exogenous changes in financial risk exposure to medical spending. We also explore the relationship between smoking and the evolution of out-of-pocket costs. Individuals experiencing a cardiovascular health shock during an uninsured spell have more than twice the cessation effect of those receiving the illness while insured. For those uninsured prior to age 65 years, experiencing a cardiovascular shock post Medicare eligibility completely offsets the cessation effect. We also find that older adults' medical spending changes separate from health shocks influence their smoking behavior. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Physicians' responses to financial and social incentives: A medically framed real effort experiment.

    PubMed

    Lagarde, Mylène; Blaauw, Duane

    2017-04-01

    Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remuneration schemes in a multi-tasking context. We assess the impact of different incentives on the quantity (productivity) and quality of outputs of 132 participants. We also test whether the existence of benefits to patients influences effort. The results show that salary yields the lowest quantity of output, and fee-for-service the highest. By contrast, we find that the highest quality is achieved when participants are paid by salary, followed by capitation. We also find a lot of heterogeneity in behaviour, with intrinsically motivated individuals hardly sensitive to financial incentives. Finally, we find that when work quality benefits patients directly, subjects improve the quality of their output, while maintaining the same levels of productivity. This paper adds to a nascent literature by providing a new approach to studying remuneration schemes and modelling the medical decision making environment in the lab.

  16. Withholding and withdrawing life-sustaining treatment: criminal responsibility for established medical practice?

    PubMed

    White, Ben; Willmott, Lindy; Allen, John

    2010-05-01

    The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the "necessaries of life". This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

  17. Caffeine enhances the physiological response to occupational stress in medical students.

    PubMed

    Pincomb, G A; Lovallo, W R; Passey, R B; Brackett, D J; Wilson, M F

    1987-01-01

    Caffeine (3.3 mg/kg) was tested against a placebo in 20 male medical students during periods of low (no exams) versus high (final exams) work stress. On each of 8 test days, heart rate and blood pressure were measured at baseline and over a 40-min postdrug interval; immediately afterward, blood was drawn to test plasma cortisol and serum lipid concentrations. Exams increased heart rate (p less than .005) and systolic blood pressure (p less than .02). Caffeine decreased heart rate (p less than .0001) and increased systolic blood pressure (p less than .005), diastolic blood pressure (p less than .0001), plasma cortisol levels (p less than .01), and serum cholesterol levels (p less than .02). Caffeine effects were additive with those of exams, and together they increased the number of men showing systolic blood pressures in the borderline hypertensive range. Thus, caffeine use during periods of increased occupational stress may enhance the cumulative stress response.

  18. The discursive construction of competence and responsibility in medical collegial talk.

    PubMed

    Atkinson, Paul

    2004-01-01

    The paper explores the construction of clinical competence in the spoken discourse of physicians. The analysis is derived from transcribed recordings of physicians' talk in the specialty of Haematology in an American teaching hospital. It is argued that current discussions of 'competence' among medical sociologists and anthropologists are not adequately based in the direct observation and recording of physicians' professional, collegial interactions. It is argued that physicians' constructions of case narratives and presentations inscribes the evaluations of the responsibility and competence of other physicians, through the representation of their agency and character in the course of accounts of cases. The paper thus addresses the naturally occurring use of 'evidence' in a clinical setting, and is an invitation to more naturalistic studies of 'evidence-based medicine'.

  19. 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.

  20. 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.

  1. Who is Responsible for Evaluating the Safety and Effectiveness of Medical Devices? The Role of Independent Technology Assessment

    PubMed Central

    Petersen, Amy J.; Karliner, Leah S.; Tice, Jeffrey A.

    2007-01-01

    Introduction The global medical technology industry brings thousands of devices to market every year. However, significant gaps persist in the scientific literature, in the medical device approval process, and in the realm of postmarketing surveillance. Although thousands of drugs obtain approval only after review in randomized controlled trials, relatively few new medical devices are subject to comparable scrutiny. Objective To improve health outcomes, we must enhance our scrutiny of medical devices, and, without simply deferring to the Food and Drug Administration, we must ask ourselves: Who is responsible for evaluating the safety and effectiveness of medical devices? Conclusions Technology assessments by independent organizations are a part of the solution to this challenge and may motivate further research focused on patient outcomes. PMID:18095046

  2. 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.

  3. Implementing medical revalidation in the United Kingdom: Findings about organisational changes and impacts from a survey of Responsible Officers

    PubMed Central

    Boyd, Alan; Bryce, Marie; Luscombe, Kayleigh; Tazzyman, Abigail; Tredinnick-Rowe, John; Archer, Julian

    2017-01-01

    Objective To describe the implementation of medical revalidation in healthcare organisations in the United Kingdom and to examine reported changes and impacts on the quality of care. Design A cross-sectional online survey gathering both quantitative and qualitative data about structures and processes for medical revalidation and wider quality management in the organisations which employ or contract with doctors (termed ‘designated bodies’) from the senior doctor in each organisation with statutory responsibility for medical revalidation (termed the ‘Responsible Officer’). Setting United Kingdom Participants Responsible Officers in designated bodies in the United Kingdom. Five hundred and ninety-five survey invitations were sent and 374 completed surveys were returned (63%). Main outcome measures The role of Responsible Officers, the development of organisational mechanisms for quality assurance or improvement, decision-making on revalidation recommendations, impact of revalidation and mechanisms for quality assurance or improvement on clinical practice and suggested improvements to revalidation arrangements. Results Responsible Officers report that revalidation has had some impacts on the way medical performance is assured and improved, particularly strengthening appraisal and oversight of quality within organisations and having some impact on clinical practice. They suggest changes to make revalidation less ‘one size fits all’ and more responsive to individual, organisational and professional contexts. Conclusions Revalidation appears primarily to have improved systems for quality improvement and the management of poor performance to date. There is more to be done to ensure it produces wider benefits, particularly in relation to doctors who already perform well. PMID:28084166

  4. British Counterinsurgency Operations in Ireland 1916-1921. A Case Study.

    DTIC Science & Technology

    2007-11-02

    some ineptitude by the British. The principal Irish parties in shaping the rebellion in Ireland were Sinn Fein, the Irish Volunteer Force ( IVF ), and...political scene. The IVF was the Irish Catholic militia force founded in 1913 in 17 response to the formation of the Protestant Ulster Volunteer Force...Having grown to over 100,000 participants by 1914, the IVF ranks were depleted by the Irishmen who volunteered to fight for the British against

  5. Predicting stimulant medication response in ADHD: evidence from an integrated profile of neuropsychological, psychophysiological and clinical factors.

    PubMed

    Hermens, Daniel F; Cooper, Nicholas J; Kohn, Michael; Clarke, Simon; Gordon, Evian

    2005-03-01

    There have been significant advances in understanding the neurobiology of Attention-Deficit/Hyperactivity Disorder (ADHD) and it is timely to examine the ability of biological and psychological markers to predict medication response in this disorder. We evaluated prediction of medication response in adolescent ADHD using neuropsychological testing and psychophysiological measures of central and autonomic function. Fifty ADHD adolescents participated in pre- and post-stimulant medication testing. Separately ranked performance in auditory oddball and visual Working Memory (WM) tasks determined 20 "responders" and 20 "non-responders" with 10 "neutrals" excluded from the discriminant function analyses (DFA). For both oddball and WM performance rankings, the two groups did not differ in age, sex, or handedness. However, responders did have higher levels of symptomatology than non-responders at baseline. Pre-stimulant medication psychophysiology variables were used as predictors in each DFA. Oddball performance correctly classified 85.0% of responders and 95.0% of non-responders. Better response was associated with increased resting beta power (left posteriorly), delayed oddball target N1 (frontally), decreased oddball target P2 (left posteriorly) and decreased WM distractor P3 (right frontally). Working memory performance classified 80.0% of responders and 90.0% of non-responders, with a broadly similar profile of psychophysiological predictors. These finding indicate the value of integrating neuropsychological and psychophysiological data in predicting medication response in ADHD.

  6. Cutting Close to the Bone: Student Trauma, Free Speech, and Institutional Responsibility in Medical Education.

    PubMed

    Kumagai, Arno K; Jackson, Brittani; Razack, Saleem

    2017-03-01

    Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years. This potential for iatrogenic educational trauma remains unaddressed, and medical educators must take responsibility for attending to it. Possible solutions include trigger warnings or statements given to students before an educational activity that may cause personal discomfort. The authors of this Perspective assert, however, both that this concept does not distinguish between psychological trauma and discomfort and that well-intentioned trigger warnings target the wrong goal-the avoidance of distress. Exposure to discomfort not only is unavoidable in the practice of medicine but may be crucial to personal and professional moral development. The authors argue that a more appropriate solution is to create safe spaces for dialogues about difficult topics and jarring experiences. This approach places even the notion of free speech under a critical lens-it is not an end in itself but a means to create a professional ethic dedicated to treating all individuals with excellence and justice. Ultimately, this approach aspires to create an inclusive curriculum sensitive to the realities of teaching and learning in increasingly diverse societies.

  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. [Risk management in health care systems: the new legislative orientations in medical civil responsibility].

    PubMed

    Tomassini, A; Signorelli, C; Colzani, E

    2004-01-01

    The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

  9. 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.

  10. 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.

  11. 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…

  12. 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.…

  13. British Columbia Transfer TIPS. Second Edition Revised

    ERIC Educational Resources Information Center

    Finlay, Finola, Ed.; Karlinski, Jean, Ed.

    2005-01-01

    BCTransfer TIPS is a user friendly document outlining how transfer between British Columbia (BC) post-secondary institutions works. It includes tips, student quotes, scenarios, a personal plan and checklist. Information in this document can only be reproduced with permission from the British Columbia Council on Admissions and Transfer (BCCAT.)

  14. British Children's Books in the Twentieth Century.

    ERIC Educational Resources Information Center

    Eyre, Frank

    A revised and expanded version of an earlier study of modern British children's literature (1952), this latest edition begins with an introductory section on the historical development of children's literature and follows with chapters examining the main trends in British children's books from 1900 to the present day. Special attention is given to…

  15. 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…

  16. 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…

  17. Utilisation of British University Research Reactors.

    ERIC Educational Resources Information Center

    Duncton, P. J.; And Others

    British experience relating to the employment of university research reactors and subcritical assemblies in the education of nuclear scientists and technologists, in the training of reactor operators and for fundamental pure and applied research in this field is reviewed. The facilities available in a number of British universities and the uses…

  18. Indian Education Programs in British Columbia.

    ERIC Educational Resources Information Center

    Kelly, Reg

    The British North America Act of 1867, the founding constitution of Canada, provides that all matters pertaining to Indians and Indian lands are under Federal jurisdiction. Because of this, the province of British Columbia (BC) has not felt it could do much for native peoples and little attention has been paid to the extension of provincial…

  19. 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…

  20. 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…

  1. 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…

  2. Imperatives in medical education and training in response to demands for a sustainable workforce.

    PubMed

    Dowton, S Bruce

    Factors to be considered in planning our medical workforce to meet future needs include: Need for outcomes-based curricular designs in medical schools and postgraduate training. Shortening the length of medical training. Improving career flexibility to permit professional re-invention. Developing awareness within the profession about how innovation happens.

  3. Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

    PubMed Central

    2012-01-01

    Background Despite numerous studies evaluating the benefits of Helicopter Emergency Medical Services (HEMS) in primary scene responses, little information exists on the scope of HEMS activities in Australia. We describe HEMS primary scene responses with respect to the time taken, the distances travelled relative to the closest designated trauma hospital and the receiving hospital; as well as the clinical characteristics of patients attended. Methods Clinical service data were retrospectively obtained from three HEMS in New South Wales between July 2008 and June 2009. All available primary scene response data were extracted and examined. Geographic Information System (GIS) based network analysis was used to estimate hypothetical ground transport distances from the locality of each primary scene response to firstly the closest designated trauma hospital and secondly the receiving hospital. Predictors of bypassing the closest designated trauma hospital were analysed using logistic regression. Results Analyses included 596 primary missions. Overall the HEMS had a median return trip time of 94min including a median of 9min for activation, 34min travelling to the scene, 30min on-scene and 25min transporting patients to the receiving hospital. 72% of missions were within 100km of the receiving hospital and 87% of missions were in areas classified as ‘major cities’ or ‘inner regional’. The majority of incidents attended by HEMS were trauma-related, with road trauma the predominant cause (44%). The majority of trauma patients (81%) had normal physiology at HEMS arrival (RTS = 7.84). We found 62% of missions bypassed the closest designated trauma hospital. Multivariate predictors of bypass included: age; presence of spinal or burns trauma; the level of the closest designated trauma hospital; the transporting HEMS. Conclusion Our results document the large distances travelled by HEMS in NSW, especially in rural areas. The high proportion of HEMS missions that bypass

  4. 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.

  5. Transforming family practice in British Columbia

    PubMed Central

    Cavers, William J.R.; Tregillus, Valerie H.F.; Micco, Angela; Hollander, Marcus J.

    2010-01-01

    ABSTRACT OBJECTIVE To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC’s health authorities also attend as guests. METHOD This paper is based on the 2008–2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. REPORT The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. CONCLUSION Early results indicate that the GPSC’s initiatives are enhancing the delivery of primary care services in BC. PMID:21156899

  6. Introducing complementary medicine into the medical curriculum.

    PubMed Central

    Rampes, H; Sharples, F; Maragh, S; Fisher, P

    1997-01-01

    We surveyed the deans of British medical schools to determine the provision of complementary medicine in the undergraduate curriculum. We also sampled medical students at one British medical school to determine their knowledge of, and views on instruction in, complementary medicine. There is little education in complementary medicine at British medical schools, but it is an area of active curriculum development. Students' levels of knowledge vary widely between different therapies. Most medical students would like to learn about acupuncture, hypnosis, homoeopathy and osteopathy. We conclude that complementary medicine should be included in the medical undergraduate curriculum. This could be done without a great increase in teaching of facts, and could serve as a vehicle to introduce broader issues, as recommended by the General Medical Council. PMID:9059376

  7. [Responsibility of the anaesthetist in preoperative risk management. Comments on the legal implications of medical publications in this field].

    PubMed

    Bock, R-W; Dudziak, R; Wilke, H J

    2004-06-01

    There is an increasing number of publications in the medical literature which address the medical and legal obligations of a specialist in a given field. These articles, mostly editorials, seek to delineate the optimal course of treatment based on the current state of the art and science of medicine. However, we believe that the unreflected adoption of these often highly theoretical ideas and suggestions carries its own dangers. For one thing, there is the threatening financial crisis in the public health system. In addition, the feasibility of implementing these suggestions in routine medical and surgical practice is questionable. Last but not least, suggestions and guidelines for preoperative risk management by, for instance, Lingnau and Strohmenger 2002 cross the well established boundaries of the various medical and surgical specialties, which obviously demands careful deliberations among the specialties involved. So far, few specialty boards have seen fit to act on these suggestions. Our article on the medical and legal responsibilities of the anaesthesiologist in perioperative risk management restates the aforementioned concerns. We attempt to point out medical and legal points of controversy. In particular, we caution against the ever present danger of a bona fide adoption of visionary guidelines as the "standard of care" by both medical and legal experts. We feel that it is imperative to carefully evaluate editorial comments and suggestions, however well meaning, in the light of established teaching and practice, lest these comments and suggestions become the basis of an unjustified determination of a physicians innocence or guilt in a court of law.

  8. 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.

  9. 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…

  10. Developments in British environmental law

    SciTech Connect

    Williams, D.G.T.

    1984-07-01

    Decisions on whether or not to build nuclear power plants are increasingly settled in the courts because of conflicting interests in the growth of electric power demand and environmental protection that has led to a breakdown in public order. Lawyers share the same sense of bewilderment as lay people over nuclear as well as noise, smoke, and other types of environmental questions. The author reviews British criminal and civil law to see how the courts have dealt with pollution issues in the past. Public inquiry over a proposed development has triggered many of Britain's major law and environment problems, the Windscale inquiry being a notable example. A reluctance to legislate is an underlying factor in the trend toward inquiry and litigation. 139 references.

  11. British surgical aid to Jordan

    PubMed Central

    Boyd, N. A.; Barry, N. A.; Davies, A. K.

    1971-01-01

    The surgical commitment of No. 2 Field Hospital, R.A.M.C., during its stay in Jordan is presented. The majority of patients that were admitted had sustained war wounds, many of which were infected due to the delay in treatment. The difficulties encountered in their subsequent management are discussed. Special reference is made to the use of ketamine (Ketalar) and mafenide acetate (Sulphamylon) in the treatment of those burns cases under our care. It is the first time for many years that a British field hospital has been employed in an active rôle. ImagesFig. 1Fig. 3Fig. 4Fig. 8Fig. 11Fig. 12Fig. 13Fig. 14Fig. 2Fig. 5Fig. 6Fig. 7Fig. 9Fig. 10 PMID:5114910

  12. Association of the dopamine receptor interacting protein gene, NEF3, with early response to antipsychotic medication.

    PubMed

    Strous, Rael D; Greenbaum, Lior; Kanyas, Kyra; Merbl, Yifat; Horowitz, Anat; Karni, Osnat; Viglin, Dina; Olender, Tsviya; Deshpande, Smita N; Lancet, Doron; Ben-Asher, Edna; Lerer, Bernard

    2007-06-01

    Genetic variation in antipsychotic drug targets could underlie variability among patients in the time required for antipsychotic effects to be elicited. In a clinical, pharmacogenetic study we focused on the dopamine receptor interacting protein (DRIP) gene family. DRIPs are pivotally involved in regulating dopamine receptor signal transduction. Consecutively hospitalized, acutely psychotic patients with DSM-IV schizophrenia (n=121) were included in the study if they received treatment with typical antipsychotic medication (TYP, n=72) or TYP plus risperidone (TYP-R, n=49) for at least 2 wk. Clinical state and adverse effects were rated at baseline and after 2 wk. Patients improved significantly on both TYP and TYP-R with no significant difference between them. Early responders were defined as patients whose PANSS change scores were greater than the median. Twenty-two single nucleotide polymorphisms (SNPs) were analysed in five DRIP-encoding genes. Two SNPs in NEF3, which encodes the DRIP, neurofilament-medium (NF-M), were associated with early response (rs1457266, p=0.01; rs1379357, p=0.006). A 5 SNP haplotype spanning NEF3 was over-represented in early responders (p=0.015), in the combined patient group and in the TYP group alone. These findings suggest that variation in NEF3, most likely functional variants that are in linkage disequilibrium with the SNPs that we studied, influences rate of response to TYP. Since NEF3 is primarily associated with dopamine D1 receptor function, the evidence for a complementary role of dopamine D1 receptors in antipsychotic effects is considered. The findings reported here open an interesting research avenue in the pharmacogenetics of antipsychotic effects but require replication in larger samples treated in a controlled context.

