Clinical research: business opportunities for pharmacy-based investigational drug services.
Marnocha, R M
1999-02-01
The application by an academic health center of business principles to the conduct of clinical research is described. Re-engineering of the infrastructure for clinical research at the University of Wisconsin and University of Wisconsin Hospital and Clinics began in 1990 with the creation of the Center for Clinical Trials (CCT) and the restructuring of the investigational drug services (IDS). Strategies to further improve the institution's clinical research activities have been continually assessed and most recently have centered on the adaptation of a business philosophy within the institution's multidisciplinary research infrastructure. Toward that end, the CCT and IDS have introduced basic business principles into operational activities. Four basic business concepts have been implemented: viewing the research protocol as a commodity, seeking payment for services rendered, tracking investments, and assessing performance. It is proposed that incorporation of these basic business concepts is not only compatible with the infrastructure for clinical research but beneficial to that infrastructure. The adaptation of a business mindset is likely to enable an academic health center to reach its clinical research goals.
42 CFR 405.2402 - Basic requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Basic requirements. 405.2402 Section 405.2402 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...
42 CFR 405.2430 - Basic requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Basic requirements. 405.2430 Section 405.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...
42 CFR 489.20 - Basic commitments.
Code of Federal Regulations, 2010 CFR
2010-10-01
... furnished after December 31, 1990. (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. (4) Certified nurse-midwife services, as defined in section...) Services performed by a nurse practitioner or clinical nurse specialist who meets the applicable definition...
Wholistic Health Care for a Campus Student Health Service.
ERIC Educational Resources Information Center
Van Ness, John H.
1981-01-01
Discusses the importance of environmental and emotional considerations in medical care. Outlines the basic principles of holistic health care and provides a rationale for a campus-based center. Describes an existing holistic student health service and proposes a basic program for a campus holistic health clinic. (RC)
42 CFR 424.32 - Basic requirements for all claims.
Code of Federal Regulations, 2011 CFR
2011-10-01
... claim for physician services, clinical psychologist services, or clinical social worker services must... be obtained upon request from CMS or any Social Security branch or district office, or from Medicare intermediaries or carriers. The CMS-1490S is also available at local Social Security Offices. (d) Submission of...
42 CFR 424.32 - Basic requirements for all claims.
Code of Federal Regulations, 2010 CFR
2010-10-01
... claim for physician services, clinical psychologist services, or clinical social worker services must... be obtained upon request from CMS or any Social Security branch or district office, or from Medicare intermediaries or carriers. The CMS-1490S is also available at local Social Security Offices. (d) Submission of...
Life-science research within US academic medical centers.
Zinner, Darren E; Campbell, Eric G
2009-09-02
Besides the generic "basic" vs "applied" labels, little information is known about the types of life-science research conducted within academic medical centers (AMCs). To determine the relative proportion, characteristics, funding, and productivity of AMC faculty by the type of research they conduct. Mailed survey conducted in 2007 of 3080 life-science faculty at the 50 universities with medical schools that received the most funding from the National Institutes of Health in 2004. Response rate was 74%. Research faculty affiliated with a medical school or teaching hospital, representing 77% of respondents (n = 1663). Type of research (basic, translational, clinical trials, health services research/clinical epidemiology, multimode, other), total funding, industry funding, publications, professional activities, patenting behavior, and industry relationships. Among AMC research faculty, 33.6% exclusively conducted basic science research as principal investigators compared with translational researchers (9.1%), clinical trial investigators (7.1%), and health services researchers/clinical epidemiologists (9.0%). While principal investigators garnered a mean of $410,755 in total annual research funding, 22.1% of all AMC research faculty were unsponsored, a proportion that ranged from 11.5% for basic science researchers to 46.8% for health services researchers (P < .001). The average AMC faculty member received $33,417 in industry-sponsored funding, with most of this money concentrated among clinical trial ($110,869) and multimode ($59,916) principal investigators. Translational (61.3%), clinical trial (67.3%), and multimode (70.9%) researchers were significantly more likely than basic science researchers (41.9%) to report a relationship with industry and that these relationships contributed to their most important scientific work (P < .05 for all comparisons). The research function of AMCs is active and diverse, incorporating a substantial proportion of faculty who are conducting research and publishing without sponsorship.
42 CFR 424.32 - Basic requirements for all claims.
Code of Federal Regulations, 2012 CFR
2012-10-01
... instructions. (2) A claim for physician services, clinical psychologist services, or clinical social worker... purchase. All other claims forms can be obtained upon request from CMS or any Social Security branch or... Social Security Offices. (d) Submission of electronic claims—(1) Definitions. For purposes of this...
42 CFR 424.32 - Basic requirements for all claims.
Code of Federal Regulations, 2014 CFR
2014-10-01
... instructions. (2) A claim for physician services, clinical psychologist services, or clinical social worker... purchase. All other claims forms can be obtained upon request from CMS or any Social Security branch or... Social Security Offices. (d) Submission of electronic claims—(1) Definitions. For purposes of this...
42 CFR 424.32 - Basic requirements for all claims.
Code of Federal Regulations, 2013 CFR
2013-10-01
... instructions. (2) A claim for physician services, clinical psychologist services, or clinical social worker... purchase. All other claims forms can be obtained upon request from CMS or any Social Security branch or... Social Security Offices. (d) Submission of electronic claims—(1) Definitions. For purposes of this...
2013-01-01
Background There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. Methods This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents’ service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Results Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Conclusion Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents’ service use and the cost implications for publically funded health and social care services is needed. Trial registration Registration of the original RCT of the IY Basic Parenting Programme - Current Controlled Trials ISRCTN46984318 PMID:24350571
[Standardization of cancer biobank in precision medicine era].
Ji, Jiafu
2016-05-25
Tumor specimens have a great role in basic and clinical translational researches on cancer, especially in the era of precision medicine. Thus the standardization of cancer biobank is of high importance. The establishment and maintenance of cancer biobank require comprehensive quality management, so as to provide high quality service for basic and clinical researches. At present, sample-oriented collection and management, and clinical and pathological data annotation are the main focuses of biobank standardization in China.
Charles, Joanna M; Bywater, Tracey J; Edwards, Rhiannon Tudor; Hutchings, Judy; Zou, Lu
2013-12-18
There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children's health and social care service use, but little is known about the programme's impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents' service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents' service use and the cost implications for publically funded health and social care services is needed.
[RABIN MEDICAL CENTER - A TERTIARY CENTER OF EXCELLENCE IN SERVICE, TEACHING AND RESEARCH].
Niv, Yaron; Halpern, Eyran
2017-04-01
Rabin Medical Center (RMC) belongs to Clalit Health Services and is a tertiary, academic medical center with all the facilities of modern and advanced medicine. Annually in the RMC, 650,000 patients are treated in the outpatient clinics, and 100,000 patients are hospitalized in the hospital departments. All these patients are treated by 4500 devoted staff members, including 1000 physicians and 2000 nurses. RMC is one of the largest, centrally located medical centers for medical and nursing students' education in Israel, taking place in clinical departments, as well as in basic sciences courses. We also have a nursing school attached to the hospital. Our vision supports excellence in research. We have a special Research Department that supports RMC researchers, with research coordinators, and all the relevant facilities to assist in clinical and basic science studies. We also promote collaboration efforts with many academic centers in Israel and abroad. The scope of RMC research is broad, including 700 new studies every year and 1500 active studies currently. This issue of Harefuah is dedicated to the clinical and basic science research conducted at RMC with original papers presenting research performed by our departments and laboratories.
Developing Federal Clinical Care Recommendations for Women.
Godfrey, Emily M; Tepper, Naomi K; Curtis, Kathryn M; Moskosky, Susan B; Gavin, Loretta E
2015-08-01
The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S. Published by Elsevier Inc.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0419... who conduct studies using active controls and have a basic understanding of statistical principles... clinical investigators who conduct studies using active controls and have a basic understanding of...
... Customer Service and Ordering Information Subscribe to AHA Journals All Issues Subjects All Subjects Arrhythmia and Electrophysiology Basic, Translational, and Clinical Research Critical Care and Resuscitation Epidemiology, Lifestyle, and Prevention ...
Medicine at Michigan State (III): Conditioning for Innovation
ERIC Educational Resources Information Center
Walsh, John
1972-01-01
Discusses the reasons why basic science courses are taught in all-university departments'' and the clinical experience is provided in cooperation with community health services, rather than a clinical teaching hospital, in the programs for Doctor of Medicine and Doctor of Osteopathy. (AL)
An Assessment of Six School-Based Clinics: Services, Impact and Potential.
ERIC Educational Resources Information Center
Kirby, Douglas; And Others
For two decades, school-based clinics have been providing basic health care to medically underserved teenagers and addressing the increasingly complex health and social problems facing young people, particularly unintended pregnancy. Today there are 150 school-based clinics operating in most major cities and many rural areas. In 1984, the Center…
CLINIC-LABORATORY DESIGN BASED ON FUNCTION AND PHILOSOPHY AT PURDUE UNIVERSITY.
ERIC Educational Resources Information Center
HANLEY, T.D.; STEER, M.D.
THIS REPORT DESCRIBES THE DESIGN OF A NEW CLINIC AND LABORATORY FOR SPEECH AND HEARING TO ACCOMMODATE THE THREE BASIC PROGRAMS OF--(1) CLINICAL TRAINING OF UNDERGRADUATE AND GRADUATE STUDENT MAJORS, (2) SERVICES MADE AVAILABLE TO THE SPEECH AND HEARING HANDICAPPED, AND (3) RESEARCH IN SPEECH PATHOLOGY, AUDIOLOGY, PSYCHO-ACOUSTICS, AND…
... and School-Linked Dental Sealant Programs Coordinate Community Water Fluoridation Programs Targeted Clinical Preventive Services & Health Systems Changes State Oral Health Plans Research & Publications Oral Health In America: Summary of the ...
42 CFR 60.1 - What is the HEAL program?
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 1 2014-10-01 2014-10-01 false What is the HEAL program? 60.1 Section 60.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic...
42 CFR 60.1 - What is the HEAL program?
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 1 2013-10-01 2013-10-01 false What is the HEAL program? 60.1 Section 60.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic...
42 CFR 60.1 - What is the HEAL program?
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 1 2012-10-01 2012-10-01 false What is the HEAL program? 60.1 Section 60.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic...
42 CFR 60.1 - What is the HEAL program?
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 1 2011-10-01 2011-10-01 false What is the HEAL program? 60.1 Section 60.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic...
Building the chronic kidney disease management team.
Spry, Leslie
2008-01-01
The need to be efficient and the demands for performance-based service are changing how nephrologists deliver care. Chronic kidney disease (CKD) occurs in patients with complex medical and social problems. CKD management requires that multidisciplinary professionals provide patient education, disease management, and psychosocial support. To remain cost-efficient, many physicians are training and supervising midlevel practitioners in the delivery of specialized health care. Specialized care that meets present CKD patient needs is best delivered in a CKD clinic. Three models of CKD clinic are identified: (1) anemia management CKD clinic, (2) the basic CKD clinic, and (3) the comprehensive CKD clinic. Each clinic model is based on critical elements of staffing, billable services, and patient-focused health care. Billable services are anemia-management services, physician services that may be provided by midlevel practitioners, and medical nutrition therapy. In some cases, social worker services may be billable. Building a patient-focused clinic that offers CKD management requires planning, familiarity with federal regulations and statutes, and skillful practitioners. Making services cost-efficient and outcome oriented requires careful physician leadership, talented midlevel practitioners, and billing professionals who understand the goals of the CKD clinic. As Medicare payment reforms evolve, a well-organized CKD program can be well poised to meet the requirements of payers and congressional mandates for performance-based purchasing.
2013-09-01
funding to the MoPH for the delivery of health services throughout Afghanistan, ranging from immunizations and prenatal care to hospital services...for the Afghan people through a two-tiered system : • Basic Package of Health Services provides primary health care services—such as immunizations and... prenatal care —at small and rural health clinics and forms the core of health service delivery for all primary care facilities in Afghanistan
Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.
Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H
2011-01-01
The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on existing health centers, the data suggest that the mobile clinics provided services for people who otherwise may not have attended a health center. The GAIA mobile clinics were integrated into a catchment area through a community participation model, allowing point-of-care primary health services to be provided to thousands of people in remote rural villagers. Strong relationships have been forged with local community leaders and with Malawi Ministry of Health officers as the foundation for long-term sustainable engagement and eventual integration of services into Health Ministry programs.
Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model.
Muralidhar, Venkiteswaran; Ahasan, Md Faizul; Khan, Ahad Mahmud; Alam, Mohammad Shariful
2017-03-20
The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities. 2017 BMJ Publishing Group Ltd.
Clinical operations generation next… The age of technology and outsourcing
Temkar, Priya
2015-01-01
Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. PMID:26623386
Clinical operations generation next… The age of technology and outsourcing.
Temkar, Priya
2015-01-01
Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.
Berkowitz, Seth A; Hulberg, A Catherine; Hong, Clemens; Stowell, Brian J; Tirozzi, Karen J; Traore, Carine Y; Atlas, Steven J
2016-03-01
Unmet basic resource needs, such as difficulty affording healthcare, medications, food and housing, may contribute to worse healthcare quality indicators, but interventions are hampered by lack of specific knowledge regarding the distribution of unmet basic resource needs and their association with priority clinical conditions and health service use patterns. Cross-sectional study of primary care patients in two urban academic practices from 1 October 2013 to 30 April 2014. Patients were screened for unmet needs and enrolled in a programme to link them with community resources. Key measures included patient report of unmet basic resource needs, clinical conditions prioritised by quality improvement programmes (hypertension, diabetes and depression), and health service use patterns such as frequent emergency department (ED) visits (>2 in the preceding year) and frequent clinic 'no-shows' (>1 in the preceding year). 416 patients with unmet needs were included, and compared with 2750 patients who did not report needs. The most common types of needs reported were: difficulties affording healthcare (46.5%), food (40.1%) and utilities (36.3%). Patients who reported unmet needs were more likely to have depression (17.8% vs 9.5%, p<0.0001), diabetes (32.7% vs 20.4%, p<0.0001), hypertension (54.3% vs 46.3%, p=0.002), be frequent ED users (11.3% vs 5.4%, p<0.0001), and have frequent 'no-shows' to clinic (21.6% vs 11.9%, p<0.0001). Difficulty affording healthcare and food are particularly common needs among patients with priority conditions. Strategies to identify and address unmet needs as part of routine care may be an important way to improve healthcare quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
59 MDW/ST OVERVIEW BRIEFING 15 JUNE 2017
2017-06-15
your department has told you they cannot fund your publication, the 59th Clinical Research Division may pay for your basic journal publishing charges...Simulation Training • Clinical Rehabilitative Medicine • Clinical Investigations Program • Dental & Nursing Research 5 \\I ••• • Science & Technology... Research and Evaluation • USAF Post Graduate Dental School and Clinics , JBSA-Lackland • Dental Evaluation and Consultation Service, JBSA-Fort Sam
Rivaroxaban to Prevent Pulmonary Embolism after Hip or Knee Replacement
... Customer Service and Ordering Information Subscribe to AHA Journals All Issues Subjects All Subjects Arrhythmia and Electrophysiology Basic, Translational, and Clinical Research Critical Care and Resuscitation Epidemiology, Lifestyle, and Prevention ...
Priority setting in purchasing.
Carroll, G
The NHS cannot deliver full comprehensive health care to all the population. In this article the need to define a range of basic health services is emphasized. Agreement on priorities requires ethical, economic and clinical debate.
Pitt, Catherine; Roberts, Bayard; Checchi, Francesco
2012-01-10
Where hard-to-access populations (such as those living in insecure areas) lack access to basic health services, relief agencies, donors, and ministries of health face a dilemma in selecting the most effective intervention strategy. This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world's leading cause of child mortality. A "Markov cycle tree" cohort model was developed in Excel with Visual Basic to compare the number of deaths from pneumonia in children aged 1 to 59 months expected under three scenarios: 1) No curative services available, 2) Curative services provided by a highly-skilled but intermittent mobile clinic, and 3) Curative services provided by a low-skilled community health post. Parameter values were informed by literature and expert interviews. Probabilistic sensitivity analyses were conducted for several plausible scenarios. We estimated median pneumonia-specific under-5 mortality rates of 0.51 (95% credible interval: 0.49 to 0.541) deaths per 10,000 child-days without treatment, 0.45 (95% CI: 0.43 to 0.48) with weekly mobile clinics, and 0.31 (95% CI: 0.29 to 0.32) with CHWs in fixed health posts. Sensitivity analyses found the fixed strategy superior, except when mobile clinics visited communities daily, where rates of care-seeking were substantially higher at mobile clinics than fixed posts, or where several variables simultaneously differed substantially from our baseline assumptions. Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers.
Diamond-Smith, Nadia; Sudhinaraset, May; Montagu, Dominic
2016-08-11
The majority of women in sub-Saharan Africa now deliver in a facility, however, little is known about the quality of services for maternal and newborn basic and emergency care, nor how this is associated with patient's perception of their experiences. Using data from the Service Provision Assessment (SPA) survey from Kenya 2010 and Namibia 2009, we explore whether facilities have the necessary signal functions for providing emergency and basic maternal (EmOC) and newborn care (EmNC), and antenatal care (ANC) using descriptives and multivariate regression. We explore differences by type of facility (hospital, center or other) and by private and public facilities. Finally, we see if patient satisfaction (taken from exit surveys at antenatal care) is associated with the quality of services (specific services provided). We find that most facilities do not have all of the signal functions, with 46 and 27 % in Kenya and 18 and 5 % in Namibia of facilities have high/basic scores in routine and emergency obstetric care, respectively. We found that hospitals preform better than centers in general and few differences emerged between public and private facilities. Patient perceptions were not consistently associated with services provided; however, patients had fewer complaints in private compared to public facilities in Kenya (-0.46 fewer complaints in private) and smaller facilities compared to larger in Namibia (-0.26 fewer complaints in smaller facilities). Service quality itself (measured in scores), however, was only significantly better in Kenya for EmOC and EmNC. This analysis sheds light on the inadequate levels of care for saving maternal and newborn lives in most facilities in two countries of Africa. It also highlights the disconnect between patients' perceptions and clinical quality of services. More effort is needed to ensure that high quality supply of services is present to meet growing demand as an increasing number of women deliver in facilities.
Lob, G; Lob, T; Bauer, H; Niethard, F; Polonius, J; Siebert, H
2009-04-01
Medical developments have led to extensive specialization in the field of surgery. This has already been reflected for many years in altered structure and organization forms of surgical clinics. Indispensable quality standards, statutory general conditions, increasing competition in service providers and health insurance with transparency of the service procedure all intensify this trend. The aim of this investigation was, therefore, to determine how far this differentiation of service supply in the field of surgery is also reflected in the area and in surgical departments and clinics of basic and routine supply. To achieve this, all available published information on the structure and organization of surgical clinics in the Federal Republic of Germany was classified according to current departmentalization into "undivided" or general/visceral surgery facilities compared to orthopedic/trauma surgery departments.
ERIC Educational Resources Information Center
Kalichman, Seth C.; Cain, Demetria; Knecht, Joanna; Hill, Justin
2008-01-01
Basic factual information about disease is the cornerstone of health promotion and disease prevention interventions. Previous studies have shown that content analysis of the questions asked of service providers can elucidate the information needs of service consumers. Questions asked by individuals at known high risk for HIV infection have not…
Behets, Frieda Mtf; Matendo, Richard; Vaz, Lara Me; Kilese, Nick; Nanlele, Diderot; Kokolomami, Jack; Okitolando, Emile W; Van Rie, Annelies
2006-12-01
To assess the content and delivery of essential antenatal services before implementation of programmes for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). We assessed 18 antenatal care centres (eight public units and ten managed by nongovernmental organizations) in Kinshasa, Democratic Republic of the Congo. We used a survey to capture information about the number and type of antenatal health workers, infrastructure capacity and the delivery of basic antenatal care services such as: nutritional counselling; tetanus toxoid vaccination; prevention and management of anaemia, malaria, sexually transmitted infections, and tuberculosis; and counselling for postpartum contraception. Antenatal care units differed with respect to size, capacity, cost, service delivery systems and content. For instance, 17 of the 18 sites offered anaemia screening but only two sites included the cost in the card that gives access to antenatal care. Nine of the clinics (50%) reported providing the malaria prophyalxis sulfadoxine pyrimethamine as per national policy. Four (22%) of the sites offered syphilis screening. Scaling up PMTCT programmes in under-resourced settings requires evaluation and strengthening of existing basic antenatal care service delivery.
Optimizing the patient transport function at Mayo Clinic.
Kuchera, Dustin; Rohleder, Thomas R
2011-01-01
In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.
Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee; Yoo, Sooyoung
2015-04-01
To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.
Barkham, M; Margison, F; Leach, C; Lucock, M; Mellor-Clark, J; Evans, C; Benson, L; Connell, J; Audin, K; McGrath, G
2001-04-01
To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.
Udager, Aaron M; Alva, Ajjai; Mehra, Rohit
2014-01-01
The idea that detailed knowledge of molecular oncogenesis will drive diagnostic, prognostic, and therapeutic clinical decision making in an increasingly multidisciplinary practice of oncologic care has been anticipated for many years. With the recent rapid advancement in our understanding of the molecular underpinnings of genitourinary malignancies, this concept is now starting to take shape in the fields of prostate, kidney, bladder, testicular, and penile cancer. Such breakthroughs necessitate the development of robust clinical-grade assays that can be quickly made available for patients to facilitate diagnosis in challenging cases, risk-stratify patients for subsequent clinical management, select the appropriate targeted therapy from among increasingly diverse and numerous options, and enroll patients in advanced clinical trials. This rapid translation of basic and clinical cancer research requires a streamlined, multidisciplinary approach to clinical assay development, termed here the molecular diagnostics service line laboratory. In this review, we summarize the current state and explore the future of molecular diagnostics in genitourinary oncology to conceptualize a genitourinary service line laboratory at a tertiary clinical institution.
Sun, Xing-guo
2015-07-01
Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.
Human resource staffing and service functions of community health services organizations in China.
Yang, Jun; Guo, Aimin; Wang, Yadong; Zhao, Yali; Yang, Xinhua; Li, Hang; Duckitt, Roger; Liang, Wannian
2008-01-01
We report a study on the developmental status of human resource staffing and service functions of community health services (CHS) in China and offer recommendations for improving the CHS in the future. A study questionnaire was completed by 712 CHS organizations distributed in 52 cities and districts in all areas of China using a multilevel stratified randomized sampling method. Data were collected on the backgrounds, human resources, and service functions of CHS organizations. We found that 68.2% of doctors and 86.5% of nurses employed in CHS centers have low-level medical training. The doctor-nurse ratio in CHS centers is 1.2 to 1 and in CHS stations is 1.3 to 1. More than 50% of CHS organizations have developed on-the-job training programs, causing cost trends for staff training to increase. Although the delivery of basic clinical services and public health services is steadily increasing, 58.6% of stations are open less than 12 hours per day. Health records are established in a high proportion of CHS organizations. Two kinds of health education--general public health education, and personal education for specific problems--have been adopted by more than 92% of CHS centers and 90% of CHS stations. Desired functions for CHS organizations have been partially achieved. Training for doctors and nurses engaged in CHS should be promoted and improved as quickly as possible. Training in basic clinical services and management of noncommunicable chronic diseases should be strongly promoted. Changes in government policies should be pursued to promote effective support for the development of CHS.
ERIC Educational Resources Information Center
O'Malley, Mary-Pat
2010-01-01
Maternity care in Ireland has been described as a "testament to the strength and influence of the medical profession" (Mc Kee 1986: 192). A review of maternity and gynaecology services in the Dublin area in 2004 revealed that "no participant...thought that the maternity services were women centred at the time" (Women's Health…
Eisner, Emily; Drake, Richard; Lobban, Fiona; Bucci, Sandra; Emsley, Richard; Barrowclough, Christine
2018-02-01
Early signs interventions show promise but could be further developed. A recent review suggested that 'basic symptoms' should be added to conventional early signs to improve relapse prediction. This study builds on preliminary evidence that basic symptoms predict relapse and aimed to: 1. examine which phenomena participants report prior to relapse and how they describe them; 2. determine the best way of identifying pre-relapse basic symptoms; 3. assess current practice by comparing self- and casenote-reported pre-relapse experiences. Participants with non-affective psychosis were recruited from UK mental health services. In-depth interviews (n=23), verbal checklists of basic symptoms (n=23) and casenote extracts (n=208) were analysed using directed content analysis and non-parametric statistical tests. Three-quarters of interviewees reported basic symptoms and all reported conventional early signs and 'other' pre-relapse experiences. Interviewees provided rich descriptions of basic symptoms. Verbal checklist interviews asking specifically about basic symptoms identified these experiences more readily than open questions during in-depth interviews. Only 5% of casenotes recorded basic symptoms; interviewees were 16 times more likely to report basic symptoms than their casenotes did. The majority of interviewees self-reported pre-relapse basic symptoms when asked specifically about these experiences but very few casenotes reported these symptoms. Basic symptoms may be potent predictors of relapse that clinicians miss. A self-report measure would aid monitoring of basic symptoms in routine clinical practice and would facilitate a prospective investigation comparing basic symptoms and conventional early signs as predictors of relapse. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Smith, Elise; Behrmann, Jason; Martin, Carolina; Williams-Jones, Bryn
2010-08-01
A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.
Suganami, Shigeru
2012-03-01
From the experience of more than 130 emergency medical relief missions in over 50 countries/areas, the AMDA would like to propose a system of mobile clinical examinations to prepare for possible natural disasters in Japan. Such a system will require the development of vehicles equipped with a full range of laboratory equipment, which I believe will become a public property in the world, and contribute to the enhancement of medical services in disaster areas as well as in areas with less developed medical technologies. AMDA's recent medical relief activities include the support of the victims of the earthquakes in Haiti (2010) and Turkey (2011), and the flood in Thailand (2012). In these countries, the AMDA faced the lack of a clinical examination system which resulted in a huge number of patients who could not receive proper treatment after injury, or those who suffered from infectious diseases. Domestically, when the AMDA sent medical teams to the affected areas of the Great East Japan Earthquake and tsunami (2011), their activities took place mainly in evacuation shelters, where survivors needed treatment for chronic diseases and preventive care. All of these experiences highlight the importance of clinical examination in disaster areas, as well as in developing countries/areas similarly lacking basic medical services. The Japanese Society of Laboratory Medicine will surely play an important role in the development of the proposed system of mobile clinical examinations. The AMDA would like to collaborate with the JSLM in emergency relief activities and medical aid projects in areas affected by disasters or lack basic medical services.
Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee
2015-01-01
Objectives To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. Methods We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. Results The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. Conclusions We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs. PMID:25995962
Foundations for Gerontological Education.
ERIC Educational Resources Information Center
Johnson, Harold R.; And Others
1980-01-01
Focuses on: (1) components of a basic core of knowledge essential for all people working in the field of aging; (2) knowledge essential for professions related to biomedical science, human services, social and physical environment; and (3) knowledge essential for clinical psychology, nursing, nutrition, and social work. (Author)
Cornelius, Talea; Jones, Maranda; Merly, Cynthia; Welles, Brandi; Kalichman, Moira O; Kalichman, Seth C
2017-04-01
Antiretroviral therapy (ART) has transformed HIV into a manageable illness. However, high levels of adherence must be maintained. Lack of access to basic resources (food, transportation, and housing) has been consistently associated with suboptimal ART adherence. Moving beyond such direct effects, this study takes a hierarchical resources approach in which the effects of access to basic resources on ART adherence are mediated through interpersonal resources (social support and care services) and personal resources (self-efficacy). Participants were 915 HIV-positive men and women living in Atlanta, GA, recruited from community centers and infectious disease clinics. Participants answered baseline questionnaires, and provided prospective data on ART adherence. Across a series of nested models, a consistent pattern emerged whereby lack of access to basic resources had indirect, negative effects on adherence, mediated through both lack of access to social support and services, and through lower treatment self-efficacy. There was also a significant direct effect of lack of access to transportation on adherence. Lack of access to basic resources negatively impacts ART adherence. Effects for housing instability and food insecurity were fully mediated through social support, access to services, and self-efficacy, highlighting these as important targets for intervention. Targeting service supports could be especially beneficial due to the potential to both promote adherence and to link clients with other services to supplement food, housing, and transportation. Inability to access transportation had a direct negative effect on adherence, suggesting that free or reduced cost transportation could positively impact ART adherence among disadvantaged populations.
Centralized vs. decentralized child mental health services.
Adams, M S
1977-09-01
One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.
47 CFR 69.119 - Basic service element expedited approval process.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 3 2011-10-01 2011-10-01 false Basic service element expedited approval... CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element... approval of new basic service elements are those indicated in § 1.45 of the rules, except as specified...
47 CFR 69.119 - Basic service element expedited approval process.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 3 2013-10-01 2013-10-01 false Basic service element expedited approval... CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element... approval of new basic service elements are those indicated in § 1.45 of the rules, except as specified...
47 CFR 69.119 - Basic service element expedited approval process.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 3 2014-10-01 2014-10-01 false Basic service element expedited approval... CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element... approval of new basic service elements are those indicated in § 1.45 of the rules, except as specified...
47 CFR 69.119 - Basic service element expedited approval process.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 47 Telecommunication 3 2012-10-01 2012-10-01 false Basic service element expedited approval... CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element... approval of new basic service elements are those indicated in § 1.45 of the rules, except as specified...
Mills, Rachel; Haga, Susanne B.
2013-01-01
One of the basic questions in the early uses of pharmacogenetic (PGx) testing revolves around the clinical delivery of testing. Because multiple health professionals may play a role in the delivery of PGx testing, various clinical delivery models have begun to be studied. We propose that a partnership between genetic counselors and pharmacists can assist clinicians in the delivery of comprehensive PGx services. Based on their expert knowledge of pharmacokinetics and pharmacodynamics, pharmacists can facilitate the appropriate application of PGx test results to adjust medication use as warranted and act as a liaison to the healthcare team recommending changes in medication based on test results and patient input. Genetic counselors are well-trained in genetics as well as risk communication and counseling methodology, but have limited knowledge of pharmaceuticals. The complementary knowledge and skill set supports the partnership between genetic counselors and pharmacists to provide effective PGx testing services. PMID:23746189
2001-07-01
patients’ oral morning temperatures fall approximately ten days after starting cholesterol-lowering statin medication such as simvastatin, atorvastatin or...application for DREAMS renewal for fiscal years 2001-2002 (submitted June 2001). Appendix: Effect of Atorvastatin (Lipitor®) Therapy on Morning
Development of job standards for clinical nutrition therapy for dyslipidemia patients.
Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min
2015-04-01
Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.
[Basic considerations during outsourcing of clinical data management services].
Shen, Tong; Liu, Yan
2015-11-01
With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-20
... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of..., Pennsylvania 18964, made application by renewal to the Drug Enforcement Administration (DEA) to be registered as an importer of the following basic classes of controlled substances: Drug Schedule Oxycodone (9143...
Model for School Pre-Employment Activities.
ERIC Educational Resources Information Center
Wasil, Raymond A.
The guide argues for the establishment of placement services in secondary schools and provides detailed instructional units and suggestions for conducting pre-employment clinics which aim to provide all students leaving school with a basic understanding and working knowledge of the skills necessary to seek out and obtain employment or additional…
Documentation Across the Services
2017-05-19
you they cannot fund your publication, the 59th Clinical Research Division may pay for your basic journal publishing charges (to include costs for...tables and black and white photos). We cannot pay for reprints. If you are a 59 MDW staff member, we can forward your request for funds to the designated
MacLaren, Robert; Brett McQueen, R; Campbell, Jon
2013-04-01
To compare pharmacist and prescriber perceptions of the clinical and financial outcomes of pharmacy services in the intensive care unit (ICU). ICU pharmacists were invited to participate in the survey and were asked to invite two ICU prescriber colleagues to complete questionnaires. ICUs with clinical pharmacy services. The questionnaires were designed to solicit frequency, efficiency, and perceptions about the clinical and financial impact (on a 10-point scale) of pharmacy services including patient care (eight functions), education (three functions), administration (three functions), and scholarship (four functions). Basic services were defined as fundamental, and higher-level services were categorized as desirable or optimal. Respondents were asked to suggest possible sources of funding and reimbursement for ICU pharmacy services. Eighty packets containing one 26-item pharmacy questionnaire and two 16-item prescriber questionnaires were distributed to ICU pharmacists. Forty-one pharmacists (51%) and 46 prescribers (29%) returned questionnaires. Pharmacists had worked in the ICU for 8.3 ± 6.4 years and devoted 50.3 ± 18.7% of their efforts to clinical practice. Prescribers generally rated the impact of pharmacy services more favorably than pharmacists. Fundamental services were provided more frequently and were rated more positively than desirable or optimal services across both groups. The percent efficiencies of providing services without the pharmacist ranged between 40% and 65%. Both groups indicated that salary support for the pharmacist should come from hospital departments of pharmacy or critical care or colleges of pharmacy. Prescribers were more likely to consider other sources of funding for pharmacist salaries. Both groups supported reimbursement of clinical pharmacy services. Critical care pharmacy activities were associated with perceptions of beneficial clinical and financial outcomes. Prescribers valued most services more than pharmacists. Fundamental services were viewed more favorably than desirable or optimal services, possibly because they occurred more frequently or were required for safe patient care. Substantial inefficiencies may occur if pharmacy services disappeared. Considerable support existed for funding and reimbursement of critical care pharmacy services. © 2013 Pharmacotherapy Publications, Inc.
Bussières, Sylvain; Tanguay, Alain; Hébert, Denise; Fleet, Richard
2017-01-01
Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results.
Schentag, J J; Paladino, J A; Birmingham, M C; Zimmer, G; Carr, J R; Hanson, S C
1995-01-01
To apply basic benchmarking techniques to hospital antibiotic expenditures and clinical pharmacy personnel and their duties, to identify cost savings strategies for clinical pharmacy services. Prospective survey of 18 hospitals ranging in size from 201 to 942 beds. Each was asked to provide antibiotic expenditures, an overview of their clinical pharmacy services, and to describe the duties of clinical pharmacists involved in antibiotic management activities. Specific information was sought on the use of pharmacokinetic dosing services, antibiotic streamlining, and oral switch in each of the hospitals. Most smaller hospitals (< 300 beds) did not employ clinical pharmacists with the specific duties of antibiotic management or streamlining. At these institutions, antibiotic management services consisted of formulary enforcement and aminoglycoside and/or vancomycin dosing services. The larger hospitals we surveyed employed clinical pharmacists designated as antibiotic management specialists, but their usual activities were aminoglycoside and/or vancomycin dosing services and formulary enforcement. In virtually all hospitals, the yearly expenses for antibiotics exceeded those of Millard Fillmore Hospitals by $2,000-3,000 per occupied bed. In a 500-bed hospital, this difference in expenditures would exceed $1.5 million yearly. Millard Fillmore Health System has similar types of patients, but employs clinical pharmacists to perform streamlining and/or switch functions at days 2-4, when cultures come back from the laboratory. The antibiotic streamlining and oral switch duties of clinical pharmacy specialists are associated with the majority of cost savings in hospital antibiotic management programs. The savings are considerable to the extent that most hospitals with 200-300 beds could readily cost-justify a full-time clinical pharmacist to perform these activities on a daily basis. Expenses of the program would be offset entirely by the reduction in the actual pharmacy expenditures on antibiotics.
Cheeran, Binith; Cohen, Leonardo; Dobkin, Bruce; Ford, Gary; Greenwood, Richard; Howard, David; Husain, Masud; Macleod, Malcolm; Nudo, Randolph; Rothwell, John; Rudd, Anthony; Teo, James; Ward, Nicholas; Wolf, Steven
2009-02-01
Major advances during the past 50 years highlight the immense potential for restoration of function after neural injury, even in the damaged adult human brain. Yet, the translation of these advances into clinically useful treatments is painstakingly slow. Here, we consider why the traditional model of a "translational research pipeline" that transforms basic science into novel clinical practice has failed to improve rehabilitation practice for people after stroke. We find that (1) most treatments trialed in vitro and in animal models have not yet resulted in obviously useful functional gains in patients; (2) most clinical trials of restorative treatments after stroke have been limited to small-scale studies; (3) patient recruitment for larger clinical trials is difficult; (4) the determinants of patient outcomes and what patients want remain complex and ill-defined, so that basic scientists have no clear view of the clinical importance of the problems that they are addressing; (5) research in academic neuroscience centers is poorly integrated with practice in front-line hospitals and the community, where the majority of patients are treated; and (6) partnership with both industry stakeholders and patient pressure groups is poorly developed, at least in the United Kingdom where research in the translational restorative neurosciences in stroke depends on public sector research funds and private charities. We argue that interaction between patients, front-line clinicians, and clinical and basic scientists is essential so that they can explore their different priorities, skills, and concerns. These interactions can be facilitated by funding research consortia that include basic and clinical scientists, clinicians and patient/carer representatives with funds targeted at those impairments that are major determinants of patient and carer outcomes. Consortia would be instrumental in developing a lexicon of common methods, standardized outcome measures, data sharing and long-term goals. Interactions of this sort would create a research-friendly, rather than only target-led, culture in front-line stroke rehabilitation services.
Centralized vs. Decentralized Child Mental Health Services
Adams, Milton S.
1977-01-01
One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here. PMID:904014
Evaluation and justification of clinical pharmacy services.
Anderson, Scott V; Schumock, Glen T
2009-12-01
Pharmacy managers often must justify clinical pharmacy services (CPSs). This can be done by generalizing evidence from the literature or by conducting local evaluations. In either case, it is important that the clinical, humanistic or economic benefits of CPSs are considered, and limitations of the studies recognized. The basic model for the evaluation of CPSs includes the consideration of costs and outcomes, as well as the inclusion of a comparator group. Recent systematic reviews and individual studies provide good evidence regarding the value of CPSs, and are discussed here. Benefit-to-cost ratios of selected CPSs are also provided. While much of the evidence for CPSs has been conducted in the hospital setting, in the future, CPS expansion will occur in ambulatory care settings and will be benefited by healthcare reform efforts.
Association of Parental Health Literacy with Oral Health of Navajo Nation Preschoolers
ERIC Educational Resources Information Center
Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.
2016-01-01
Health literacy is "the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions". Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale…
Functions of School Nurses and Health Assistants in U.S. School Health Programs.
ERIC Educational Resources Information Center
Fryer, George E., Jr.; Igoe, Judith B.
1996-01-01
Data from a nationwide survey of school districts were used to contrast roles of nurses and health assistants in school health programs. Results indicated that nurses were underused in school health education. Health assistants tended to administer medication and basic first aid, and nurses provided technically involved clinical services. (SM)
ERIC Educational Resources Information Center
Dexter, Franklin; Masursky, Danielle; Wachtel, Ruth E.; Nussmeier, Nancy A.
2010-01-01
Operating room (OR) management differs from clinical anesthesia in that statistical literacy is needed daily to make good decisions. Two of the authors teach a course in operations research for surgical services to anesthesiologists, anesthesia residents, OR nursing directors, hospital administration students, and analysts to provide them with the…
Prevention of falls in older people.
Close, Jacqueline C T
In recent years the evidence base for prevention of falls in older people has increased and associated with this has been an inevitable expansion in clinical services which attempt to localize and implement what is described in the literature. This article reviews the basic physiology implicit in maintenance of the upright posture; highlights the diversity of medical and non-medical risk factors associated with falls; describes the clinical assessment of an older person at risk of falls; reviews the evidence for intervention in the prevention of falls in older people; and acknowledges the need for a clear strategic direction to successfully prevent falls and the requirement for ongoing research as well as much needed service evaluation.
A specialized information center. The clinical neurology information center.
Friedlander, W J
1978-01-01
The history, philosophy, and methodology of a unique specialized medical information center are reported. The Clinical Neurology Information Center is an educational information service (giving its audience information which can be the basis for formulating their own questions) rather than an instructional information service (giving information in reply to questions). Clinical, as well as basic neuroscience, information is culled by professional neurologists from 855 medical periodicals. The essence of each article is summarized in a single sentence ("terse conclusions") or a bibliographic reference only is given; this material is published every two weeks in the Concise Clinical Neurology Review (CCNR). The format of the CCNR is such that the reader should be able to scan a very large amount of current literature by investing only twenty to thirty minutes every two weeks. The values of this system as well as some of its problems are discussed. PMID:354706
Godény, Sándor
2012-02-05
The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.
Spetz, Joanne; Parente, Stephen T; Town, Robert J; Bazarko, Dawn
2013-11-01
Retail clinics have the potential to reduce health spending by offering convenient, low-cost access to basic health care services. Retail clinics are often staffed by nurse practitioners (NPs), whose services are regulated by state scope-of-practice regulations. By limiting NPs' work scope, restrictive regulations could affect possible cost savings. Using multistate insurance claims data from 2004-07, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations. We found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently. Eliminating restrictions on NPs' scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.
Promoting Teen Mothers' Mental Health.
Freed, Patricia; SmithBattle, Lee
2016-01-01
In this second article in a two-part series, we call for the integration of strengths-based and trauma-informed care into services for teen mothers. Nurses working with teen mothers in health clinics, schools and home visiting programs can play a pivotal role in promoting their mental health. Many teen mothers have high levels of psychological distress and histories of adverse experiences that cannot be ignored, and cannot solely be addressed by referral to mental health services. Nurses must be prepared to assess for trauma and be open to listening to teen mothers' experiences. Principles of strengths-based and trauma-informed care are complementary and can be integrated in clinical services so that teen mothers' distress is addressed and their strengths and aspirations are supported. Potential screening tools, interviewing skills and basic strategies to alleviate teen mothers' distress are discussed.
47 CFR 69.119 - Basic service element expedited approval process.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Basic service element expedited approval process. 69.119 Section 69.119 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element...
Roman, Lee Anne; Raffo, Jennifer E; Dertz, Katherine; Agee, Bonita; Evans, Denise; Penninga, Katherine; Pierce, Tiffany; Cunningham, Belinda; VanderMeulen, Peggy
2017-12-01
Objectives To address disparities in adverse birth outcomes, communities are challenged to improve the quality of health services and foster systems integration. The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care (PNC) across a continuum of clinical and community-based services. Methods Three focus groups (N = 21) were conducted and thematic analysis methods were used to identify basic and global themes about experiences of care. Women were recruited through a local Federal Healthy Start (HS) program in Michigan that targets services to African American women. Results Four basic themes were identified: (1) Pursuit of PNC; (2) Experiences of traditional PNC; (3) Enhanced prenatal and postnatal care; and (4) Women's health: A missed opportunity. Two global themes were also identified: (1) Communication with providers, and (2) Perceived socio-economic and racial bias. Many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care. Delays in PNC limited early access to HS and enhanced prenatal care (EPC) programs with little evidence of supportive transitions to primary care. Notably, women's narratives revealed few connections among clinical and community-based services. Conclusions The process of participating in PNC and community-based programs is challenging for women, especially for those with multiple health problems and living in difficult life circumstances. PNC, HS and other EPC programs could partner to streamline processes, improve the content and process of care, and enhance engagement in services.
47 CFR 22.757 - Channels for basic exchange telephone radio systems.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Channels for basic exchange telephone radio... CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service Basic Exchange Telephone Radio Systems § 22.757 Channels for basic exchange telephone radio systems. The channels listed in § 22.725 are...
Barnard, Sharmani; Free, Caroline; Bakolis, Ioannis; Turner, Katy M E; Looker, Katharine J; Baraitser, Paula
2018-02-07
Online services for self-sampling at home could improve access to STI testing; however, little is known about those using this new modality of care. This study describes the characteristics of users of online services and compares them with users of clinic services. We conducted a cross-sectional analysis of routinely collected data on STI testing activity from online and clinic sexual health services in Lambeth and Southwark between 1January 2016 and 31March 2016. Activity was included for chlamydia, gonorrhoea, HIV and syphilis testing for residents of the boroughs aged 16 years and older. Logistic regression models were used to explore potential associations between type of service use with age group, gender, ethnic group, sexual orientation, positivity and Index of Multiple Deprivation (IMD) quintiles. We used the same methods to explore potential associations between return of complete samples for testing with age group, gender, ethnic group, sexual orientation and IMD quintiles among online users. 6456 STI tests were carried out by residents in the boroughs. Of these, 3582 (55.5%) were performed using clinic services and 2874 (44.5%) using the online service. In multivariate analysis, online users were more likely than clinic users to be aged between 20 and 30 years, female, white British, homosexual or bisexual, test negative for chlamydia or gonorrhoea and live in less deprived areas. Of the individuals that ordered a kit from the online service, 72.5% returned sufficient samples. In multivariate analysis, returners were more likely than non-returners to be aged >20 years and white British. Nearly half (44.5%) of all basic STI testing was done online, although the characteristics of users of clinic and online services differed and positivity rates for those using the online service for testing were lower. Clinics remain an important point of access for some groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Assessment of surveys for the management of hospital clinical pharmacy services.
Čufar, Andreja; Mrhar, Aleš; Robnik-Šikonja, Marko
2015-06-01
Survey data sets are important sources of data, and their successful exploitation is of key importance for informed policy decision-making. We present how a survey analysis approach initially developed for customer satisfaction research in marketing can be adapted for an introduction of clinical pharmacy services into a hospital. We use a data mining analytical approach to extract relevant managerial consequences. We evaluate the importance of competences for users of a clinical pharmacy with the OrdEval algorithm and determine their nature according to the users' expectations. For this, we need substantially fewer questions than are required by the Kano approach. From 52 clinical pharmacy activities we were able to identify seven activities with a substantial negative impact (i.e., negative reinforcement) on the overall satisfaction of clinical pharmacy services, and two activities with a strong positive impact (upward reinforcement). Using analysis of individual feature values, we identified six performance, 10 excitement, and one basic clinical pharmacists' activity. We show how the OrdEval algorithm can exploit the information hidden in the ordering of class and attribute values, and their inherent correlation using a small sample of highly relevant respondents. The visualization of the outputs turns out highly useful in our clinical pharmacy research case study. Copyright © 2015 Elsevier B.V. All rights reserved.
Faulkner, K; Järvinen, H; Butler, P; McLean, I D; Pentecost, M; Rickard, M; Abdullah, B
2010-01-01
The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to the clinical audit programme and the IAEA clinical audit protocol.
Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C
2015-09-01
To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.
Alhamdan, Adel A.; Alshammari, Sulaiman A.; Al-Amoud, Maysoon M.; Hameed, Tariq A.; Al-Muammar, May N.; Bindawas, Saad M.; Al-Orf, Saada M.; Mohamed, Ashry G.; Al-Ghamdi, Essam A.; Calder, Philip C.
2015-01-01
Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly. PMID:26318467
Berkovitz, Saul; Cummings, Mike; Perrin, Chris; Ito, Rieko
2008-03-01
Recent research has established the efficacy, effectiveness and cost effectiveness of acupuncture for some forms of chronic musculoskeletal pain. However, there are practical problems with delivery which currently prevent its large scale implementation in the National Health Service. We have developed a delivery model at our hospital, a 'high volume' acupuncture clinic (HVAC) in which patients are treated in a group setting for single conditions using standardised or semi-standardised electroacupuncture protocols by practitioners with basic training. We discuss our experiences using this model for chronic knee pain and present an outcome audit for the first 77 patients, demonstrating satisfactory initial (eight week) clinical results. Longer term (one year) data are currently being collected and the model should next be tested in primary care to confirm its feasibility.
Basic science faculty in surgical departments: advantages, disadvantages and opportunities.
Chinoy, Mala R; Moskowitz, Jay; Wilmore, Douglas W; Souba, Wiley W
2005-01-01
The number of Ph.D. faculty in clinical departments now exceeds the number of Ph.D. faculty in basic science departments. Given the escalating pressures on academic surgeons to produce in the clinical arena, the recruitment and retention of high-quality Ph.D.s will become critical to the success of an academic surgical department. This success will be as dependent on the surgical faculty understanding the importance of the partnership as the success of the Ph.D. investigator. Tighter alignment among the various clinical and research programs and between surgeons and basic scientists will facilitate the generation of new knowledge that can be translated into useful products and services (thus improving care). To capitalize on what Ph.D.s bring to the table, surgery departments may need to establish a more formal research infrastructure that encourages the ongoing exchange of ideas and resources. Physically removing barriers between the research groups, encouraging the open exchange of techniques and observations and sharing core laboratories is characteristic of successful research teams. These strategies can meaningfully contribute to developing successful training program grants, program projects and bringing greater research recognition to the department of surgery.
47 CFR 76.930 - Initiation of review of basic cable service and equipment rates.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Initiation of review of basic cable service and...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.930 Initiation of review of basic cable service and equipment rates. A cable operator shall file its schedule of...
78 FR 34111 - National Cancer Institute; Notice of Closed Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-06
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of meetings of the Board of Scientific Counselors for Basic Sciences and Clinical Sciences and Epidemiology...
Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin
2014-01-01
Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations' (EHOs) and community-based organizations' (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive system of health care provision and access in the Karen/Kayin State over the past 20 years. It underscores the climate of vulnerability of the EHOs and CBHOs due to lack of regional and international understanding of the political complexities in Burma/Myanmar. As Association of Southeast Asian Nations (ASEAN) integration gathers pace, this case study highlights potential issues relating to migration and health access. The case also documents the challenge of integrating indigenous and/or cross-border health systems, with the ongoing risk of deepening ethnic conflicts in Burma/Myanmar as the peace process is negotiated.
Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin
2014-01-01
Background Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations’ (EHOs) and community-based organizations’ (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive system of health care provision and access in the Karen/Kayin State over the past 20 years. It underscores the climate of vulnerability of the EHOs and CBHOs due to lack of regional and international understanding of the political complexities in Burma/Myanmar. As Association of Southeast Asian Nations (ASEAN) integration gathers pace, this case study highlights potential issues relating to migration and health access. The case also documents the challenge of integrating indigenous and/or cross-border health systems, with the ongoing risk of deepening ethnic conflicts in Burma/Myanmar as the peace process is negotiated. PMID:25280737
Li, Tongtong; Lei, Trudy; Xie, Zheng; Zhang, Tuohong
2016-02-04
To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China. Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.
The importance of therapeutic farriery in equine practice.
Werner, Harry W
2012-08-01
For an equine practice to offer therapeutic farriery as a professional service, that service must be founded in individual competence and cooperation between veterinarian and farrier. Inadequate farriery education and experience may result in substandard or even contraindicated therapeutic farriery prescriptions and farrier care. Within continuing education for equine practitioners, excellent opportunities to advance one's understanding of and clinical competence in therapeutic farriery are increasingly available. It is the obligation of the veterinarian to acquire and maintain a working understanding of both basic and therapeutic farriery to work effectively with the farrier and offer a valid service to the client. Copyright © 2012 Elsevier Inc. All rights reserved.
Improving traffic signal management and operations : a basic service model.
DOT National Transportation Integrated Search
2009-12-01
This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...
Jiang, Xiaomei; Ren, Shanshan; Hou, Liyan; He, Dian; Pang, Cheng; Cheng, Yimin
2011-01-01
To evaluate the effectiveness of an intervention program on promoting the use of contraceptives in migrant population working in factories, and to compare the difference of results between the basic intervention mode and the comprehensive intervention mode. This was an epidemiologic intervention study carried out in each 2 factories in Shenzhen and Dongguan among migrant workers by comparing the effectiveness of a baseline survey and a end-line survey. The basic intervention mode was composed of spreading contraceptives and reproductive health information, conducting education and communication and providing references to access free services from family planning clinics (IEC). The comprehensive intervention mode provided more services on face to face counseling and distributing free contraceptives. The demographic characteristics of subjects before and after surveys were comparable. Whether in the basic group or comprehensive mode group, the awareness of contraceptive/reproductive health knowledge was increased significantly after intervention (P = 0.000), and the pass rate was higher in the comprehensive intervention group (P = 0.000). The self-reported most frequently used contraceptives was condoms. The proportion of using condoms and purchasing condoms was increased after intervention (P = 0.000) from 69.7% and 67.7% before intervention to 84.9% and 90.2% after basic intervention and 87.1% and 95.1% after comprehensive intervention. The proportion of using contraceptives every time was increased from 35.7% before intervention to 38.1% after basic intervention (P = 0.018) and to 42.9% after comprehensive intervention (P = 0.000). Intervention measures based on implementing in factories were effective in promoting contraception among migrant workers, and the integration of counseling and free contraceptive services with IEC was better. Carrying on and extending this kind of intervention measures to other migrant population in similar conditions is suggested.