  13. Blister Packaging Medication to Increase Treatment Adherence and Clinical Response: Impact on Suicide-related Morbidity and Mortality

    DTIC Science & Technology

    2014-12-01

    AD _ Award Number: W81XWH-09-1-0723 TITLE: Blister Packaging Medication to Increase Treatment Adherence and Clinical Response: Impact on Suicide...YYYY) , 2. REPORT TYPE December 2014 Final Report 3. DATES COVERED (From - To) 29Sept2009 - 28 Sept2014 4. TITLE AND SUBTITLE Blister Packaging

  14. 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,…

  15. 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…

  16. 802.11 Wireless Infrastructure To Enhance Medical Response to Disasters

    PubMed Central

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

    2005-01-01

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

  17. 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

  18. Dissociation between emotional and endocrine responses preceding an academic examination in male medical students.

    PubMed

    Allen, P I; Batty, K A; Dodd, C A; Herbert, J; Hugh, C J; Moore, G F; Seymour, M J; Shiers, H M; Stacey, P M; Young, S K

    1985-11-01

    A study was made in 2 consecutive years of the emotional states and morning and afternoon serum levels of prolactin, cortisol and testosterone of male medical students during a 4- to 5-week period preceding a major university examination. 'Distress', 'anxiety' and, to a lesser degree, 'depression' increased during the 2 weeks immediately preceding the examination and were positively correlated with personality anxiety or neuroticism traits. Group means for hormones showed no consistent change over the same period. Neither was there evidence for a correlation between endocrine and emotional changes within individual students during the pre-examination period. A restricted study showed that there were significant increments in cortisol in samples taken during the examination itself. Changes in emotional state before an examination occurred in the absence of equally dramatic changes in levels of the three hormones studied, though this relationship may have altered during the examination itself. This suggests that the factors controlling the two categories of response may relate differently, in some way, to the imminence of this stressful event.

  19. 802.11 wireless infrastructure to enhance medical response to disasters.

    PubMed

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

    2005-01-01

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

  20. Effects of Motivation and Medication on Electrophysiological Markers of Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Groom, Madeleine J.; Scerif, Gaia; Liddle, Peter F.; Batty, Martin J.; Liddle, Elizabeth B.; Roberts, Katherine L.; Cahill, John D.; Liotti, Mario; Hollis, Chris

    2010-01-01

    Background Theories of attention-deficit/hyperactivity disorder (ADHD) posit either executive deficits and/or alterations in motivational style and reward processing as core to the disorder. Effects of motivational incentives on electrophysiological correlates of inhibitory control and relationships between motivation and stimulant medication have not been explicitly tested. Methods Children (9–15 years) with combined-type ADHD (n = 28) and matched typically developing children (CTRL) (n = 28) performed a go/no-go task. Electroencephalogram data were recorded. Amplitude of two event-related potentials, the N2 and P3 (markers of response conflict and attention), were measured. The ADHD children were all stimulant responders tested on and off their usual dose of methylphenidate; CTRLs were never medicated. All children performed the task under three motivational conditions: reward; response cost; and baseline, in which points awarded/deducted for inhibitory performance varied. Results There were effects of diagnosis (CTRL > ADHD unmedicated), medication (on > off), and motivation (reward and/or response cost > baseline) on N2 and P3 amplitude, although the N2 diagnosis effect did not reach statistical significance (p = .1). Interactions between motivation and diagnosis/medication were nonsignificant (p > .1). Conclusions Motivational incentives increased amplitudes of electrophysiological correlates of response conflict and attention in children with ADHD, towards the baseline (low motivation) amplitudes of control subjects. These results suggest that, on these measures, motivational incentives have similar effects in children with ADHD as typically developing CTRLs and have additive effects with stimulant medication, enhancing stimulus salience and allocation of attentional resources during response inhibition. PMID:19914599

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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…

  6. 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.

  7. What they mean by "good science': the medical community's response to boutique fetal ultrasounds.

    PubMed

    Raucher, Michal S

    2009-10-01

    Since 1994, when the first fetal imaging boutique appeared in Texas, many sites have been established around the country for parents to receive nonmedical fetal imaging using three- and four-dimensional ultrasound machines. These businesses boast the benefits they offer to parental-fetal bonding, but the medical community objects to the use of ultrasound machines for nonmedical purposes. In this article, I present the statements released by the medical community, highlighting the alarmist strategies used to paint boutique ultrasounds as bad science and elevate the medical use of ultrasounds. Through a close reading of the statements, it is shown that the medical community's primary concern is not the health of the fetus or the woman but rather their place as the sole users of fetal ultrasounds. This detailed analysis reveals a medical community fearful that its authority is being usurped and is therefore responding with statements meant to denigrate boutique fetal ultrasounds.

  8. 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

  9. Impaired neuroendocrine and immune response to acute stress in medication-naive patients with a first episode of psychosis.

    PubMed

    van Venrooij, Janine A E M; Fluitman, Sjoerd B A H A; Lijmer, Jeroen G; Kavelaars, Annemieke; Heijnen, Cobi J; Westenberg, Herman G M; Kahn, René S; Gispen-de Wied, Christine C

    2012-03-01

    Little is known about how the biological stress response systems--the autonomic nervous system (ANS), the hypothalamic-pituitary-adrenal (HPA) axis, and the immune system--function during psychosis. Results of studies on the effect of stress on the immune and autonomic system in patients with schizophrenia are inconsistent. The present study investigates whether the stress response is impaired in medication-naive patients with a first episode of psychosis. Ten male patients with a first episode of psychosis and 15 controls were exposed to the stress of public speaking. Parameters of the ANS (heart rate and catecholamines), the HPA axis (plasma adrenocorticotropic hormone [ACTH] and cortisol), and the immune system (number and activity of natural killer [NK] cells) were measured. Peak responses were calculated to examine the relationship between stress-induced activation of the different systems. Subjective stress and anxiety before and during the task were assessed. Patients and controls displayed similar autonomic responses to acute stress. However, there was an impaired HPA axis response, slow onset and return of ACTH, and flattened cortisol response and a reduced increase in number NK cells and NK cell activity in patients with a first episode of psychosis. Furthermore, in patients, the relationship between the different stress response systems was weaker or absent compared with controls. These findings indicate that impairments in stress processing are associated with the endophenotype of psychosis and are not a result of illness progression or antipsychotic medication.

  10. 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.

  11. Racial Discrimination in the British Labor Market.

    ERIC Educational Resources Information Center

    Firth, Michael

    1981-01-01

    Contains results of a study of racial discrimination in the British job market for accountants and financial executives. Results show that considerable discrimination remains several years after the adoption of the Race Relations Act of 1968. (CT)

  12. British and American attitudes toward credit cards.

    PubMed

    Yang, Bijou; James, Simon; Lester, David

    2006-04-01

    American university students owned more than twice as many credit cards as British university students. However, scores on a credit card attitude scale predicted the number of cards owned by respondents in both countries.

  13. 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 ...

  14. 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

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

    PubMed Central

    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. PMID:11825153

  16. Perceived Learning Needs of Family Physicians in British Columbia

    PubMed Central

    Craig, Jennifer

    1990-01-01

    To determine family physicians' preferences for time, location, instructional format, and topics, the Division of Continuing Medical Education at the University of British Columbia conducted a survey, in which 1200 questionnaires were mailed to a stratified, proportional random sample of the 3270 general practitioners in the province, the stratifications being urban or rural and decade of graduation. A return rate of 61% yielded 648 usable questionnaires, which exceeds the sample required for analysis with no stratifications. Most popular days for involvement in continuing medical education were Fridays and Saturdays in the months of February, March, October, and November. Common skin disorders and hypertension headed the list of most relevant topics for the whole group and for the urban stratification. Hypertension was superseded by eye emergencies in the rural stratification. PMID:21234037

  17. Neuromuscular complexity during gait is not responsive to medication in persons with Parkinson's disease.

    PubMed

    Roemmich, Ryan T; Fregly, Benjamin J; Hass, Chris J

    2014-09-01

    The purpose of this study was to investigate the effects of dopaminergic therapy on neuromuscular complexity during gait and on the relationship between neuromuscular complexity and gait speed in persons with Parkinson's disease (PD). Nine persons with PD walked at self-selected speed for 5 min after having withdrawn from dopaminergic medication for at least 12 h and while optimally-medicated. Electromyographic recordings were taken from eight leg muscles bilaterally. Non-negative matrix factorization was applied to reduce the dimensionality of the electromyographic signals into motor modules. We assessed neuromuscular complexity by investigating the number, structure, and timing of the modules. We also investigated the influence of dopaminergic medication on the relationships between neuromuscular complexity and gait speed. Though gait speed increased significantly after medication intake, medication did not affect neuromuscular complexity. Neuromuscular complexity was significantly associated with gait speed only while the participants were medicated. Thus, the supraspinal structures that govern neuromuscular complexity during gait do not appear to be solely dopaminergically-influenced in PD. The lack of dopaminergic influence on neuromuscular complexity may explain why persons with PD exhibit gait slowness even while medicated, and an intervention that restores neuromuscular complexity may result in gait speed improvement in PD.

  18. 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.

  19. 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.

  20. 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.

  1. Simulation as an ethical imperative and epistemic responsibility for the implementation of medical guidelines in health care.

    PubMed

    Garbayo, Luciana; Stahl, James

    2017-03-01

    Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued. In this article we argue that to systematically identify, predict and prevent medical guideline implementation errors is both an epistemic responsibility and an ethical imperative in health care, in order to properly provide beneficence, minimize or avoid harm, show respect for persons, and administer justice. Furthermore, we suggest that implementation knowledge is best achieved technically by providing simulation modeling studies to anticipate the realization of medical guidelines, in multiple contexts, with system and scenario analysis, in its alignment with the emerging field of implementation science and in recognition of learning health systems. It follows from both claims that it is an ethical imperative and an epistemic responsibility to simulate medical guidelines in context to minimize (avoidable) harm in health care, before guideline implementation.

  2. 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.

  3. 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

  4. 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.

  5. Medication practice and feminist thought: a theoretical and ethical response to adherence in HIV/AIDS.

    PubMed

    Broyles, Lauren M; Colbert, Alison M; Erlen, Judith A

    2005-08-01

    Accurate self-administration of antiretroviral medication therapy for HIV/AIDS is a significant clinical and ethical concern because of its implications for individual morbidity and mortality, the health of the public, and escalating healthcare costs. However, the traditional construction of patient medication adherence is oversimplified, myopic, and ethically problematic. Adherence relies on existing social power structures and western normative assumptions about the proper roles of patients and providers, and principally focuses on patient variables, obscuring the powerful socioeconomic and institutional influences on behaviour. Some professionals advocate for alternate approaches to adherence, but many of the available alternatives remain conceptually underdeveloped. Using HIV/AIDS as an exemplar, this paper presents medication practice as a theoretical reconstruction and explicates its conceptual and ethical evolution. We first propose that one of these alternatives, medication practice, broadens the understanding of individuals' medication-taking behaviour, speaks to the inherent power inequities in the patient-provider interaction, and addresses the ethical shortcomings in the traditional construal. We then integrate medication practice with feminist thought, further validating individuals' situated knowledge, choices, and multiple roles; more fully recognizing the individual as a multidiminsional, autonomous human being; and reducing notions of obedience and deference to authority. Blame is thus extricated from the healthcare relationship, reshaping the traditionally adversarial components of the interaction, and eliminating the view of adherence as a patient problem in need of patient-centred interventions.

  6. 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.

  7. Medical marijuana: Irresponsible medical care?

    PubMed

    Gordon, Nayvin

    2017-03-01

    Illness should continue to be treated by health professionals employing scientific evidence. This is responsible policy. It is not appropriate or medically justified for family physicians to refer patients to medical marijuana clinics; instead, they should inform their patients that medical treatment must be based on scientific evidence.

  8. 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)

  9. 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

  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. The Americanization of the British National Health Service.

    PubMed

    Mechanic, D

    1995-01-01

    The core reform of the British National Health Service (NHS) was the establishment of a quasi market with a split between purchasers and providers. Health authorities and general practitioner (GP) fundholders were to be discriminating purchasers seeking more efficient and responsive services. This market orientation was embedded in a larger context of managerial, allocational, public health, and primary care changes. This paper reviews the background and dynamics of these modifications and offers an early assessment. There is evidence that the reforms have unleashed much energy, activity, and thoughtfulness about future health care, but it remains unclear whether the gains justify the increased administrative and other transaction costs and potential threats to equal access.

  12. Emergency response nurse scheduling with medical support robot by multi-agent and fuzzy technique.

    PubMed

    Kono, Shinya; Kitamura, Akira

    2015-08-01

    In this paper, a new co-operative re-scheduling method corresponding the medical support tasks that the time of occurrence can not be predicted is described, assuming robot can co-operate medical activities with the nurse. Here, Multi-Agent-System (MAS) is used for the co-operative re-scheduling, in which Fuzzy-Contract-Net (FCN) is applied to the robots task assignment for the emergency tasks. As the simulation results, it is confirmed that the re-scheduling results by the proposed method can keep the patients satisfaction and decrease the work load of the nurse.

  13. Lupines, manganese, and devil-sickness: an Anglo-Saxon medical response to epilepsy.

    PubMed

    Dendle, P

    2001-01-01

    The most frequently prescribed herb for "devil-sickness" in the vernacular medical books from Anglo-Saxon England, the lupine, is exceptionally high in manganese. Since manganese depletion has been linked with recurring seizures in both clinical and experimental studies, it is possible that lupine administration responded to the particular pathophysiology of epilepsy. Lupine is not prescribed for seizures in classical Mediterranean medical sources, implying that the Northern European peoples (if not the Anglo-Saxons themselves) discovered whatever anticonvulsive properties the herb may exhibit.

  14. Real-time Medical Emergency Response System: Exploiting IoT and Big Data for Public Health.

    PubMed

    Rathore, M Mazhar; Ahmad, Awais; Paul, Anand; Wan, Jiafu; Zhang, Daqiang

    2016-12-01

    Healthy people are important for any nation's development. Use of the Internet of Things (IoT)-based body area networks (BANs) is increasing for continuous monitoring and medical healthcare in order to perform real-time actions in case of emergencies. However, in the case of monitoring the health of all citizens or people in a country, the millions of sensors attached to human bodies generate massive volume of heterogeneous data, called "Big Data." Processing Big Data and performing real-time actions in critical situations is a challenging task. Therefore, in order to address such issues, we propose a Real-time Medical Emergency Response System that involves IoT-based medical sensors deployed on the human body. Moreover, the proposed system consists of the data analysis building, called "Intelligent Building," depicted by the proposed layered architecture and implementation model, and it is responsible for analysis and decision-making. The data collected from millions of body-attached sensors is forwarded to Intelligent Building for processing and for performing necessary actions using various units such as collection, Hadoop Processing (HPU), and analysis and decision. The feasibility and efficiency of the proposed system are evaluated by implementing the system on Hadoop using an UBUNTU 14.04 LTS coreTMi5 machine. Various medical sensory datasets and real-time network traffic are considered for evaluating the efficiency of the system. The results show that the proposed system has the capability of efficiently processing WBAN sensory data from millions of users in order to perform real-time responses in case of emergencies.

  15. 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…

  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. Mass medication modeling in response to public health emergencies: outcomes of a drive-thru exercise.

    PubMed

    Zerwekh, Tyler; McKnight, Jason; Hupert, Nathaniel; Wattson, Daniel; Hendrickson, Lisa; Lane, David

    2007-01-01

    This article presents the outcomes of a full-scale training exercise utilizing a drive-thru clinic model for dispensing of Strategic National Stockpile medication. The Hawaii Department of Health developed a clinic design for vehicles based on previous exercises and research on sample throughput rates. The streamlined model selected includes a triage area near the entrance and consecutive stations for the public to register, have an evaluation for drug contradictions, and receive the medication. During the 2-hour exercise held in April 2005, a total of 622 patients were processed in their vehicles for an overall rate of 5.2 persons per minute. Although patient services were reduced in comparison to current walk-in clinic models, the public was able to receive prophylactic medication in a timely manner with a high rate of accuracy and minimal human-to-human contact. These results demonstrate that local health departments, particularly in rural areas, can provide essential medications, vaccinations, or rations through a drive-thru clinic, thus limiting morbidity and mortality during a public health emergency.

  18. WTC medical monitoring and treatment program: comprehensive health care response in aftermath of disaster.

    PubMed

    Moline, Jacqueline M; Herbert, Robin; Levin, Stephen; Stein, Diane; Luft, Benjamin J; Udasin, Iris G; Landrigan, Philip J

    2008-01-01

    The attack on the World Trade Center (WTC) on September 11th, 2001 exposed thousands of individuals to an unprecedented mix of chemicals, combustion products and micronized building materials. Clinicians at the Mount Sinai Irving Selikoff Center for Occupational and Environmental Medicine, in partnership with affected stakeholder organizations, developed a medical screening program to evaluate the health status of workers and volunteers who spent time at the WTC site and thus sustained exposure in the aftermath of September 11th. Standardized questionnaires were adapted for use in this unique population and all clinicians underwent training to ensure comparability. The WTC Worker and Volunteer Medical Screening Program (MSP) received federal funding in April 2002 and examinations began in July 2002. The MSP and the follow up medical monitoring program has successfully recruited nearly 22,000 responders, and serves as a model for the rapid development of a medical screening program to assess the health of populations exposed to environmental hazards as a result of natural and man-made disasters. The MSP constitutes a successful screening program for WTC responders. We discuss the challenges that confronted the program; the absence of a prior model for the rapid development of a program to evaluate results from mixed chemical exposures; little documentation of the size of the exposed population or of who might have been exposed; and uncertainty about both the nature and potential severity of immediate and long-term health effects.

  19. 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…

  20. 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)

  1. A comprehensive medical education program response to rural primary care needs.

    PubMed

    Glasser, Michael; Hunsaker, Matthew; Sweet, Kimberly; MacDowell, Martin; Meurer, Mark

    2008-10-01

    This article presents the characteristics and results of the Rural Medical Education (RMED) Program which addresses medical workforce needs focused on reducing rural health disparities. The program is comprehensive in implementing a system of recruitment of candidates from rural backgrounds, offering a rural-focused curriculum, and instituting evaluative components to track outcomes. Distinctive program features include a Recruitment and Retention Committee of rural community members; special rural-focused topics and events during the first three years of undergraduate medical education; and a required fourth-year, 16-week rural preceptorship through which students work with primary care physicians and conduct community-oriented primary care projects. Since 1993, 216 students have matriculated. More than three quarters of candidates interviewed received offers into the program (overall acceptance rate of 75%). Comparisons between RMED and all other students on composite MCAT scores and United States Medical Licensing Examination (USMLE) Part 1 scores show a slightly lower MCAT average for RMED students, but USMLE scores are equal to those of non-RMED students. To date, 159 students have graduated, with 76% entering primary care residencies; 103 are currently in practice, with 64.4% in primary care practice in small towns and/or rural communities. RMED Program outcomes compare favorably with those of other rural medical education programs. RMED can serve as a model at many levels, including recruitment, collaboration, curriculum, and retention. Future challenges for program development and disparity reduction include recruiting students from the growing number of rural minority populations, expanding the number of program slots, and integrating the program with other health professions to address the needs of rural populations.

  2. A Comprehensive Medical Education Program Response to Rural Primary Care Needs

    PubMed Central

    Glasser, Michael; Hunsaker, Matthew; Sweet, Kimberly; MacDowell, Martin; Meurer, Mark

    2013-01-01

    This article presents the characteristics and results of the Rural Medical Education (RMED) Program which addresses medical workforce needs focused on reducing rural health disparities. The program is comprehensive in implementing a system of recruitment of candidates from rural backgrounds, offering a rural-focused curriculum, and instituting evaluative components to track outcomes. Distinctive program features include a Recruitment and Retention Committee of rural community members; special rural-focused topics and events during the first three years of undergraduate medical education; and a required fourth-year, 16-week rural preceptorship through which students work with primary care physicians and conduct community-oriented primary care projects. Since 1993, 216 students have matriculated. More than three quarters of candidates interviewed received offers into the program (overall acceptance rate of 75%). Comparisons between RMED and all other students on composite MCAT scores and United States Medical Licensing Examination (USMLE) Part 1 scores show a slightly lower MCAT average for RMED students, but USMLE scores are equal to those of non-RMED students. To date, 159 students have graduated, with 76% entering primary care residencies; 103 are currently in practice, with 64.4% in primary care practice in small towns and/or rural communities. RMED Program outcomes compare favorably with those of other rural medical education programs. RMED can serve as a model at many levels, including recruitment, collaboration, curriculum, and retention. Future challenges for program development and disparity reduction include recruiting students from the growing number of rural minority populations, expanding the number of program slots, and integrating the program with other health professions to address the needs of rural populations. PMID:18820528

  3. 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

  4. Medical responses to civil war and revolution in Spain, 1936-1939: international aid and local self-organization.

    PubMed

    Willis, Elizabeth A

    2008-01-01

    The traditional view that war is 'good' for medicine has been challenged by some historians in recent decades. In the case of the Spanish Civil War, 1936-1939, a number of advances in wound treatment, emergency surgery and other areas reputedly occurred, and were important in shaping the medical response to more extended warfare in 1939-1945. At the same time, there was a significant attempt at humanitarian intervention, aiming to provide medical aid and health care for the war's casualties and refugees, in parallel with local transformations in health provision. Political differences within as well as between the contending forces complicated matters. These developments are examined with a view to assessing their implications in the contemporary international context.

  5. 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

  6. 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

  7. US SNUPPS design modified for British use

    SciTech Connect

    Not Available

    1982-11-01

    Britain is making some modifications in the Westinghouse pressurized water reactor (PWR) generic design used in the US and complying with the Standardized Nuclear Utility Power Plant System (SNUPPS). Britain is also working closely with Bechtel personnel on construction and safety improvements. The safety changes will improve emergency-core-cooling-system reliability, reduce the number of welds, improve shutdown capability, provide an emergency ultimate heat sink, lower staff radiation exposure, use turbine-generator configurations that are standard in British power plants, adapt to the British grid frequencies, and strengthen secondary containment buildings. 1 figure. (DCK)

  8. Differences in the Clinical Characteristics of Rapid Response System Activation in Patients Admitted to Medical or Surgical Services

    PubMed Central

    2017-01-01

    Variability in rapid response system (RRS) characteristics based on the admitted wards is unknown. We aimed to compare differences in the clinical characteristics of RRS activation between patients admitted to medical versus surgical services. We reviewed patients admitted to the hospital who were detected by the RRS from October 2012 to February 2014 at a tertiary care academic hospital. We compared the triggers for RRS activation, interventions performed, and outcomes of the 2 patient groups. The RRS was activated for 460 patients, and the activation rate was almost 2.3 times higher for surgical services than that for medical services (70% vs. 30%). The triggers for RRS activation significantly differed between patient groups (P = 0.001). They included abnormal values for the respiratory rate (23.2%) and blood gas analysis (20.3%), and low blood pressure (18.8%) in the medical group; and low blood pressure (32.0%), low oxygen saturation (20.8%), and an abnormal heart rate (17.7%) in the surgical group. Patients were more likely classified as do not resuscitate or required intensive care unit admission in the medical group compared to those in the surgical group (65.3% vs. 54.7%, P = 0.045). In multivariate analysis, whether the patient belongs to medical services was found to be an independent predictor of mortality after adjusting for the modified early warning score, Charlson comorbidity index, and intervention performed by the RRS team. Our data suggest that RRS triggers, interventions, and outcomes greatly differ between patient groups. Further research is needed to evaluate the efficacy of an RRS approach tailored to specific patient groups. PMID:28244298

  9. Customer satisfaction and consumer responsibility: toward an alternative model of medical service quality.

    PubMed

    Pinto, M B; Barber, J C

    1999-01-01

    In the increasingly competitive environment of medical services and patient care, physicians feel a strong pressure for increasing efforts to improve patient satisfaction with the goal of creating a loyal patient base. These steps to promote patient satisfaction have typically involved developing new programs and services, as medical offices seek to attract and keep their patients by continually enhancing service features. While patient satisfaction is a worthy goal, this paper argues that we often make mistakes and incur expensive costs in pursuing satisfaction as an end unto itself. This paper proposes an alternative model, based on creating a doctor-patient therapeutic alliance which has the dual benefits of enhancing patient satisfaction while improving the critical personal relationship between doctors and their patients, so necessary for the delivery of optimal care.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Compensating the workers: industrial injury and compensation in the British asbestos industry, 1930s-60s.

    PubMed

    Tweedale, G; Jeremy, D J

    1999-01-01

    In 1931 the British government introduced pioneering legislation to combat occupational disease in the asbestos industry. A key feature was an Asbestosis Scheme for compensating workers for industrial injury and death. This article examines the implementation of the Scheme at Turner & Newall, the leading UK asbestos producer. The evidence reveals an inequitable system of compensation, especially when compared to the company's generosity to its shareholders. Deficiencies in British compensation law, the weaknesses of regulatory forces, and the company's policy of minimising the extent of asbestos disease are held responsible.

  16. A decade of experience: Cryptococcus gattii in British Columbia.

    PubMed

    Bartlett, Karen H; Cheng, Po-Yan; Duncan, Colleen; Galanis, Eleni; Hoang, Linda; Kidd, Sarah; Lee, Min-Kuang; Lester, Sally; MacDougall, Laura; Mak, Sunny; Morshed, Muhammad; Taylor, Marsha; Kronstad, James

    2012-06-01

    It has been over a decade since Cryptococcus gattii was first recognized as the causative organism of an outbreak of cryptococcosis on Vancouver Island, British Columbia. A number of novel observations have been associated with the study of this emergent pathogen. A novel genotype of C. gattii, VGIIa was described as the major genotype associated with clinical disease. Minor genotypes, VGIIb and VGI, are also responsible for disease in British Columbians, in both human and animal populations. The clinical major genotype VGIIa and minor genotype VGIIb are identical to C. gattii isolated from the environment of Vancouver Island. There is more heterogeneity in VGI, and a clear association with the environment is not apparent. Between 1999 and 2010, there have been 281 cases of C. gattii cryptococcosis. Risk factors for infection are reported to be age greater than 50 years, history of smoking, corticosteroid use, HIV infection, and history of cancer or chronic lung disease. The major C. gattii genotype VGIIa is as virulent in mice as the model Cryptococcus, H99 C. neoformans, although the outbreak strain produces a less protective inflammatory response in C57BL/6 mice. The minor genotype VGIIb is significantly less virulent in mouse models. Cryptococcus gattii is found associated with native trees and soil on Vancouver Island. Transiently positive isolations have been made from air and water. An ecological niche for this organism is associated within a limited biogeoclimatic zone characterized by daily average winter temperatures above freezing.

  17. Lexical Organization in Deaf Children Who Use British Sign Language: Evidence from a Semantic Fluency Task

    ERIC Educational Resources Information Center

    Marshall, Chloe R.; Rowley, Katherine; Mason, Kathryn; Herman, Rosalind; Morgan, Gary

    2013-01-01

    We adapted the semantic fluency task into British Sign Language (BSL). In Study 1, we present data from twenty-two deaf signers aged four to fifteen. We show that the same "cognitive signatures" that characterize this task in spoken languages are also present in deaf children, for example, the semantic clustering of responses. In Study…

  18. 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…

  19. 75 FR 19209 - Airworthiness Directives; British Aerospace Regional Aircraft Model HP.137 Jetstream Mk.1...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... Register approved the incorporation by reference of BAE Systems British Aerospace Jetstream Series 3100... issued AD 003-11- 2002 (which references BAE Systems Service Bulletin (SB) 32- JA020741), requiring an... unserviceable. In response to this development, BAE Systems issued SB 32- JA030644 so that a revised...

  20. 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…

  1. 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…

  2. The Recruitment of International Students: The British Experience, 1979-1987 and the Way Forward.

    ERIC Educational Resources Information Center

    Belcher, John

    1987-01-01

    A discussion of recent British experiences and policy concerning the recruitment of foreign students looks at a 1979 policy decision about international student fees, institutional response, overseas marketing efforts, and the resulting foreign student population and its problems, and proposes directions for institutions, public agencies, and…

  3. 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…

  4. 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…

  5. 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.

  6. [The PEG-dilemma - pleading for an ethically responsible medical treatment].

    PubMed

    Löser, Chr

    2013-05-01

    Within the 32 years of its existence our attitude towards artificial enteral nutrition via PEG-tubes has changed in a fundamental way: in our modern understanding nutrition via PEG is supportive, early, preventive, and in many cases temporary. PEG-feeding is not an alternative but a possible supplement to normal oral food intake and requires an individual medical indication as well as an ethical justification. This does not follow standardised algorithmic thinking but is decided on an individual base taking personal wishes, resources, and needs of the individual patient into account. Nutrition via PEG-tube is not a terminal basic or even symbolic treatment at the end of life. The present dilemma of the PEG is that the public discussion primarily focus one-sided on the problems of PEG-placement in multimorbid, elderly, and/or demented patients or patients in end-stage tumour diseases where indeed PEG-placement is neither medically nor ethically justified - we still place PEG-tubes to often in the wrong patients! On the other hand we still consider supportive and in many cases temporary nutrition via PEG too rare and even too late in those patients which clearly could benefit from an early, supportive, and preventive PEG-treatment on the base of our present evidence-based scientific knowledge - we still consider PEG-treatment not adequately and in most cases too late in the right patients! Placing a PEG-tube is not the second last step before death and physicians have to accept the ethically given limits of medical treatment by realizing our modern understanding of the benefits and limits of supportive artificial nutrition via PEG.

  7. 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.

  8. British Library Conducts New Technology Research.

    ERIC Educational Resources Information Center

    Graddon, Pamela H. B.

    1982-01-01

    Discusses technological research efforts by the Research and Development Department of the British Library in the areas of videotex, videodisc, and teleconferencing, noting the videotex service known as Prestel and the department's network project, called BLEND (Birmingham and Loughborough Electronic Network Development). (EJS)

  9. 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…

  10. 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

  11. British used Congreve Rockets to Attack Napoleon

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Sir William Congreve developed a rocket with a range of about 9,000 feet. The incendiary rocket used black powder, an iron case, and a 16-foot guide stick. In 1806, British used Congreve rockets to attack Napoleon's headquarters in France. In 1807, Congreve directed a rocket attack against Copenhagen.

  12. Reading Habits of British Secondary Students.

    ERIC Educational Resources Information Center

    Newkirk, Thomas

    Findings from a number of studies of the reading interests and habits of British secondary school students are reviewed, and the results of a new survey of the opinions of 55 teachers are briefly reported. The studies indicate that a number of "classic" texts are popular but that "subliterature" is also popular and becomes more…

  13. British School Chemistry Laboratories, 1830-1920.

    PubMed

    Brock, W H

    2017-04-05

    The essay examines the British secondary school as a chemical site in the nineteenth century up until the 1920s. It sketches how chemistry became part of the secondary school curriculum in the mid-nineteenth century, discusses how school laboratories were designed, and examines to what extent school laboratories provided opportunities for original research by schoolmasters.

  14. 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…

  15. Did Senior British Officers Effectively Lead Change?

    DTIC Science & Technology

    2014-12-12

    additional information. To obtain greater fidelity and detail on the changes undergone by the British Army, a set of broader follow-up questions were set...were analyzed against the quantitative data findings as well as the Rainey and Fernandez model. These were used to gather detail and fidelity to...

  16. The British Council's Global Cataloguing Service.

    ERIC Educational Resources Information Center

    Magalhaes, Rodrigo; Nogueira, Madalena Sa

    1985-01-01

    The British Council Global Cataloging Service was initiated in 1980 to reduce duplication of cataloging same titles in council libraries abroad. Each of 56 council libraries participating in system receives list of new accessions and updated microfiche catalog. Portugal was one of the first six countries chosen to test the system. (EJS)

  17. British Columbia/Alberta Transfer System Protocol

    ERIC Educational Resources Information Center

    British Columbia Council on Admissions and Transfer, 2007

    2007-01-01

    The purpose of this agreement is to provide assurance to students that they will receive transfer credit for courses or programs they have successfully completed where the content/outcomes are demonstrably equivalent to those offered at the institution to which they transfer. This protocol is undertaken by the British Columbia Council on…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. Deprivatizing Private Education: The British Columbia Experience.

    ERIC Educational Resources Information Center

    Barman, Jean

    1991-01-01

    The experience of British Columbia in deprivatizing private schools by requiring their registration and providing financial support is reviewed. It is argued that family choice and state control have grown dialectically. Government funding has created higher enrollments and new schools, but resultant public oversight ultimately constrains choice.…

  3. 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…

  4. 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…

  5. Home Data Banks Turn British On

    ERIC Educational Resources Information Center

    Science News, 1978

    1978-01-01

    Describes the operation and numerous capabilities of a British computerized data retrieval system named Prestel. It provides access, through the regular telephone network and a TV screen, to computer-based information supplied by many companies, agencies and commercial outlets. (GA)

  6. 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…

  7. 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…

  8. [Civil responsibility of medical care activities in regard to the precautionary principle].

    PubMed

    Le Foyer de Costil, H

    2000-01-01

    In the absence of a legal body regulating the precaution, do we have to confine the principle to public health? A negative answer is required at a time the medical liability is increasing more and more and the obligation to take all means is slipping toward to a strict obligation as to the result. The respect of the principle of precaution can be found in the obligation for the doctor to prove that he has fully informed the patient, but the medicine specificity requires delimitation of this obligation outlines.

  9. The truth about genetic variation in the serotonin transporter gene and response to stress and medication.

    PubMed

    McGuffin, Peter; Alsabban, Shaza; Uher, Rudolf

    2011-06-01

    The question of whether a functional variant in the promoter of the serotonin transporter gene (5-HTTLPR) influences response to adversity and/or antidepressants has generated great interest and controversy. A review of the literature suggests that the issue is complicated by differences in methodology and sample ethnicity. When these confounders are accounted for, there probably is a real, if small, effect of 5-HTTLPR on response to both serotonin reuptake inhibitors and environmental adversity.

  10. Local responses to French medical imperialism in late nineteenth-century Algeria.

    PubMed

    Gallois, William

    2007-08-01

    This article offers the first account of the lives of Algerian-born doctors working in the French colonial medical service between 1870 and 1900. Their stories reveal the manner in which the idea of medical imperialism had collapsed in Algeria, as a result of maladministration, racial policies, competition between civil and military authorities, budgetary constraints and the rise of the colons. The article also indicates the way in which medicine became a locus of opposition to French rule. It shows how the first decades of the Third Republic were critical in terms of a shift from the earlier idea of medicine serving as an emblem of the mission civilisatrice to the ideological potential of medicine being seen in much more nuanced terms by both French settlers and Algerian locals. It is argued that the notion of cultural resistance to imperialism through medicine emerges in the 1870s and 1880s, thereby prefiguring the work of Fanon and the Front de Liberation Nationale's later analysis of the 'sickness' of colonial Algerian society.

  11. Selling conscience short: a response to Schuklenk and Smalling on conscientious objections by medical professionals.

    PubMed

    Maclure, Jocelyn; Dumont, Isabelle

    2017-04-01

    In a thought-provoking paper, Schuklenk and Smalling argue that no right to conscientious objection should be granted to medical professionals. First, they hold that it is impossible to assess either the truth of conscience-based claims or the sincerity of the objectors. Second, even a fettered right to conscientious refusal inevitably has adverse effects on the rights of patients. We argue that the main problem with their position is that it is not derived from a broader reflection on the meaning and implications of freedom of conscience and reasonable accommodation. We point out that they collapse two related but distinct questions, that is, the subjective conception of freedom of conscience and the sincerity test. We note that they do not successfully show that the standard norm according to which exemption claims should not impose undue hardship on others is unworkable. We suggest that the main reason why arguments such as no one is forced to be a medical professional are flawed is that public norms should not constrain citizens to choose between two of their basic rights unless it is necessary. In fine, Schuklenk and Smalling, who see conscience claims as arbitrary dislikes, sell freedom of conscience short and forego any attempts at balancing the competing rights involved. We maintain the authors neglect that most of legal reasoning is contextual and that the blanket restriction of healthcare professionals' freedom of conscience is disproportionate.

  12. The British Southern Campaign 1778-1781: The Impact of Strategic Level Assessments and Assumptions on British Decision Making

    DTIC Science & Technology

    2010-05-03

    Georgi ~ and the Carolinas against the British, driving Campbell (the British commander) out of the backcountry." 31 Few Georgians joined the British...64 Wilson, 30-35. 65 Ibid, 101-102. 66 Shy, 296. 67 Wilson, 63-64. 29 68 Smith, 98. 30 Bibliography Babits, Lawrence E. and Joshua Howard

  13. The Academic Medical Center Linear Disability Score (ALDS) item bank: item response theory analysis in a mixed patient population

    PubMed Central

    Holman, Rebecca; Weisscher, Nadine; Glas, Cees AW; Dijkgraaf, Marcel GW; Vermeulen, Marinus; de Haan, Rob J; Lindeboom, Robert

    2005-01-01

    Background Currently, there is a lot of interest in the flexible framework offered by item banks for measuring patient relevant outcomes. However, there are few item banks, which have been developed to quantify functional status, as expressed by the ability to perform activities of daily life. This paper examines the measurement properties of the Academic Medical Center linear disability score item bank in a mixed population. Methods This paper uses item response theory to analyse data on 115 of 170 items from a total of 1002 respondents. These were: 551 (55%) residents of supported housing, residential care or nursing homes; 235 (23%) patients with chronic pain; 127 (13%) inpatients on a neurology ward following a stroke; and 89 (9%) patients suffering from Parkinson's disease. Results Of the 170 items, 115 were judged to be clinically relevant. Of these 115 items, 77 were retained in the item bank following the item response theory analysis. Of the 38 items that were excluded from the item bank, 24 had either been presented to fewer than 200 respondents or had fewer than 10% or more than 90% of responses in the category 'can carry out'. A further 11 items had different measurement properties for younger and older or for male and female respondents. Finally, 3 items were excluded because the item response theory model did not fit the data. Conclusion The Academic Medical Center linear disability score item bank has promising measurement characteristics for the mixed patient population described in this paper. Further studies will be needed to examine the measurement properties of the item bank in other populations. PMID:16381611

  14. 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.