Cheeran, Binith; Cohen, Leonardo; Dobkin, Bruce; Ford, Gary; Greenwood, Richard; Howard, David; Husain, Masud; Macleod, Malcolm; Nudo, Randolph; Rothwell, John; Rudd, Anthony; Teo, James; Ward, Nicholas; Wolf, Steven
2011-01-01
Background Major advances during the past 50 years highlight the immense potential for restoration of function after neural injury, even in the damaged adult human brain. Yet, the translation of these advances into clinically useful treatments is painstakingly slow. Objective Here, we consider why the traditional model of a “translational research pipeline” that transforms basic science into novel clinical practice has failed to improve rehabilitation practice for people after stroke. Results We find that (1) most treatments trialed in vitro and in animal models have not yet resulted in obviously useful functional gains in patients; (2) most clinical trials of restorative treatments after stroke have been limited to small-scale studies; (3) patient recruitment for larger clinical trials is difficult; (4) the determinants of patient outcomes and what patients want remain complex and ill-defined, so that basic scientists have no clear view of the clinical importance of the problems that they are addressing; (5) research in academic neuroscience centers is poorly integrated with practice in front-line hospitals and the community, where the majority of patients are treated; and (6) partnership with both industry stakeholders and patient pressure groups is poorly developed, at least in the United Kingdom where research in the translational restorative neurosciences in stroke depends on public sector research funds and private charities. Conclusions We argue that interaction between patients, front-line clinicians, and clinical and basic scientists is essential so that they can explore their different priorities, skills, and concerns. These interactions can be facilitated by funding research consortia that include basic and clinical scientists, clinicians and patient/carer representatives with funds targeted at those impairments that are major determinants of patient and carer outcomes. Consortia would be instrumental in developing a lexicon of common methods, standardized outcome measures, data sharing and long-term goals. Interactions of this sort would create a research-friendly, rather than only target-led, culture in front-line stroke rehabilitation services. PMID:19189939
Future directions in the use of dental implants.
Bloem, T J
1989-10-01
Future development in implant prosthodontics should be based on the fundamentals of sound research and reliable clinical implementation. The goals should be to research the safety and efficacy of implants with regard to materials, host receptor site and interfacial zone; to develop acceptable uniform standards of evaluation; and to submit findings to scientific methods of analysis in determining benefit-to-risk factors. This presentation will offer a glimpse at some current developments in basic and clinical research focusing on studies in biocompatability and host acceptance; the implant-tissue interface; processes in osteogenesis related to vascularization of host sites; and bioengineering studies related to stress analysis and dimensional accuracy of impression systems for implants. The presentation will further describe future direction in research, training and implementation of services through development of an interdisciplinary team. A center is proposed to address the need for combined efforts in clinical and basic science research, the broad scope of implant utilization, and the teaching of implant procedures within an academic setting and to our colleagues.
47 CFR 32.5000 - Basic local service revenue.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 2 2011-10-01 2011-10-01 false Basic local service revenue. 32.5000 Section 32.5000 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5000 Basic...
47 CFR 32.5000 - Basic local service revenue.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 2 2014-10-01 2014-10-01 false Basic local service revenue. 32.5000 Section 32.5000 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5000 Basic...
47 CFR 32.5000 - Basic local service revenue.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 2 2013-10-01 2013-10-01 false Basic local service revenue. 32.5000 Section 32.5000 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5000 Basic...
Ishida, Mayumi; Onishi, Hideki; Wada, Mei; Tada, Yukio; Ito, Hiroshi; Narabayashi, Masaru; Sasaki, Yasutsuna; Nomura, Shinobu; Uchitomi, Yosuke
2011-03-01
There have been no previous studies about consultation of the bereaved who have lost a loved one to cancer and ask for medical help. The aim of this study was to investigate their basic characteristics and their psychiatric disorders. A retrospective study using clinical and background data obtained over 30 months (from April 2007 to September 2009) was conducted at outpatient services for bereaved families at the Department of Psycho-Oncology at Saitama Medical University International Medical Center, Japan. During the period of investigation, 51 patients underwent consultation. The patients were frequently female (P < 0.0001) and the spouse of the deceased. Regarding the psychiatric diagnoses, major depression was the most common (39%), followed by adjustment disorders (28%). This study revealed basic characteristics and psychiatric disorders of the bereaved who asked for medical help. Most of the patients were women (86.3%) and 86.3% of them received a psychiatric diagnosis. This information is important for both physicians and psychologists since the bereaved who have lost a loved one to cancer often ask for medical help in clinical settings.
Understanding MRI: basic MR physics for physicians.
Currie, Stuart; Hoggard, Nigel; Craven, Ian J; Hadjivassiliou, Marios; Wilkinson, Iain D
2013-04-01
More frequently hospital clinicians are reviewing images from MR studies of their patients before seeking formal radiological opinion. This practice is driven by a multitude of factors, including an increased demand placed on hospital services, the wide availability of the picture archiving and communication system, time pressures for patient treatment (eg, in the management of acute stroke) and an inherent desire for the clinician to learn. Knowledge of the basic physical principles behind MRI is essential for correct image interpretation. This article, written for the general hospital physician, describes the basic physics of MRI taking into account the machinery, contrast weighting, spin- and gradient-echo techniques and pertinent safety issues. Examples provided are primarily referenced to neuroradiology reflecting the subspecialty for which MR currently has the greatest clinical application.
NASA Astrophysics Data System (ADS)
Liao, Zangyi
2017-12-01
Accomplishing the regional equalization of basic public service supply among the provinces in China is an important objective that can promote the people’s livelihood construction. In order to measure the problem which is about the non-equalization of basic public service supply, this paper takes these aspects as the first index, such as the infrastructure construction, basic education services, public employment services, public health service and social security service. At the same time, it cooperates with 16 index as the second index to construct the performance evaluation systems, and then use the Theil index to evaluate the performance in provinces that using the panel data from the year 2000 to 2012.
Greening, S E; Grohs, D H; Guidos, B J
1997-01-01
Providing effective training, retraining and evaluation programs, including proficiency testing programs, for cytoprofessionals is a challenge shared by many academic and clinical educators internationally. In cytopathology the quality of training has immediately transferable and critically important impacts on satisfactory performance in the clinical setting. Well-designed interactive computer-assisted instruction and testing programs have been shown to enhance initial learning and to reinforce factual and conceptual knowledge. Computer systems designed not only to promote diagnostic accuracy but to integrate and streamline work flow in clinical service settings are candidates for educational adaptation. The AcCell 2000 system, designed as a diagnostic screening support system, offers technology that is adaptable to educational needs during basic and in-service training as well as testing of screening proficiency in both locator and identification skills. We describe the considerations, approaches and applications of the AcCell 2000 system in education programs for both training and evaluation of gynecologic diagnostic screening proficiency.
Availability of essential health services in post-conflict Liberia.
Kruk, Margaret E; Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro
2010-07-01
To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county's 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities.
Gómez-Gil, E; Esteva de Antonio, I; Almaraz, M C; Godás Sieso, T; Halperin Rabinovich, I; Soriguer Escofet, F
2011-05-01
To evaluate the demand for public health services in two gender identity disorder units (Andalusia and Catalonia) during the period of 2000-2009. A descriptive and comparative study was made of the demand for health services, the demographic and clinical characteristics of the patients, and the sex reassignment surgeries performed. A total of 828 subjects in Andalusia and 549 in Catalonia requested clinical assistance. In both communities, the percentages of cases diagnosed of transsexualism (88 vs 89.7%), the percentages excluded in the sex reassignment program (16.7 vs 15.3%), the male/female ratio (1.6:1 vs 2.1:1), and the mean age (28 vs 29 years) were similar. A total of 284 sex-reassignment surgeries were performed in Andalusia and 50 in Catalonia. The demand has been maintained in Andalusia and has increased in Catalonia in recent years. The basic demographic and clinical characteristics of transsexual patients were similar between both units and comparable to those of other countries. Copyright © 2010 Elsevier España, S.L. All rights reserved.
Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.
De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina
2015-12-01
The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring patients requiring a higher level of care was present in most (80%) clinics and one of the hospitals. However, no facility had a written protocol for transferring patients to other facilities. One hospital reported intermittent access to an ambulance for transfers. Deficits in the supply of emergency equipment and limited protocols for inter-facility transfers exist in North East Department of Haiti. These essential areas represent appropriate targets for interventions aimed at improving access to emergency care within the North East region of Haiti.
Service Learning in a Basic Writing Class: A Best Case Scenario
ERIC Educational Resources Information Center
Pine, Nancy
2008-01-01
This article explores the particular challenges and possibilities of service learning pedagogy for basic writers. Because a number of scholars of service learning and basic writing (Adler-Kassner, Arca, and Kraemer) are concerned primarily with developing underprepared students' academic literacies, I investigated how the students in a service…
Turan, Janet M.; Steinfeld, Rachel L.; Onono, Maricianah; Bukusi, Elizabeth A.; Woods, Meghan; Shade, Starley B.; Washington, Sierra; Marima, Reson; Penner, Jeremy; Ackers, Marta L.; Mbori-Ngacha, Dorothy; Cohen, Craig R.
2012-01-01
Background Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT), HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC) services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma. Methodology/Principal Findings A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya. Twelve facilities were randomized to provide either fully integrated services (ANC, PMTCT, and HIV treatment services all delivered in the ANC clinic) or non-integrated services (ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment). During June 2009– March 2011, 1,172 HIV-positive pregnant women were enrolled in the study. The main study outcomes are rates of maternal enrollment in HIV care and treatment, infant HIV testing uptake, and HIV-free infant survival. Baseline results revealed that the intervention and control cohorts were similar with respect to socio-demographics, male partner HIV testing, sero-discordance of the couple, obstetric history, baseline CD4 count, and WHO Stage. Challenges faced while conducting this trial at low-resource rural health facilities included frequent staff turnover, stock-outs of essential supplies, transportation challenges, and changes in national guidelines. Conclusions/Significance This is the first randomized trial of ANC and HIV service integration to be conducted in rural Africa. It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery strategy, with important implications for programs striving to eliminate vertical transmission of HIV and improve maternal health. Trial Registration ClinicalTrials.gov NCT00931216 NCT00931216. PMID:22970177
Just caring: defining a basic benefit package.
Fleck, Leonard M
2011-12-01
What should be the content of a package of health care services that we would want to guarantee to all Americans? This question cannot be answered adequately apart from also addressing the issue of fair health care rationing. Consequently, as I argue in this essay, appeal to the language of "basic," "essential," "adequate," "minimally decent," or "medically necessary" for purposes of answering our question is unhelpful. All these notions are too vague to be useful. Cost matters. Effectiveness matters. The clinical circumstances of a patient matters. But what we must ultimately determine is what we mutually agree are the just claims to needed health care of each American in a relatively complex range of clinical circumstances. Answering this question will require a public moral conversation, a fair process of rational democratic deliberation aimed at defining both just claims to needed health care and just limits.
Johnson, R C; Mason, F O; Sims, R H
1997-01-01
A basic list of 133 book and journal titles in dentistry is presented. The list is intended as a bibliographic selection tool for those libraries and health institutions that support clinical dentistry programs and services in the nondental school environment in the United States and Canada. The book and journal titles were selected by the membership of the Dental Section of the Medical Library Association (MLA). The Dental Section membership represents dental and other health sciences libraries and dental research institutions from the United States and Canada, as well as from other countries. The list was compiled and edited by the Ad Hoc Publications Committee of the Dental Section of MLA. The final list was reviewed and subsequently was approved for publication and distribution by the Dental Section of MLA during the section's 1996 annual meeting in Kansas City, Missouri. PMID:9285122
47 CFR 69.118 - Traffic sensitive switched services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Docket 86-10, FCC 93-53 (1993). Moreover, all customers that use basic 800 database service shall be... account revenues from the relevant Basic Service Element or Elements and 800 Database Service Elements in...
47 CFR 69.118 - Traffic sensitive switched services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Docket 86-10, FCC 93-53 (1993). Moreover, all customers that use basic 800 database service shall be... account revenues from the relevant Basic Service Element or Elements and 800 Database Service Elements in...
47 CFR 69.118 - Traffic sensitive switched services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Docket 86-10, FCC 93-53 (1993). Moreover, all customers that use basic 800 database service shall be... account revenues from the relevant Basic Service Element or Elements and 800 Database Service Elements in...
47 CFR 69.118 - Traffic sensitive switched services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Docket 86-10, FCC 93-53 (1993). Moreover, all customers that use basic 800 database service shall be... account revenues from the relevant Basic Service Element or Elements and 800 Database Service Elements in...
47 CFR 69.118 - Traffic sensitive switched services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Docket 86-10, FCC 93-53 (1993). Moreover, all customers that use basic 800 database service shall be... account revenues from the relevant Basic Service Element or Elements and 800 Database Service Elements in...
Adult Basic Education 1985-1986 End-of-Year Report.
ERIC Educational Resources Information Center
Mei, Dolores M.; And Others
The Adult Basic Education/High School Equivalency (ABE/HSE) Services Program provides basic educational services for out-of-school youth and adults in New York City. The program offers classes in basic literacy (BL), basic education (BE), high school equivalency (HSE), and English as a second language (ESL). The program's budget is $11 million.…
47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for the basic service tier and cable programming services tiers. 76.922 Section 76.922 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...
Basic Functional Capabilities for a Military Message Processing Service
1974-09-01
AD-AiI1 166 BASIC FUNCTIONA’. CAPABILITIES FOR A MILITARY MESSAGE PROCESSING SERVICE Ronald Tugender, et al University of Southern California...Itte) S. TYPE OF REPORT & PERIOD COVERED BASIC FUNCTIONAL CAPABILITIES FOR A Research Report MILITARY MESSAGE PROCESSING SERVICE 6. PERFORMING ONG...WOROD (Conionwo m trevre aide If tneeoooy arm idmentify by egekA INber) automated message processing , command and control, writer-to-reader service
2013-01-01
Background In resource-limited settings where healthcare services are limited and poverty is common, it is difficult to ethically conduct clinical research without providing patient-care. Therefore, integration of patient-care with clinical research appears as an attractive way of conducting research while providing patient-care. In this article, we discuss the ethical implications of such approach with perspectives from Papua New Guinea. Discussion Considering the difficulties of providing basic healthcare services in developing countries, it may be argued that integration of clinical research with patient-care is an effective, rational and ethical way of conducting research. However, blending patient-care with clinical research may increase the risk of subordinating patient-care in favour of scientific gains; therapeutic misconception and inappropriate inducement; and the risk of causing health system failures due to limited capacity in developing countries to sustain the level of healthcare services sponsored by the research. Nevertheless, these ethical and administrative implications can be minimised if patient-care takes precedence over research; the input of local ethics committees and institutions are considered; and funding agencies acknowledge their ethical obligation when sponsoring research in resource-limited settings. Summary Although integration of patient-care with clinical research in developing countries appears as an attractive way of conducting research when resources are limited, careful planning and consideration on the ethical implications of such approach must be considered. PMID:23885908
Laman, Moses; Pomat, William; Siba, Peter; Betuela, Inoni
2013-07-26
In resource-limited settings where healthcare services are limited and poverty is common, it is difficult to ethically conduct clinical research without providing patient-care. Therefore, integration of patient-care with clinical research appears as an attractive way of conducting research while providing patient-care. In this article, we discuss the ethical implications of such approach with perspectives from Papua New Guinea. Considering the difficulties of providing basic healthcare services in developing countries, it may be argued that integration of clinical research with patient-care is an effective, rational and ethical way of conducting research. However, blending patient-care with clinical research may increase the risk of subordinating patient-care in favour of scientific gains; therapeutic misconception and inappropriate inducement; and the risk of causing health system failures due to limited capacity in developing countries to sustain the level of healthcare services sponsored by the research. Nevertheless, these ethical and administrative implications can be minimised if patient-care takes precedence over research; the input of local ethics committees and institutions are considered; and funding agencies acknowledge their ethical obligation when sponsoring research in resource-limited settings. Although integration of patient-care with clinical research in developing countries appears as an attractive way of conducting research when resources are limited, careful planning and consideration on the ethical implications of such approach must be considered.
An overview of recent end-to-end wireless medical video telemedicine systems using 3G.
Panayides, A; Pattichis, M S; Pattichis, C S; Schizas, C N; Spanias, A; Kyriacou, E
2010-01-01
Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.
Sannikov, A G
2008-01-01
The assessment of the effectiveness of the informatization of the forensic psychiatric expertise service in the Tyumen oblast based on the data of the medical sociological research carried out by means of total questionnaire design of the forensic psychiatrists applied in repetition-free mode. The following basic positive outcomes of the informatization of the forensic psychiatric service are marked: the optimization of clinical, registering-accounting and managerial activities of the expert commissions; enhancement of the expertise staff's self-appraisal related to the mastering of information technologies; employees' formed will to implement the IT-technologies for the purpose of professional development. Besides the assessment of the effectiveness of the specialized service's informatization the results of the research can provide information on the optimal structure of the medical information systems.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND... basic tier, and any additional video programming signals a service added to the basic tier by the cable operator. (b) Cable programming service. Cable programming service includes any video programming provided...
Blueprint for Incorporating Service Learning: A Basic, Developmental, K-12 Service Learning Typology
ERIC Educational Resources Information Center
Terry, Alice W.; Bohnenberger, Jann E.
2004-01-01
Citing the need for a basic, K-12 developmental framework for service learning, this article describes such a model. This model, an inclusive typology of service learning, distinguishes three levels of service learning: Community Service, Community Exploration, and Community Action. The authors correlate this typology to Piaget's cognitive…
[Violence in Mexican women using public health services].
Gómez-Dantés, Héctor; Vázquez-Martínez, José Luis; Fernández-Cantón, Sonia B
2006-01-01
To compare the prevalence of violence and determine its risk factors among women who use Mexican Social Services (IMSS) clinics and do not have access to social security services. Sociodemographic data linked to domestic violence reported by women attending the Mexican Institute of Social Security (IMSS) health services was analyzed. Bivariate and multivariate analysis was performed using STATAV.7. Psychological violence in IMSS women was 18% followed by physical violence (9.1%), sexual (6.7%) and economic (5%). Prevalence of violence in women with no social security care was psychological (21.4%), physical (10.5%), sexual (7.5%) and economical (5%). Women between 25 and 44 years of age with basic schooling and married and with family background of violence were the most affected. The daily consumption of alcohol by their partners was an important predictor of domestic violence. Violence in women with no social security is higher. Partner's alcohol intake pattern is an important risk factor. Detection of domestic violence in the clinical setting is necessary to recognize its real magnitude as a social problem.
Capacity building of skilled birth attendants: a review of pre-service education curricula.
Adegoke, Adetoro A; Mani, Safiyanu; Abubakar, Aisha; van den Broek, Nynke
2013-07-01
to assess the level, type and content of pre-service education curricula of health workers providing maternity services against the ICM global standards for Midwifery Education and Essential competencies for midwifery practice. We reviewed the quality and relevance of pre-service education curricula of four cadres of health-care providers of maternity care in Northern Nigeria. we adapted and used the ICM global standards for Midwifery Education and Essential competencies for midwifery practice to design a framework of criteria against which we assessed curricula for pre-service training. We reviewed the pre-service curricula for Nurses, Midwives, Community Health Extension Workers (CHEW) and Junior Community Health Extension Workers (JCHEW) in three states. Criteria against which the curricula were evaluated include: minimum entry requirement, the length of the programme, theory: practice ratio, curriculum model, minimum number of births conducted during training, clinical experience, competencies, maximum number of students allowable and proportion of Maternal, Newborn and Child Health components (MNCH) as part of the total curriculum. four pre-service education programmes were reviewed; the 3 year basic midwifery, 3 year basic nursing, 3 year Community Health Extension Worker (CHEW) and 2 year Junior Community Health Extension Worker (JCHEW) programme. Findings showed that, none of these four training curricula met all the standards. The basic midwifery curriculum most closely met the standards and competencies set out. The nursing curriculum showed a strong focus on foundations of nursing practice, theories of nursing, public health and maternal newborn and child health. This includes well-defined modules on family health which are undertaken from the first year to the third year of the programme. The CHEW and JCHEW curricula are currently inadequate with regard to training health-care workers to be skilled birth attendants. although the midwifery curriculum most closely reflects the ICM global standards for Midwifery Education and Essential competencies for midwifery practice, a revision of the competencies and content is required especially as it relates to the first year of training. There is an urgent need to modify the JCHEW and CHEW curricula by increasing the content and clinical hands-on experience of MNCH components of the curricula. Without effecting these changes, it is doubtful that graduates of the CHEW and JCHEW programmes have the requisite competencies needed to function adequately as skilled birth attendants in Health Centres, PHCs and MCHs, without direct supervision of a midwife or medical doctor with midwifery skills. Copyright © 2012 Elsevier Ltd. All rights reserved.
Decline of clinical research in academic medical centers.
Meador, Kimford J
2015-09-29
Marked changes in US medical school funding began in the 1960s with progressively increasing revenues from clinical services. The growth of clinical revenues slowed in the mid-1990s, creating a funding crisis for US academic health care centers, who responded by having their faculty increase their clinical duties at the expense of research activities. Surveys document the resultant stresses on the academic clinician researcher. The NIH provides greater funding for basic and translational research than for clinical research, and the new Patient-Centered Outcomes Research Institute is inadequately funded to address the scope of needed clinical research. An increasing portion of clinical research is funded by industry, which leaves many important clinical issues unaddressed. There is an inadequate supply of skilled clinical researchers and a lack of external support for clinical research. The impact on the academic environment in university medical centers is especially severe on young faculty, who have a shrinking potential to achieve successful academic careers. National health care research funding policies should encourage the right balance of life-science investigations. Medical universities need to improve and highlight education on clinical research for students, residents, fellows, and young faculty. Medical universities also need to provide appropriate incentives for clinical research. Without training to ensure an adequate supply of skilled clinical researchers and a method to adequately fund clinical research, discoveries from basic and translational research cannot be clinically tested and affect patient care. Thus, many clinical problems will continue to be evaluated and treated with inadequate or even absent evidence-based knowledge. © 2015 American Academy of Neurology.
Decline of clinical research in academic medical centers
2015-01-01
Marked changes in US medical school funding began in the 1960s with progressively increasing revenues from clinical services. The growth of clinical revenues slowed in the mid-1990s, creating a funding crisis for US academic health care centers, who responded by having their faculty increase their clinical duties at the expense of research activities. Surveys document the resultant stresses on the academic clinician researcher. The NIH provides greater funding for basic and translational research than for clinical research, and the new Patient-Centered Outcomes Research Institute is inadequately funded to address the scope of needed clinical research. An increasing portion of clinical research is funded by industry, which leaves many important clinical issues unaddressed. There is an inadequate supply of skilled clinical researchers and a lack of external support for clinical research. The impact on the academic environment in university medical centers is especially severe on young faculty, who have a shrinking potential to achieve successful academic careers. National health care research funding policies should encourage the right balance of life-science investigations. Medical universities need to improve and highlight education on clinical research for students, residents, fellows, and young faculty. Medical universities also need to provide appropriate incentives for clinical research. Without training to ensure an adequate supply of skilled clinical researchers and a method to adequately fund clinical research, discoveries from basic and translational research cannot be clinically tested and affect patient care. Thus, many clinical problems will continue to be evaluated and treated with inadequate or even absent evidence-based knowledge. PMID:26156509
Lafort, Yves; Jocitala, Osvaldo; Candrinho, Balthazar; Greener, Letitia; Beksinska, Mags; Smit, Jenni A; Chersich, Matthew; Delva, Wim
2016-07-26
In the context of an implementation research project aiming at improving use of HIV and sexual and reproductive health (SRH) services for female sex workers (FSWs), a broad situational analysis was conducted in Tete, Mozambique, assessing if services are adapted to the needs of FSWs. Methods comprised (1) a policy analysis including a review of national guidelines and interviews with policy makers, and (2) health facility assessments at 6 public and 1 private health facilities, and 1 clinic specifically targeting FSWs, consisting of an audit checklist, interviews with 18 HIV/SRH care providers and interviews of 99 HIV/SRH care users. There exist national guidelines for most HIV/SRH care services, but none provides guidance for care adapted to the needs of high-risk women such as FSWs. The Ministry of Health recently initiated the process of establishing guidelines for attendance of key populations, including FSWs, at public health facilities. Policy makers have different views on the best approach for providing services to FSWs-integrated in the general health services or through parallel services for key populations-and there exists no national strategy. The most important provider of HIV/SRH services in the study area is the government. Most basic services are widely available, with the exception of certain family planning methods, cervical cancer screening, services for victims of sexual and gender-based violence, and termination of pregnancy (TOP). The public facilities face serious limitations in term of space, staff, equipment, regular supplies and adequate provider practices. A stand-alone clinic targeting key populations offers a limited range of services to the FSW population in part of the area. Private clinics offer only a few services, at commercial prices. There is a need to improve the availability of quality HIV/SRH services in general and to FSWs specifically, and to develop guidelines for care adapted to the needs of FSWs. Access for FSWs can be improved by either expanding the range of services and the coverage of the targeted clinic and/or by improving access to adapted care at the public health services and ensure a minimum standard of quality.
Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah
2017-01-01
Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked. PMID:28196113
Lim, Huy Ming; Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah
2017-01-01
Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96). Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked.
An evaluation of clinical laboratory services in sub-Saharan Africa. Ex africa semper aliquid novi?
Gray, I P; Carter, J Y
1997-11-06
Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries 'first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.
Availability of essential health services in post-conflict Liberia
Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro
2010-01-01
Abstract Objective To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. Methods We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Findings Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county’s 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Conclusion Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities. PMID:20616972
Review of HIV Pre exposure prophylaxis (PrEP) and example of HIV PrEP Toolkit
2017-08-28
Research Division may pay for your basic journal publishing charges (to include costs for tables and black and white photos). We cannot pay for...USAF, BSC Director, Clinical Investigations & Research Support Warrior Medics - Mission Ready Patient Focused PROCESSING OF PROFESSIONAL MEDICAL...SGS O&M); SGS R&D: Tri-Service Nursing Research Program (TSNRP); Defense Medical Research & Development Program (DMRDP); NIH; Congressionally
Back-to-basics with a surgical rotation programme.