  15. ["The demon that turned into worms": the translation of public health in the British Caribbean, 1914-1920].

    PubMed

    Palmer, Steven

    2006-01-01

    The earliest programs of the Rockefeller Foundation's International Health Commission - IHC were pilot projects for the treatment of hookworm disease in the British colonies of British Guiana and Trinidad. These pioneering ventures into international health have often been portrayed as governed by rigid biomedical principles. In contrast to this view, the article emphasizes the degree to which the exigencies of a public health project that sought to make biomedicine intelligible within the medical systems of subject populations combined with the knowledge of local IHC staff members of Indo-Caribbean descent to generate some fascinating experiments in ethno-medical translation. One term in particular "The Demon that Turned into Worms" is focused on to show how these efforts at medical translation may have legitimized and promoted medical pluralism.

  16. Adverse events in medical management--vigabatrin as a paradigm of forensic responsibility with novel therapy.

    PubMed

    Beran, R G

    2001-01-01

    The ethics of medical management are not always straightforward. There are many contributing factors: the condition treated; its effects on the patient; the required treatment; the effects of that treatment; and a cost/benefit ratio. Treatment of epilepsy with vigabatrin (VGB) exemplifies these problems. VGB has recently been reported to cause constricted visual fields. Formal testing of visual fields of patients attending an outpatient epilepsy service showed constriction with tunnel vision, even in patients who are asymptomatic. The ethical questions include: Should all reports of adverse events be subjected to tests of validity and subsequent quality assurance? Should treatment with VGB be stopped, risking recurrence of seizures? What are the legal consequences of continuing VGB? Does informed consent protect the doctor? After stopping VGB can the patient drive?

  17. Students' responses to the introduction of a digital laboratory guide in medical neuroscience.

    PubMed

    Brueckner, Jennifer K; Traurig, Harold

    2003-11-01

    This study investigated student acceptance of a digital laboratory guide in a medical neuroscience course. The guide was created in Macromedia Authorware 5.2 by transforming a text-based lab manual into a comprehensive multimedia program. Student attitudinal survey data indicated that the guide was used primarily as a study tool at home. Some 53% of students (primarily males) used the guide for independent study exclusively, while the remainder used it for both independent and group study; 87% of the class used the guide as a routine study tool rather than as a final review for examinations. Most students perceived that the guide increased their study efficiency and lab performance while decreasing their out-of-class study time in the lab. Female students were significantly more enthusiastic about the guide's impact on their study efficiency, lab performance and laboratory study time. Gender differences in student satisfaction with and use of instructional multimedia are discussed.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. Evaluating Medication Response in ADHD: Cognitive, Behavioral, and Single-Subject Methodology.

    ERIC Educational Resources Information Center

    Hale, James B.; Hoeppner, Jo-Ann B.; DeWitt, Mary Beth; Coury, Daniel L.; Ritacco, David G.; Trommer, Barbara

    1998-01-01

    A technique is presented for evaluating methylphenidate (MPH) effects on core behavioral symptoms of attention deficit hyperactivity disorder at the single-subject level of analysis. Case-study results and multivariate analyses suggests systematic evaluation of behavior and cognitive MPH dose-response relationships could lead to more accurate MPH…

  3. 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,…

  4. 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

  5. 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…

  6. Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training.

    PubMed

    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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.…

  11. 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

  12. Truffle diversity (Tuber, Tuberaceae) in British Columbia.

    PubMed

    Berch, Shannon M; Bonito, Gregory

    2016-08-01

    To improve baseline data for the developing truffle industry in British Columbia, we compiled existing Tuber species sequences from published and unpublished studies and generated new ITS sequences for truffles belonging to Tuber collected in the province. In doing so, we obtained evidence that 13 species of Tuber occur in the province, including six introduced and seven native species, two of which are putative undescribed species. Of the native species, the Tuber anniae species complex is widely distributed in the province while Tuber beyerlei appears to be much more restricted in distribution. Four of the introduced species have commercial value (Tuber melanosporum, Tuber aestivum, Tuber brumale, and Tuber borchii) as do two of the native species (Tuber gibbosum and Tuber oregonense). Focused sampling on likely tree hosts, both hardwood and Pinaceae species, as well as in currently unexplored parts of the province seems likely to expand our knowledge of the diversity and distribution of Tuber species in British Columbia.

  13. 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.

  14. Trace nutrients. Selenium in British food.

    PubMed

    Thorn, J; Robertson, J; Buss, D H; Bunton, N G

    1978-03-01

    1. The amount of selenium in nationally representative samples of prepared and cooked groups of foods, and in a variety of raw individual foods, was determined fluorimetrically. 2. The average British diet was calculated to provide approximately 60 microgram Se/d, of which half was derived from cereals and cereal products and another 40% from meat and fish. Milk, table fats, fruit and vegetables provided little or no Se. 3. Individual foods which were particularly rich in Se (greater than 0.2 mg/kg) included 'bread-making' and wholemeal flours, kidney, fatty fish, brazil nuts (Bertholletia excelsa) and several other varieties of nut. In contrast, breast milk and other foods for babies (except some cereal products) contained little Se. 4. The total intake, and the amounts of Se in major foods, were lower than in most other studies. This is probably the result of the comparatively low levels of this element in British soil.

  15. Holistic Review in Medical School Admissions and Selection: A Strategic, Mission-Driven Response to Shifting Societal Needs.

    PubMed

    Conrad, Sarah S; Addams, Amy N; Young, Geoffrey H

    2016-11-01

    Medical schools and residency programs have always sought excellence in the areas of education, research, and clinical care. However, these pursuits are not accomplished within a vacuum-rather, they are continually and necessarily influenced by social, cultural, political, legal, and economic forces. Persistent demographic inequalities coupled with rapidly evolving biomedical research and a complex legal landscape heighten our collective awareness and emphasize the continued need to consider medicine's social contract when selecting, educating, and developing physicians and physician-scientists.Selection-who gains access to a medical education and to a career as a physician, researcher, and/or faculty member-is as much art as science. Quantitative assessments of applicants yield valuable information but fail to convey the full story of an applicant and the paths they have taken. Human judgment and evidence-based practice remain critical parts of implementing selection processes that yield the desired outcomes. Holistic review, in promoting the use of strategically designed, evidence-driven, mission-based, diversity-aware processes, provides a conceptual and practical framework for marrying the art with the science without sacrificing the unique value that each brings.In this Commentary, the authors situate medical student selection as both responsive to and informed by broader social context, health and health care needs, educational research and evidence, and state and federal law and policy. They propose that holistic review is a strategic, mission-driven, evidence-based process that recognizes diversity as critical to excellence, offers a flexible framework for selecting future physicians, and facilitates achieving institutional mission and addressing societal needs.

  16. Obsessive-compulsive aspects as predictors of poor response to treatments in patients with chronic migraine and medication overuse.

    PubMed

    Curone, M; D'Amico, D; Bussone, G

    2012-05-01

    Patients with chronic migraine (CM) and medication overuse (MO) have a high frequency of psychiatric comorbidity or psychopathological traits, the presence of which may have important implications for the course of the CM and the MO, both for response to treatment and possible relapses. Overuse of symptomatic drugs is regarded as one of the most important risk factor for the transformation of episodic migraine into CM and drug-seeking tendency due to fear of headache in chronic migraine patients shares with obsessive-compulsive disorder (OCD) the compulsive quality of the behavior. Aim of this study was to review the clinical history of a sample of CM patients with MO in which an obsessive-compulsive trait was identified, performing a comparison with a sample of patients without obsessive-compulsive trait. We selected 14 patients with positivity to Spectrum Project OBS (obsessive-compulsive disorder) questionnaire and other 14 patients with negativity to the same tool from among a sample of patients who were enrolled in a previous study on the psychopathological profile of patients suffering from CM with MO. According to data obtained from the clinical records referring to the previous 5 years, patients with OBS questionnaire positivity showed a worse clinical course and a tendency to early relapse in MO after symptomatic medication withdrawal. Our results show that the comorbidity of OCD should be always evaluated in patients with CM and MO as it may play a relevant role--particularly if not treated--among the risk factors favoring the progression of episodic migraine to the chronic form, and/or the tendency to a pathological behavior that prompts the overuse of symptomatic medications.

  17. Checklist of British and Irish Hymenoptera - Cynipoidea

    PubMed Central

    Forshage, Mattias; Bowdrey, Jeremy; Spooner, Brian M.; van Veen, Frank

    2017-01-01

    Abstract Background The British and Irish checklist of Cynipoidea is revised, considerably updating the last complete checklist published in 1978. Disregarding uncertain identifications, 220 species are now known from Britain and Ireland, comprising 91 Cynipidae (including two established non-natives), 127 Figitidae and two Ibaliidae. New information One replacement name is proposed, Kleidotoma thomsoni Forshage, for the secondary homonym Kleidotoma tetratoma Thomson, 1861 (nec K. tetratoma (Hartig, 1841)). PMID:28325971

  18. Medical education, social responsibility and praxis: Responding to the needs of all children

    PubMed Central

    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

  19. 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.

  20. 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

  1. Education in sexuality in the medical curriculum.

    PubMed

    Dennis, K J; Elstein, M

    1980-08-01

    Medical curricula have been deficient in the area of education in sexuality, and it is only over the last decade or so that medical schools in the UK and abroad have recognized the importance of teaching human sexual physiology and sexuality. Attention in this discussion of education in sexuality in the medical curricula is directed to the following: present status of sex education in British schools and in medical schools; a suggested component of human sexuality in the undergraduate medical curriculum (learning objectives and strategy for introducing education in sexuality in the medical curriculum); and postgraduate education in sexual matters. Secondary schools, whether comprehensive, grammar, or private, have been slow to develop cognitive learning in such topics as the place of sexual drive within and without marriage, variations in sexual orientation, and the technicalities of various contraceptives methods. They have done even less to encourage the development of positive responsible attitudes to human sexuality. Students at the time of arrival at a medical school will have many gaps in their knowledge of the commonplace in human sexuality and in reproduction. If they have positive, healthy, and responsible attitudes toward their own sexual drives and to the sexuality of others, it is only because they are among the minority whose parents have been able to transmit them to their offspring. The Royal Commission on Medical Education (Todd report 1965-1968) identified deficiencies in the sex education of Britain's doctors and recommended that medical students should learn about the reproductive organs and their physiology and should also have an awareness of the wide implications of the problems of fertility and infertility and know something about marital problems and their management. In the older and well established medical schools, the teaching of human sexuality, especially in the earlier preclinical part of the course, depends upon enthusiasts

  2. 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.

  3. 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.

  4. 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.

  5. Competition law and British natural gas regulation

    SciTech Connect

    Black, A.J.

    1992-01-01

    British Gas (BG) is a seriously successful monopolist which, since its 1986 privatisation, is acing increased regulation by the Office of Gas Supply (OFGAS). OFGAS is the first public body specifically created to regulate a European gas industry. It employs a rate-capping formula instead of the more labour intensive rate-of-retum method favoured in North America. Despite initial criticisms, OFGAS has surprised industry observers with efficacious results. This article succinctly discusses the process of natural gas industry privatisation in the United Kingdom (U.K.) and the development of a British type of [open quotes]open access.[close quotes] Contemporary British gas regulation is a distinct paradigm involving the privatisation of a vertically integrated pipeline system coupled with an altemative regulatory method. These regulatory results include lower prices for core customers and the promotion of third party direct sales within the U.K. Since Britain leads the European Community (E.C.) in common carriage provisions, the regulatory r6gime here provides a benchmark for the other Member States.

  6. [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).

  7. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract.

    PubMed

    Checkland, Kath; Harrison, Stephen; McDonald, Ruth; Grant, Suzanne; Campbell, Stephen; Guthrie, Bruce

    2008-07-01

    In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of 'pay-for-performance', including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, QOF) represent a move towards a more biomedical model of health and illness, which is contrary to the ideal of providing holistic (or biopsychosocial) care that has been traditionally espoused by GPs. This paper reports results from two linked studies (in England and Scotland) investigating the early stages of the new contract. We describe the way in which four practices with different organisational approaches and espoused identities have all changed their practice structures, consultations and clinical care in response to QOF in ways which will result in patients receiving a more biomedical type of care. In spite of these observed changes, respondents continued to maintain discursive claims to holism. We discuss how this disconnection between rhetoric and reality can be maintained, and consider its implications for the future development of GPs' claims to a professional identity.

  8. Personal responsibility, regret, and medical stigma among individuals living with lung cancer.

    PubMed

    Criswell, Kevin R; Owen, Jason E; Thornton, Andrea A; Stanton, Annette L

    2016-04-01

    Understanding the degree to which adults with lung cancer perceive personal responsibility for their disease, personal regret for actions that may have contributed to lung cancer, and potential stigmatization from others is important, because these perceptions and experiences may be linked with treatment nonadherence, feelings of isolation, avoidance of healthcare providers, and poor quality of life. The purpose of this study was to evaluate rates and intensity of these types of experiences and to characterize the extent to which they are linked with smoking status and psychological adjustment in those living with lung cancer. Adults with lung cancer (N = 213) were recruited from two major cancer centers to complete a mail survey. Perceived responsibility was frequent in those who had ever smoked (74-80%), whereas regret and feelings of stigmatization were less frequent. When present, however, personal regret and stigmatization were associated with adverse psychological outcomes, particularly for never smokers. These results are consistent with the theory of stereotype threat and have clinical implications for management of people with lung cancer.

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. Do the British Guidelines for Asthma Management facilitate concordance?

    PubMed Central

    Steven, Karen; Marsden, Wendy; Neville, Ronald G; Hoskins, Gaylor; Sullivan, Frank M; Drummond, Neil

    2004-01-01

    Abstract Background  Asthma is an example of a common, chronic illness in which clinicians are encouraged to promote concordance and adhere to guidelines. Some existing research suggests that these aims may be incompatible. Objectives  To describe patient goals for life and for asthma management in order to inform concordance with people with asthma. Design  A cross‐sectional, qualitative survey. Setting and participants  A purposive sample of 47 adults with asthma from Dundee, UK. The subjects were identified from general practice asthma registers and had a range of ages and asthma severity but no significant comorbidity. Methods  Tape‐recorded semi‐structured interviews. The topic guide was based on the literature and had been piloted in a previous study. Results  The participants focussed on improving their lives, only aiming to improve their asthma as a means of improving their lives. Three aspects of asthma were reported to help or hinder improving life: the use of asthma medication, trigger avoidance and exercise. People integrated these three aspects of asthma in order to maximize life. Conclusions  The study supports the more individualized goals of the recently revised British Guidelines for Asthma Management but highlights the need to develop this further in future revisions. It also provides an explanation for patients’ acceptance of less than ‘perfect’ asthma control and it suggests that shared goals may be achieved in practice by considering the advantages and disadvantages of medication and allergen avoidance on everyday life rather than on asthma. PMID:14982501

  14. Expo '86, Vancouver: impact on British Columbia's Children's Hospital.

    PubMed Central

    Hlady, L J; Macnab, A J; Smith, D F; Wensley, D F

    1987-01-01

    Over 22 million visitors attended the 1986 world exposition in Vancouver, and this had a significant impact on the local pediatric facility. A total of 559 children visited the emergency department of British Columbia's Children's Hospital with injuries or illnesses resulting from the fair. Of these, 193 (34%) had come directly from the site. The children's ages ranged from 1 1/2 months to 18 years, 4 months (mean 6.99 years). Of the 559 children 31% were not covered by medical insurance. Twenty-four of the children were admitted to the hospital, and one died at the Expo site. Most of the illnesses were upper respiratory tract infections and gastroenteritis. The proportion of visits for trauma was 50%, compared with the yearly average of 25%. There was a 6% increase in the workload in the emergency department during the fair; the percentage was even higher during July and August, particularly after 1800 hours. Recommendations are made to aid with the planning of medical care for similar events. PMID:3676971

  15. 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

  16. 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.

  17. 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.

  18. EGCG Attenuates Uric Acid-Induced Inflammatory and Oxidative Stress Responses by Medicating the NOTCH Pathway

    PubMed Central

    Xie, Hua; Sun, Jianqin; Chen, Yanqiu; Zong, Min; Li, Shijie; Wang, Yan

    2015-01-01

    Background. The aim of this study is to investigate whether (-)-epigallocatechin-3-gallate (EGCG) can prevent the UA-induced inflammatory effect of human umbilical vein endothelial cells (HUVEC) and the involved mechanisms in vitro. Methods. HUVEC were subjected to uric acid (UA) with or without EGCG treatment. RT-PCR and western blots were performed to determine the level of inflammation marker. The antioxidant activity was evaluated by measuring scavenged reactive oxygen species (ROS). Functional studies of the role of Notch-1 in HUVEC lines were performed using RNA interference analyses. Results. UA significantly increased the expressions of IL-6, ICAM-1, TNF-α, and MCP-1 and the production of ROS in HUVEC. Meanwhile, the expression of Notch-1 and its downstream effects significantly increased. Using siRNA, inhibition of Notch-1 signaling significantly impeded the expressions of inflammatory cytokines under UA treatment. Interestingly, EGCG suppressed the expressions of inflammatory cytokines and the generation of ROS. Western blot analysis of Notch-1 showed that EGCG significantly decreased the expressions of inflammatory cytokines through Notch-1 signaling pathways. Conclusions. In summary, our findings indicated that Notch-1 plays an important role in the UA-induced inflammatory response, and the downregulation of Notch-1 by EGCG could be an effective approach to decrease inflammation and oxidative stress induced by UA. PMID:26539255

  19. [Medical service of the Armed Forces of Great Britain (review of foreign internet-publications)].

    PubMed

    Agapitov, A A; Bolekhan, V N; Ivchenko, E V; Krassiĭ, A B; Nagibovich, O A; Petrov, S V; Rezvantsev, M V

    2012-07-01

    The present review is dedicated to organization and principles of operation of the Medical service of the Armed Forces of Great Britain. At the beginning of the review a brief description of British Armed Forces and their medical service is presented. Then the particular key elements of the medical service such as the medical services of the Armed Forces major components, inpatient care, medical supplies, research, medical care at an operation theater, medical personnel training are considered. The special attention is paid to the Joint Medical Command formed four years ago as a prototype for the future integration and centralization of the whole medical service. The cooperation with the civil health care has played an increasing role in the organization of British military medicine. That is why the review includes the short description of the major structure of the British civil health care system--the National Health Service.

  20. 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

  1. 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.

  2. 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.