Hall, Catherine L
This article describes the development and implementation of a rotation programme for Band 5 nurses within the surgical directorate at Heart of England NHS Foundation Trust. The article highlights the challenges raised for nurses with health service modernization and develops the rationale for the need for a different way of thinking. At Heart of England NHS Foundation Trust, the authors evaluation has led to the development of the surgical rotation programme for Band 5 nurses. This rotation programme challenged basic clinical practice and traditional modes of staff placement. Indications, so far, are that quality of care for patients has improved and nurses satisfaction has increased as a result of the implementation of the Band 5 surgical rotation programme.
Lázaro de Mercado, P
1997-06-01
Health services are systems whose mission is to improve the health status of both individuals and society in general. In recent decades, these systems have faced challenges such as their increasing complexity, limited resources, rapid innovation and diffusion of medical technologies, pressures on demand from society and professionals, and the lack of knowledge of the effects of these factors on costs and society's health. In addition, health care expenditures have grown twice as fast as wealth in industrialized countries during the last 25 years. These problems have prompted cost containment as a key issue in health policy and, at the same time, have promoted the development of socioeconomic evaluation as a scientific activity in the frame of health services research. Socioeconomic evaluation tries to determine if the sacrifice made by society, which devotes part of its limited resources to health care, maximizes the outcomes for population. This article describes basic concepts and methods of economic appraisal in health services which are illustrated with examples of clinical practice in cardiology. Common methods of evaluation are described; the relation between the clinical outcome of a procedure and its associated costs is emphasized in explaining the types of efficiency analysis (cost-efficacy, cost-effectiveness, cost-utility, and cost-benefit); and finally a guide for socioeconomic evaluation is provided.
Vascular access: a never-ending story.
Hedin, U
2014-12-01
Vascular surgeons are more and more becoming responsible for "life-line" creation well functioning and maintenance of hemodialysis patients and to provide a well functioning and multidisciplinary access service together with nefrologists, dialysis staff, and interventional radiology. For many, this sometimes arduous surgery with associated complicated clinical decision making, becomes a constant and challenging burden but much through the appearance of national and international guidelines and especially the endovascular technology, feasible solutions are easily at hand and the life as an access surgeon more pleasant. Here, basics in dialysis access care are presented together with some examples of novel available solutions to troublesome clinical problems.
Code of Federal Regulations, 2012 CFR
2012-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
Code of Federal Regulations, 2014 CFR
2014-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
Code of Federal Regulations, 2013 CFR
2013-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
42 CFR 417.101 - Health benefits plan: Basic health services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...
42 CFR 417.101 - Health benefits plan: Basic health services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...
42 CFR 417.101 - Health benefits plan: Basic health services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...
Code of Federal Regulations, 2012 CFR
2012-10-01
... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
Code of Federal Regulations, 2014 CFR
2014-10-01
... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
Code of Federal Regulations, 2013 CFR
2013-10-01
... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
47 CFR 76.1618 - Basic tier availability.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 4 2011-10-01 2011-10-01 false Basic tier availability. 76.1618 Section 76.1618 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1618 Basic tier availability. A cable operator...
47 CFR 76.1618 - Basic tier availability.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 47 Telecommunication 4 2012-10-01 2012-10-01 false Basic tier availability. 76.1618 Section 76.1618 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1618 Basic tier availability. A cable operator...
47 CFR 76.1618 - Basic tier availability.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 4 2013-10-01 2013-10-01 false Basic tier availability. 76.1618 Section 76.1618 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1618 Basic tier availability. A cable operator...
47 CFR 76.1618 - Basic tier availability.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 4 2014-10-01 2014-10-01 false Basic tier availability. 76.1618 Section 76.1618 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1618 Basic tier availability. A cable operator...
47 CFR 76.1618 - Basic tier availability.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Basic tier availability. 76.1618 Section 76.1618 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1618 Basic tier availability. A cable operator...
5 CFR 531.405 - Waiting periods for within-grade increase.
Code of Federal Regulations, 2010 CFR
2010-01-01
... step 4-52 calendar weeks of creditable service; (ii) Rate of basic pay equal to or greater than the... creditable service; and (iii) Rate of basic pay equal to or greater than the rate of basic pay at step 7-156... step 4-260 days of creditable service in a pay status over a period of not less than 52 calendar weeks...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-27
... 11-153] Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics... substantially affect compatibility between cable service and consumer electronics equipment for most subscribers... problems between cable service and consumer electronics equipment were limiting and/or precluding the...
42 CFR 417.101 - Health benefits plan: Basic health services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...
42 CFR 417.101 - Health benefits plan: Basic health services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...
GramHealth: a bottom-up approach to provide preventive healthcare services for unreached community.
Ahmed, Ashir; Kabir, Lutfe; Kai, Eiko; Inoue, Sozo
2013-01-01
Insufficient healthcare facilities and unavailability of medical experts in rural areas are the two major reasons that kept the people unreached to healthcare services. Recent penetration of mobile phone and the demand to basic healthcare services, remote health consultancy over mobile phone became popular in developing countries. In this paper, we introduce two such representative initiatives from Bangladesh and discuss the technical challenges they face to serve a remote patient. To solve these issues, we have prototyped a box with necessary diagnostic tools, we call it a "portable clinic" and a software tool, "GramHealth" for managing the patient information. We carried out experiments in three villages in Bangladesh to observe the usability of the portable clinic and verify the functionality of "GramHealth". We display the qualitative analysis of the results obtained from the experiment. GramHealth DB has a unique combination of structured, semi-structured and un-structured data. We are currently looking at these data to see whether these can be treated as BigData and if yes, how to analyze the data and what to expect from these data to make a better clinical decision support.
Trends in treatment performed in the Phelophepa Dental Clinic: 1995-2000.
Kroon, J; Prince, E; Denicker, G A
2001-10-01
Mobile clinics are a cost-effective method of meeting the dental needs of rural communities in South Africa. Phelophepa, the first primary health care train of its kind world-wide, provides eye care, education, medicine, basic health care and since June 1995 dental treatment to rural communities. All services are rendered by students under supervision of qualified staff. The aim of this study was to analyse and report the data for treatment performed in the dental clinic from June 1995 to May 2000. During its first five years of operation, dental services were provided at 183 towns in all provinces except Gauteng. Of the 42,073 patients treated during this time (an average of 229.9 per town), 67.4% were adults. 71.3% of the 103,283 procedures performed were extractions, 15.7% could be classified as preventive with the remaining 13% as restorative procedures. The average value of the service provided to each patient was R218.53. The exposure of dental, dental therapy and oral hygiene students to rural areas of South Africa serves the important purpose of sensitising students to the realities of oral diseases in these communities.
Clinical governance and infection control in the United Kingdom.
Masterson, R G; Teare, E L
2001-01-01
The recent organizational changes in the NHS have at their core the concept of clinical governance. Although initially poorly defined and understood this term has now taken on a clear identity, placing quality alongside fiscal probity and corporate governance at the top of NHS priorities. Integral to clinical governance are the basic elements of clear national standards for services and treatments that are to be locally delivered through assured, monitored, high quality healthcare. It is within this framework that workers in infection control must develop their own methods of applying clinical governance. This review explores the implications that the strategy of clinical governance holds for the speciality of infection control, emphasizing the benefits its active adoption can bring and highlighting the key relevance of clinical risk management in this setting. It illustrates clinical governance as a tool to engage colleagues on a multi-disciplinary front, most particularly the crucial link to senior Trust management.
47 CFR 87.19 - Basic eligibility.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Basic eligibility. 87.19 Section 87.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Applications and Licenses § 87.19 Basic eligibility. (a) General. Foreign governments or their representatives...
42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...
Clinical skills: cardiac rhythm recognition and monitoring.
Sharman, Joanna
With technological advances, changes in provision of healthcare services and increasing pressure on critical care services, ward patients' severity of illness is ever increasing. As such, nurses need to develop their skills and knowledge to care for their client group. Competency in cardiac rhythm monitoring is beneficial to identify changes in cardiac status, assess response to treatment, diagnosis and post-surgical monitoring. This paper describes the basic anatomy and physiology of the heart and its conduction system, and explains a simple and easy to remember process of analysing cardiac rhythms (Resuscitation Council UK, 2000) that can be used in first-line assessment to assist healthcare practitioners in providing care to their patients.
Geropsychology training in a specialist geropsychology doctoral program.
Qualls, Sara Honn; Segal, Daniel L; Benight, Charles C; Kenny, Michael P
2005-01-01
The first PhD specialty program in Geropsychology that launched in fall, 2004 at CU-Colorado Springs is described. Consistent with a scientist-practitioner model, the curriculum sequence builds systematically from basic to complex knowledge and skills across the domains of scientific psychology, research methodology, general clinical, geropsychology science, and clinical geropsychology. Practicum experiences also build skills in core clinical competencies needed by geropsychologists, including assessment, psychotherapy, neuropsychological evaluations, caregiver consultation and counseling, health psychology, and outreach/prevention. Research mentoring prepares students with the skills needed to conduct independent research useful to the clinical practice of geropsychology. Challenges faced in the process of developing the program include the development of a training clinic, balancing specialty and generalized training, building a specialty culture while maintaining faculty integration, attracting faculty and students during a start-up phase, and defining an identity within the field. The mental health services center that was launched to meet training needs while addressing a services niche in the community contributes substantially to the essence of this program, and is described in some detail. Future opportunities and challenges include program funding, heavy demands of specialty training on top of generalist training, maintaining congruence between expectations of clinical and non-clinical faculty, providing interdisciplinary experience, and expansion of practicum opportunities.
42 CFR 438.802 - Basic requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 4 2011-10-01 2011-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...
42 CFR 438.802 - Basic requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 4 2013-10-01 2013-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...
42 CFR 438.802 - Basic requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 4 2012-10-01 2012-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...
42 CFR 438.802 - Basic requirements.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 4 2014-10-01 2014-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...
42 CFR 438.802 - Basic requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...
42 CFR 489.10 - Basic requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Basic requirements. 489.10 Section 489.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL General Provisions § 489.10 Basic...
42 CFR 489.10 - Basic requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 5 2011-10-01 2011-10-01 false Basic requirements. 489.10 Section 489.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL General Provisions § 489.10 Basic...
42 CFR 417.472 - Basic contract requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Basic contract requirements. 417.472 Section 417.472 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... PREPAYMENT PLANS Medicare Contract Requirements § 417.472 Basic contract requirements. (a) Submittal of...
Variation of SNOMED CT coding of clinical research concepts among coding experts.
Andrews, James E; Richesson, Rachel L; Krischer, Jeffrey
2007-01-01
To compare consistency of coding among professional SNOMED CT coders representing three commercial providers of coding services when coding clinical research concepts with SNOMED CT. A sample of clinical research questions from case report forms (CRFs) generated by the NIH-funded Rare Disease Clinical Research Network (RDCRN) were sent to three coding companies with instructions to code the core concepts using SNOMED CT. The sample consisted of 319 question/answer pairs from 15 separate studies. The companies were asked to select SNOMED CT concepts (in any form, including post-coordinated) that capture the core concept(s) reflected in the question. Also, they were asked to state their level of certainty, as well as how precise they felt their coding was. Basic frequencies were calculated to determine raw level agreement among the companies and other descriptive information. Krippendorff's alpha was used to determine a statistical measure of agreement among the coding companies for several measures (semantic, certainty, and precision). No significant level of agreement among the experts was found. There is little semantic agreement in coding of clinical research data items across coders from 3 professional coding services, even using a very liberal definition of agreement.
Effective coverage of primary care services in eight high-mortality countries
Malata, Address; Ndiaye, Youssoupha; Kruk, Margaret E
2017-01-01
Introduction Measurement of effective coverage (quality-corrected coverage) of essential health services is critical to monitoring progress towards the Sustainable Development Goal for health. We combine facility and household surveys from eight low-income and middle-income countries to examine effective coverage of maternal and child health services. Methods We developed indices of essential clinical actions for antenatal care, family planning and care for sick children from existing guidelines and used data from direct observations of clinical visits conducted in Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania and Uganda between 2007 and 2015 to measure quality of care delivered. We calculated healthcare coverage for each service from nationally representative household surveys and combined quality with utilisation estimates at the subnational level to quantify effective coverage. Results Health facility and household surveys yielded over 40 000 direct clinical observations and over 100 000 individual reports of healthcare utilisation. Coverage varied between services, with much greater use of any antenatal care than family planning or sick-child care, as well as within countries. Quality of care was poor, with few regions demonstrating more than 60% average performance of basic clinical practices in any service. Effective coverage across all eight countries averaged 28% for antenatal care, 26% for family planning and 21% for sick-child care. Coverage and quality were not strongly correlated at the subnational level; effective coverage varied by as much as 20% between regions within a country. Conclusion Effective coverage of three primary care services for women and children in eight countries was substantially lower than crude service coverage due to major deficiencies in care quality. Better performing regions can serve as examples for improvement. Systematic increases in the quality of care delivered—not just utilisation gains—will be necessary to progress towards truly beneficial universal health coverage. PMID:29632704
Communication Systems in Healthcare
Coiera, Enrico
2006-01-01
The care of patients now almost inevitably seems to involve many different individuals, all needing to share patient information and discuss their management. As a consequence there is increasing interest in, and use of, information and communication technologies to support health services. Yet, while there is significant discussion of, and investment in, information technologies, communication systems receive much less attention and the clinical adoption of even simpler services like voice-mail or electronic mail is still not commonplace in many health services. There remain enormous gaps in our broad understanding of the role of communication services in health care delivery. Laboratory medicine is perhaps even more poorly studied than many other areas, such as the interface between primary care and hospital services. Given this lack of specific information about laboratory communication services, this paper will step back and generally review the components of a communication system, including the basic concepts of a communication channel, service, device and interaction mode. The review will then try and summarise some of what is known about specific communication problems that arise across health services in the main, including the community and hospital service delivery. PMID:17077879
College clinic service quality and patient satisfaction.
Deshwal, Pankaj; Ranjan, Vini; Mittal, Geetika
2014-01-01
The purpose of this paper is to identify the service quality dimensions that play an important role in patient satisfaction in campus clinics in Delhi; assess student satisfaction with service; and suggests ways to improve areas of dissatisfaction. A questionnaire was distributed to students who had completed at least two consultations at the college clinic. Convenience sampling was used to approach respondents. The questionnaire uses modified SERVQUAL and other instruments, including original dimensions and those constructed through detailed discussions. Factor analyses, reliability tests and the Kaiser-Meyer-Olkin measure of sampling adequacy were conducted. The final sample had a total of 445 respondents. After factor analysis, the authors found that the dimensions affecting patient satisfaction are: staff professionalism; clinic staff reliability; clinic accessibility and basic facilities; tangibles; cleanliness; awareness of the clinic/diseases and how clinic staff deals with emergencies. Most students were satisfied with the professionalism of the clinic staff. More than 70 percent of the respondents reported that the clinic staff paid good attention to them. The campus clinic was deemed reliable by more than 50 percent of respondents. The students found the clinic's location convenient, with more than 50 percent supporting its location. However, there was dissatisfaction among the students regarding the tangibles of the clinic, with more than 50 percent favoring upgrading. There was satisfaction among the respondents regarding the availability of the doctor after clinic hours, but contact details for the clinic staff were not easily accessible on campus. More than 60 percent of respondents were satisfied with the cleanliness of the campus clinic. More than 50 percent felt that the campus clinic was not equipped to deal with emergencies efficiently. At the same time, 90 percent of respondents reported the availability of referral facilities in case of emergencies. The authors believe that this is the first study conducted to assess patient satisfaction in the campus clinics of engineering institutes in Delhi region. This paper provides valuable information to college clinic administrators.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Basic rules. 408.80 Section 408.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.80 Basic rules. (a...
Clinical Correlations as a Tool in Basic Science Medical Education
Klement, Brenda J.; Paulsen, Douglas F.; Wineski, Lawrence E.
2016-01-01
Clinical correlations are tools to assist students in associating basic science concepts with a medical application or disease. There are many forms of clinical correlations and many ways to use them in the classroom. Five types of clinical correlations that may be embedded within basic science courses have been identified and described. (1) Correlated examples consist of superficial clinical information or stories accompanying basic science concepts to make the information more interesting and relevant. (2) Interactive learning and demonstrations provide hands-on experiences or the demonstration of a clinical topic. (3) Specialized workshops have an application-based focus, are more specialized than typical laboratory sessions, and range in complexity from basic to advanced. (4) Small-group activities require groups of students, guided by faculty, to solve simple problems that relate basic science information to clinical topics. (5) Course-centered problem solving is a more advanced correlation activity than the others and focuses on recognition and treatment of clinical problems to promote clinical reasoning skills. Diverse teaching activities are used in basic science medical education, and those that include clinical relevance promote interest, communication, and collaboration, enhance knowledge retention, and help develop clinical reasoning skills. PMID:29349328
Exploring cognitive integration of basic science and its effect on diagnostic reasoning in novices.
Lisk, Kristina; Agur, Anne M R; Woods, Nicole N
2016-06-01
Integration of basic and clinical science knowledge is increasingly being recognized as important for practice in the health professions. The concept of 'cognitive integration' places emphasis on the value of basic science in providing critical connections to clinical signs and symptoms while accounting for the fact that clinicians may not spontaneously articulate their use of basic science knowledge in clinical reasoning. In this study we used a diagnostic justification test to explore the impact of integrated basic science instruction on novices' diagnostic reasoning process. Participants were allocated to an integrated basic science or clinical science training group. The integrated basic science group was taught the clinical features along with the underlying causal mechanisms of four musculoskeletal pathologies while the clinical science group was taught only the clinical features. Participants completed a diagnostic accuracy test immediately after initial learning, and one week later a diagnostic accuracy and justification test. The results showed that novices who learned the integrated causal mechanisms had superior diagnostic accuracy and better understanding of the relative importance of key clinical features. These findings further our understanding of cognitive integration by providing evidence of the specific changes in clinical reasoning when basic and clinical sciences are integrated during learning.
47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for equipment and installation used to receive the basic service tier. 76.923 Section 76.923 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...
A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
Tanzil, Sana; Zahidie, Aysha; Ahsan, Adeel; Kazi, Ambreen; Shaikh, Babar Tasneem
2014-06-25
Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples' Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.
A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
2014-01-01
Background Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples’ Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. Methods A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. Results There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Conclusion Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services. PMID:24965769
Information-seeking behavior of basic science researchers: implications for library services.
Haines, Laura L; Light, Jeanene; O'Malley, Donna; Delwiche, Frances A
2010-01-01
This study examined the information-seeking behaviors of basic science researchers to inform the development of customized library services. A qualitative study using semi-structured interviews was conducted on a sample of basic science researchers employed at a university medical school. The basic science researchers used a variety of information resources ranging from popular Internet search engines to highly technical databases. They generally relied on basic keyword searching, using the simplest interface of a database or search engine. They were highly collegial, interacting primarily with coworkers in their laboratories and colleagues employed at other institutions. They made little use of traditional library services and instead performed many traditional library functions internally. Although the basic science researchers expressed a positive attitude toward the library, they did not view its resources or services as integral to their work. To maximize their use by researchers, library resources must be accessible via departmental websites. Use of library services may be increased by cultivating relationships with key departmental administrative personnel. Despite their self-sufficiency, subjects expressed a desire for centralized information about ongoing research on campus and shared resources, suggesting a role for the library in creating and managing an institutional repository.
Information-seeking behavior of basic science researchers: implications for library services
Haines, Laura L.; Light, Jeanene; O'Malley, Donna; Delwiche, Frances A.
2010-01-01
Objectives: This study examined the information-seeking behaviors of basic science researchers to inform the development of customized library services. Methods: A qualitative study using semi-structured interviews was conducted on a sample of basic science researchers employed at a university medical school. Results: The basic science researchers used a variety of information resources ranging from popular Internet search engines to highly technical databases. They generally relied on basic keyword searching, using the simplest interface of a database or search engine. They were highly collegial, interacting primarily with coworkers in their laboratories and colleagues employed at other institutions. They made little use of traditional library services and instead performed many traditional library functions internally. Conclusions: Although the basic science researchers expressed a positive attitude toward the library, they did not view its resources or services as integral to their work. To maximize their use by researchers, library resources must be accessible via departmental websites. Use of library services may be increased by cultivating relationships with key departmental administrative personnel. Despite their self-sufficiency, subjects expressed a desire for centralized information about ongoing research on campus and shared resources, suggesting a role for the library in creating and managing an institutional repository. PMID:20098658
Ballestros Peña, Sendoa; Lorrio Palomino, Sergio; Ariz Zubiaur, Mónica
2012-11-01
BASICS: A Prehospital Care and Transfer Recording (PCTR) is an out-of-hospital medical recording. This paper was made to assess and compare the level of fulfillment of the basic parameters of the PCTR developed by the Life Support Units with nurses (Life Support Units with Nurse, LSUwN and without nurses (Basic Life Support Units, BLSU) from SAMUR Bilbao in 2010. A descriptive, retrospective and comparative study was performed by analysing a randomized sample of 660 PCTR (precision 3%), aiming to check the fulfillment of the basic data. 98.33% of total recordings were readable. In overall, fulfillment rate was 90.31% (CI 89.24- 97.3 71%) of all basic parameters for LSUwN PCTR and 84.81% (CI 83.56 to 86%) for BLSU. 34.1% of PCTR were completely and correctly fulfilled. The LSUwN scored significantly better (p < 0.000). There were recording failures in "date and time", "address" and "physical examination". There were differences between the recording of clinical and administrative information (88.64% vs 86.72%, p = 0.02). In order to consider a parameter has optimal, it has to reach 100% of fulfillment. If it doesn't, and its score reaches no more than 80%, it should be reviewed. In this case, the results would be considered acceptable, but the administrative items of BLSU records, and allergies in both units should be strengthened. LSUwN has obtained better scores. The need of recording clinical information must be instilled as evidence of quality care.
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.
Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali
2013-08-01
Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.
Competencies for Articulation: Electronics.
ERIC Educational Resources Information Center
Southeast Community Coll., Lincoln, NE.
Designed to help articulate vocational education student progress from one level of training to another and to employment, this electronics education guide lists competencies for soldering; performing basic operations with test equipment; servicing basic logic circuits; servicing DC power supplies; servicing solid state amplifiers; and servicing…
ERIC Educational Resources Information Center
Nielsen, Dorte Guldbrand; Gotzsche, Ole; Sonne, Ole; Eika, Berit
2012-01-01
Two major views on the relationship between basic science knowledge and clinical knowledge stand out; the Two-world view seeing basic science and clinical science as two separate knowledge bases and the encapsulated knowledge view stating that basic science knowledge plays an overt role being encapsulated in the clinical knowledge. However, resent…
2010-01-01
Background In Switzerland, General Practitioners (GPs) play an important role for out-of-hours emergency care as one service option beside freely accessible and costly emergency departments of hospitals. The aim of this study was to evaluate the services provided and the economic consequences of a Swiss GP out-of-hours service. Methods GPs participating in the out-of-hours service in the city of Zurich collected data on medical problems (ICPC coding), mode of contact, mode of resource use and services provided (time units; diagnostics; treatments). From a health care insurance perspective, we assessed the association between total costs and its two components (basic costs: charges for time units and emergency surcharge; individual costs: charges for clinical examination, diagnostics and treatment in the discretion of the GP). Results 125 GPs collected data on 685 patient contacts. The most prevalent health problems were of respiratory (24%), musculoskeletal (13%) and digestive origin (12%). Home visits (61%) were the most common contact mode, followed by practice (25%) and telephone contacts (14%). 82% of patients could be treated by ambulatory care. In 20% of patients additional technical diagnostics, most often laboratory tests, were used. The mean total costs for one emergency patient contact were €144 (95%-CI: 137-151). The mode of contact was an important determinant of total costs (mean total costs for home visits: €176 [95%-CI: 168-184]; practice contact: €90 [95%-CI: 84-98]; telephone contact: €48 [95%-CI: 40-55]). Basic costs contributed 83% of total costs for home visits and 70% of total costs for practice contacts. Individual mean costs were similarly low for home visits (€30) and practice contacts (€27). Medical problems had no relevant influence on this cost pattern. Conclusions GPs managed most emergency demand in their out-of-hours service by ambulatory care. They applied little diagnostic testing and basic care. Our findings are of relevance for policy makers even from other countries with different pricing policies. Policy makers should be interested in a reimbursement system promoting out-of-hours care run by GPs as one valuable service option. PMID:21171989
A Little Bit Can Go a Long Way: An Examination of Required Service in the Basic Communication Course
ERIC Educational Resources Information Center
McIntyre, Kristen A.; Sellnow, Deanna D.
2014-01-01
This study examines the utility of service-learning pedagogy in the general education basic communication course to meet service-learning outcomes, with an emphasis on civic engagement. Results of the data suggest that students in both a one-time service site and multiple-site condition indicated that the service experience enhanced three of the…
PCS subscriber profile data and information requirements
NASA Astrophysics Data System (ADS)
Schumacher, Gregory D.
1996-01-01
Enhanced services for mobile subscribers are currently undergoing significant growth. This growth will continue to increase as more wireless serviceproviders enter the marketplace. Profit margins for basic service will fall as competition increases leading to interest in higher margin enhanced services. Likewise subscribers will demand enhanced services to further increase productivity over basic wire service. However there are limitations in today's network infrastructure defined by inter-system interface standards such as IS-41, GSM and WACS. These network limitations prevent enhanced services from being offered in the seamless and geographically ubiquitous fashion subscribers are familiar with in basic wireless service. This paper examines what are the needs of wireless enhanced services to be provided as subscribers want them. This paper then looks at the major inter-system interfaces available for mobility and call control in terms of how well these enhanced service needs are fulfilled.
Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert
2008-01-01
The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd
Moran, Anna M; Nancarrow, Susan A; Wiseman, Leah; Maher, Kerryn; Boyce, Rosalie A; Borthwick, Alan M; Murphy, Karen
2012-11-27
Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly met the needs of the practitioners with whom they worked. However, the resource intensiveness of the traineeship model was acknowledged by most who participated in the programme. This research has demonstrated that the implementation of a PA using a traineeship approach requires good coordination and communication with a number of agencies and staff and substantial resources to support training and supervision. There are added benefits of the new role to the podiatry service in terms of regaining control over podiatric services which was perceived to improve clinical governance and patient pathways.