  3. Improving Community Understanding of Medical Research: Audience Response Technology for Community Consultation for Exception to Informed Consent

    PubMed Central

    Vohra, Taher; Chebl, Raphe Bou; Miller, Joseph; Russman, Andrew; Baker, Anna; Lewandowski, Christopher

    2014-01-01

    Introduction The Department of Health and Human Services and Food and Drug Administration described guidelines for exception from informed consent (EFIC) research. These guidelines require community consultation (CC) events, which allow members of the community to understand the study, provide feedback and give advice. A real-time gauge of audience understanding would allow the speaker to modify the discussion. The objective of the study is to describe the use of audience response survey (ARS) technology in EFIC CCs. Methods As part of the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), 13 CC events were conducted. We prepared a PowerPoint™ presentation with 4 embedded ARS questions,according to specific IRB guidelines to ensure that the pertinent information would reach our targeted audience. During 6 CCs, an ARS was used to gauge audience comprehension. Participants completed paper surveys regarding their opinion of the study following each CC. Results The ARS was used with minimal explanation and only one ARS was lost. Greater than 80% of the participants correctly answered 3 of the 4 ARS questions with 61% correctly answering the question regarding EFIC. A total of 105 participants answered the paper survey; 80–90% of the responses to the paper survey were either strongly agree or agree. The average scores on the paper survey in the ARS sites compared to the non-ARS sites were significantly more positive. Conclusion The use of an audience response system during the community consultation aspects of EFIC is feasible and provides a real-time assessment of audience comprehension of the study and EFIC process. It may improve the community’s opinion and support of the study. PMID:25035746

  4. 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.

  5. White British; Dual Heritage; British Muslim: Young Britons' Conceptualisation of Identity and Citizenship

    ERIC Educational Resources Information Center

    Basit, Tehmina N.

    2009-01-01

    This paper examines young British people's conceptualisation of identity and citizenship. Data were gathered through a questionnaire survey from 442 young male and female citizens of majority and minority ethnic origins, aged 14-24 years and at different stages of education, employment and non-employment. This was followed up by in-depth…

  6. Noch Einmal:American English - British English (Once More: American English -- British English).

    ERIC Educational Resources Information Center

    Botts, M.

    1980-01-01

    Replies critically to the article by D. K. Stevenson and R. J. Brunt, "Living English: Seeing the Forest in Spite of the Trees -- On Differences between American English and British English," in this journal, issue 1979/2. A reply by Stevenson and Brunt continues the controversy. (IFS/WGA)

  7. 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.

  8. Strategies to Maximize Data Collection Response Rates in a Randomized Control Trial Focused on Children with Medical Complexity

    PubMed Central

    Celebrezze, Margaret; Cady, Rhonda; Lunos, Scott; Looman, Wendy S.

    2016-01-01

    Abstract Introduction: Obtaining complete and timely subject data is key to the success of clinical trials, particularly for studies requiring data collected from subjects at home or other remote sites. A multifaceted strategy for data collection in a randomized controlled trial (RCT) focused on care coordination for children with medical complexity is described. The influences of data collection mode, incentives, and study group membership on subject response patterns are analyzed. Data collection included monthly healthcare service utilization (HCSU) calendars and annual surveys focused on care coordination outcomes. Materials and Methods: One hundred sixty-three families were enrolled in the 30-month TeleFamilies RCT. Subjects were 2–15 years of age at enrollment. HCSU data were collected by parent/guardian self-report using mail, e-mail, telephone, or texting. Surveys were collected by mail. Incentives were provided for completed surveys after 8 months to improve collection returns. Outcome measures were the number of HCSU calendars and surveys returned, the return interval, data collection mode, and incentive impact. Results: Return rates of 90% for HCSU calendars and 82% for annual surveys were achieved. Mean return intervals were 72 and 65 days for HCSU and surveys, respectively. Survey response increased from 55% to 95% after introduction of a gift card and added research staff. Conclusions: High return rates for HCSU calendars and health-related surveys are attainable but required a flexible and personnel-intensive approach to collection methods. Family preference for data collection approach should be obtained at enrollment, should be modified as needed, and requires flexible options, training, intensive staff/family interaction, and patience. PMID:26484851

  9. Ototoxic Medications (Medication Effects)

    MedlinePlus

    ... Information for the Public / Hearing and Balance Ototoxic Medications (Medication Effects) By Barbara Cone, Patricia Dorn, Dawn Konrad- ... Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage the ear, resulting in hearing loss, ...

  10. British gynaecologists' attitudes in 2008 to the provision of legal abortion.

    PubMed

    Savage, W; Francome, C

    2011-05-01

    In 2008, we investigated the attitudes and practice of British consultant gynaecologists towards induced abortion, and made comparisons with our similar survey in 1989. A random sample of one in six (217) was selected from the register of the Royal College of Obstetricians and Gynaecologists (RCOG). The response to the postal questionnaire was 70% (152). Satisfaction with the way the 1967 Abortion Act is operating was expressed by 59% (76% in 1989) and an upper limit of 24 weeks was supported by 50% (77% in 1989). Abortion after 20 weeks was approved to protect health by 92%; after rape by 60% and for serious fetal handicap by 87%. A change in the regulations to require the signature of only one doctor (rather than two) to certify the need for abortion was supported by 65%. Only a minority (41%) provided 2nd trimester abortion in person; 61% would separate abortion provision from general gynaecology; 57% suggested there should be separate abortion units for gestations over 13 weeks and 56% felt that fertility control should become be a sub-specialty. Satisfaction with the Abortion Act 1967 has decreased during the last 20 years. Gynaecologists' attitudes to the indications for 2nd trimester abortion remain wide, with clear implications for women seeking abortion. The service to women would be improved if abortion on request was permitted in the 1st trimester and after only one medical signature in the 2nd trimester. Our view is that the decision to end a pregnancy should be made by the woman and that abortion should be decriminalised.

  11. Are We There yet? Intercultural Encounters with British Studies

    ERIC Educational Resources Information Center

    Dasli, Maria

    2012-01-01

    This paper aims to contribute to the current debate on British Studies from the perspective of eight international students attending a British Studies module in part completion of a foundation/access programme in the UK. Drawing on three sets of in-depth student interviews and 15 classroom observations used to triangulate findings, the analysis…

  12. BCASP and the Evolution of School Psychology in British Columbia

    ERIC Educational Resources Information Center

    Agar, Douglas J.

    2016-01-01

    Since 1992, the British Columbia Association of School Psychologists (BCASP) has been the professional body for school psychologists in British Columbia. In the intervening 24 years, BCASP has been very successful in performing the dual roles of a certifying body and a professional development organization for school psychologists in British…

  13. 78 FR 72598 - Airworthiness Directives; British Aerospace Regional Aircraft Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-03

    ... Federal Aviation Administration 14 CFR Part 39 RIN 2120-AA64 Airworthiness Directives; British Aerospace... directive (AD) for British Aerospace Regional Aircraft Jetstream Series 3101 and Jetstream Model 3201... after receipt. FOR FURTHER INFORMATION CONTACT: Taylor Martin, Aerospace Engineer, FAA, Small...

  14. The Misrepresentation of Religion in Modern British (Religious) Education

    ERIC Educational Resources Information Center

    Barnes, Philip

    2006-01-01

    The purpose of this paper is to articulate a new perspective on British multi-faith religious education that both complements and, in part, subsumes existing critiques. My argument, while controversial, is straightforward: it is that British religious education has misrepresented the nature of religion in efforts to commend itself as contributing…

  15. Unions between Foreign Language and Business: British Patterns.

    ERIC Educational Resources Information Center

    Scott, James Calvert

    Traditional British attitudes toward foreigners, which are now being challenged by current economic realities, and the increasing internationalization of British business, which magnifies the need for employees to communicate effectively with people from other countries and cultures, are discussed. A brief overview is provided that covers recent…

  16. Britishness as Racist Nativism: A Case of the Unnamed "Other"

    ERIC Educational Resources Information Center

    Smith, Heather Jane

    2016-01-01

    The construct of Britishness, as with nationalism elsewhere in the world, although amorphous and permeable over time, continues to be used by politicians and the media as a powerful exclusionary force. Moreover in England, fundamental British values (FBV), its most recent and official incarnation, now hold particular currency in education policy…

  17. Knowledge, Character and Professionalisation in Nineteenth-Century British Science

    ERIC Educational Resources Information Center

    Ellis, Heather

    2014-01-01

    Historians have frequently referred to the British Association for the Advancement of Science as an institution that had the professionalisation of British science as its chief aim. This article seeks to complicate this picture by asking what, if any, concept of "professionalisation" would have been understood by nineteenth-century…

  18. Teaching Psychology in American and British Universities: Some Personal Impressions.

    ERIC Educational Resources Information Center

    Remington, Bob; Green, Patrick

    1988-01-01

    British psychologists, who have taught in both the United States and Great Britain, compare the teaching of psychology in British and U.S. universities. Discussing similarities and differences in course structure, curriculum, teaching methods, and evaluation procedures, they suggest ways in which each system could benefit from some of the other's…

  19. British and Finnish Baseball: International Variations on an American Pastime

    ERIC Educational Resources Information Center

    Williams, Emyr W.; Romar, Jan-Erik; Hartman, Michael

    2010-01-01

    Both British and Finnish baseball are easy to introduce, as the specific skills involved in both sports are identical to those used in traditional baseball. If students have the skills to play traditional baseball, they have the skills to play British and Finnish baseball as well. After a brief overview of the unique rules and strategies of these…

  20. The Politics of Britishness: Multiculturalism, Schooling and Social Cohesion

    ERIC Educational Resources Information Center

    Keddie, Amanda

    2014-01-01

    This paper is set against a backdrop of contemporary concerns about Britishness. It explores the dominant view that unprecedented levels of cultural diversity within western contexts such as the UK are undermining social cohesion and are attributable to minority groups' failure to connect or assimilate with mainstream "British" (read…

  1. Soaps and Suspicious Activity: Dramatic Experiences in British Classrooms.

    ERIC Educational Resources Information Center

    Ferree, Angela M.

    2001-01-01

    Offers examples of dramatic experiences (student produced soap operas) in two classrooms in British comprehensive secondary schools. Concludes that students in other countries would find such experiences as meaningful and enjoyable as their British counterparts. Notes that the two teachers managed to be flexible, appropriating effective…

  2. Contagious ecthyma in mountain goat of coastal British Columbia.

    PubMed

    Hebert, D M; Samuel, W M; Smith, G W

    1977-04-01

    Contagious ecthyma has been reported previously from mountain goat (Oreamnos americanus) in one restricted area of eastern British Columbia. A second focus of infection is reported for mountain goat from western British Columbia. Diagnosis was based on appearance of lesions at necropsy, histopathology and demonstration of poxvirus with the electron microscope. The epizootiology of this infection in mountain goat is discussed briefly.

  3. Prospects for Adult Literacy Policy in British Columbia.

    ERIC Educational Resources Information Center

    Darville, Richard

    1989-01-01

    Intended to assist in the formulation of effective policies for adult literacy in British Columbia, this paper reviews the current discussion of adult literacy policy and programming across Canada. It also reviews existing policies in Canada and in British Columbia, in education ministries, and in other ministries with interests and activities…

  4. Academic Freedom, Autonomy and Accountability in British Universities.

    ERIC Educational Resources Information Center

    Berdahl, Robert

    1990-01-01

    This paper argues that, using Eric Ashby's writing on academic freedom and autonomy and Burton Clark's essay on different modes of coordination, the British government has unnecessarily terminated the University Grants Committee and, in its overreliance on market forces, is threatening the future academic integrity of British universities.…

  5. Shakespearean Intertexts and European Identities in Contemporary Black British Fiction

    ERIC Educational Resources Information Center

    Muñoz-Valdivieso, Sofía

    2012-01-01

    The article analyses the presence of William Shakespeare as intertext in three recent novels by black British writers which deploy the work of the Bard as they explore British and European identities. Caryl Phillips's "The Nature of Blood" recreates an Othello-like figure who in early Modern Venice struggles to come to terms with his…

  6. Postpartum domperidone use in British Columbia: a retrospective cohort study

    PubMed Central

    Smolina, Kate; Morgan, Steven G.; Hanley, Gillian E.; Oberlander, Tim F.; Mintzes, Barbara

    2016-01-01

    Background: Domperidone is commonly used off-label to stimulate milk production in mothers who have low milk supply. The aim of this study was to describe trends, patterns and determinants of postpartum domperidone use. Methods: This is a retrospective, population-based study involving all women with a live birth between Jan. 1, 2002, and Dec. 31, 2011, in the province of British Columbia. We examined administrative data sets containing person-specific information on filled prescriptions and use of medical services, and we used logistic regression to examine associations between domperidone use and maternal characteristics. Results: The study population consisted of 225 532 women with 320 351 live births. The prevalence of postpartum domperidone use more than doubled between 2002 and 2011. In 2011, 1 in 3 women with a preterm birth and 1 in 5 women with a full-term birth were prescribed domperidone in the first 6 months postpartum. Women who were older, had a higher body mass index, had a chronic disease, were first-time mothers, delivered more than 1 baby (multiple pregnancy), had a preterm birth or had a cesarian delivery were more likely to fill a postpartum domperidone prescription. Interpretation: We found an increase in postpartum domperidone use over a 10-year period. More research is needed on maternal and infant health outcomes. PMID:27280111

  7. Predisposing factors leading to depression in the British Army.

    PubMed

    Finnegan, Alan; Finnegan, Sara; McGee, Paula; Srinivasan, Mike; Simpson, Robin

    Few studies have explored the predisposing factors leading to depression within the British Army, and this qualitative investigation provides a novel approach to advance knowledge in this poorly researched area. Information was provided by army mental health (MH) clinicians, with results aligned to theoretical groupings under the headings of: occupational stressors; macho culture, stigma and bullying; unhappy young soldier; relationships and gender. These issues were influenced by peacetime and operational settings; the support offered by the Army Medical Services and unit command. The results indicate that Army personnel are exposed to multi-factorial stressors that are incremental/accumulative in nature. Soldiers can cope with extreme pressures, often in hostile environments, but often cannot cope with a failing relationship. Officers were worried about the occupational implications of reporting ill, and the negative impact on their career, and might seek support from private civilian agencies, which have potentially dangerous ramifications as they may still deploy. GPs refer female soldiers more frequently for a mental health assessment because women express their emotions more openly then men. Young disillusioned soldiers who want to leave the Army form the main group of personnel accessing mental health support, although often they are not clinically depressed.

  8. [Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

    PubMed

    Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

    2017-02-01

    Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

  9. Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control.

    PubMed

    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.

  10. 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

  11. Guide to the Records Relating to Science and Technology in the British Public Record Office: A RAMP Study.

    ERIC Educational Resources Information Center

    Jubb, Michael

    Prepared under contract with the International Council on Archives (ICA), this guide provides descriptions of all classes of public records held by the British Public Record Office (PRO) which are likely to contain scientific or technical information. The PRO is responsible for keeping and making available to the public those records of the…

  12. Colonialism, Education and Social Change in the British Empire: The Cases of Australia, Papua New Guinea and Ireland

    ERIC Educational Resources Information Center

    O'Donoghue, Tom

    2009-01-01

    This paper focuses on the history of relations between colonialism, schooling and social change in Australia, Papua New Guinea and Ireland, countries that were once part of the British Empire. It indicates that responses to schooling ranged from acceptance and tolerance, to modification and rejection, depending on the country, the issue, and the…

  13. The Special Relationship: The United States as the British Have Seen It. A Selective Reading List by British Writers.

    ERIC Educational Resources Information Center

    Wright, Esmond, Comp.

    The selective annotated bibliography is a reader's guide to aspects of the American past and present as seen by British writers since the 1940s. Approximately 250 entries provide a sampling of how British students of United States studies perceive the New World. Childrens books are omitted. Nine categories are organized alphabetically by author.…

  14. Assessing Changes in Medical Student Attitudes toward Non-Traditional Human Sexual Behaviors Using a Confidential Audience Response System

    ERIC Educational Resources Information Center

    Tucker, Phebe; Candler, Chris; Hamm, Robert M.; Smith, E. Michael; Hudson, Joseph C.

    2010-01-01

    Medical students encountering patients with unfamiliar, unconventional sexual practices may have attitudes that can affect open communication during sexual history-taking. We measured changes in first-year US medical student attitudes toward 22 non-traditional sexual behaviors before and after exposure to human sexuality instruction. An…

  15. The Perceptions of the Preparedness of Medical Graduates to Take on Internship Responsibilities in Low Resource Hospitals in Kenya

    ERIC Educational Resources Information Center

    Muthaura, Patricia N.; Khamis, Tashmin K.

    2013-01-01

    The Aga Khan University is developing an Undergraduate Medical Education (UGME) curriculum for implementation in East Africa in 2016, which aims to serve the health needs of the populations there. Pilot focus group discussions of recent interns were conducted at the Aga Khan University Hospital, Nairobi to find out: (1) If Kenyan medical students…

  16. Child Behavior Research. A Survey of British Research Into Child Psychiatric Disorder and Normal Social Development. A Report to the MRC Child Psychiatry Sub-Committee.

    ERIC Educational Resources Information Center

    Shaffer, D., Comp.

    Approximately 250 abstracts of currently active (1975-1976) British research into child psychiatric disorder and normal social development are presented. It is explained that the information was gathered from a 1974 survey of research and education organizations, child psychiatrists at medical schools, and the heads of academic departments of…

  17. ‘Recharge My Exhausted Batteries’: Overbeck’s Rejuvenator, Patenting, and Public Medical Consumers, 1924–37

    PubMed Central

    Stark, James F.

    2014-01-01

    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

  18. Metaphyseal osteopathy in a British Shorthair cat.

    PubMed

    Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

    2015-04-01

    Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed.

  19. GM2 gangliosidosis in British Jacob sheep.

    PubMed

    Wessels, M E; Holmes, J P; Jeffrey, M; Jackson, M; Mackintosh, A; Kolodny, E H; Zeng, B J; Wang, C B; Scholes, S F E

    2014-01-01

    GM2 gangliosidosis (Tay-Sachs disease) was diagnosed in 6- to 8-month-old pedigree Jacob lambs from two unrelated flocks presenting clinically with progressive neurological dysfunction of 10 day's to 8 week's duration. Clinical signs included hindlimb ataxia and weakness, recumbency and proprioceptive defects. Histopathological examination of the nervous system identified extensive neuronal cytoplasmic accumulation of material that stained with periodic acid--Schiff and Luxol fast blue. Electron microscopy identified membranous cytoplasmic bodies within the nervous system. Serum biochemistry detected a marked decrease in hexosaminidase A activity in the one lamb tested, when compared with the concentration in age matched controls and genetic analysis identified a mutation in the sheep hexa allele G444R consistent with Tay-Sachs disease in Jacob sheep in North America. The identification of Tay-Sachs disease in British Jacob sheep supports previous evidence that the mutation in North American Jacob sheep originated from imported UK stock.

  20. Homosexual parents in British custody appeals.

    PubMed

    Cameron, Paul

    2003-04-01

    6 British child custody appeal cases including a homosexual parent were compared with 6 randomly drawn appeal cases between heterosexual parents for parental and mental instability, partners' instability, residential instability, criminality, and lying, and having harmed the children and exposing children to harms. In 3 of the 6 cases the homosexual or his associates were recorded as engaging in criminality, in another 2 cases with lying. In one of the 6 homosexual cases the children were recorded as harmed. The 9 recorded harms or probable harms to children in cases involving a homosexual parent were attributed to the homosexual or her associates: children were recorded as harmed and exposed to the harm of neglect in one of the 6 comparison cases.