2012-01-01
Background Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a ‘trainee’ approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. Method A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Results Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly met the needs of the practitioners with whom they worked. However, the resource intensiveness of the traineeship model was acknowledged by most who participated in the programme. Conclusions This research has demonstrated that the implementation of a PA using a traineeship approach requires good coordination and communication with a number of agencies and staff and substantial resources to support training and supervision. There are added benefits of the new role to the podiatry service in terms of regaining control over podiatric services which was perceived to improve clinical governance and patient pathways. PMID:23181834
Skinner, Sarah
2013-11-01
General practitioners (GPs) are expected to be allowed to request MRI scans for adults for selected clinically appropriate indications from November 2013 as part of the expansion of Medicare-funded MRI services announced by the Federal Government in 2011. This article aims to give a brief overview of MRI brain imaging relevant to GPs, which will facilitate explanation of scan findings and management planning with their patients. Basic imaging techniques, common findings and terminology are presented using some illustrative case examples.
China launched a pilot project to improve its rare disease healthcare levels.
Cui, Yazhou; Zhou, Xiaoyan; Han, Jinxiang
2014-01-27
China is facing the great challenge of serving the world's largest rare disease population. It is necessary to develop a specific medical plan to increase the levels of optimal prevention, diagnosis and treatment of rare diseases under the existing clinical service structures in China. In 2013, China launched its first pilot project focused on 20 representative rare diseases. A national network including approximately 100 provincial or municipal medical centers has been established to enable collaboration on rare diseases across China. The main objectives for this project are to develop and apply medical guidelines and clinical pathways for rare diseases, to establish a rare disease patient registry and data repository system, and to promote molecular testing for rare genetic disorders. This project also emphasizes building close links among the collaborative network, clinicians on the frontlines in basic medical services institutions and rare disease patient organizations. Primarily, this project expects to develop an actionable medical services plan to increase the delivery of quality healthcare for individuals and families living with rare diseases in China within five years.
5 CFR 531.406 - Creditable service.
Code of Federal Regulations, 2010 CFR
2010-01-01
... pay is equal to or greater than the rate of basic pay for step 4 of the applicable grade and less than... period for an employee whose rate of basic pay is equal to or greater than the rate of basic pay for step....406 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER THE...
25 CFR 36.97 - What basic requirements must a program's health services meet?
Code of Federal Regulations, 2011 CFR
2011-04-01
... 25 Indians 1 2011-04-01 2011-04-01 false What basic requirements must a program's health services meet? 36.97 Section 36.97 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY...
25 CFR 36.97 - What basic requirements must a program's health services meet?
Code of Federal Regulations, 2014 CFR
2014-04-01
... 25 Indians 1 2014-04-01 2014-04-01 false What basic requirements must a program's health services meet? 36.97 Section 36.97 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY...
25 CFR 36.97 - What basic requirements must a program's health services meet?
Code of Federal Regulations, 2012 CFR
2012-04-01
... 25 Indians 1 2012-04-01 2011-04-01 true What basic requirements must a program's health services meet? 36.97 Section 36.97 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-09
...-126] Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics... between consumer electronics equipment (such as digital television sets) and newly encrypted cable service... Act''), Congress sought to make sure that consumer electronics equipment could receive cable...
... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...
Slavkin, Harold C
2017-09-01
Scientific inquiry and discovery are the fuel for education, research, technology, and health care in all the health professions: dentistry, medicine, nursing, pharmacy, and allied health sciences. The progression of discoveries from basic or fundamental to clinical research is followed by the progression from clinical to implementation and improved health outcomes and processes. Generally, implementation science is the scientific study of methods to promote the systematic uptake of research findings (e.g., basic, translational, behavioral, socioeconomic, and clinical) as well as other related evidence-based practices into standards of care, thereby improving the quality, effectiveness, and cost benefits of health care services. There is little doubt that science has and will continue to provide the essential fuel for innovations that lead to new and improved technologies for risk assessment, prevention, diagnosis, treatments and therapeutics, and implementation for addressing oral and craniofacial diseases and disorders. The history of the U.S. dental profession reviewed in this article gives testimony to the continued need for investments in scientific inquiry that accelerate progress in comprehensive health care for all people. This article was written as part of the project "Advancing Dental Education in the 21 st Century."
Awaken to the World of Food Service; Commercial Cooking and Baking--Basic: 9193.01.
ERIC Educational Resources Information Center
Dade County Public Schools, Miami, FL.
This course outline has been prepared as a guide for the tenth grade student in commercial cooking and baking or food management, production, and services. It provides basic experiences in the field of commercial food service, the hotel and restaurant industry and types of food service establishments. The course consists of 90 clock hours, covered…
Stroupe, Kevin T; Stelmack, Joan A; Tang, X Charlene; Wei, Yongliang; Sayers, Scott; Reda, Domenic J; Kwon, Ellen; Massof, Robert W
2018-05-01
Examining costs and consequences of different low-vision (LV) programs provides important information about resources needed to expand treatment options efficiently. To examine the costs and consequences of LV rehabilitation or basic LV services. The US Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) II was conducted from September 27, 2010, to July 31, 2014, at 9 VA facilities and included 323 veterans with macular diseases and a best-corrected distance visual acuity of 20/50 to 20/200. Veterans were randomized to receive basic LV services that provided LV devices without therapy, or LV rehabilitation that added a therapist to LV services who provided instruction and homework on using LV devices, eccentric viewing, and environmental modification. We compared costs and consequences between these groups. Low-vision devices without therapy and LV devices with therapy. Costs of providing basic LV services or LV rehabilitation were assessed. We measured consequences as changes in functional visual ability from baseline to follow-up 4 months after randomization using the VA Low Vision Visual Functioning Questionnaire. Visual ability was measured in dimensionless log odds units (logits). Of 323 randomized patients, the mean (SD) age was 80 (10.5) years, 314 (97.2%) were men, and 292 (90.4%) were white. One hundred sixty (49.5%) received basic LV services and 163 (50.1%) received LV rehabilitation. The mean (SD) total direct health care costs per patient were similar between patients who were randomized to receive basic LV services ($1662 [$671]) or LV rehabilitation ($1788 [$864]) (basic LV services, $126 lower; 95% CI, $299 lower to $35 higher; P = .15). However, basic LV services required less time and had lower transportation costs. Patients receiving LV rehabilitation had greater improvements in overall visual ability, reading ability, visual information processing, and visual motor skill scores.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Qualified Health Maintenance Organizations: Services § 417.106 Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. (a) Quality assurance program. Each HMO or CMP must have an ongoing quality assurance program for its health services that meets the...
47 CFR 69.157 - Line port costs in excess of basic, analog service.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Line port costs in excess of basic, analog service. 69.157 Section 69.157 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges for Price Cap Local Exchange Carriers...
42 CFR 417.103 - Providers of basic and supplemental health services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... mental health centers, home health agencies, visiting nurses' associations, independent laboratories, or... 42 Public Health 3 2010-10-01 2010-10-01 false Providers of basic and supplemental health services. 417.103 Section 417.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...
Terrorism-related risk management for health care facilities.
Reid, Daniel J; Reid, William H
2005-01-01
Clinicians should have a basic understanding of the physical and financial risk to mental health facilities related to external threat, such as (but not necessarily limited to) terrorism. Patient care and accessibility to mental health services rest not only on clinical skills, but on a place to practice them and an organized system supported by staff, physical facilities and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or serving at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state, and national standards for hospital safety, or insurance providers' individual facility requirements.
Majuru, Batsirai; Jagals, Paul; Hunter, Paul R
2012-10-01
Although a number of studies have reported on water supply improvements, few have simultaneously taken into account the reliability of the water services. The study aimed to assess whether upgrading water supply systems in small rural communities improved access, availability and potability of water by assessing the water services against selected benchmarks from the World Health Organisation and South African Department of Water Affairs, and to determine the impact of unreliability on the services. These benchmarks were applied in three rural communities in Limpopo, South Africa where rudimentary water supply services were being upgraded to basic services. Data were collected through structured interviews, observations and measurement, and multi-level linear regression models were used to assess the impact of water service upgrades on key outcome measures of distance to source, daily per capita water quantity and Escherichia coli count. When the basic system was operational, 72% of households met the minimum benchmarks for distance and water quantity, but only 8% met both enhanced benchmarks. During non-operational periods of the basic service, daily per capita water consumption decreased by 5.19l (p<0.001, 95% CI 4.06-6.31) and distances to water sources were 639 m further (p ≤ 0.001, 95% CI 560-718). Although both rudimentary and basic systems delivered water that met potability criteria at the sources, the quality of stored water sampled in the home was still unacceptable throughout the various service levels. These results show that basic water services can make substantial improvements to water access, availability, potability, but only if such services are reliable. Copyright © 2012 Elsevier B.V. All rights reserved.
Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
2018-01-01
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.
Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
2018-01-01
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470
Qadri, Syed M; Donkor, David A; Yan, Matthew; Ning, Shuoyan; Branch, Donald R; Seghatchian, Jerard; Sheffield, William P
2018-04-01
Canadian Blood Services (CBS), Canada's national blood transfusion service, has for many years sponsored an annual conference, for the education and awareness of interested participants, showcasing the latest evidence-based understanding of both basic science and clinical issues in transfusion medicine and science. The 15th iteration of this symposium took place September 9, 2017 and focused on some of the vital aspects of red blood cells (RBC), in line with the" 3Rs" concept, namely the provision of the Right red blood cell (RBC) product to the Right patient at the Right time. Presentations touched upon: the evolution of blood banking in North America; the monocyte monolayer assay as a predictor of post-transfusion hemolysis; hemoglobin-based oxygen carriers; RBC alloimmunization; serological approaches to complex RBC antibody problems; randomized clinical trials related to the age of stored RBC; RBC genotyping; pathophysiology, prevention and treatment of hemolytic disease of the fetus and newborn (HDFN); and testing and timing in perinatal serology. This commentary provides summaries of all speakers' presentations annotated with relevant references. Special thanks are due to all contributors for their praiseworthy approaches in sharing their experiences and knowledge on this interesting scientific/clinical and management theme. Copyright © 2018 Elsevier Ltd. All rights reserved.
WE-B-BRD-01: Innovation in Radiation Therapy Planning II: Cloud Computing in RT
DOE Office of Scientific and Technical Information (OSTI.GOV)
Moore, K; Kagadis, G; Xing, L
As defined by the National Institute of Standards and Technology, cloud computing is “a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction.” Despite the omnipresent role of computers in radiotherapy, cloud computing has yet to achieve widespread adoption in clinical or research applications, though the transition to such “on-demand” access is underway. As this transition proceeds, new opportunities for aggregate studies and efficient use of computational resources are set againstmore » new challenges in patient privacy protection, data integrity, and management of clinical informatics systems. In this Session, current and future applications of cloud computing and distributed computational resources will be discussed in the context of medical imaging, radiotherapy research, and clinical radiation oncology applications. Learning Objectives: Understand basic concepts of cloud computing. Understand how cloud computing could be used for medical imaging applications. Understand how cloud computing could be employed for radiotherapy research.4. Understand how clinical radiotherapy software applications would function in the cloud.« less
Project L'Ouverture, 1981-1982. O.E.E. Final Evaluation Report.
ERIC Educational Resources Information Center
Keane, Demetra Nicolau; And Others
Originally proposed as a supplement to basic bilingual programs for Haitian students in three New York City high schools, Project L'Ouverture changed its focus to the development and reinforcement of basic skills. In response to a need for basic bilingual services not available in participating schools, the project provided tutorial services to…
Police Traffic Services Basic Training Program. Student Study Guide. Volume 3 of 3.
ERIC Educational Resources Information Center
Hale, Allen; Hamilton, John W.
As part of the basic training program in police traffic services intended to establish a national standard, the student study guide was developed to serve as a basic reference text to reinforce and supplement the subject material presented in class. The document consists of the six following major sections: (1) background for policy traffic…
Writing Partners: Service Learning as a Route to Authority for Basic Writers
ERIC Educational Resources Information Center
Gabor, Catherine
2009-01-01
This article looks at best practices in basic writing instruction in terms of non-traditional audiences and writerly authority. Much conventional wisdom discourages participation in service-learning projects for basic writers because of the assumption that their writing is not yet ready to "go public." Countering this line of thinking, the author…
Community-based, Experiential Learning for Second Year Neuroscience Undergraduates
Yu, Heather J.; Ramos-Goyette, Sharon; McCoy, John G.; Tirrell, Michael E.
2013-01-01
Service learning is becoming a keystone of the undergraduate learning experience. At Stonehill College, we implemented a service learning course, called a Learning Community, in Neuroscience. This course was created to complement the basic research available to Stonehill Neuroscience majors with experience in a more applied and “clinical” setting. The Neuroscience Learning Community is designed to promote a deep understanding of Neuroscience by combining traditional classroom instruction with clinical perspectives and real-life experiences. This Neuroscience Learning Community helps students translate abstract concepts within the context of neurodevelopment by providing students with contextual experience in a real-life, unscripted setting. The experiential learning outside of the classroom enabled students to participate in informed discussions in the classroom, especially with regard to neurodevelopmental disorders. We believe that all students taking this course gain an understanding of the importance of basic and applied Neuroscience as it relates to the individual and the community. Students also have used this concrete, learning-by-doing experience to make informed decisions about career paths and choice of major. PMID:24319392
Schilling, R B
1993-05-01
Picture archiving and communication systems (PACS) provide image viewing at diagnostic, reporting, consultation, and remote workstations; archival on magnetic or optical media by means of short- or long-term storage devices; communications by means of local or wide area networks or public communication services; and integrated systems with modality interfaces and gateways to health care facilities and departmental information systems. Research indicates three basic needs for image and report management: (a) improved communication and turnaround time between radiologists and other imaging specialists and referring physicians, (b) fast reliable access to both current and previously obtained images and reports, and (c) space-efficient archival support. Although PACS considerations are much more complex than those associated with single modalities, the same basic purchase criteria apply. These criteria include technical leadership, image quality, throughput, life cost (eg, initial cost, maintenance, upgrades, and depreciation), and total service. Because a PACS takes much longer to implement than a single modality, the customer and manufacturer must develop a closer working relationship than has been necessary in the past.
[Education and training in neurology: update].
Yanagisawa, Nobuo
2010-11-01
Progress in basic neurosciences and advances in technology in the last decades have contributed to clarification of neural mechanisms in behavior or cognition in health and disease. They have elaborated diagnosis and treatment of nervous diseases remarkably. Needs in neurologists in both primary and specific medical services are rapidly increasing, with aging society and progresses in medical care in Japan. Attraction of neurology for students and junior residents is a great concern of Japanese Society of Neurology. In the undergraduate education, recent achievement in basic neurosciences including neurogenetics, molecular cytology, physio-pathology and imaging technique should be taught comprehensively. In the early postgraduate course for two years, neurology is either elective or obligatory depending on the curriculum of training institutions. Work at the stroke care unit is strongly recommended in the course of emergency service, which is mandatory. Experiences in acute infectious diseases, in various stages of neurodegenerative diseases, in collaboration with other specialist doctors for systemic diseases including metabolic or collagen diseases, in collaboration with other medical personnel in care of dementia are all included in advanced stages of postgraduate education before board examination. In summary, studies for practical services as well as clinical researches, teaching of symptoms and signs based on neural functions, and socio-economical issues for chronic nervous diseases in aged society are important in the education in neurology.
Rebuilding health systems in post-conflict countries: estimating the costs of basic services.
Newbrander, William; Yoder, Richard; Debevoise, Anne Bilby
2007-01-01
After the fall of the Taliban in 2001, the Afghan transitional government and international donors found the health system near collapse. Afghanistan had some of the worst health indicators ever recorded. To begin activities that would quickly improve the health situation, the Ministry of Health (MOH) needed both a national package of health services and reliable data on the costs of providing those services. This study details the process of determining national health priorities, creating a basic package of services, and estimating per capita and unit costs for providing those services, with an emphasis on the costing exercise. Strategies for obtaining a rapid yet reasonably accurate estimate of health service costs nationwide are discussed. In 2002 this costing exercise indicated that the basic package of services could be provided for US dollars 4.55 per person. In 2006, the findings were validated: the four major donors who contracted with non-governmental organizations (NGOs) to provide basic health services for nearly 80% of the population found per capita costs ranging from dollars 4.30 to dollars 5.12. This study is relevant for other post-conflict countries that are re-establishing health services and seeking to develop cost-effective and equitable health systems. Copyright (c) 2007 John Wiley & Sons, Ltd.
Neonatal records and the computer.
Walker, C H
1977-01-01
To use a combined single document clinical case sheet/computer record which can form the basic document for a life medical record is a practical proposition. With adequate briefing doctors and nurses soon become familiar with the record and appreciate its value. Secretarial and clerical requirements are reduced to a minimum as transcription of medical data is eliminated, so greatly speeding up processing and feed back to the medical services. A few illustrations of trends in neonatal statistics and of computer linked maternal/neonatal data are presented. PMID:879830
5 CFR 1604.6 - Error correction.
Code of Federal Regulations, 2010 CFR
2010-01-01
... a service member requesting that a TSP contribution be deducted from bonus pay. Within 30 days of... times the number of months it would take for the service member to earn basic pay equal to the dollar... less than twice the number of months it would take for the service member to earn basic pay equal to...
Pre-Service Teachers' Mental Models of Basic Astronomy Concepts
ERIC Educational Resources Information Center
Arslan, A. Saglam; Durikan, U.
2016-01-01
The aim of the present study is to determine pre-service teachers' mental models related to basic astronomy concepts. The study was conducted using a survey method with 293 pre-service teachers from 4 different departments; physics education, science education, primary teacher education and early childhood education. An achievement test with…
25 CFR 36.97 - What basic requirements must a program's health services meet?
Code of Federal Regulations, 2013 CFR
2013-04-01
... the BIE and the Indian Health Service or between a tribally-operated homeliving program and the Indian Health Service or tribal health program. (b) A homeliving program must have written procedures for... MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY...
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Commission review of franchising authority... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.944 Commission review of franchising authority... forum for appeals of decisions by franchising authorities on rates for the basic service tier or...
Heitmann, Ryan J; Hammons, Crystal B; Batig, Alison L
2017-07-01
Women comprise 14.5% of active duty service members. Delivery of women's health services is a critical component to personal, medical, and mission readiness. Our objective was to evaluate the knowledge, skills, and practices pertaining to basic elements of women's/reproductive health issues among transitional internship-trained general medical officers in the Army, Navy, and Air Force. This is a cross-sectional survey study of transitional internship-trained graduates from 2012 to 2015 who transitioned to an operational assignment as an independent provider after internship graduation. The study involved an anonymous 21-question survey evaluating aspects of knowledge and practice related to basic reproductive health care services (contraceptive provision, cervical cancer, and chlamydia screening). Thirty-four of 62 (55%) eligible physicians completed the survey. The majority (85%) of respondents were male; 71% practiced at troop or unit-based clinic outside a hospital setting. Among the respondents, 97% cared for female service members within their patient population; one respondent (3%) reported no female service members in their patient population. Most respondents (82%) reported provision of contraceptive services to female patients of reproductive age. The copper intrauterine device (IUD) was least comfortably discussed. Less than half of the respondents were trained to place either the copper or levonorgestrel IUD or the etonogestrel contraceptive implant. Seventy-six percent of respondents performed cervical cancer screening and 79% performed chlamydia screening in their female patient population. Among the respondents, 15% did not offer cervical cancer and 12% did not offer chlamydia screening in their practice. Eighty-eight percent of the respondents correctly identified the recommended age at which to begin cervical cancer screening and 64% correctly identified the aged-based recommendation and interval to screen for chlamydia. Our survey conveyed that the majority of respondents were comfortable discussing self-administered methods (combined contraceptives); fewer were comfortable discussing or had training to place the more efficacious, longer-acting methods. Although screening services specific to female health are offered, the uniform provision of these basic services appears to be inconsistent among our surveyed population of first-line health care providers. Our study identifies potential areas for refinement in transitional year medical training that could translate to enhanced female medical and mission readiness. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
Do Racial and Gender Disparities Exist in Newer Glaucoma Treatments?
... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...
A critical narrative review of transfer of basic science knowledge in health professions education.
Castillo, Jean-Marie; Park, Yoon Soo; Harris, Ilene; Cheung, Jeffrey J H; Sood, Lonika; Clark, Maureen D; Kulasegaram, Kulamakan; Brydges, Ryan; Norman, Geoffrey; Woods, Nicole
2018-06-01
'Transfer' is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies. A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a 'transfer out'/'transfer in' conceptual framework. 'Transfer out' refers to the application of knowledge developed in one learning situation to the solving of a new problem. 'Transfer in' refers to the use of previously acquired knowledge to learn from new problems or learning situations. Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored 'transfer out' to clinical reasoning and 7% (one article) explored 'transfer in'. Measures of 'transfer out' fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning - 'transfer in' - of new related content and ultimately the 'transfer out' to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning. Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method
Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali
2013-01-01
Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities. PMID:24578831
ERIC Educational Resources Information Center
DiLullo, Camille; Morris, Harry J.; Kriebel, Richard M.
2009-01-01
Understanding the relevance of basic science knowledge in the determination of patient assessment, diagnosis, and treatment is critical to good medical practice. One method often used to direct students in the fundamental process of integrating basic science and clinical information is problem-based learning (PBL). The faculty facilitated small…
ERIC Educational Resources Information Center
Rose, Pauline
2007-01-01
Basic education is commonly regarded as a state responsibility. However, in reality, non-state providers (NSPs) have always been involved in basic education service delivery, and there is often a blurring of boundaries between state and non-state roles with respect to financing, ownership, management, and regulation. In recent years, the focus on…
Lofthus, Ann-Mari; Westerlund, Heidi; Bjørgen, Dagfinn; Lindstrøm, Jonas Christoffer; Lauveng, Arnhild; Rose, Diana; Ruud, Torleif; Heiervang, Kristin
2018-02-01
Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open-ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the "Users interview users" method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society. © 2016 Australian College of Mental Health Nurses Inc.
Physician perceptions of the role and value of basic science knowledge in daily clinical practice.
Fischer, Jennifer A; Muller-Weeks, Susan
2012-01-01
The role of basic science education in a clinical setting remains unclear. Research to understand how academic clinicians perceive and use this part of their education can aid curricular development. To assess physician's attitudes toward the value of science knowledge in their clinical practice. Academic physicians from three medical schools completed a questionnaire about the utility of basic science education in core clinical tasks and in practice-based learning and improvement. A total of 109 clinical faculty returned the survey. Overall, 89% of the respondents indicated that basic science education is valuable to their clinical practice. When asked about the utility of basic science information in relation to direct patient care, greater than 50% of the doctors felt they use this when diagnosing and communicating with patients. This rose to greater than 60% when asked about choosing treatment options for their patients. Individuals also responded that basic science knowledge is valuable when developing evidence-based best practices. Specifically, 89% felt that they draw upon this information when training students/residents and 84% use this information when reading journal articles. This study shows that basic science education is perceived by responding academic physicians to be important to their clinical work.
Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.
Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek
2015-09-01
Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.
[Realization of design regarding experimental research in the clinical real-world research].
He, Q; Shi, J P
2018-04-10
Real world study (RWS), a further verification and supplement for explanatory randomized controlled trial to evaluate the effectiveness of intervention measures in real clinical environment, has increasingly become the focus in the field of research on medical and health care services. However, some people mistakenly equate real world study with observational research, and argue that intervention and randomization cannot be carried out in real world study. In fact, both observational and experimental design are the basic designs in real world study, while the latter usually refers to pragmatic randomized controlled trial and registry-based randomized controlled trial. Other nonrandomized controlled and adaptive designs can also be adopted in the RWS.
Guex, Patrice; Conus, Philippe; Pomini, Valentino; Kramer, Ueli; Bonsack, Charles; Eap, Chin
2011-01-19
The novelties in clinical psychiatry are close to somatic medicine adaptation. The clinical staging concept in psychiatry (as in cancerology) is the result of an early intervention strategy in psychotic disorders. A differentiated mode of understanding of the phases of psychiatric disorders allows a prevention oriented approach. Individualized therapeutic programmes in accordance with specific problematics favors the orientation towards focalised follow-ups, for instance CBT programmes on Internet may be proposed to patients motivated and rather autonomous. Others, on the contrary, less accessible to health care should benefit of the support of a mobile team and specific coaching to return to vocational services. Systematic follow-up of the metabolic syndrome, often induced by atypical antipsychotics, belongs to those basic adjustment processes.
Padwa, Howard; Urada, Darren; Gauthier, Patrick; Rieckmann, Traci; Hurley, Brian; Crèvecouer-MacPhail, Desirée; Rawson, Richard A
2016-10-01
Historically, publicly funded substance use disorder (SUD) treatment services in the United States have been disorganized and inefficient. By reconfiguring and linking services to create systems of care-services, structures, and processes that are purposively interconnected to treat SUD systematically-health systems can transform discrete service components into cohesive service systems that comprehensively and efficiently treat SUDs. In this article we: (1) articulate the potential benefits of organizing publicly funded SUD services into systems of care; (2) review basic principles underlying theories of SUD system organization; (3) describe the mix and configuration of services needed to create comprehensive, integrated systems of publicly funded SUD care; (4) elucidate how patients can flow through systems of SUD services in a clinically sound and cost-efficient manner, and; (5) propose eight steps that can be taken to create systems of care by identifying and leveraging the strengths, assets, and capacities of SUD service providers already operating within their health care systems. In July 2015, the Centers for Medicare and Medicaid Services (CMS) announced opportunities for states to redesign their Medicaid-funded SUD service systems. This paper provides considerations for SUD system design and development. Copyright © 2016 Elsevier Inc. All rights reserved.
Using Video Games to Support Pre-Service Elementary Teachers Learning of Basic Physics Principles
ERIC Educational Resources Information Center
Anderson, Janice; Barnett, Michael
2011-01-01
The purpose of this work is to share our findings in using video gaming technology to facilitate the understanding of basic electromagnetism with pre-service elementary teachers. To this end we explored the impact of using a game called "Supercharged!" on pre-service teachers' understanding of electromagnetic concepts compared to students who…
ERIC Educational Resources Information Center
Berney, Tomi D.; Carey, Cecilia
The Bilingual Academic Services and Integrated Career Systems Program (Project BASICS) is a federally-funded program of instructional and support services provided to 122 students at a Queens high school. The program's aim was to develop English literacy skills and appreciation of cultural diversity, and to prepare students for the psychosocial…
Determinants of Demand in the Public Dental Emergency Service.
Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N
2017-02-01
Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.
Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang
2014-01-01
Background Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Methods Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Conclusion Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. PMID:24740282
Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang
2014-01-01
Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.
Krause, Sandra; Williams, Holly; Onyango, Monica A; Sami, Samira; Doedens, Wilma; Giga, Noreen; Stone, Erin; Tomczyk, Barbara
2015-01-01
The Minimum Initial Services Package (MISP) for reproductive health, a standard of care in humanitarian emergencies, is a coordinated set of priority activities developed to prevent excess morbidity and mortality, particularly among women and girls, which should be implemented at the onset of an emergency. The purpose of the evaluation was to determine the status of MISP implementation for Syrian refugees in Jordan as part of a global evaluation of reproductive health in crises. In March 2013, applying a formative evaluation approach 11 key informant interviews, 13 health facility assessments, and focus group discussions (14 groups; 159 participants) were conducted in two Syrian refugee sites in Jordan, Zaatri Camp, and Irbid City, respectively. Information was coded, themes were identified, and relationships between data explored. Lead health agencies addressed the MISP by securing funding and supplies and establishing reproductive health focal points, services and coordination mechanisms. However, Irbid City was less likely to be included in coordination activities and health facilities reported challenges in human resource capacity. Access to clinical management of rape survivors was limited, and both women and service provider's knowledge about availability of these services was low. Activities to reduce the transmission of HIV and to prevent excess maternal and newborn morbidity and mortality were available, although some interventions needed strengthening. Some planning for comprehensive reproductive health services, including health indicator collection, was delayed. Contraceptives were available to meet demand. Syndromic treatment of sexually transmitted infections and antiretrovirals for continuing users were not available. In general refugee women and adolescent girls perceived clinical services negatively and complained about the lack of basic necessities. MISP services and key elements to support implementation were largely in place. Pre-existing Jordanian health infrastructure, prior MISP trainings, dedicated leadership and available funding and supplies facilitated MISP implementation. The lack of a national protocol on clinical management of rape survivors hindered provision of these services, while communities' lack of information about the health benefits of the services as well as perceived cultural repercussions likely contributed to no recent service uptake from survivors. This information can inform MISP programming in this setting.
5 CFR 531.405 - Waiting periods for within-grade increase.
Code of Federal Regulations, 2011 CFR
2011-01-01
... step 4-260 days of creditable service in a pay status over a period of not less than 52 calendar weeks... step 4-52 calendar weeks of creditable service; (ii) Rate of basic pay equal to or greater than the rate of basic pay at step 4 and less than the rate of basic pay at step 7-104 calendar weeks of...
Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal
2007-01-01
In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.
Li, Zhijian; Hou, Jiale; Lu, Lin; Tang, Shenglan; Ma, Jin
2012-01-01
Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents' satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents' satisfaction. Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1) the health insurance system; 2) essential drugs; 3) basic clinical services; and 4) public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied) and the public health/preventive services (average score=3.62); but less satisfied with the provision of essential drugs (average score=3.20) and health insurance schemes (average score=3.23). The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes) had overall poorer satisfaction levels on these four aspects of health care (P<0.01). 25.39% of the respondents thought that their financial burden had increased and 38.49% thought that drugs had become more expensive. The respondents showed more satisfaction with the clinical services (average score=3.79) and public health services/interventions (average score=3.79); and less satisfaction with the health insurance system (average score=3.23) and the essential drug system (average score=3.20). Disadvantaged groups showed lower satisfaction levels overall relative to non-disadvantaged groups.
10 Tips to Reduce Your Chance of Losing Vision from the Most Common Cause of Blindness
... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...
47 CFR 87.19 - Basic eligibility.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Applications and Licenses § 87.19 Basic eligibility. (a) General. Foreign governments or their representatives cannot hold station licenses. (b) Aeronautical enroute and aeronautical fixed stations. The following...
Finger, W R
1991-06-01
The sexually transmitted disease (STD) program in Udorn, a popular Thai tourist city, has worked closely with 750 prostitutes for 15 years, incorporating the concerns of brothel managers and prostitutes into service delivery. The program in Udorn is part of a nationwide network of STD clinics. The level of person-to-person interaction was increased once it was determined by 1989 that HIV had infected 6% of prostitutes in the city's brothels. Outreach educators were recruited and trained to ensure that all prostitutes in Udorn had the basic facts about HIV and AIDS. Over the last 2 years, the STD program has trained outreach educators to work in 8 brothels, started a local AIDS prevention foundation supported by local businessmen, and taken other steps to incorporate AIDS prevention into its clinic structure. Such clinic-based programs are an important way of targeting groups at high risk of HIV transmission.
Education Research: Neurology training reassessed
Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John
2012-01-01
Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077
Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John
2012-10-23
To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.
ERIC Educational Resources Information Center
Fassett, William E.; Campbell, William H.
1984-01-01
A comparison of Basic Pharmaceutical Sciences Examination (BPSE) results with student performance evaluations in core clerkships, institutional and community externships, didactic and clinical courses, and related basic science coursework revealed the BPSE does not predict student performance during clinical instruction. (MSE)
Neuropsychological Practice in the Oncology Setting.
Noll, Kyle R; Bradshaw, Mariana E; Rexer, Jennie; Wefel, Jeffrey S
2018-05-01
Oncology has experienced positive shifts in survival curves for many cancers largely due to the development of earlier diagnostics and better therapeutics. This has increased the visibility and need for survivorship services, including clinical neuropsychology. Patients with cancer frequently experience cognitive dysfunction related to the presence of cancer itself and treatment neurotoxicity. These cognitive difficulties can profoundly impact patient functioning and autonomy with accompanying declines in quality of life. Clinical neuropsychologists are uniquely positioned to evaluate the cognitive and affective sequelae of cancer and treatment and provide interventions and recommendations that can benefit well-being and potentially alter the disease course. Despite increasing recognition of the importance of neuropsychological issues to cancer survivorship, many neuropsychologists have limited training and guidance regarding navigating and implementing services within the oncology setting. This article provides the basic rationale for neuropsychological practice and research activities in oncology, as well as the experience of the Section of Neuropsychology at The University of Texas MD Anderson Cancer Center.
Trends in acute mental health care: comparing psychiatric and substance abuse treatment programs.
Timko, Christine; Lesar, Michelle; Calvi, Noël J; Moos, Rudolf H
2003-01-01
This study compared psychiatric and substance abuse acute care programs, within both inpatient and residential modalities of care, on organization and staffing, clinical management practices and policies, and services and activities. A total of 412 (95% of those eligible) Department of Veterans Affairs' programs were surveyed nationwide. Some 40% to 50% of patients in psychiatric and substance abuse programs, in both inpatient and residential venues of care, had dual diagnoses. Even though psychiatric programs had a sicker patient population, they provided fewer services, including basic components of integrated programs, than substance abuse programs did. Findings also showed that there is a strong emphasis on the use of clinical practice guidelines, performance monitoring, and obtaining client satisfaction and outcome data in mental health programs. The author's suggest how psychiatric programs might better meet the needs of acutely ill and dually diagnosed patients (e.g., by incorporating former patients as role models and mutual help groups, as substance abuse programs do; and by having policies that balance patient choice with program demand).
[Functional deterioration of basic daily living activities after an emergency service consultation].
Gutiérrez Rodríguez, J; Varela Suárez, C; Alonso Alvarez, M; Solano Jaurrieta, J J
2000-05-01
To determine the incidence of functional decline of elderly patients discharged from an emergency department and to analized functional impairment as a risk of readmission. A prospective cohort aged 75 or older were followed up after discharge from an emergency department between 01-02-95 and 01-04-95. The study protocol included sociodemografics, clinicals, functionals and mentalsoutcomes. We studied the incidence of functional decline in basic activities of daily living, with Barthel Index, and association with the risk of readmission. The sample was composed by 125 elders (mean aged 81.9 +/- 4.6 years and 60.8% were women). The incidence of functional decline in basic activities of daily living at the visit to emergency department was 20.8% and one moth after discharge was 18.4%. Both activities with more functional impairment were bathing, dressing and movility activities. Functional decline was associated with the risk of readmission at emergency department (Odds Ratio = 4.1 [1.4-11.8]) 20% of patients who are discharged of emergency department present a new functional impairment in basics activities of daily living. Functional decline is associated with the risk of readmission one moth after discharged.
Integration of Basic and Clinical Sciences: Faculty Perspectives at a U.S. Dental School.
van der Hoeven, Dharini; van der Hoeven, Ransome; Zhu, Liang; Busaidy, Kamal; Quock, Ryan L
2018-04-01
Although dental education has traditionally been organized into basic sciences education (first and second years) and clinical education (third and fourth years), there has been growing interest in ways to better integrate the two to more effectively educate students and prepare them for practice. Since 2012, The University of Texas School of Dentistry at Houston (UTSD) has made it a priority to improve integration of basic and clinical sciences, with a focus to this point on integrating the basic sciences. The aim of this study was to determine the perspectives of basic and clinical science faculty members regarding basic and clinical sciences integration and the degree of integration currently occurring. In October 2016, all 227 faculty members (15 basic scientists and 212 clinicians) were invited to participate in an online survey. Of the 212 clinicians, 84 completed the clinician educator survey (response rate 40%). All 15 basic scientists completed the basic science educator survey (response rate 100%). The majority of basic and clinical respondents affirmed the value of integration (93.3%, 97.6%, respectively) and reported regular integration in their teaching (80%, 86.9%). There were no significant differences between basic scientists and clinicians on perceived importance (p=0.457) and comfort with integration (p=0.240), but the basic scientists were more likely to integrate (p=0.039) and collaborate (p=0.021) than the clinicians. There were no significant differences between generalist and specialist clinicians on importance (p=0.474) and degree (p=0.972) of integration in teaching and intent to collaborate (p=0.864), but the specialists reported feeling more comfortable presenting basic science information (p=0.033). Protected faculty time for collaborative efforts and a repository of integrated basic science and clinical examples for use in teaching and faculty development were recommended to improve integration. Although questions might be raised about the respondents' definition of "integration," this study provides a baseline assessment of perceptions at a dental school that is placing a priority on integration.
Stevenson, Frazier T; Bowe, Connie M; Gandour-Edwards, Regina; Kumari, Vijaya G
2005-02-01
Many studies have evaluated the desirability of expert versus non-expert facilitators in problem-based learning (PBL), but performance differences between basic science and clinical facilitators has been less studied. In a PBL course at our university, pairs of faculty facilitators (1 clinician, 1 basic scientist) were assigned to student groups to maximise integration of basic science with clinical science. This study set out to establish whether students evaluate basic science and clinical faculty members differently when they teach side by side. Online questionnaires were used to survey 188 students about their faculty facilitators immediately after they completed each of 3 serial PBL cases. Overall satisfaction was measured using a scale of 1-7 and yes/no responses were gathered from closed questions describing faculty performance. results: Year 1 students rated basic science and clinical facilitators the same, but Year 2 students rated the clinicians higher overall. Year 1 students rated basic scientists higher in their ability to understand the limits of their own knowledge. Year 2 students rated the clinicians higher in several content expertise-linked areas: preparedness, promotion of in-depth understanding, and ability to focus the group, and down-rated the basic scientists for demonstrating overspecialised knowledge. Students' overall ratings of individual faculty best correlated with the qualities of stimulation, focus and preparedness, but not with overspecialisation, excessive interjection of the faculty member's own opinions, and encouragement of psychosocial issue discussion. When taught by paired basic science and clinical PBL facilitators, students in Year 1 rated basic science and clinical PBL faculty equally, while Year 2 students rated clinicians more highly overall. The Year 2 difference may be explained by perceived differences in content expertise.
ERIC Educational Resources Information Center
Haçat, Sibel Oguz
2018-01-01
The aim of the present study is to identify the approach of social studies pre-service teachers to legal topics in the "Basic Law" lesson within the Social Studies Teaching Bachelor's Degree Program. A case study based on qualitative research methods was employed. The study group consisted of 57 social studies pre-service teachers. Data…
Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek
2017-07-01
The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.
Integration of basic sciences and clinical sciences in oral radiology education for dental students.
Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N
2013-06-01
Educational research suggests that cognitive processing in diagnostic radiology requires a solid foundation in the basic sciences and knowledge of the radiological changes associated with disease. Although it is generally assumed that dental students must acquire both sets of knowledge, little is known about the most effective way to teach them. Currently, the basic and clinical sciences are taught separately. This study was conducted to compare the diagnostic accuracy of students when taught basic sciences segregated or integrated with clinical features. Predoctoral dental students (n=51) were taught four confusable intrabony abnormalities using basic science descriptions integrated with the radiographic features or taught segregated from the radiographic features. The students were tested with diagnostic images, and memory tests were performed immediately after learning and one week later. On immediate and delayed testing, participants in the integrated basic science group outperformed those from the segregated group. A main effect of learning condition was found to be significant (p<0.05). The results of this study support the critical role of integrating biomedical knowledge in diagnostic radiology and shows that teaching basic sciences integrated with clinical features produces higher diagnostic accuracy in novices than teaching basic sciences segregated from clinical features.
Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit
2015-01-01
Background The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services. Methods Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. Results To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Conclusions Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. PMID:25492948
ERIC Educational Resources Information Center
Kabat, Hugh F.; And Others
The areas of basic science pharmacy instruction and clinical pharmacy practice and their interrelationships were identified in order to help develop didactic and clinical experience alternatives. A 10-member advisory committee ranked basic pharmaceutical science topical areas in terms of their applicability to clinical practice utilizing a Delphi…
Serbia National Poison Control Centre: organization and current activities.
Jovanović, Dugan; Joksović, Dragan; Vucinić, Savica; Todorović, Veljko; Segrt, Zoran; Kilibarda, Vesna; Bokonjić, Dubravko
2005-01-01
Ministry of Health of the former Federal Republic of Yugoslavia established the National Poison Control Centre in 1995. However, that was only the formally solution since clinical, analytical and experimental services in toxicology had worked independently for at least 40 years. Besides the Headquarters, NPCC has currently 2 main units, the Clinic of Emergency and Clinical Toxicology and Pharmacology and the Institute of Toxicology and Pharmacology. The latter is consisted of Toxicological Information Department, Department of Analytical Toxicology and Department of Experimental Toxicology and Pharmacology. The Mobile Toxicological Chemical Unit is a separate department that is activated from personnel of the NPCC in a case of chemical accidents and/or disasters. Clinical, information and analytical parts of NPCC have a 365-day/24-hour working service. The Clinic of Emergency and Clinical Toxicology and Pharmacology is a place where the intoxicated patients are treated, including those that need the intensive care measures. Toxicological Information Department uses the data from a self-made computer Database for different information purposes. Department of Analytical Toxicology is equipped with a lot of contemporary analytical equipment that is giving the opportunity of identification and quantification of chemicals/metabolites/degradation products in biological material, food, water, air and soil. Basic pharmacological and toxicological research of chemicals and pre-clinical investigations of antidotes are realized in the Department of Experimental Toxicology and Pharmacology. In terms of medical prevention and rational treatment of human poison exposures in Serbia, the current organization of NPCC has so far proven to be effective.
Cause and Effect: Testing a Mechanism and Method for the Cognitive Integration of Basic Science.
Kulasegaram, Kulamakan; Manzone, Julian C; Ku, Cheryl; Skye, Aimee; Wadey, Veronica; Woods, Nicole N
2015-11-01
Methods of integrating basic science with clinical knowledge are still debated in medical training. One possibility is increasing the spatial and temporal proximity of clinical content to basic science. An alternative model argues that teaching must purposefully expose relationships between the domains. The authors compared different methods of integrating basic science: causal explanations linking basic science to clinical features, presenting both domains separately but in proximity, and simply presenting clinical features First-year undergraduate health professions students were randomized to four conditions: (1) science-causal explanations (SC), (2) basic science before clinical concepts (BC), (3) clinical concepts before basic science (CB), and (4) clinical features list only (FL). Based on assigned conditions, participants were given explanations for four disorders in neurology or rheumatology followed by a memory quiz and diagnostic test consisting of 12 cases which were repeated after one week. Ninety-four participants completed the study. No difference was found on memory test performance, but on the diagnostic test, a condition by time interaction was found (F[3,88] = 3.05, P < .03, ηp = 0.10). Although all groups had similar immediate performance, the SC group had a minimal decrease in performance on delayed testing; the CB and FL groups had the greatest decreases. These results suggest that creating proximity between basic science and clinical concepts may not guarantee cognitive integration. Although cause-and-effect explanations may not be possible for all domains, making explicit and specific connections between domains will likely facilitate the benefits of integration for learners.
Publishing a master's thesis: a guide for novice authors.
Resta, Robert G; McCarthy Veach, Patricia; Charles, Sarah; Vogel, Kristen; Blase, Terri; Palmer, Christina G S
2010-06-01
Publication of original research, clinical experiences, and critical reviews of literature are vital to the growth of the genetic counseling field, delivery of genetic counseling services, and professional development of genetic counselors. Busy clinical schedules, lack of time and funding, and training that emphasizes clinical skills over research skills may make it difficult for new genetic counselors to turn their thesis projects into publications. This paper summarizes and elaborates upon a presentation aimed at de-mystifying the publishing process given at the 2008 National Society of Genetic Counselors Annual Education Conference. Specific topics include familiarizing prospective authors, particularly genetic counseling students, with the basics of the publication process and related ethical considerations. Former students' experiences with publishing master's theses also are described in hopes of encouraging new genetic counselors to submit for publication papers based on their thesis projects.
The Development of Clinical Reasoning Skills: A Major Objective of the Anatomy Course
ERIC Educational Resources Information Center
Elizondo-Omana, Rodrigo E.; Lopez, Santos Guzman
2008-01-01
Traditional medical school curricula have made a clear demarcation between the basic biomedical sciences and the clinical years. It is our view that a comprehensive medical education necessarily involves an increased correlation between basic science knowledge and its clinical applications. A basic anatomy course should have two main objectives:…
Students' perspectives on basic nursing care education.
Huisman-de Waal, Getty; Feo, Rebecca; Vermeulen, Hester; Heinen, Maud
2018-02-05
The aim of the study is to explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. Basic care activities lie at the core of nursing, but are ill-informed by evidence and often poorly delivered. Nursing students' education on basic care might be lacking, and the question remains how they learn to deliver basic care in clinical practice. Descriptive study, using an online questionnaire. Nursing students at the vocational and bachelor level of six nursing schools in the Netherlands were invited to complete an online questionnaire regarding their perception of basic nursing care education in general (both theoretical education and clinical placement), and specifically in relation to nutrition and communication. Nursing students (n=226 bachelor students, n=30 vocational students) completed the questionnaire. Most students reported that they learned more about basic nursing care during clinical placement than during theoretical education. Vocational students also reported learning more about basic nursing care in both theoretical education and clinical practice than bachelor students. In terms of nutrition, low numbers of students from both education levels reported learning about nutrition protocols and guidelines during theoretical education. In terms of communication, vocational students indicated that they learned more about different aspects of communication during clinical practice than theoretical education, and were also more likely to learn about communication (in both theoretical education and clinical practice) than were bachelor students. Basic nursing care seems to be largely invisible in nursing education, especially at the bachelor level and during theoretical education. Improved basic nursing care will enhance nurse sensitive outcomes and patient satisfaction and will contribute to lower healthcare costs. This study shows that there is scope within current nurse education in the Netherlands to focus more systematically and explicitly on basic nursing care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
ERIC Educational Resources Information Center
Johns, R. L.
Evidence presented by the National School Food Service and Nutrition Education Finance Project shows clearly that present State and federal legislation affecting the school food service program is not consistent with the basic values and beliefs of this country, nor is that legislation consistent with the legitimate and appropriate purposes of…
ERIC Educational Resources Information Center
Çetin, Oguz
2016-01-01
In this study aiming to present a description based on science pre-service teachers' views related to use of Basic Information Technologies (BIT) in education and training, an interview is carried out with 21 pre-service science teachers who study in different classes in Faculty of Education, Nigde University. For this aim, improved interview form…
ERIC Educational Resources Information Center
Waddy, Paul H.; And Others
To improve vocational educational programs in agriculture, occupational information on a common core of basic skills within the occupational area of the tree service worker is presented in the revised task inventory survey. The purpose of the occupational survey was to identify a common core of basic skills which are performed and are essential…
47 CFR 76.611 - Cable television basic signal leakage performance criteria.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 4 2011-10-01 2011-10-01 false Cable television basic signal leakage performance criteria. 76.611 Section 76.611 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Technical Standards § 76.611 Cable...
[The health system of Costa Rica].
Sáenz, María del Rocío; Acosta, Mónica; Muiser, Jorine; Bermúdez, Juan Luis
2011-01-01
This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector. The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS), an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the affiliates, employers and the state, and manages three regimes: maternity and illness insurance, disability, old age and death insurance, and a non-contributive regime. CCSS provides services in its own facilities but also contracts with private providers. The private sector includes a broad set of services offering ambulatory and hospital care. These services are financed mostly out-of-pocket, but also with private insurance premiums. The Ministry of Health is the steward of the system, in charge of strategic planning, sanitary regulation, and research and technology development. Among the recent policy innovations we can mention the establishment of the basic teams for comprehensive health care (EBAIS), the de-concentration of hospitals and public clinics, the introduction of management agreements and the creation of the Health Boards.
Calvo, Fran; Carbonell, Xavier; Valero, Ramón; Costa, Jordi; Turró, Oriol; Giralt, Cristina; Ramírez, Marissa
2017-08-23
The aim of this study is to define the risk factors associated with early discharge in out-patients clinics. Cross-sectional and observational study. Substance abuse clinics in Girona (Catalonia, Spain). A total of 264 individuals were included in the sample, and 34.8% of them abandoned the process within two months of starting the therapy (n=92). Clinical and socio-demographic variables of the clinical history were compared between participants with/without adherence. The Student t test was used to measure the comparison, and the chi-squared test was used for the analysis of qualitative variables. A binary logistic regression model was adjusted, with adherence as the dependent variable. The results indicated that attending the appointments unaccompanied (OR=3.13), being female (OR=2.44), having cocaine related issues (OR=1.14), and being younger (OR=0.89) are the factors which increase the risk early abandonment. Contrarily, being referred to specialists from a Primary Health Centre reduces the risk (OR=0.28). It is concluded that special attention must be devoted to the patients' families, women, and young patients. Moreover, the appropriate coordination between specialist services and basic services increases adherence to treatment among drug users. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Paul Polani and the development of medical genetics
Harper, Peter S.
2007-01-01
Paul Polani (1914-2006) was one of the key figures internationally in the beginnings and development of medical genetics. Best remembered scientifically for his highly original work on the basis of human sex chromosome disorders, notably Turner syndrome, he pioneered the application of basic biological research to clinical genetic problems. The unit that he founded in 1960, at Guys Hospital, London, provided an unparalleled model for combined research and service in medical genetics across a wide range of laboratory areas and helped to establish medical genetics as a specific discipline. PMID:17066298
Educating perioperative managers about materials and financial management.
Davis, Eric
2005-04-01
One of the most resource intensive areas in many hospitals is the OR, which often accounts for more than 50% of a hospital's materials management budget. Surgical services managers often have no formal training in materials and financial management, but they are held accountable for one of the most costly clinical areas in the hospital. A program proposed for Navy perioperative nurse managers is a five-day course that covers the basics of Navy medical materials and financial management as they apply to the OR. Application strategies for the civilian sector also are discussed.
1.4 Research and the dental student.
DePaola, Dominick; Howell, Howard; Baker, Charles G; Boy-Lefevre, Marie Laure; Hull, Peter; Holmstrup, Palle; Jerolimov, Vjekoslav; Hardwick, Kevin; Lamster, Ira B; Lopez, Nestor J; Rifkin, Barry
2002-01-01
There has been significant concern that the dental curriculum and system of clinical education, in particular, is not designed to take advantage of the explosion in knowledge in biomedical science and its application to the health of the public. Although there are some examples of innovations in dental education on a global scale that have the capacity to increase the assimilation of basic and clinical knowledge, most of the dental education models are mired in the traditional '2 + 2' approach to education. This can be seen in North America and the European '2 + 3' model or the stomatological '4 + 2' approach. In each of these systems, the basic and behavioural science courses continue to be perceived as hurdles over which students must leap in order to reach the clinical programmes where there is little opportunity to use basic science information to advance patient care and treatment. Examples of issues that are not well represented include: innovations in imaging; diagnosis; bio-materials; science-based approaches to clinical practice; novel approaches to therapeutics; interactions between the oral, dental and craniofacial complex and systemic health and disorders; the role of oral infections and systemic disease; the increasing appreciation of chronic diseases and disorders such as osteoporosis and diabetes that affect oral tissues; the promise of bioengineering, tissue engineering and biomimetics; the potential use of saliva as a diagnostic tool; the understanding of oral complications of cancer treatment; the treatments of HIV/AIDS diseases and hepatitis; the use of dental and dental hygiene staff on health-care teams to deal with issues such as birth defects, orofacial trauma, head and neck cancer, chronic pain management and so on. There seems to be an excessive emphasis on restorative dentistry and, to a lesser extent, on the more biological approaches to diagnosis, prevention and therapeutics. This continued lack of integration of basic and clinical sciences in the curriculum continues to foster a dental workforce that is highly technically competent to provide specific clinical services but poorly equipped to evaluate and implement new biological approaches to diagnosis, therapeutics and intervention. Unfortunately, after many attempts by organized dental symposia aimed at the integration of basic and clinical sciences, there has been little discernible curricular change. It appears that there is an opportunity through this global congress to identify the best practices in the various global curricula that could change this paradigm in dental education and lead us toward the education of a more scientifically orientated practitioner-one who can take advantage of innovations in new and emerging technologies in their application to patient care. It is the challenge of this section to try to ascertain the best method or methods by which dental education promotes research to the dental student and what research represents in terms of critical thinking and evidence-based approaches to dental education and clinical practice.