  1. Mercury, cadmium, and lead in British otters

    SciTech Connect

    Mason, C.F.; Last, N.I.; Macdonald, S.M.

    1986-12-01

    Otters (subfamily Lutrinae), at the top of the food chain and feeding largely on fish, are likely to be especially vulnerable to the effects of bioaccumulating pollutants, while their aquatic habitat is often a sink for such chemicals derived from agricultural, industrial and domestic sources. The European otter (Lutra lutra) has shown substantial declines through much of its range over the past 30 years, which have been attributed to pollution by organochlorines. There are few published data on metals in tissues of European otters and these refer only to mercury. The present paper reports on burdens of mercury, cadmium and lead in tissues of a sample of British otters collected between 1982 and 1984.

  2. EFFECTIVENESS OF THE EMERGENCY RESPONSE COURSE IN IMPROVING STUDENT PHYSICAL THERAPISTS' AND LICENSED PHYSICAL THERAPISTS' DECISION‐MAKING RELATED TO ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS

    PubMed Central

    Cross, Patrick Stephen; Hauer, Patrick L.; Blom, Heather; Burcham, Jared; Myers, Amanda K.; Grimsrud, Casey

    2013-01-01

    Purpose: To analyze the effectiveness of the American Red Cross Emergency Response Course (ARC ERC) in improving decision‐making skills of physical therapists (PTs) and third semester clinical doctorate student physical therapists (SPTs) when assessing acute sports injuries and medical conditions. Methods: An existing questionnaire was modified, with permission from the original authors of the instrument. The questionnaire was administered to PTs and SPTs before the start of and immediately after the completion of 5 different ARC ERCs. The overall percentages of “Appropriate” responses for the 17 case scenarios were calculated for each participant for the pre‐and post‐tests. Participants also rated their perceived level of preparedness for managing various conditions using a 5‐point Likert Scale (ranging from Prepared to Unprepared). The overall percentage of “Prepared/Somewhat Prepared” responses for the 16 medical conditions was calculated for each participant for the pre‐and post‐tests. In addition, mean Likert scale scores were calculated for level of perceived preparedness for each of the 16 medical conditions. Paired t‐tests, calculated with SPSS 20.0, were used to analyze the data. Results: 37 of 37 (100.0%) of eligible PTs and 45 of 48 (93.8%) of eligible SPTs completed the pre‐ and post‐test questionnaires. The percentage of “Appropriate” responses for all 17 cases in the aggregate (PTs: 76.8% pre‐test, 89.0% post‐test; SPTs: 68.5%, 84.3%), as well as the percentage of “Prepared/Somewhat Prepared” responses for all conditions in the aggregate (PTs: 67.5%, 96.5%; SPTs: 37.1%, 90.6%) were significantly different from pre‐test to post‐test (P = .000). There was also a significant difference (P < .05) in the mean overall preparedness Likert scale scores from pre‐test to post‐test for each medical condition for the SPT's, and 15 of the 16 medical conditions (muscle strains: P = .119) for the PTs. Conclusions: The

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

    PubMed Central

    HIROKAWA, Kumi; MIWA, Machiko; TANIGUCHI, Toshiyo; TSUCHIYA, Masao; KAWAKAMI, Norito

    2015-01-01

    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. PMID:26632120

  4. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  5. "Worse than being married": the exodus of British doctors from the National Health Service to Canada, c. 1955-75.

    PubMed

    Wright, David; Mullally, Sasha; Cordukes, Mary Colleen

    2010-10-01

    Despite a sizeable literature on the evolution of health insurance in Britain and Canada, there is virtually no research on the transnational migration of physicians between these countries in the immediate postwar period. This article hopes to address this neglected subject. Three inter-related topics will be examined. First, the paper will summarize the debate over physician emigration from the National Health Service (NHS) in postwar Britain. It will demonstrate how British social scientists and politicians began to come to grips with a major demographic exodus of British-trained doctors in the late 1950s and early 1960s. Second, it will analyze the changing health human resource situation in 1960s Canada, which focused, for practical and cultural reasons, on General Medical Council of Britain licensed practitioners. Third, through oral interviews of British-trained physicians who settled in Canada during the 1960s, it will examine the professional and personal reasons why physicians left Britain for Canada. It reveals that, among a myriad of personal issues that motivated a physician to leave the NHS, the inflexibility and hierarchical nature of British medicine loomed very large. The paper will conclude by reflecting on the contemporary significance of this fascinating historical phenomenon.

  6. Commercializing medical technology.

    PubMed

    Scanlon, Kevin J; Lieberman, Mark A

    2007-04-01

    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880's, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930's-1970's) because the German scientists fled Hitler's government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980's. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain, Singapore

  7. Commercializing medical technology

    PubMed Central

    Lieberman, Mark A.

    2007-01-01

    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880’s, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930’s–1970’s) because the German scientists fled Hitler’s government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980’s. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain

  8. British participation in the first Solvay Councils on physics

    NASA Astrophysics Data System (ADS)

    Heilbron, J. L.

    2015-09-01

    Analysis of the makeup and contributions of the British contingents to the first two Solvay Councils can elucidate the character of British mathematical physics and its internal dynamics at a critical time in its development. The paper provides this analysis, outlines the process of selection of the participants, parses the meaning of "international" in the Solvay context, and offers an explanation of the differential attendance of the British at the two Councils. Most of those invited to the first refused whereas all but one of those invited to the second accepted. The unusual social and scientific views of Ernest Solvay help to explain this divergence.

  9. The development of bacteriology, sanitation science and allied research in the British Army 1850-1918: equipping the RAMC for war.

    PubMed

    Atenstaedt, R L

    2010-09-01

    The recent 90 year anniversary of the end of the First World War is an opportune time to reconsider the important role of the Royal Army Medical Corps in this conflict. One area which has been neglected is the role of the Royal Army Medical Corps in responding to infectious diseases and to understand this properly it is important to consider the development of bacteriology, sanitation science and allied research in the British Army up to the Great War. The context of the home front is also central, with the British population from 1880-1914 increasingly benefiting from improved public sanitation and the new science of bacteriology. Historians acknowledge that the British campaign in the Crimea in the 1850s was pursued with inadequate medical provision and as a result, the Army suffered severely from infectious diseases. Limited changes were introduced after the Crimean War, such as the establishment of the Army Medical School, with its high quality instruction in military hygiene and later bacteriology. Army medics also led the way in various branches of scientific research, through research in the colonies. As compared with the continental powers, however, the application of bacteriology and sanitation to field craft in the British Army was delayed. It took the experiences of the South African and Russo-Japanese Wars for the importance of these sciences to be recognised by the Army as a whole. These subjects began to form part of the education of army Medical Officers, but training was basic and few trainees had specialised in bacteriology by 1914. In spite of these limitations, the Royal Army Medical Corps responded well to the demands placed upon it by World War One, recruiting civilian bacteriologists to its ranks, developing technological innovations such as mobile bacteriological laboratories for them to work in, forming a sanitation service and fostering medical research.

  10. Recovery and resilience after a nuclear power plant disaster: a medical decision model for managing an effective, timely, and balanced response.

    PubMed

    Coleman, C Norman; Blumenthal, Daniel J; Casto, Charles A; Alfant, Michael; Simon, Steven L; Remick, Alan L; Gepford, Heather J; Bowman, Thomas; Telfer, Jana L; Blumenthal, Pamela M; Noska, Michael A

    2013-04-01

    Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents.

  11. Commentary: do medical schools have a responsibility to train physicians to meet the needs of the public? The case of persistent rural physician shortages.

    PubMed

    Rosenblatt, Roger A

    2010-04-01

    Persistent shortages of rural physicians have plagued the U.S. health care system for much of the last century. Recent, sharp declines in the number and proportion of U.S. medical students entering primary care have exacerbated this chronic problem because primary care physicians are the foundation of rural health care systems. The article by Chen and colleagues in the current issue of this journal replicates findings of a study 15 years ago by the author of this commentary and his colleagues that demonstrated that a relatively small number of medical schools are responsible for a large share of all of the rural physicians in the country. The lack of progress in the ensuing 15 years is distressing because there is now excellent evidence that targeted rural tracks in medical schools-including selective admissions of students from rural backgrounds and supportive integrated curricula-yield dramatic increases in the number of students choosing rural careers. U.S. medical schools-supported in large part by public funds-have a responsibility to ensure that the specialty choices and practice locations of their graduates meet the needs of the nation at large, as well as the rural and underserved communities in the regions they serve.

  12. The northern sector of the last British Ice Sheet: Maximum extent and demise

    NASA Astrophysics Data System (ADS)

    Bradwell, Tom; Stoker, Martyn S.; Golledge, Nicholas R.; Wilson, Christian K.; Merritt, Jon W.; Long, David; Everest, Jeremy D.; Hestvik, Ole B.; Stevenson, Alan G.; Hubbard, Alun L.; Finlayson, Andrew G.; Mathers, Hannah E.

    2008-06-01

    Shetland indicates that the re-organisation of the British Ice Sheet was extremely dynamic — probably dominated by a series of internally forced readvances. Critically, much of the ice in the low-lying North Sea Basin may have disintegrated catastrophically as decoupling progressed in response to rising sea levels. Final-stage deglaciation was marked by near-shore ice streaming and increasing topographic control on ice-flow direction. Punctuated retreat of the British Ice Sheet continued until c. 16 ka BP when, following the North Atlantic iceberg-discharge event (Heinrich-1), ice was situated at the present-day coastline in NW Scotland.

  13. Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: Final results of the RNS System Pivotal trial

    PubMed Central

    Heck, Christianne N; King-Stephens, David; Massey, Andrew D; Nair, Dileep R; Jobst, Barbara C; Barkley, Gregory L; Salanova, Vicenta; Cole, Andrew J; Smith, Michael C; Gwinn, Ryder P; Skidmore, Christopher; Van Ness, Paul C; Bergey, Gregory K; Park, Yong D; Miller, Ian; Geller, Eric; Rutecki, Paul A; Zimmerman, Richard; Spencer, David C; Goldman, Alica; Edwards, Jonathan C; Leiphart, James W; Wharen, Robert E; Fessler, James; Fountain, Nathan B; Worrell, Gregory A; Gross, Robert E; Eisenschenk, Stephan; Duckrow, Robert B; Hirsch, Lawrence J; Bazil, Carl; O'Donovan, Cormac A; Sun, Felice T; Courtney, Tracy A; Seale, Cairn G; Morrell, Martha J

    2014-01-01

    Objective To demonstrate the safety and effectiveness of responsive stimulation at the seizure focus as an adjunctive therapy to reduce the frequency of seizures in adults with medically intractable partial onset seizures arising from one or two seizure foci. Methods Randomized multicenter double-blinded controlled trial of responsive focal cortical stimulation (RNS System). Subjects with medically intractable partial onset seizures from one or two foci were implanted, and 1 month postimplant were randomized 1:1 to active or sham stimulation. After the fifth postimplant month, all subjects received responsive stimulation in an open label period (OLP) to complete 2 years of postimplant follow-up. Results All 191 subjects were randomized. The percent change in seizures at the end of the blinded period was −37.9% in the active and −17.3% in the sham stimulation group (p = 0.012, Generalized Estimating Equations). The median percent reduction in seizures in the OLP was 44% at 1 year and 53% at 2 years, which represents a progressive and significant improvement with time (p < 0.0001). The serious adverse event rate was not different between subjects receiving active and sham stimulation. Adverse events were consistent with the known risks of an implanted medical device, seizures, and of other epilepsy treatments. There were no adverse effects on neuropsychological function or mood. Significance Responsive stimulation to the seizure focus reduced the frequency of partial-onset seizures acutely, showed improving seizure reduction over time, was well tolerated, and was acceptably safe. The RNS System provides an additional treatment option for patients with medically intractable partial-onset seizures. PMID:24621228

  14. Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire*

    PubMed Central

    Shen, Wei-feng; Jiang, Li-bing; Jiang, Guan-yu; Zhang, Mao; Ma, Yue-feng; He, Xiao-jun

    2014-01-01

    Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: ‘mass casualty incident’, ‘MCI’, ‘research method’, ‘Wenchuan’, ‘earthquake’, ‘research paradigm’, ‘science of surge’, ‘surge’, ‘surge capacity’, and ‘vulnerability’. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the

  15. Spatiotemporal patterns of observed bark beetle-caused tree mortality in British Columbia and the western United States.

    PubMed

    Meddens, Arjan J H; Hicke, Jeffrey A; Ferguson, Charles A

    2012-10-01

    Outbreaks of aggressive bark beetle species cause widespread tree mortality, affecting timber production, wildlife habitat, wildfire, forest composition and structure, biogeochemical cycling, and biogeophysical processes. As a result, agencies responsible for forest management in the United States and British Columbia conduct aerial surveys to map these forest disturbances. Here we combined aerial surveys from British Columbia (2001 2010) and the western conterminous United States (1997-2010), produced 1-km2 grids of the area of crown mortality from bark beetle attack, and analyzed spatial and temporal patterns. We converted aerial-survey polygon data for each combination of host type and bark beetle species available in the western United States, and for each bark beetle species available in British Columbia. We converted affected area (which includes live and killed trees) to mortality area (crown area of killed trees) using species-specific crown diameters and the number (U.S.) or percentage (British Columbia) of killed trees. In the United States we also produced an upper estimate of mortality area by forcing the mortality area to match that from high-resolution imagery in Idaho, Colorado, and New Mexico. Resulting adjustment factors of 3.7-20.9 illustrate the underestimate of mortality by the U.S. aerial surveys. The upper estimate, which we suggest is more realistic, better matched the spatial patterns and severity of the British Columbia mortality area. Cumulative mortality area from all bark beetles was 5.46 Mha in British Columbia in 2001-2010 and 0.47-5.37 Mha (lower and upper estimate) in the western conterminous United States during 1997-2010. We note that we report year of detection here; studies that consider year of tree mortality should shift the time series back one year. We conclude by discussing uses and limitations of these data in ecological studies, including uncertainties associated with assumptions in the methods, lack of complete coverage

  16. Does an offer for a free on-line continuing medical education (CME) activity increase physician survey response rate? A randomized trial

    PubMed Central

    2012-01-01

    Background Achieving a high response rate in a physician survey is challenging. Monetary incentives increase response rates but obviously add cost to a survey project. We wondered whether an offer of a free continuing medical education (CME) activity would be effective in improving survey response rate. Results As part of a survey of a national sample of physicians, we randomized half to an offer for a free on-line CME activity upon completion of a web-based survey and the other half to no such offer. We compared response rates between the groups. A total of 1214 out of 8477 potentially eligible physicians responded to our survey, for an overall response rate of 14.3%. The response rate among the control group (no offer of CME credit) was 16.6%, while among those offered the CME opportunity, the response rate was 12.0% (p < 0.0001). Conclusions An offer for a free on-line CME activity did not improve physician survey response rate. On the contrary, the offer for a free CME activity actually appeared to worsen the response rate. PMID:22397624

  17. Neural activation during response inhibition in adult attention-deficit/hyperactivity disorder: preliminary findings on the effects of medication and symptom severity.

    PubMed

    Congdon, Eliza; Altshuler, Lori L; Mumford, Jeanette A; Karlsgodt, Katherine H; Sabb, Fred W; Ventura, Joseph; McGough, James J; London, Edythe D; Cannon, Tyrone D; Bilder, Robert M; Poldrack, Russell A

    2014-04-30

    Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop-Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N=35) and healthy comparison subjects (N=62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop-Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated with current medication, with individuals taking psychostimulants (N=25) showing less stopping-related activation than those not currently receiving psychostimulant medication (N=10). Follow-up analyses suggested that this difference in activation was independent of symptom severity. These results provide evidence that deficits in inhibition-related neural activation persist in a subset of adult ADHD individuals, namely those individuals currently taking psychostimulants. These findings help to explain some of the disparities in the literature, and advance our understanding of why deficits in response inhibition are more variable in adult, as compared with child and adolescent, ADHD patients.

  18. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee.

    PubMed

    Okosieme, Onyebuchi; Gilbert, Jackie; Abraham, Prakash; Boelaert, Kristien; Dayan, Colin; Gurnell, Mark; Leese, Graham; McCabe, Christopher; Perros, Petros; Smith, Vicki; Williams, Graham; Vanderpump, Mark

    2016-06-01

    The management of primary hypothyroidism with levothyroxine (L-T4) is simple, effective and safe, and most patients report improved well-being on initiation of treatment. However, a proportion of individuals continue to suffer with symptoms despite achieving adequate biochemical correction. The management of such individuals has been the subject of controversy and of considerable public interest. The American Thyroid Association (ATA) and the European Thyroid Association (ETA) have recently published guidelines on the diagnosis and management of hypothyroidism. These guidelines have been based on extensive reviews of the medical literature and include sections on the role of combination therapy with L-T4 and liothyronine (L-T3) in individuals who are persistently dissatisfied with L-T4 therapy. This position statement by the British Thyroid Association (BTA) summarises the key points in these guidelines and makes recommendations on the management of primary hypothyroidism based on the current literature, review of the published positions of the ETA and ATA, and in line with best principles of good medical practice. The statement is endorsed by the Association of Clinical Biochemistry, (ACB), British Thyroid Foundation, (BTF), Royal College of Physicians (RCP) and Society for Endocrinology (SFE).

  19. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

    ERIC Educational Resources Information Center

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

    2009-01-01

    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

  20. BRITISH MOLDING MACHINE, PBQ AUTOMATIC COPE AND DRAG MOLDING MACHINE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    BRITISH MOLDING MACHINE, PBQ AUTOMATIC COPE AND DRAG MOLDING MACHINE MAKES BOTH MOLD HALVES INDIVIDUALLY WHICH ARE LATER ROTATED, ASSEMBLED, AND LOWERED TO POURING CONVEYORS BY ASSISTING MACHINES. - Southern Ductile Casting Company, Casting, 2217 Carolina Avenue, Bessemer, Jefferson County, AL

  1. SPECIES RICHNESS AND BIODIVERSITY CONSERVATION PRIORITIES IN BRITISH COLUMBIA

    EPA Science Inventory

    Patterns in the geographic distribution of seven species groups were used to identify important areas for conservation in British Columbia, Canada. Potential priority sites for conservation were determined using an integer programming algorithm that maximized the number of speci...