Pharmaceutical care in community pharmacies: practice and research in the US.
Christensen, Dale B; Farris, Karen B
2006-01-01
To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research has been conducted, but there is no national research agenda or infrastructure. Reimbursement for cognitive services remains an infrequent, but growing, activity.
Kaambwa, Billingsley; Ratcliffe, Julie; Shulver, Wendy; Killington, Maggie; Taylor, Alan; Crotty, Maria; Carati, Colin; Tieman, Jennifer; Wade, Victoria; Kidd, Michael R
2017-02-01
Introduction Telehealth approaches to health care delivery can potentially improve quality of care and clinical outcomes, reduce mortality and hospital utilisation, and complement conventional treatments. However, substantial research into the potential for integrating telehealth within health care in Australia, particularly in the provision of services relevant to older people, including palliative care, aged care and rehabilitation, is lacking. Furthermore, to date, no discrete choice experiment (DCE) studies internationally have sought the views and preferences of older people about the basic features that should make up a telehealth approach to these services. Methods Using a DCE, we investigated the relative importance of six salient features of telehealth (what aspects of care are to be pursued during telehealth sessions, distance to the nearest hospital or clinic, clinicians' attitude to telehealth, patients' experience of using technology, what types of assessments should be conducted face-to-face versus via telehealth sessions and the costs associated with receiving telehealth). Data were obtained from an online panel of older people aged 65 years and above, drawn from the Australian general population. Results The mean age for 330 study participants was 69 years. In general, individuals expressed strong preferences for telehealth services that offered all aspects of care, were relatively inexpensive and targeted specifically at individuals living in remote regions without easy access to a hospital or clinic. Participants also preferred telehealth services to be offered to individuals with some prior experience of using technology, provided by clinicians who were positive about telehealth but wanted all or some pre-telehealth health assessments to take place in a hospital or clinic. Preferences only differed by gender. Additionally, respondents did not feel that telehealth led to loss of privacy and confidentiality. Discussion Our findings indicate a preference amongst respondents for face-to-face pre-telehealth health assessments and, thereafter, a comprehensive telehealth model (in terms of services offered) targeted at those with some technological know-how as a substitute for attendance at hospitals and clinics, especially where these health facilities were far away from older people's homes. The findings may be usefully incorporated into the design of future telehealth models of service delivery for older people.
42 CFR 489.61 - Basic requirement for surety bonds.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Basic requirement for surety bonds. 489.61 Section 489.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Surety Bond Requirements...
42 CFR 489.61 - Basic requirement for surety bonds.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 5 2011-10-01 2011-10-01 false Basic requirement for surety bonds. 489.61 Section 489.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Surety Bond Requirements...
Vink, Sylvia; van Tartwijk, Jan; Verloop, Nico; Gosselink, Manon; Driessen, Erik; Bolk, Jan
2016-08-01
To determine the content of integrated curricula, clinical concepts and the underlying basic science concepts need to be made explicit. Preconstructed concept maps are recommended for this purpose. They are mainly constructed by experts. However, concept maps constructed by residents are hypothesized to be less complex, to reveal more tacit basic science concepts and these basic science concepts are expected to be used for the organization of the maps. These hypotheses are derived from studies about knowledge development of individuals. However, integrated curricula require a high degree of cooperation between clinicians and basic scientists. This study examined whether there are consistent variations regarding the articulation of integration when groups of experienced clinicians and basic scientists and groups of residents and basic scientists-in-training construct concept maps. Seven groups of three clinicians and basic scientists on experienced level and seven such groups on resident level constructed concept maps illuminating clinical problems. They were guided by instructions that focused them on articulation of integration. The concept maps were analysed by features that described integration. Descriptive statistics showed consistent variations between the two expertise levels. The concept maps of the resident groups exceeded those of the experienced groups in articulated integration. First, they used significantly more links between clinical and basic science concepts. Second, these links connected basic science concepts with a greater variety of clinical concepts than the experienced groups. Third, although residents did not use significantly more basic science concepts, they used them significantly more frequent to organize the clinical concepts. The conclusion was drawn that not all hypotheses could be confirmed and that the resident concept maps were more elaborate than expected. This article discusses the implications for the role that residents and basic scientists-in-training might play in the construction of preconstructed concept maps and the development of integrated curricula.
Integration of Basic and Clinical Science in the Psychiatry Clerkship.
Wilkins, Kirsten M; Moore, David; Rohrbaugh, Robert M; Briscoe, Gregory W
2017-06-01
Integration of basic and clinical science is a key component of medical education reform, yet best practices have not been identified. The authors compared two methods of basic and clinical science integration in the psychiatry clerkship. Two interventions aimed at integrating basic and clinical science were implemented and compared in a dementia conference: flipped curriculum and coteaching by clinician and physician-scientist. The authors surveyed students following each intervention. Likert-scale responses were compared. Participants in both groups responded favorably to the integration format and would recommend integration be implemented elsewhere in the curriculum. Survey response rates differed significantly between the groups and student engagement with the flipped curriculum video was limited. Flipped curriculum and co-teaching by clinician and physician-scientist are two methods of integrating basic and clinical science in the psychiatry clerkship. Student learning preferences may influence engagement with a particular teaching format.
GeneFisher-P: variations of GeneFisher as processes in Bio-jETI
Lamprecht, Anna-Lena; Margaria, Tiziana; Steffen, Bernhard; Sczyrba, Alexander; Hartmeier, Sven; Giegerich, Robert
2008-01-01
Background PCR primer design is an everyday, but not trivial task requiring state-of-the-art software. We describe the popular tool GeneFisher and explain its recent restructuring using workflow techniques. We apply a service-oriented approach to model and implement GeneFisher-P, a process-based version of the GeneFisher web application, as a part of the Bio-jETI platform for service modeling and execution. We show how to introduce a flexible process layer to meet the growing demand for improved user-friendliness and flexibility. Results Within Bio-jETI, we model the process using the jABC framework, a mature model-driven, service-oriented process definition platform. We encapsulate remote legacy tools and integrate web services using jETI, an extension of the jABC for seamless integration of remote resources as basic services, ready to be used in the process. Some of the basic services used by GeneFisher are in fact already provided as individual web services at BiBiServ and can be directly accessed. Others are legacy programs, and are made available to Bio-jETI via the jETI technology. The full power of service-based process orientation is required when more bioinformatics tools, available as web services or via jETI, lead to easy extensions or variations of the basic process. This concerns for instance variations of data retrieval or alignment tools as provided by the European Bioinformatics Institute (EBI). Conclusions The resulting service- and process-oriented GeneFisher-P demonstrates how basic services from heterogeneous sources can be easily orchestrated in the Bio-jETI platform and lead to a flexible family of specialized processes tailored to specific tasks. PMID:18460174
47 CFR 76.611 - Cable television basic signal leakage performance criteria.
Code of Federal Regulations, 2014 CFR
2014-10-01
... average power level of the strongest cable television carrier on the system. (c) In paragraph (a)(1) and... 47 Telecommunication 4 2014-10-01 2014-10-01 false Cable television basic signal leakage...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Technical Standards § 76.611 Cable...
47 CFR 76.611 - Cable television basic signal leakage performance criteria.
Code of Federal Regulations, 2013 CFR
2013-10-01
... average power level of the strongest cable television carrier on the system. (c) In paragraph (a)(1) and... 47 Telecommunication 4 2013-10-01 2013-10-01 false Cable television basic signal leakage...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Technical Standards § 76.611 Cable...
47 CFR 76.611 - Cable television basic signal leakage performance criteria.
Code of Federal Regulations, 2012 CFR
2012-10-01
... average power level of the strongest cable television carrier on the system. (c) In paragraph (a)(1) and... 47 Telecommunication 4 2012-10-01 2012-10-01 false Cable television basic signal leakage...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Technical Standards § 76.611 Cable...
Service Station Attendant. Performance Objectives. Basic Course.
ERIC Educational Resources Information Center
Davis, John
Several intermediate performance objectives and corresponding criterion measures are listed for each of 24 terminal objectives for a basic secondary level service station attendant course. The materials were developed for a two-semester course (2 and 3 hours daily). The specialized classroom and shop experiences are designed to enable the student…
5 CFR 352.703 - Basic entitlement to reemployment rights on leaving Federal employment.
Code of Federal Regulations, 2010 CFR
2010-01-01
... Self-Determination Act to be performed by that tribal organization: (1) An employee serving in a... Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations § 352.703 Basic entitlement to reemployment rights on leaving Federal employment. (a...
5 CFR 352.703 - Basic entitlement to reemployment rights on leaving Federal employment.
Code of Federal Regulations, 2011 CFR
2011-01-01
... Self-Determination Act to be performed by that tribal organization: (1) An employee serving in a... Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations § 352.703 Basic entitlement to reemployment rights on leaving Federal employment. (a...
5 CFR 352.703 - Basic entitlement to reemployment rights on leaving Federal employment.
Code of Federal Regulations, 2014 CFR
2014-01-01
... Self-Determination Act to be performed by that tribal organization: (1) An employee serving in a... Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations § 352.703 Basic entitlement to reemployment rights on leaving Federal employment. (a...
5 CFR 352.703 - Basic entitlement to reemployment rights on leaving Federal employment.
Code of Federal Regulations, 2013 CFR
2013-01-01
... Self-Determination Act to be performed by that tribal organization: (1) An employee serving in a... Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations § 352.703 Basic entitlement to reemployment rights on leaving Federal employment. (a...
5 CFR 352.703 - Basic entitlement to reemployment rights on leaving Federal employment.
Code of Federal Regulations, 2012 CFR
2012-01-01
... Self-Determination Act to be performed by that tribal organization: (1) An employee serving in a... Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations § 352.703 Basic entitlement to reemployment rights on leaving Federal employment. (a...
47 CFR 32.5000 - Basic local service revenue.
Code of Federal Regulations, 2010 CFR
2010-10-01
... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5000 Basic local service revenue. Class B telephone companies shall use this account for revenues of the type and character required of Class A companies in Accounts 5001 through 5060. [67 FR 5691, Feb. 6, 2002] ...
South Africa's School Infrastructure Performance Indicator System
ERIC Educational Resources Information Center
Gibberd, Jeremy
2007-01-01
While some South African schools have excellent infrastructure, others lack basic services such as water and sanitation. This article describes the school infrastructure performance indicator system (SIPIS) in South Africa. The project offers an approach that can address both the urgent provision of basic services as well as support the…
47 CFR 76.933 - Franchising authority review of basic cable rates and equipment costs.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Franchising authority review of basic cable rates and equipment costs. 76.933 Section 76.933 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...
42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 4 2011-10-01 2011-10-01 false Basic elements of Medicaid and CHIP eligibility reviews. 431.974 Section 431.974 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL...
42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Basic elements of Medicaid and CHIP eligibility reviews. 431.974 Section 431.974 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL...
Temkin, Elizabeth
2007-01-01
The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage. PMID:17761562
[Basic research in traumatology and its contribution to routine operation].
Hausner, T; Redl, H
2017-02-01
Basic research in traumatology supports the clinical outcome of patients in trauma care and tries to find science-based solutions for clinical problems. Furthermore, institutions for basic research in traumatology usually offer training in different skills, such as how to write a scientific paper, or practice in microsurgery or intubation. Two examples of clinically significant research topics are presented.
Makino, Hirofumi; Sada, Ken-Ei
2013-10-01
In Japan, the Research Committee on Intractable Vasculitides, supported by the Ministry of Health, Labour and Welfare, has been promoting basic and clinical research on vasculitis since 1972. The present Research Committee on Intractable Vasculitides comprises 4 subcommittees under the direction of a Principal Investigator: Basic and Pathological Research Subcommittee, Clinical Research Subcommittee of Small and Medium-sized Vessel Vasculitis, Clinical Research Subcommittee of Large-sized Vessel Vasculitis, and International Cooperation Research Subcommittee. Since 2008, 9 nationwide clinical studies for vasculitis have been conducted and 8 clinical and basic studies are in progress.
Implementation of Quality Management in Core Service Laboratories
Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.
2010-01-01
CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.
Grigoletti, Laura; Amaddeo, Francesco; Grassi, Aldrigo; Boldrini, Massimo; Chiappelli, Marco; Percudani, Mauro; Catapano, Francesco; Fiorillo, Andrea; Perris, Francesco; Bacigalupi, Maurizio; Albanese, Paolo; Simonetti, Simona; De Agostini, Paola; Tansella, Michele
2010-01-01
To develop predictive models to allocate patients into frequent and low service users groups within the Italian Community-based Mental Health Services (CMHSs). To allocate frequent users to different packages of care, identifying the costs of these packages. Socio-demographic and clinical data and GAF scores at baseline were collected for 1250 users attending five CMHSs. All psychiatric contacts made by these patients during six months were recorded. A logistic regression identified frequent service users predictive variables. Multinomial logistic regression identified variables able to predict the most appropriate package of care. A cost function was utilised to estimate costs. Frequent service users were 49%, using nearly 90% of all contacts. The model classified correctly 80% of users in the frequent and low users groups. Three packages of care were identified: Basic Community Treatment (4,133 Euro per six months); Intensive Community Treatment (6,180 Euro) and Rehabilitative Community Treatment (11,984 Euro) for 83%, 6% and 11% of frequent service users respectively. The model was found to be accurate for 85% of users. It is possible to develop predictive models to identify frequent service users and to assign them to pre-defined packages of care, and to use these models to inform the funding of psychiatric care.
The progress test as a diagnostic tool for a new PBL curriculum.
Al Alwan, I; Al-Moamary, M; Al-Attas, N; Al Kushi, A; AlBanyan, E; Zamakhshary, M; Al Kadri, H M F; Tamim, H; Magzoub, M; Hajeer, A; Schmidt, H
2011-12-01
The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) is running a PBL-based curriculum. A progress test was used to evaluate components of the basic medical and clinical sciences curriculum. To evaluate the performance of students at different levels of the college of medicine curriculum through USMLE-based test that focused on basic medical and clinical sciences topics. The USMLE-based basic medical and clinical sciences progress test has been conducted since 2007. It covers nine topics, including: anatomy; physiology; histology; epidemiology; biochemistry; behavioral sciences, pathology, pharmacology and immunology/microbiology. Here we analyzed results of three consecutive years of all students in years 1-4. There was a good correlation between progress test results and students' GPA. Progress test results in the clinical topics were better than basic medical sciences. In basic medical sciences, results of pharmacology, biochemistry, behavioral sciences and histology gave lower results than the other disciplines. Results of our progress test proved to be a useful indicator for both basic medical sciences and clinical sciences curriculum. Results are being utilized to help in modifying our curriculum.
Spinal cord injury: promising interventions and realistic goals.
McDonald, John W; Becker, Daniel
2003-10-01
Long regarded as impossible, spinal cord repair is approaching the realm of reality as efforts to bridge the gap between bench and bedside point to novel approaches to treatment. It is important to recognize that the research playing field is rapidly changing and that new mechanisms of resource development are required to effectively make the transition from basic science discoveries to effective clinical treatments. This article reviews recent laboratory studies and phase 1 clinical trials in neural and nonneural cell transplantation, stressing that the transition from basic science to clinical applications requires a parallel rather than serial approach, with continuous, two-way feedback to most efficiently translate basic science findings, through evaluation and optimization, to clinical treatments. An example of mobilizing endogenous stem cells for repair is reviewed, with emphasis on the rapid application of basic science to clinical therapy. Successful and efficient transition from basic science to clinical applications requires (1) a parallel rather than a serial approach; (2) development of centers that integrate three spheres of science, translational, transitional, and clinical trials; and (3) development of novel resources to fund the most critically limited step of transitional to clinical trials.
Gómez-Batiste, Xavier; Caja, Carmen; Espinosa, Jose; Bullich, Ingrid; Martínez-Muñoz, Marisa; Porta-Sales, Josep; Trelis, Jordi; Esperalba, Joaquim; Stjernsward, Jan
2012-04-01
Catalonia (Spain) has a total population of 7.3 million citizens for whom the National Health Service (NHS) provides health care that is free at the point of access. The prevalence of terminally ill patients is between 30,100 and 39,600. Twenty years ago, the World Health Organization (WHO), in collaboration with the Catalan Department of Health and the Catalan Institute of Oncology, began a demonstration project (WHO Demonstration Project) in palliative care (PC) with the aim of implementing specialist PC services, generating experience in this field, identifying areas for improvement, and introducing educative procedures (clinical and nonclinical). Over the past 20 years, 237 PC clinical services (72 home care support teams, 49 hospital support teams, 60 units with 742 dedicated beds, 50 outpatient clinics, and six psychosocial support teams) have been implemented. In the five years since the previous evaluation, 57 new clinical services (15 new hospital support teams, 36 outpatient clinics, and six psychosocial support teams among others) and four nonclinical services (education, research, WHO Collaborating Center, and planning) have been implemented. During the year 2010, a total of 46,200 processes were undertaken for the care of 23,100 patients, of whom 12,100 (52%) had cancer and 11,000 (48%) had other chronic advanced diseases. The overall yearly costs are around €52,568,000, with an overall savings of €69,300,000 (€2275 per patient, net savings to the NHS of €16,732,000). In the last five years, three qualitative evaluations and a benchmarking process have been performed to identify weak points and inequities in care provision among districts. Systematic assessments indicate high cost-effectiveness of care as well as high levels of satisfaction by patients and their relatives, thus reinforcing the principle that access to PC under the auspices of the NHS at the end of life is a basic human right. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Facilitating access to prenatal care through an interprofessional student-run free clinic.
Danhausen, Kathleen; Joshi, Deepa; Quirk, Sarah; Miller, Robert; Fowler, Michael; Schorn, Mavis N
2015-01-01
Addressing the persistent challenge of inadequate prenatal care requires innovative solutions. Student-run free health centers are poised to rise to this challenge. The Shade Tree Clinic Early Pregnancy Program, jointly operated by university medical and nursing programs, functions as an ongoing access-to-care portal for pregnant women without health insurance. The clinic is run by medical students and nurse-midwifery students and uses a service-based learning model that allows students to work and learn in supervised, interprofessional teams while providing evidence-based prenatal care. All data reported in this paper were obtained from a retrospective chart review of women served by the prenatal clinic. These data are descriptive in nature, and include the patient demographics and services provided by the clinic to 152 women between the years of 2010-2013. During this time period, the clinic served a demographically diverse clientele. Approximately half lacked documentation of legal immigration status. The majority of women seeking care were in their first trimester of pregnancy and had previously given birth. Several women had medical or obstetric complications that required timely referral to specialist care; and many women received treatment for infection and other primary care concerns. Shade Tree Clinic provides the basic components of prenatal care and assists women with other medical needs. Women also receive help when applying for and accessing public maternity insurance, and the clinic facilitates entry to any necessary specialist care while that insurance is processed. In many cases, necessary and time-sensitive care would be delayed if Shade Tree Clinic's prenatal services were not available. In addition, the clinic presents a valuable opportunity for interprofessional socialization, increased respect, and improved collaboration between students in different but complementary professions, which is an important experience while we move to meet national goals for interprofessional care among health professionals. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.
Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L
2008-07-01
Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.
Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M
2017-01-01
There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.
Northwest Latinos' health promotion lifestyle profiles according to diabetes risk status.
Sutherland, Leonie L; Weiler, Dawn M; Bond, Laura; Simonson, Shawn; Reis, Janet
2012-12-01
A sample of 225 low income and low education, middle aged Latinos with concern about diabetes and living in a mid-size Idaho city volunteered for a physical assessment for risk status for the disease. The health promoting lifestyles of Latino congregants were measured using the Health Promoting Lifestyle Profile II. Diabetes risk was measured by clinically standard glycated hemoglobin readings. From no risk for the disease to full blown diabetes as determined by glycated hemoglobin levels, the respondents reported engaging in basically the same levels of physical activity, monitoring of nutrition and use of health care services thus evidencing no apparent understanding of the role of lifestyle in disease management. The findings point to the imperative of a broad, comprehensive and especially culturally attuned educational campaign on basic disease pathophysiology, the value of prevention for individual health, and the necessity of day-to-day self-care should diabetes be diagnosed.
38 CFR 21.142 - Adult basic education.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...
38 CFR 21.142 - Adult basic education.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...
38 CFR 21.142 - Adult basic education.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...
38 CFR 21.142 - Adult basic education.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...
38 CFR 21.142 - Adult basic education.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wallner, Paul E., E-mail: pwallner@theabr.org; Anscher, Mitchell S.; Barker, Christopher A.
In early 2011, a dialogue was initiated within the Board of Directors (BOD) of the American Society for Radiation Oncology (ASTRO) regarding the future of the basic sciences of the specialty, primarily focused on the current state and potential future direction of basic research within radiation oncology. After consideration of the complexity of the issues involved and the precise nature of the undertaking, in August 2011, the BOD empanelled a Cancer Biology/Radiation Biology Task Force (TF). The TF was charged with developing an accurate snapshot of the current state of basic (preclinical) research in radiation oncology from the perspective ofmore » relevance to the modern clinical practice of radiation oncology as well as the education of our trainees and attending physicians in the biological sciences. The TF was further charged with making suggestions as to critical areas of biological basic research investigation that might be most likely to maintain and build further the scientific foundation and vitality of radiation oncology as an independent and vibrant medical specialty. It was not within the scope of service of the TF to consider the quality of ongoing research efforts within the broader radiation oncology space, to presume to consider their future potential, or to discourage in any way the investigators committed to areas of interest other than those targeted. The TF charge specifically precluded consideration of research issues related to technology, physics, or clinical investigations. This document represents an Executive Summary of the Task Force report.« less
Wallner, Paul E; Anscher, Mitchell S; Barker, Christopher A; Bassetti, Michael; Bristow, Robert G; Cha, Yong I; Dicker, Adam P; Formenti, Silvia C; Graves, Edward E; Hahn, Stephen M; Hei, Tom K; Kimmelman, Alec C; Kirsch, David G; Kozak, Kevin R; Lawrence, Theodore S; Marples, Brian; McBride, William H; Mikkelsen, Ross B; Park, Catherine C; Weidhaas, Joanne B; Zietman, Anthony L; Steinberg, Michael
2014-01-01
In early 2011, a dialogue was initiated within the Board of Directors (BOD) of the American Society for Radiation Oncology (ASTRO) regarding the future of the basic sciences of the specialty, primarily focused on the current state and potential future direction of basic research within radiation oncology. After consideration of the complexity of the issues involved and the precise nature of the undertaking, in August 2011, the BOD empanelled a Cancer Biology/Radiation Biology Task Force (TF). The TF was charged with developing an accurate snapshot of the current state of basic (preclinical) research in radiation oncology from the perspective of relevance to the modern clinical practice of radiation oncology as well as the education of our trainees and attending physicians in the biological sciences. The TF was further charged with making suggestions as to critical areas of biological basic research investigation that might be most likely to maintain and build further the scientific foundation and vitality of radiation oncology as an independent and vibrant medical specialty. It was not within the scope of service of the TF to consider the quality of ongoing research efforts within the broader radiation oncology space, to presume to consider their future potential, or to discourage in any way the investigators committed to areas of interest other than those targeted. The TF charge specifically precluded consideration of research issues related to technology, physics, or clinical investigations. This document represents an Executive Summary of the Task Force report. Copyright © 2014 Elsevier Inc. All rights reserved.
TU-C-9A-01: IROC Organization and Clinical Trial Credentialing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Followill, D; Molineu, A; Xiao, Y
2014-06-15
As a response to recommendations from a report from the Institute of Medicine, NCI is reorganizing it clinical trial groups into a National Clinical Trial Network (NCTN) that consists of four adult groups (Alliance, ECOGACRIN, NRG, and SWOG) and one children’s group (COG). NRG will house CIRO, a center to promote innovative radiation therapy research and intergroup collaboration in radiation. The quality assurance groups that support clinical trials have also been restructured. ITC, OSU Imaging corelab, Philadelphia Imaging core-lab, QARC, RPC, and RTOGQA have joined together to create the Imaging and Radiation Oncology Core (IROC) Group. IROC’s mission is tomore » provide integrated radiation oncology and diagnostic imaging quality control programs in support of the NCI’s NCTN thereby assuring high quality data for clinical trials designed to improve the clinical outcomes for cancer patients worldwide. This will be accomplished through five core services: site qualification, trial design support, credentialing, data management, case review.These changes are important for physicist participating in NCI clinical trials to understand. We will describe in detail the IROC’s activities and five core services so that as a user, the medical physicist can learn how to efficiently utilize this group. We will describe common pitfalls encountered in credentialing for current protocols and present methods to avoid them. These may include the which benchmarks are required for NSABP B-51/RTOG 1304 and how to plan them as well as tips for phantom planning. We will explain how to submit patient and phantom cases in the TRIAD system used by IROC. Learning Objectives: To understand the basic organization of IROC, its mission and five core services To learn how to use TRIAD for patient and phantom data submission To learn how to avoid common pitfalls in credentialing for current trials.« less
Publishing a Master’s Thesis: A Guide for Novice Authors
Resta, Robert G.; McCarthy Veach, Patricia; Charles, Sarah; Vogel, Kristen; Blase, Terri
2010-01-01
Publication of original research, clinical experiences, and critical reviews of literature are vital to the growth of the genetic counseling field, delivery of genetic counseling services, and professional development of genetic counselors. Busy clinical schedules, lack of time and funding, and training that emphasizes clinical skills over research skills may make it difficult for new genetic counselors to turn their thesis projects into publications. This paper summarizes and elaborates upon a presentation aimed at de-mystifying the publishing process given at the 2008 National Society of Genetic Counselors Annual Education Conference. Specific topics include familiarizing prospective authors, particularly genetic counseling students, with the basics of the publication process and related ethical considerations. Former students’ experiences with publishing master’s theses also are described in hopes of encouraging new genetic counselors to submit for publication papers based on their thesis projects. PMID:20076994
Lei, Hai Chao
2008-11-01
This study discusses basic health services in China. In this study common sense and international experience in establishing a high-performing health system were introduced. Five components are identified: basic qualified human resources for health; basic infrastructure; essential medicines; essential technology and procedures; and basic service pathways. Recommendations were presented based upon the Chinese situation. They are: increase public financing and lower private out-of-pocket payment for services; revitalize the functions of public facilities; merge different health financing schemes; co-ordinate public fiscal and pricing policies; prioritize public financing to preventive and primary healthcare; establish and strengthen the partnership between public and private facilities and insurance schemes; and re-organize the administrative system in health-based upon the rules of simplicity, unity, and efficiency. © 2008 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.