  2. FILLING MOLDS MADE ON THE BRITISH MOLDING MACHINE, AUTOMATIC COPE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    FILLING MOLDS MADE ON THE BRITISH MOLDING MACHINE, AUTOMATIC COPE AND DRAG (BMM) FROM MOBILE LADLE. EMPTY BULL LADLE IN FOREGROUND. - Southern Ductile Casting Company, Casting, 2217 Carolina Avenue, Bessemer, Jefferson County, AL

  3. Beliefs about Overcoming Psychological Problems among British and Japanese Students.

    ERIC Educational Resources Information Center

    Furnham, Adrian; Ota, Hiromi; Tatsuro, Hosoe; Koyasu, Masuo

    2000-01-01

    Examines the cultural differences among Japanese students, British students, and Japanese students studying in Britain, concerning their beliefs on overcoming five psychological problems: depression, obesity, smoking cessation, agoraphobia, and lack of confidence. (CMK)

  4. Towards Diversification of Secondary Special Education in British Columbia

    ERIC Educational Resources Information Center

    Csapo, Marg

    1978-01-01

    Discussed is the trend in British Columbia, Canada, towards diversification of secondary special education programs, which in the past were restricted to occupational programs that became "dumping grounds" for all types of problem students. (DLS)

  5. Benjamin Moore, Science, and Medical Planning in Early Twentieth-Century Britain

    ERIC Educational Resources Information Center

    Lawson, Gordon S.

    2008-01-01

    Benjamin Moore (1867-1922), physiologist and biochemist, was an eminent member of the British scientific and medical community in the early twentieth century. As a founder and president of the State Medical Services Association (SMSA) from its establishment in 1912 until his untimely death in 1922, Moore was a prominent medical services activist…

  6. Drug metabolism and pharmacogenetics: the British contribution to fields of international significance

    PubMed Central

    Caldwell, John

    2006-01-01

    The branch of pharmacology we now call ‘drug metabolism', the consideration of the enzymes and procesess determining the disposition of drugs in the body, emerged in the 1840s on the continent of Europe, but British science made little or no contribution until the 1920s. From this point on, the development of the field through the 20th century was shaped to a very significant extent by a series of influential British workers, whose contributions were of global significance and who can now be seen as fathers of the subject. Since the 1950s, and gaining pace inexorably from the 1970s, the significance of drug metabolism to human therapeutics has been greatly added to by the emergence of pharmacogenetics, clinically important hereditary variation in response to drugs, which underpins the current emphasis on personalised medicine. This review examines the British contributions to both these fields through the lives of seven key contributors and attempts to place their work both in the context of its time and its lasting influence. PMID:16402125

  7. Retirement migration, the 'other' story: caring for frail elderly British citizens in Spain.

    PubMed

    Hall, Kelly; Hardill, Irene

    2016-03-01

    Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population.

  8. Leeds Undergraduate Medical Education Conference, 7-8 July 1995.

    PubMed

    Wilson, S; Reece, A; Sykes, A; Noble, A

    1996-03-01

    The Leeds Undergraduate Medical Education Conference (LUMEC) was held on 7-8 July 1995. This conference, devoted entirely to undergraduate medical education, was unique in that it was organized entirely by four medical students. It attracted a wide and enthusiastic audience and excellent speakers. Professor Charles George (Chairman, Education Committee, General Medical Council) spoke about Tomorrow's Doctors, Dr Mark Bailey (Part-chairman, Medical Students' Committee of the British Medical Association) responded with 'Today's Students on Tomorrow's Doctors', and Dr Fleur Fisher (Ethics, Science and Information Division, British Medical Association) focused on the central place of ethics and communication skills in medicine. Professor Sam Leinster (Director of Medical Studies, Liverpool University) and Professor Tim de Dombal (Director, Clinical Information Science Unit, Leeds University) debated the need for new technology and radical change in the curriculum. Finally, Dr Stella Lowry (International Division, British Medical Association) considered the assessment of staff and Mrs Joy Crosby (Curriculum Facilitator, Dundee Medical School) discussed the assessment of students. Discussions focused on a variety of areas, including the need for change, the control of the money available for teaching and the problems of assessment.

  9. British variable star associations, 1848-1908

    NASA Astrophysics Data System (ADS)

    Toone, J.

    2010-06-01

    The study of variable stars lagged some distance behind solar system, positional (double star) and deep sky research until the middle part of the 19th century. Then, following F. W. A. Argelander's pioneering work in the 1840s, there was a striking increase in variable star research, particularly in Europe. The transformation was to such an extent that in the second half of the 19th century there were three attempts at forming variable star associations within Great Britain. The first in 1863 was the ASOVS, which never got off the ground. The second in 1883 was the LAS VSS, which was successfully launched but had somewhat limited achievements. The third launched in 1890 was the BAA VSS which was eventually both a resounding and lasting success. This paper is an outline history of these three associations up to a position of one hundred years ago (1908). [A summary version of this paper was presented at the joint meeting of the American Association of Variable Star Observers (AAVSO) and British Astronomical Association Variable Star Section (BAA VSS) held at Cambridge, UK, on 2008 April 11.

  10. Cancer mortality in the British rubber industry.

    PubMed Central

    Parkes, H G; Veys, C A; Waterhouse, J A; Peters, A

    1982-01-01

    Although it is over 30 years since an excess of bladder cancer was first identified in British rubber workers, the fear has persisted that this hazard could still be affecting men working in the industry today. Furthermore, suspicions have also arisen that other and hitherto unsuspected excesses of cancer might be occurring. For these reasons 33 815 men, who first started work in the industry between 1 January 1946 and 31 December 1960, have been followed up to 31 December 1975 to ascertain the number of deaths attributable to malignant disease and to compare these with the expected number calculated from the published mortality rates applicable to the male population of England and Wales and Scotland. The findings confirm the absence of any excess mortality from bladder cancer among men entering the industry after 1 January 1951 (the presumed bladder carcinogens were withdrawn from production processes in July 1949), but they confirm also a statistically significant excess of both lung and stomach cancer mortality. A small excess of oesophageal cancer was also observed in both the tyre and general rubber goods manufacturing sectors. American reports of an excess of leukaemia among rubber workers receive only limited support from the present study, where a small numerical excess of deaths from leukaemia is not statistically significant. A special feature of the study is the adoption of an analytical method that permits taking into account the long latent period of induction of occupational cancer. PMID:7093147

  11. Utopianism in the British evolutionary synthesis.

    PubMed

    Esposito, Maurizio

    2011-03-01

    In this paper I propose a new interpretation of the British evolutionary synthesis. The synthetic work of J. B. S. Haldane, R. A. Fisher and J. S. Huxley was characterized by both an integration of Mendelism and Darwinism and the unification of different biological subdisciplines within a coherent framework. But it must also be seen as a bold and synthetic Darwinian program in which the biosciences served as a utopian blueprint for the progress of civilization. Describing the futuristic visions of these three scientists in their synthetic heydays, I show that, despite a number of important divergences, their biopolitical ideals could be biased toward a controlled and regimented utopian society. Their common ideals entailed a social order where liberal and democratic principles were partially or totally suspended in favor of bioscientific control and planning for the future. Finally, I will argue that the original redefinition of Darwinism that modern synthesizers proposed is a significant historical example of how Darwinism has been used and adapted in different contexts. The lesson I draw from this account is a venerable one: that, whenever we wish to define Darwinism, we need to recognize not only its scientific content and achievements but expose the other traditions and ideologies it may have supported.

  12. ASPIRE - the first British student rocket programme

    NASA Astrophysics Data System (ADS)

    Baker, Adam M.; Murray, J.; Osborne, R.; Macfarlane, J.

    ASPIRE is the first British programme aiming to create and develop a small scale, hybrid engine powered launch vehicle. The project is also unique because it is a wholly amateur effort, volunteer team members having little or no professional experience in launch vehicle design, manufacture and operations; and being a mix of students and young professionals. Participants have the opportunity to develop their experience in the engineering/scientific, operational and management areas which ASPIRE encompasses. This experience will then be validated through the launching of a series of test vehicles, culminating in a demonstration of the orbital insertion of a payload by the year 2000. ASPIRE aims to eventually return an independent orbital launch capability to Britain, for the first time since 1971. This paper outlines the technical details of the ASPIRE rockets, including: airframe design and manufacture, hybrid motor design and testing, avionics development, guidance and recovery techniques, range safety practise and marketing and fund-raising. It will also cover the organisation and ethos of the programme in general. A timeline for the ASPIRE programme will be detailed, from the original ASPIRE 1 construction and launch in 1991/1992, evolving through the current series of ASPIRE Development Vehicles (ADVs), to ASPIRE 2 and 3, where the hybrid motor and other engineering subsystems are to be integrated on an increasing scale. The proposed union of an ASPIRE 3 vehicle with an Australian AUSROC launcher to achieve the 2000 orbital goal will also be covered.

  13. Socialism and the British National Health Service.

    PubMed

    Powell, M

    1997-09-01

    This paper examines some of the key characteristics of a socialist health care system using the example of the British National Health Service (NHS). It has been claimed that the NHS has socialist principles, and represents an island of socialism in a capitalist sea. However, using historical analysis, this paper argues that while the NHS claims some socialist ends, they could never be fully achieved because of the lack of socialist means. The socialist mechanisms which were associated with earlier plans for a national health service such as salaried service, health centres, elected health authorities and divorcing private practice from the public service were discarded in negotiation. Moreover, even these would have achieved socialism merely in the sense of distributing health care, without any deeper transformation associated with doctor-patient relationships and prevention. In short, the NHS is more correctly seen as nationalised rather than socialised medicine, achieving the first three levels of a socialist health service identified here. It can be said to have socialist principles in the limited distributional sense and has some socialist means to achieve these. However, it lacks the stronger means to fully achieve its distributional goals, and is very distant from the third level of a radical transformation of health care.

  14. The Planetary Consciousness of British Travel Writers

    NASA Astrophysics Data System (ADS)

    Henry, H.

    2013-04-01

    Global travel, advanced in the early 20th century by trains, automobiles, and airplanes, transformed modernist thought and experience. Stephen Kern has commented that in the modern period “a series of sweeping changes in technology and culture created distinctive new modes of thinking about and experiencing of time and space. Technological innovations including the telephone, wireless telegraph, x-ray, cinema, bicycle, automobile, and airplane established the material foundation for this reorientation.” (1983, pp. 1-2). Emerging travel technologies not only hurled passengers through multiple time zones in a day but also brought to the fore a global awareness regarding Earth as a globe in space and one's position on it. As early as 1909, while traveling in Florence, Virginia Woolf had noted in her diary, “It is strange how one begins to hold a globe in one's head: I can travel from Florence to Fitzroy Square on solid land all the time” (1984, p. 399). This paper traces the ways modernist British travel writers challenged England's geographical and geopolitical imagination at the turn of the 20th century through their travel narratives.

  15. Gambian-British and Nigerian-British Children's and Families' Experiences of Migration "Back" to West Africa. Research Briefing No. 13

    ERIC Educational Resources Information Center

    Roberts-Holmes, Guy

    2013-01-01

    This research looks at the factors motivating Gambian-British and Nigerian-British parents to send their children "back" to West Africa and what this means for parents, children and families on both continents.

  16. An investigation into regular recruit wastage from the British Army, 1988.

    PubMed

    Jefferson, T O

    1990-10-01

    A study was made of recruit medical discharges in the British Army in 1988 with the aim of ascertaining the number of medical discharges amongst recruits. AFBs 6863 (Notification of Discharge of a Regular Recruit) were used as the source of data. Recruit medical wastage rate for 1988 was 897 cases, or 16.7% of all known discharges. Three types of medical discharges were present. Four hundred and ninety-six Type 1 or concealed discharges, (9.2% of discharges for all reasons) were made up of cases who had not been boarded and had mainly been discharged under QR 9.381 (defect of enlistment). Two hundred and seventy-five Type 2 discharges (5.1% of discharges for all reasons) represented boarded cases discharged under QR 9.385 (ceasing to fulfil medical requirements). One hundred and twenty-six Type 3 discharges (2.3% of all discharges) were boarded cases mainly discharged under QR 9.381 (defect of enlistment). As all discharges under paragraphs other than QR 9.385 are given administrative discharge outflow code, only the 275 Type 2 discharges (or 31.7% of medical discharges) appeared on the Army's own source of medical data, the TRIMEDS database. This had the effect of concealing the majority of those discharges caused by conditions predating enlistment therefore decreasing the number of known false negatives not detected at recruiting medicals. The biggest causes of discharge were conditions of the lower limbs and back (54.5% of medical discharges), a conglomerate of minor categories of pathology (14.6%), asthma (9.6%) and deformities (7.4%). Within each type the bulk of the discharges was concealed in Type 1 discharges especially for conditions predating enlistment.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Surgeons reconsidered: military medical men of the American revolution.

    PubMed

    Marshall, Tabitha

    2010-01-01

    This paper assesses the reputation of British military medical staff in the 18th century, focusing on the character and professionalism of regimental surgeons and mates who served at the time of the American Revolutionary War (1775-1783). Examining the careers and contributions of men such as Thomas Dickson Reide, Robert Jackson, and Robert Hamilton reveals that--in contrast to charges of ineptitude, laziness and dishonesty among military surgeons--the British army could count on a cadre of military medical men who were devoted both to their patients and to the advancement of their profession.

  18. Blister Packaging Medication to Increase Treatment Adherence and Clinical Response: Impact on Suicide-related Morbidity and Mortality

    DTIC Science & Technology

    2011-09-01

    Task 1. Project Start-up (months 1-3) Completed la. Hire research assistant, pharmacy technician, and pharmacist (month 1) • · All study personnel...measures described in this chapter should help clinicians to appreciate the potential utility of blister packaging medications for their high-risk

  19. The Medical University.

    ERIC Educational Resources Information Center

    Piel, Gerard

    1981-01-01

    Success, it is suggested, has brought the medical school into critical new responsibility for the welfare of the university as a whole. An urgent topic for inquiry in the university is seen as the expansion of the medical economy and the attendant growth of medical schools. (MLW)

  20. Sexual Satisfaction, Performance, and Partner Response Following Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project

    PubMed Central

    Zulu, Robert; Jones, Deborah; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen

    2015-01-01

    Background: Voluntary medical male circumcision (VMMC) is an important HIV prevention strategy, particularly in regions with high HIV incidence and low rates of male circumcision. However, 88% of the Zambian male population remain uncircumcised, and of these 80% of men surveyed expressed little interest in undergoing VMMC. Methods: The Spear and Shield study (consisting of 4 weekly, 90-minute sexual risk reduction/VMMC promotion sessions) recruited and enrolled men (N = 800) who self-identified as at risk of HIV by seeking HIV testing and counseling at community health centers. Eligible men tested HIV-negative, were uncircumcised, and expressed no interest in VMMC. Participants were encouraged (but not required) to invite their female partners (N = 668) to participate in the program in a gender-concordant intervention matched to their partners’. Men completed assessments at baseline, post-intervention (about 2 months after baseline), and 6 and 12 months post-intervention; women completed assessments at baseline and post-intervention. For those men who underwent VMMC and for their partners, an additional assessment was conducted 3 months following the VMMC. The ancillary analysis in this article compared the pre- and post-VMMC responses of the 257 Zambian men who underwent circumcision during or following study participation, using growth curve analyses, as well as of the 159 female partners. Results: Men were satisfied overall with the procedure (mean satisfaction score, 8.4 out of 10), and nearly all men (96%) and women (94%) stated they would recommend VMMC to others. Approximately half of the men reported an increase or no change in erections, orgasms, and time to achieve orgasms from pre-VMMC, while one-third indicated fewer erections and orgasms and decreased time to achieve orgasms post-VMMC. Nearly half (42%) of the men, and a greater proportion (63%) of the female partners, said their sexual pleasure increased while 22% of the men reported less

  1. The evolution of casualty evacuation in the British Army in the 20th century (Part 2)--1918 to 1945.

    PubMed

    Bricknell, M C M

    2002-09-01

    This is the second in a series of papers that examine the evolution of the military casualty evacuation chain during the 20th century. The Spanish Civil War demonstrated to the world the revolutionary tactic of 'Blitzkrieg' developed by the Germans. This and the experience of the British Expeditionary Force in 1940 emphasised the need for mobility in forward medical units. The campaign in the Western Desert led to the creation of a number of new units such as the Field Surgical Unit and the Field Transfusion Unit which were introduced across the British Army as a result of the findings of the Hartgill Committee. The aeroplane transformed the evacuation chain from CCSs to base hospitals and beyond.

  2. Oslo government district bombing and Utøya island shooting July 22, 2011: The immediate prehospital emergency medical service response

    PubMed Central

    2012-01-01

    Background On July 22, 2011, a single perpetrator killed 77 people in a car bomb attack and a shooting spree incident in Norway. This article describes the emergency medical service (EMS) response elicited by the two incidents. Methods A retrospective and observational study was conducted based on data from the EMS systems involved and the public domain. The study was approved by the Data Protection Official and was defined as a quality improvement project. Results We describe the timeline and logistics of the EMS response, focusing on alarm, dispatch, initial response, triage and evacuation. The scenes in the Oslo government district and at Utøya island are described separately. Conclusions Many EMS units were activated and effectively used despite the occurrence of two geographically separate incidents within a short time frame. Important lessons were learned regarding triage and evacuation, patient flow and communication, the use of and need for emergency equipment and the coordination of helicopter EMS. PMID:22280935

  3. [Private charity - public health service. Comparison between British and German birthing centers of the 18th century].

    PubMed

    Schlumbohm, Jürgen

    In the eighteenth century, lying-in hospitals were founded in many European towns and cities. The way in which these institutions were financed differed greatly across Europe. In the UK, most of them were "charities" and relied on donations from wealthy benefactors, whereas on the continent they were usually funded by "public" money, be it from the state or local communities. The paper focuses on British charities and German hospitals, and explores the corollaries of the mode of financing. In the eighteenth century, a market emerged in Britain where numerous charities with different aims competed for donations from the well-to-do. For attracting benefactors, a charity had to convince potential donors that its clientele and purpose were particularly deserving, and that it used the money donated in a cost-efficient way. In Germany, it was mainly bureaucrats and governments who had to be persuaded, but public opinion did matter as well. In British lying-in charities, the main donors acted as governors, and benefactors could recommend persons for being admitted. In publicly funded German hospitals, the medical directors had much more power. In the competitive market, in which British charities acted, out-patient dispensaries (policlinics) became increasingly important, since they could argue that they were more cost-efficient and had lower mortality. In Germany, however, hospitals remained the dominant type of assistance in this field, in spite of the criticism they received. The different sources of finance appear to have been one of the reasons for this divergence. Teaching was the main purpose of most German lying-in hospitals. They either trained medical students or midwife apprentices or both. Since the patients served as teaching objects, all women were welcomed, and in fact most patients were single mothers. By contrast, most of the British institutions admitted only married women, because donors did not wish to encourage immorality. The charities staged the

  4. Trace nutrients. 4. Iodine in British food.

    PubMed

    Wenlock, R W; Buss, D H; Moxon, R E; Bunton, N G

    1982-05-01

    1. The amounts of iodine in nationally representative samples of prepared and cooked groups of foods and in a wide variety of individual foods and food products were determined colorimetrically. The amounts of erythrosine, a red food colour containing 577 mg I/g were also determined in selected foods and diets by high-performance liquid chromatography. 2. The average British diet was calculated to provide 323 micrograms I/d but only 255 micrograms if two fruit samples containing large amounts of glacé cherries were discounted. Of the total, 92 micrograms was derived from liquid milk. Meat and meat products provided 36 micrograms and cereal products 31 micrograms, but fresh fruits and sugars, vegetables and beverages provided little I. Fish and fish products, though rich in I, contributed only 5% to the total intake. 3. Milk was the most variable as well as the most important individual source of I. Summer milk samples contained 70 micrograms/kg and winter milk 370 micrograms/kg on average. Milk products, including butter and cheese, and eggs were also rich in I. 4. Some processed foods contained erythrosine, particularly glacé cherries and some pink or red confectionery items, biscuits, cherry cake, canned strawberries and luncheon meat. However, none of these are major foods in the average household diet and erythrosine would therefore contribute little more than 10 micrograms I/d to most diets. 5. The average daily intake of I was lower than in similar similar studies in the USA, but was twice the provisional UK recommended intake. This study provides no evidence that I intakes in the UK could be too low or too high for health.U

  5. Risk factors for heat illness among British soldiers in the hot Collective Training Environment

    PubMed Central

    Moore, Alice C; Stacey, M J; Bailey, K G H; Bunn, R J; Woods, D R; Haworth, K J; Brett, S J; Folkes, S E F

    2016-01-01

    Background Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops. Objective To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses. Methods An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation). Results The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation. Conclusions Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of ‘marginal gains’ is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE. PMID:26036822

  6. Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia.

    PubMed

    Clovis, Joanne B; Horowitz, Alice M; Poel, Dale H

    2002-01-01

    Oral and pharyngeal cancers are largely preventable and can be successfully treated when diagnosed at an early stage. Dentists in British Columbia and Nova Scotia were surveyed regarding their knowledge and opinions about oral and pharyngeal cancer. In February 1998 a pretested 41-item survey was mailed to a random sample of dentists in British Columbia and the population of dentists in Nova Scotia. A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%) only 56.7% agreed that their knowledge of the subject was current. Most dentists correctly identified tobacco use (99.4%) and alcohol use (90.4%) as risk factors, but fewer correctly identified factors such as the use of spicy foods (57.0%) and poor oral hygiene (46.3%) as not being risk factors. Only 42.5% identified both erythroplakia and leukoplakia, in that order, as the conditions most likely associated with oral cancer. Indices of risk and diagnostic knowledge were constructed by summing the number of correct responses to items in each domain. On 16 risk factors the mean correct score was 9.2, and on 14 diagnostic procedures the mean correct score was 10.0. Only 38.5% of dentists had consistent levels of knowledge on both indices. Differences between the provinces were statistically significant (p < 0.01) for only 2 knowledge items. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses. Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of risk and diagnostic factors for oral cancer.

  7. Seeing Through Smoke: Sorting through the Science and Politics in the Making of the 1956 British Clean Air Act (Invited)

    NASA Astrophysics Data System (ADS)

    Kenny, D. A.

    2010-12-01

    The 1952 “Killer Smog” left over 4000 citizens of Greater London dead in a single week. It was a highly visible environmental disaster, which pinned the British government with responsibility over factory and domestic coal smoke pollution. Within four years of the Smog, the British parliament passed the 1956 Clean Air Act, which was designed primarily to prevent the release of dark smoke from the chimneys of private dwellings and factories. This act is considered a significant turning point in the history of environmental regulation. Through the analysis of confidential documents from government ministries and Members of Parliament, my research has focused on how decisions were made following this man-made environmental catastrophe. The primary focus of this presentation will be to explore why the British government appeared lethargic in the face of its long-standing coal pollution problem and why it finally passed the first clean air act in the world. In this case, establishing responsibility and organizing research were the major time constraints on policy action. In the months following the 1952 Smog, government departments passed off responsibility and quarreled over jurisdiction in the smog matter. Ministries held responsible for air pollution jointly established the Committee on Air Pollution to find a solution to urban smog. In the years following, the Committee on Air Pollution compiled research on the health effects and economic impact of air pollution, deriving its information from a variety of sources. In its 1954 final report, the committee named smoke and sulfur dioxide the most likely culprits of the 1952 deaths, and it recommended the elimination of smoke-producing coal from the British market, a major change to how the British fueled their homes and factories. The resulting 1956 Clean Air Act was the product of numerous compromises over the economic, political, and social issues present in Great Britain at the time. The British government

  8. Responses to the Medical Review of Systems: Borderline Versus Nonborderline Patients in an Internal Medicine Outpatient Clinic

    PubMed Central

    Lam, Charlene; Wiederman, Michael W.

    2011-01-01

    Objective: In both clinical and empirical reports, individuals with borderline personality disorder have been characterized by tendencies toward somatization. In this study, we examined the relationship between somatic symptoms, in the context of a traditional medical review of systems, and borderline personality disorder, using 2 self-report measures for this Axis II dysfunction. Method: In a cross-sectional consecutive sample of 381 internal medicine outpatients being seen predominantly by resident providers in a midsized, midwestern city in October 2010, we assessed 35 physical symptoms, which constitute 1 version of a medical review of systems, and borderline personality disorder using the Borderline Personality Disorder Scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI). Results: The total number of symptoms endorsed on the medical review of systems was positively correlated with scores on the PDQ-4 (r = 0.42, P < .001, n = 369) and scores on the SHI (r = 0.36, P < .001, n = 366). In addition, the percentages of participants with borderline personality disorder increased as the number of endorsed symptoms increased. No individual symptom, or symptom pattern, was particularly related to participants with borderline personality disorder features. Conclusions: In an internal medicine outpatient sample from a resident provider clinic, patients with borderline personality disorder characteristics endorsed significantly more physical symptoms on a medical review of systems than those without such characteristics, suggesting a somatic overlay in individuals with this Axis II disorder. No specific physical symptom pattern or cluster was evident among those with these Axis II features. PMID:21977380

  9. Response to: 'Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies' by Schuklenk and Smalling.

    PubMed

    Glick, Shimon M; Jotkowitz, Alan

    2017-04-01

    The recent essay by Schuklenk and Smalling opposing respect for physicians' conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians' conscience with minimal damage to patients' rights.

  10. Medical students' responses to the dissection of the heart and brain: A dialogue on the seat of the soul.

    PubMed

    Martyn, Helen; Barrett, Anthony; Trotman, Paul; Nicholson, Helen

    2012-04-01

    The search for the soul has been documented since the fifth Century BCE when philosophers and physicians began to explore the role of human consciousness and emotion. Traditionally in western civilization, there have been two distinct followings with some believing that the brain was the seat of the soul and others believing that this role belonged to the heart. The aim of this study was to assess the attitudes of medical students towards the heart and brain during their anatomy laboratory dissections to evaluate if any extra meaning is given to these organs and where they perceived the origin of the soul. Medical students (n = 16) at the University of Otago were interviewed in regards to their thoughts about body dissection and particularly their views towards the brain and the heart. Semi-structured interviews were conducted following the dissection of these two organs, and then transcribed and analyzed. There were mixed opinions among students with some experiencing difficulty dissecting the brain because this organ had special meaning to them; they perceived it as the organ that "made a person who they were." Others commented on their emotional reactions when removing the heart, which they viewed as the "seat of emotion." Some students experienced emotional and physical reactions to these two dissections and Anatomy faculty need to be aware that students may struggle because they viewed these organs as special. A dialogue emerged amongst some medical students on the seat of the soul which gave extra meaning to the dissection.

  11. Work-family life courses and BMI trajectories in three British birth cohorts

    PubMed Central

    Lacey, R E; Sacker, A; Bell, S; Kumari, M; Worts, D; McDonough, P; Kuh, D; McMunn, A

    2017-01-01

    BACKGROUND/OBJECTIVES: Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16–42 years) for men and women in three British birth cohorts. SUBJECTS/METHODS: Multiply imputed data from three nationally representative British birth cohorts were used—the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. RESULTS: Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m–2, 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m–2, 95% CI: 5.18, 5.88; BCS: 6.69 kg m–2, 95% CI: 6.36, 7.02). CONCLUSIONS: Becoming a parent earlier and weaker long-term ties to employment are associated with greater

  12. Outbreak of Diarrhetic Shellfish Poisoning Associated with Mussels, British Columbia, Canada

    PubMed Central

    Taylor, Marsha; McIntyre, Lorraine; Ritson, Mark; Stone, Jason; Bronson, Roni; Bitzikos, Olga; Rourke, Wade; Galanis, Eleni

    2013-01-01

    In 2011, a Diarrhetic Shellfish Poisoning (DSP) outbreak occurred in British Columbia (BC), Canada that was associated with cooked mussel consumption. This is the first reported DSP outbreak in BC. Investigation of ill individuals, traceback of product and laboratory testing for toxins were used in this investigation. Sixty-two illnesses were reported. Public health and food safety investigation identified a common food source and harvest area. Public health and regulatory agencies took actions to recall product and notify the public. Shellfish monitoring program changes were implemented after the outbreak. Improved response and understanding of toxin production will improve management of future DSP outbreaks. PMID:23697950

  13. Visible light nitrogen dioxide spectrophotometer intercomparison: Mount Kobau, British Columbia, July 28 to August 10, 1991

    NASA Technical Reports Server (NTRS)

    Mcelroy, C. T.; Elokhov, A. S.; Elansky, N.; Frank, H.; Johnston, P.; Kerr, J. B.

    1994-01-01

    Under the auspices of the World Meteorological Organization, Environment Canada hosted an international comparison of visible light spectrophotometers at Mt. Kobau, British Columbia in August of 1991. Instruments from four countries were involved. The intercomparison results have indicated that some significant differences exist in the responses of the various instruments, and have provided a basis for the comparison of the historical data sets which currently exist as a result of the independent researches carried out in the past in the former Soviet Union, New Zealand, and Canada.

  14. Response to Stimulant Medication across Six Measures of School-Related Performance in Children with ADHD and Disruptive Behavior.

    ERIC Educational Resources Information Center

    Forness, Steven R.; And Others

    1992-01-01

    This study examined response to treatment with methylphenidate (Ritalin) across 6 measures of cognitive, academic, and social functioning in 71 boys (ages 7-11) with attention deficit hyperactivity disorder. Response ranged from 18 percent to 71 percent across the six measures, suggesting that classifying a child as a responder to methylphenidate…

  15. British sociology and public intellectuals: consumer society and imperial decline.

    PubMed

    Turner, Bryan S

    2006-06-01

    The following is the lecture given for the BJS 2005 Public Sociology Debate given at the London School of Economics and Political Science on ll October 2005. This lecture on the character of British sociology provides a pretext for a more general inquiry into public intellectual life in postwar Britain. The argument put forward falls into several distinctive sections. First, British social science has depended heavily on the migration of intellectuals, especially Jewish intellectuals who were refugees from fascism. Second, intellectual innovation requires massive, disruptive, violent change. Third, British sociology did nevertheless give rise to a distinctive tradition of social criticism in which one can argue there were (typically home-grown) public intellectuals. The main theme of their social criticism was to consider the constraining and divisive impact of social class, race and gender on the enjoyment of expanding social citizenship. Fourth, postwar British sociology came to be dominated by the analysis of an affluent consumer society. Finally, the main failure of British sociology in this postwar period was the absence of any sustained, macro-sociological analysis of the historical decline of Britain as a world power in the twentieth century.

  16. Analysis of Minnesota Multiphasic Personality Inventory-2-Restructured Form response bias indicators as suppressors or moderators in a medical setting.

    PubMed

    Wershba, Rebecca E; Locke, Dona E C; Lanyon, Richard I

    2015-06-01

    The use of response bias indicators in psychological measurement has been contentious, with debate as to whether they actually suppress or moderate the ability of substantive psychological indicators to identify the construct of interest. Suppression would indicate that predictor variables contain invalid variance that the bias indicators can suppress, while moderation would indicate differential levels of predictive validity at different levels of bias. Response bias indicators on the Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (MMPI-2-RF) [infrequent responses (F-r), infrequent somatic responses (Fs), infrequent psychopathology responses (Fp-r), adjustment validity (K-r), uncommon virtues (L-r), symptom validity (FBS-r), and Response Bias Scale (RBS)] were tested to determine whether they suppressed or moderated the ability of the Restructured Clinical Scale 1 (RC1) and Neurologic Complaints (NUC) scale to discriminate between epileptic seizures (ES) and nonepileptic seizures (NES, a conversion disorder that is often misdiagnosed as ES). The MMPI-2-RF was completed by 399 patients with a confirmed diagnosis of ES or NES via Epilepsy Monitoring Unit evaluation. Moderated logistic regression was used to test for moderation, and logistic regression was used to test for suppression. Most of the response bias variables showed a suppressor effect, but moderator effects were not found. These findings extend the use of bias indicators to a psychomedical context.

  17. The British Geological Survey's 'Slope Dynamics' Project

    NASA Astrophysics Data System (ADS)

    Hobbs, Peter; Foster, Claire; Pearson, Stephen; Jones, Lee; Pennington, Catherine; Jenkins, Gareth; Gibson, Andrew; Cooper, Anthony; Freeborough, Katherine

    2010-05-01

    The aim of the British Geological Survey (BGS)'s ‘Slope Dynamics' project is to provide observational data to slope stability modelling and zoning based on factors of safety obtained from a combination of geotechnical, geomorphological and oceanographic models. The project has been monitoring since 2001 the progress of terrestrial and coastal landslides within 'soft rock' formations in the UK. Recently, field observatories have been set up to allow a variety of methods, some traditional and others novel, to be applied to actively unstable natural slopes in order to achieve a thorough understanding of the substrata, the mass movement processes within them and their relationship to the environment and environmental change. Monitoring has been carried out at six or twelve monthly intervals at test sites on the east coast of England (Holderness and Norfolk) and at Hollin Hill in North Yorkshire. A key part of the project makes use of innovative terrestrial LiDAR methods to produce repeated accurate 3-D models of the ground surface, which then enable ‘change models' of landslide movements to be determined. This work was started in 2001 and is continuing. The BGS currently has two Riegl terrestrial laser scanners: the long-range LPM-i800HA and the very-long-range LPM-2K; the former being equipped with a digital camera. The multiple scans are positioned in the national grid co-ordinate system using high resolution dGPS. Together, these allow accurate observations to be made in remote and exposed locations without the need for potentially dangerous direct access to the steeper more unstable slopes. The coastal test sites, which have exhibited recession rates of between 2m and 9m per year, allow rapid changes to be monitored. Inland active landslides are less common but more suited to instrumentation and long-term monitoring. Results to date have revealed the relationships between landslide style and geology, and also the patterns and time scales of characteristic

  18. What You Find Depends on How You Measure It: Reactivity of Response Scales Measuring Predecisional Information Distortion in Medical Diagnosis

    PubMed Central

    2016-01-01

    “Predecisional information distortion” occurs when decision makers evaluate new information in a way that is biased towards their leading option. The phenomenon is well established, as is the method typically used to measure it, termed “stepwise evolution of preference” (SEP). An inadequacy of this method has recently come to the fore: it measures distortion as the total advantage afforded a leading option over its competitor, and therefore it cannot differentiate between distortion to strengthen a leading option (“proleader” distortion) and distortion to weaken a trailing option (“antitrailer” distortion). To address this, recent research introduced new response scales to SEP. We explore whether and how these new response scales might influence the very proleader and antitrailer processes that they were designed to capture (“reactivity”). We used the SEP method with concurrent verbal reporting: fifty family physicians verbalized their thoughts as they evaluated patient symptoms and signs (“cues”) in relation to two competing diagnostic hypotheses. Twenty-five physicians evaluated each cue using the response scale traditional to SEP (a single response scale, returning a single measure of distortion); the other twenty-five did so using the response scales introduced in recent studies (two separate response scales, returning two separate measures of distortion: proleader and antitrailer). We measured proleader and antitrailer processes in verbalizations, and compared verbalizations in the single-scale and separate-scales groups. Response scales did not appear to affect proleader processes: the two groups of physicians were equally likely to bolster their leading diagnosis verbally. Response scales did, however, appear to affect antitrailer processes: the two groups denigrated their trailing diagnosis verbally to differing degrees. Our findings suggest that the response scales used to measure information distortion might influence its

  19. Temporal patterns of adherence to medications and behavioral treatment and their relationship to patient characteristics and treatment response

    PubMed Central

    Gueorguieva, Ralitza; Wu, Ran; Krystal, John H.; Donovan, Dennis; O’Malley, Stephanie S.

    2013-01-01

    Background The primary analyses of the COMBINE study revealed significant naltrexone and Combined Behavioral Intervention (CBI) main effects on drinking outcomes but failed to find additional benefits of the combination of treatments. Investigating differences in patterns of adherence over time may shed light on the treatment effects in COMBINE. The goals of the study were to identify trajectories of medication adherence and participation in CBI, to estimate predictive and moderating effects of adherence trajectories on drinking outcomes and to characterize subjects in adherence trajectories. The results of these analyses may suggest approaches to improving adherence in order to ultimately improve treatment outcome. Methods We used a trajectory-based approach to identify patterns of treatment adherence separately for naltrexone, acamprosate and CBI adherence. Logistic regression and general linear models assessed associations among adherence trajectories, drinking outcomes and patient characteristics. Results Three trajectories of adherence were identified for each treatment: “excellent adherers”, “late non-adherers” and “early non-adherers” and there was good agreement among adherence trajectories with different treatments. “Excellent adherers” had significantly higher percent days abstinent (PDA) and lower percent heavy drinking days (PHDD). CBI significantly decreased PHDD for subjects on acamprosate in the “early non-adherers with medication” trajectory (p=0.01). Either naltrexone or acamprosate was associated with lower PHDD than placebo for “early non-adherers with CBI” (p<0.01). Receiving active medication decreased the likelihood to be in the excellent medication adherence trajectory. Younger age, greater drinking severity, dissatisfaction with the medicine and session frequency, adverse events and lack of benefit were related to less favorable medication adherence trajectories. “Excellent adherers with CBI” were significantly

  20. Emanuel Edward Klein, a diligent and industrious plodder or the father of British microbiology.

    PubMed

    Atalic, Bruno; Peric, Ines Drenjancevic; Ferencic, Stella Fatovic

    2010-08-01

    Emanuel Edward Klein (Osijek, 1844 - Hove, 1925) was a British microbiologist of Croatian origin. He completed his medical studies in Vienna in 1869. In 1869 he was sent to England to determine terms for the translation of Samuel Stricker's manual Handbuch von den Geweben des Menchen und der Tiere. During his visit he made a good impression on John Burdon Sanderson and John Simon, which was the main reason why he was invited to London in 1871 to conduct investigations under their guidance. In 1873 Klein began his collaboration with the Saint Bartholomew's Hospital, where he was appointed as a Joint Professor of General Anatomy and Physiology. His researches were in the fields of anatomy, histology, pathology, embryology, physiology, and especially microbiology. He did a great deal to its development in Britain. He has written about 260 scientific papers on a broad range of different topics. Despite all the aforementioned facts, his work was never properly studied, and he is almost unknown outside academic circles. For that reason, attitudes towards him still range between the extremes of calling him the father of British microbiology on one side, and attributing him as a diligent and industrious plodder on the other. In this paper we will try to prove the first attitude. We will put his researches in a general context. Finally we will highlight his original achievements in the isolation of new microbes.