2015-01-01
Background The Minimum Initial Services Package (MISP) for reproductive health, a standard of care in humanitarian emergencies, is a coordinated set of priority activities developed to prevent excess morbidity and mortality, particularly among women and girls, which should be implemented at the onset of an emergency. The purpose of the evaluation was to determine the status of MISP implementation for Syrian refugees in Jordan as part of a global evaluation of reproductive health in crises. Methods In March 2013, applying a formative evaluation approach 11 key informant interviews, 13 health facility assessments, and focus group discussions (14 groups; 159 participants) were conducted in two Syrian refugee sites in Jordan, Zaatri Camp, and Irbid City, respectively. Information was coded, themes were identified, and relationships between data explored. Results Lead health agencies addressed the MISP by securing funding and supplies and establishing reproductive health focal points, services and coordination mechanisms. However, Irbid City was less likely to be included in coordination activities and health facilities reported challenges in human resource capacity. Access to clinical management of rape survivors was limited, and both women and service provider’s knowledge about availability of these services was low. Activities to reduce the transmission of HIV and to prevent excess maternal and newborn morbidity and mortality were available, although some interventions needed strengthening. Some planning for comprehensive reproductive health services, including health indicator collection, was delayed. Contraceptives were available to meet demand. Syndromic treatment of sexually transmitted infections and antiretrovirals for continuing users were not available. In general refugee women and adolescent girls perceived clinical services negatively and complained about the lack of basic necessities. Conclusions MISP services and key elements to support implementation were largely in place. Pre-existing Jordanian health infrastructure, prior MISP trainings, dedicated leadership and available funding and supplies facilitated MISP implementation. The lack of a national protocol on clinical management of rape survivors hindered provision of these services, while communities’ lack of information about the health benefits of the services as well as perceived cultural repercussions likely contributed to no recent service uptake from survivors. This information can inform MISP programming in this setting. PMID:25798190
Mild Traumatic Brain Injury Pocket Guide (CONUS)
2010-01-01
Cognitive Rehab Driving Following TBI Patient Education Clinical Tools and Resources Report Documentation Page Form ApprovedOMB No. 0704-0188 Public... Rehab Driving Following TBI Patient Education Clinical Tools and Resources 2 3 TBI Basics VA/DoD CPG Management of Headaches Management of Other...Symptoms ICD-9 Coding Cognitive Rehab Driving Following TBI Patient Education Clinical Tools and Resources TBI BASICS 4 5 TBI BASICS dod definition
20 CFR 404.2106 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2011 CFR
2011-04-01
... Provisions § 404.2106 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 416.2206 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2011 CFR
2011-04-01
... Provisions § 416.2206 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 416.2206 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Provisions § 416.2206 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 404.2106 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Provisions § 404.2106 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
ADHD in the Context of Finnish Basic Education
ERIC Educational Resources Information Center
Honkasilta, J.; Sandberg, E.; Närhi, V.; Jahnukainen, M.
2014-01-01
Students with Attention Deficit/Hyperactivity Disorder (ADHD) are a growing group served under special education services in many western societies. This article describes the history and current state of the services, as well as the assessment procedure. Our conclusion is that the status of students with ADHD in Finnish basic education (Grades 1…
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Services of a certified registered nurse... certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions. (a... registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the...
38 CFR 3.314 - Basic pension determinations.
Code of Federal Regulations, 2014 CFR
2014-07-01
... therefor are: (1) Claims based on service of less than 90 days in the Spanish-American War require a rating... on service in the Mexican border period, World War I, World War II, the Korean conflict and the... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Basic pension...
38 CFR 3.314 - Basic pension determinations.
Code of Federal Regulations, 2012 CFR
2012-07-01
... therefor are: (1) Claims based on service of less than 90 days in the Spanish-American War require a rating... on service in the Mexican border period, World War I, World War II, the Korean conflict and the... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Basic pension...
38 CFR 3.314 - Basic pension determinations.
Code of Federal Regulations, 2013 CFR
2013-07-01
... therefor are: (1) Claims based on service of less than 90 days in the Spanish-American War require a rating... on service in the Mexican border period, World War I, World War II, the Korean conflict and the... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Basic pension...
38 CFR 3.314 - Basic pension determinations.
Code of Federal Regulations, 2011 CFR
2011-07-01
... therefor are: (1) Claims based on service of less than 90 days in the Spanish-American War require a rating... on service in the Mexican border period, World War I, World War II, the Korean conflict and the... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Basic pension...
20 CFR 404.2106 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2014 CFR
2014-04-01
... Provisions § 404.2106 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 404.2106 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2012 CFR
2012-04-01
... Provisions § 404.2106 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 416.2206 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2013 CFR
2013-04-01
... Provisions § 416.2206 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 416.2206 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2014 CFR
2014-04-01
... Provisions § 416.2206 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 416.2206 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2012 CFR
2012-04-01
... Provisions § 416.2206 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
20 CFR 404.2106 - Basic qualifications for alternate participants.
Code of Federal Regulations, 2013 CFR
2013-04-01
... Provisions § 404.2106 Basic qualifications for alternate participants. (a) General. We may arrange for VR... (that is, any entity whether for-profit or not-for-profit), other than a State VR agency. (1) An... provide VR services in the State in which it provides services; and (ii) Under the terms of the written...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-12
...-Based Professional Subscriber Fees Charged by OPRA for its Basic Service November 8, 2010. Pursuant to... Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed amendment would revise the device-based professional subscriber fees charged by OPRA in respect of its Basic Service. A...
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Basic elements of the Medicaid quality control (MQC... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing...
Code of Federal Regulations, 2011 CFR
2011-10-01
...) Basic rule. Medicare Part B pays for anesthesia services and related care furnished by a certified... anesthesia at a level that builds on a premedical undergraduate science background. Anesthetist includes both... respect to non-physician anesthetists; (3) Has graduated from a nurse anesthesia educational program that...
Subsistence Specialist Handbook. Pamphlet No. P35101. Fourth Edition.
ERIC Educational Resources Information Center
Coast Guard Inst., Oklahoma City, OK.
This self-paced course is designed to present a basic, general overview of the duties of a Coast Guard Third Class Subsistence Specialist. The course provides basic information necessary to perform food preparation and food service tasks using various types of food service equipment and utensils. The course contains 16 illustrated reading…
25 CFR 36.97 - What basic requirements must a program's health services meet?
Code of Federal Regulations, 2010 CFR
2010-04-01
... MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY... necessary health services for all students residing in the homeliving program, subject to agreements between... dealing with emergency health care issues. (c) Parents or guardians may opt out of any non-emergency...
34 CFR 403.61 - What projects, services, and activities are permissible under the basic programs?
Code of Federal Regulations, 2014 CFR
2014-07-01
... 34 Education 3 2014-07-01 2014-07-01 false What projects, services, and activities are permissible under the basic programs? 403.61 Section 403.61 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE...
34 CFR 403.61 - What projects, services, and activities are permissible under the basic programs?
Code of Federal Regulations, 2012 CFR
2012-07-01
... 34 Education 3 2012-07-01 2012-07-01 false What projects, services, and activities are permissible under the basic programs? 403.61 Section 403.61 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE...
34 CFR 403.61 - What projects, services, and activities are permissible under the basic programs?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 34 Education 3 2010-07-01 2010-07-01 false What projects, services, and activities are permissible under the basic programs? 403.61 Section 403.61 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE...
34 CFR 403.61 - What projects, services, and activities are permissible under the basic programs?
Code of Federal Regulations, 2013 CFR
2013-07-01
... 34 Education 3 2013-07-01 2013-07-01 false What projects, services, and activities are permissible under the basic programs? 403.61 Section 403.61 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE...
34 CFR 403.61 - What projects, services, and activities are permissible under the basic programs?
Code of Federal Regulations, 2011 CFR
2011-07-01
... 34 Education 3 2011-07-01 2011-07-01 false What projects, services, and activities are permissible under the basic programs? 403.61 Section 403.61 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE...
Zhang, Gui-lin; Pan, Xi-long
2013-04-18
To measure the efficiency changes of basic public health service in Beijing rural areas and to provide some suggestions for the basic public health service project throughout China. In the study, stratified random samples from 32 township health centers (THCs) were measured by data envelopment analysis (DEA) model with the panel data from 2007 to 2009. (1) The average total efficiency score of samples was 0.972. The TE non-efficient THCs were with excess in all input indicators and insufficient outputs in technology management, health promotion and chronic disease management. (2) The total factor productivity (TFP) from 2007 to 2008 increased 8.8%, which was attributed to technology change. The TFP decreased by 6.6% from 2008 to 2009, but the technical efficiency increased by 3.3%. There is room for improvemrnt in the basic public health service project in Beijing rural areas. Scale efficiency should be improved and the common development of technical efficiency and technology progress promoted in order to increase the project outputs.
Tenure Track Investigator | Center for Cancer Research
The Neuro-Oncology Branch (NOB), Center for Cancer Research (CCR) of the National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Bethesda, MD, is actively recruiting for a tenure-track principal investigator to work in the area of immunology and/or immunotherapy. The NOB Immunology/Immunotherapy Investigator will be tasked with forming and leading an independent research program. This position will build the basic immunology program in the NOB and complement ongoing and planned translational research and clinical trials evaluating the effects of immunotherapy in patients with primary brain tumors. This program will be able to access biospecimens generated from ongoing and planned immunotherapy protocols within the NOB, thus creating an opportunity to perform correlative studies to interrogate the complex biology of immunologic response, toxicity, and treatment resistance. Demonstrated expertise in scientific inquiries in immunotherapy and/or immunology are essential, but prior work in brain tumors is not required. This is an exciting opportunity to join a growing trans-institutional research team that promotes and supports collaborations across the basic, translational, and clinical research spectrum to develop novel therapeutics for individuals with primary central nervous system malignancies that will globally influence the field.
TU-D-201-01: 2016 Economics Update
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fontenot, J; Fuss, W
The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a medical physicist. This will include general information about the different categories of payers and payees, how work is described by CPT codes, and how various payers set values for this work in different clinical settings. 2016 is another year of significant changes to the payment system. This presentation will describe the work encompassed in these codes and will give attendees an overview of the changes for 2016 as they apply to radiation oncology. Finally, some insightmore » into what can be expected during 2017 will be presented. This includes what information is typically released by the Centers for Medicaid and Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning objectives1) Basics of how Medicare is structured and how reimbursement rates are set.2) Basic understanding of proposed changes to the 2016 Medicare rules.3) Describe economics and policy resources that are available from the AAPM and how to interact with the professional economics committee.« less
Chandeying, V; Skov, S; Kemapunmanus, M; Law, M; Geater, A; Rowe, P
1998-06-01
(1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. Alternate allocation of subjects to one of two management protocols. Women presenting to university gynaecology outpatients department with a complaint of vaginal discharge. Subjects were alternately allocated management according to one of two protocols: one without (group A) and one with (group B) immediate access to results of basic laboratory tests. Full clinical assessment including speculum examination and microbiological assessment for infection with gonorrhoea, chlamydia, candida, trichomonas, and bacterial vaginosis was performed on all women. Follow up assessment of clinical and microbiological response was performed 1-2 weeks later. At initial assessment, both groups were similar in all respects except that more group B women had inflammation of the vulva. The prevalences of various conditions were: candidiasis 22%, bacterial vaginosis 38%, trichomoniasis 4%, chlamydia 4%, gonorrhoea 0.4%. There was no association between any demographic characteristic and diagnosis of cause of the discharge. Both protocols resulted in clinically and statistically significant improvements for women with candidiasis, bacterial vaginosis, and trichomoniasis. There were no clinically important differences in outcomes between the two protocols. The sensitivities and specificities of various indicators were: curd-like vaginal discharge for candidiasis, 72% and 100%; homogeneous vaginal discharge for bacterial vaginosis or trichomoniasis, 94% and 88%; absent or scanty lactobacilli for bacterial vaginosis, 99% and 68%; > 20% clue cells for bacterial vaginosis, 81% and 99%; visible endocervical mucopus for chlamydia or gonorrhoea, 36% and 86%; microscopic endocervical mucopus for chlamydia or gonorrhoea, 64% and 69%. Both protocols were equally effective in managing women with abnormal vaginal discharge. Simple clinical indicators for candidiasis, bacterial vaginosis, or trichomonas as in protocol A are sufficiently sensitive and specific for use in situations with no laboratory support. A modification to protocol A could increase detection of bacterial vaginosis at basic health service level. Further work is needed to identify appropriate indicators for infection with chlamydia or gonorrhoea.
Chandeying, V.; Skov, S.; Kemapunmanus, M.; Law, M.; Geater, A.; Rowe, P.
1998-01-01
OBJECTIVES: (1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. DESIGN: Alternate allocation of subjects to one of two management protocols. SUBJECTS: Women presenting to university gynaecology outpatients department with a complaint of vaginal discharge. METHODS: Subjects were alternately allocated management according to one of two protocols: one without (group A) and one with (group B) immediate access to results of basic laboratory tests. Full clinical assessment including speculum examination and microbiological assessment for infection with gonorrhoea, chlamydia, candida, trichomonas, and bacterial vaginosis was performed on all women. Follow up assessment of clinical and microbiological response was performed 1-2 weeks later. RESULTS: At initial assessment, both groups were similar in all respects except that more group B women had inflammation of the vulva. The prevalences of various conditions were: candidiasis 22%, bacterial vaginosis 38%, trichomoniasis 4%, chlamydia 4%, gonorrhoea 0.4%. There was no association between any demographic characteristic and diagnosis of cause of the discharge. Both protocols resulted in clinically and statistically significant improvements for women with candidiasis, bacterial vaginosis, and trichomoniasis. There were no clinically important differences in outcomes between the two protocols. The sensitivities and specificities of various indicators were: curd-like vaginal discharge for candidiasis, 72% and 100%; homogeneous vaginal discharge for bacterial vaginosis or trichomoniasis, 94% and 88%; absent or scanty lactobacilli for bacterial vaginosis, 99% and 68%; > 20% clue cells for bacterial vaginosis, 81% and 99%; visible endocervical mucopus for chlamydia or gonorrhoea, 36% and 86%; microscopic endocervical mucopus for chlamydia or gonorrhoea, 64% and 69%. CONCLUSIONS: Both protocols were equally effective in managing women with abnormal vaginal discharge. Simple clinical indicators for candidiasis, bacterial vaginosis, or trichomonas as in protocol A are sufficiently sensitive and specific for use in situations with no laboratory support. A modification to protocol A could increase detection of bacterial vaginosis at basic health service level. Further work is needed to identify appropriate indicators for infection with chlamydia or gonorrhoea. PMID:9849555
Font, F; Alonso González, M; Nathan, R; Kimario, J; Lwilla, F; Ascaso, C; Tanner, M; Menéndez, C; Alonso, P L
2001-06-01
Malaria control continues to rely on the diagnosis and prompt treatment of both suspected and confirmed cases through the health care structures. In south-eastern Tanzania malaria is one of the leading causes of morbidity and mortality. The absence of microscopic examination in most of the health facilities implies that health workers must rely on clinical suspicion to identify the need of treatment for malaria. Of 1558 randomly selected paediatric consultations at peripheral health facilities throughout Kilombero District, 41.1% were diagnosed by the attending health worker as clinical malaria cases and 42.5% prescribed an antimalarial. According to our malaria case definition of fever or history of fever with asexual falciparum parasitaemia of any density, 25.5% of all children attending the health services had malaria. This yielded a sensitivity of 70.4% (IC95% = 65.9-74.8%) and a specificity of 68.9% (IC95% = 66.2-71.5%). Accordingly, 30.4% of confirmed cases left with no antimalarial treatment. Among malaria-diagnosed patients, 10% were underdosed and 10.5% were overdosed. In this area, as in many African rural areas, the low diagnostic accuracy may imply that the burden of malaria cases may be overestimated. Greater emphasis on the functioning and quality of basic health services in rural endemic areas is required if improved case management of malaria is to help roll back this scourge.
Bernard, Chantal; Chandrakanth, S. A.; Cornell, Ian Scott; Dalton, James; Evans, Andrew; Garcia, Bertha M.; Godin, Chris; Godlewski, Marek; Jansen, Gerard H.; Kabani, Amin; Louahlia, Said; Manning, Lisa; Maung, Raymond; Moore, Lisa; Philley, Joanne; Slatnik, Jack; Srigley, John; Thibault, Alain; Picard, Donald Daniel; Cracower, Hanah; Tetu, Bernard
2014-01-01
The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered. PMID:24843826
Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit
2015-05-01
The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Alternative forms of transport and their use in the health services of developing countries.
Gish, O; Walker, G
1978-01-01
During the past few years greater interest has been shown in ways in which the coverage of health services in developing countries might be increased. Frequently, it has been advocated that greater use be made of mobile health services, often using relatively sophisticated transport systems, including aircraft. The present article examines the uses to which mobility in health services has been put and the merits of different forms of transport, within the resource constraints and health "needs" of Third World countries. Our main conclusions are that for the majority of health service movement appropriate intermediate technology transport should be used (i.e. bicycle, animals, or motorcycles). The use of mechanical transport within health services with the highest benefit per unit cost is likely to be that employed in the regular supportive (not policing) visits to permanently staffed fixed basic care facilities by more highly skilled and scarce health personnel. Those clinics located closer to the regional base can usually be reached more cheaply by land transport, while those at a distance might justify the use of a light aircraft. Where aircraft are used in this supportive role, it is important they are integrated into the ongoing health services and tightly scheduled to lessen the risk of their diversion to less cost-effective activities.
Petrova, Guenka; Clerfeuille, Fabrice; Vakrilova, Milena; Mitkov, Cvetomir; Poubanne, Yannick
2008-01-01
The objective of this work is to study the possibilities of the tetraclass model for the evaluation of the changes in the consumer satisfaction from the provided pharmacy services during the time. Methods Within the same 4 months period in 2004 and 2006 were questioned at approximately 10 pharmacy consumers per working day. Every consumer evaluated the 34 service elements on a 5 points semantic-differential scale. The technique of the correspondence data analysis was used for the categorisation of the services. Results Most of the services have been categorized as basic ones. For the age group up to 40 years the access to pharmacy became a key element and external aspects became a secondary element in 2006 year. For the group of patients that are using the services of the pharmacy for more than 2 years, availability of phone connection, quality of answers and product prices move from plus to secondary element. The ratio quality/price moves from the group of basic to key services, visibility of the prices and hygiene became basic elements from secondary ones. During the two years period, all the service elements connected with the staff as availability, identification, good looking, confidence, dressing, advices, technical competence, explanation, and time spent with clients remain basic services. The confidentiality of the staff remains always a key element. Conclusion Our study shows that the tetraclass model allows taking more informed managerial decisions in the pharmacies, as well as, is providing information for the concrete area of services and possible measures. In case of a development of a simple statistical program for quick processing of the inquiry data, the method will became applicable and affordable even for small pharmacies. PMID:25147588
A Guide to Writing Academic Portfolios for Radiologists.
Thomas, John V; Sanyal, Rupan; O'Malley, Janis P; Singh, Satinder P; Morgan, Desiree E; Canon, Cheri L
2016-12-01
The academic educator's portfolio is a collection of materials that document academic performance and achievements, supplementing the curriculum vitae, in order to showcase a faculty member's most significant accomplishments. A decade ago, a survey of medical schools revealed frustration in the nonuniform methods of measuring faculty's medical education productivity. A proposed solution was the use of an academic educator's portfolio. In the academic medical community, compiling an academic portfolio is always a challenge because teaching has never been confined to the traditional classroom setting and often involves active participation of the medical student, resident, or fellow in the ongoing care of the patient. Diagnostic radiology in addition requires a knowledge base that encompasses basic sciences, imaging physics, technology, and traditional and molecular medicine. Teaching and performing research that involves this complex mix, while providing patient care that is often behind the scenes, provides unique challenges in the documentation of teaching, research, and clinical service for diagnostic radiology faculty. An academic portfolio is seen as a way to explain why relevant academic activities are significant to promotions committee members who may have backgrounds in unrelated academic areas and may not be familiar with a faculty member's work. The academic portfolio consists of teaching, research, and service portfolios. The teaching portfolio is a collection of materials that document teaching performance and documents the educator's transition to a more effective educator. A research portfolio showcases the most significant research accomplishments. The service portfolio documents service responsibilities and highlight any service excellence. All portfolios should briefly discuss the educator's philosophy, activities, methods used to implement activities, leadership, mentoring, or committee roles in these respective areas. Recognizing that academic programs have differing needs, this article will attempt to provide some basic guidelines that may help junior faculty in diagnostic radiology develop their teaching, research, and service portfolios. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun
2012-04-01
In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.
Reiter, Harald; Muehlsteff, Jens; Sipilä, Auli
2011-01-01
Functional textiles are seen as promising technology to enable healthcare services and medical care outside hospitals due to their ability to integrate textile-based sensing and monitoring technologies into the daily life. In the past much effort has been spent onto basic functional textile research already showing that reliable monitoring solutions can be realized. The challenge remains to find and develop suited medical application and to fulfil the boundary conditions for medical endorsement and exploitation. The HeartCycle vest described in this abstract will serve as an example for a functional textile carefully developed according to the requirements of a specific medical application, its clinical validation, the related certification aspects and the next improvement steps towards exploitation.
Epidemiology of Pediatric Prehospital Basic Life Support Care in the United States.
Diggs, Leigh Ann; Sheth-Chandra, Manasi; De Leo, Gianluca
2016-01-01
Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services data available, the 2013 National Emergency Medical Services Information System (NEMSIS) Public Release Research Data Set. Pediatric calls represented 7.4% of emergency medical services activations. Most pediatric patients were male (49.8%), White (40.0%), and of non-Hispanic origin (56.5%). Most incidents occurred in the home. Injury, cardiac arrest, and resuscitation attempts were highest in the 15 to 19 year old age group. Global complaints (37.1%) predominated by anatomic location and musculoskeletal complaints (26.9%) by organ system. The most common primary symptom was pain (30.3%) followed by mental/psychiatric (13.4%). Provider's top primary impression was traumatic injury (35.7%). The most common cause of injury was motor vehicle accident (32.3%). The most common procedure performed was patient assessment (27.4%). Median EMS system response time was 7 minutes (IQR: 5-12). Median EMS scene time was 12 minutes (IQR: 8-19). Median transport time was 14 minutes (IQR: 8-24). Median EMS total call time was 51 minutes (IQR: 33-77). The epidemiology of pediatric basic life support can help to guide efforts in both emergency medical services operations and training.
Nielsen, Dorte Guldbrand; Gotzsche, Ole; Sonne, Ole; Eika, Berit
2012-10-01
Two major views on the relationship between basic science knowledge and clinical knowledge stand out; the Two-world view seeing basic science and clinical science as two separate knowledge bases and the encapsulated knowledge view stating that basic science knowledge plays an overt role being encapsulated in the clinical knowledge. However, resent research has implied that a more complex relationship between the two knowledge bases exists. In this study, we explore the relationship between immediate relevant basic science (physiology) and clinical knowledge within a specific domain of medicine (echocardiography). Twenty eight medical students in their 3rd year and 45 physicians (15 interns, 15 cardiology residents and 15 cardiology consultants) took a multiple-choice test of physiology knowledge. The physicians also viewed images of a transthoracic echocardiography (TTE) examination and completed a checklist of possible pathologies found. A total score for each participant was calculated for the physiology test, and for all physicians also for the TTE checklist. Consultants scored significantly higher on the physiology test than did medical students and interns. A significant correlation between physiology test scores and TTE checklist scores was found for the cardiology residents only. Basic science knowledge of immediate relevance for daily clinical work expands with increased work experience within a specific domain. Consultants showed no relationship between physiology knowledge and TTE interpretation indicating that experts do not use basic science knowledge in routine daily practice, but knowledge of immediate relevance remains ready for use.
Erberich, Stephan G; Bhandekar, Manasee; Chervenak, Ann; Kesselman, Carl; Nelson, Marvin D
2007-01-01
Functional MRI is successfully being used in clinical and research applications including preoperative planning, language mapping, and outcome monitoring. However, clinical use of fMRI is less widespread due to its complexity of imaging, image workflow, post-processing, and lack of algorithmic standards hindering result comparability. As a consequence, wide-spread adoption of fMRI as clinical tool is low contributing to the uncertainty of community physicians how to integrate fMRI into practice. In addition, training of physicians with fMRI is in its infancy and requires clinical and technical understanding. Therefore, many institutions which perform fMRI have a team of basic researchers and physicians to perform fMRI as a routine imaging tool. In order to provide fMRI as an advanced diagnostic tool to the benefit of a larger patient population, image acquisition and image post-processing must be streamlined, standardized, and available at any institution which does not have these resources available. Here we describe a software architecture, the functional imaging laboratory (funcLAB/G), which addresses (i) standardized image processing using Statistical Parametric Mapping and (ii) its extension to secure sharing and availability for the community using standards-based Grid technology (Globus Toolkit). funcLAB/G carries the potential to overcome the limitations of fMRI in clinical use and thus makes standardized fMRI available to the broader healthcare enterprise utilizing the Internet and HealthGrid Web Services technology.
Alternative Methods by Which Basic Science Pharmacy Faculty Can Relate to Clinical Practice.
ERIC Educational Resources Information Center
Kabat, Hugh F.; And Others
1982-01-01
A panel of pharmacy faculty ranked a broad inventory of basic pharmaceutical science topics in terms of their applicability to clinical pharmacy practice. The panel concluded that basic pharmaceutical sciences are essentially applications of foundation areas in biological, physical, and social sciences. (Author/MLW)
Introduction to Library Public Services. Sixth Edition. Library and Information Science Text Series.
ERIC Educational Resources Information Center
Evans, G. Edward; Amodeo, Anthony J.; Carter, Thomas L.
This book covers the role, purpose, and philosophy related to each of the major functional areas of library public service. This sixth edition, on the presumption that most people know the basic facts about computer hardware, does not include the chapter (in the previous edition) on computer basics, and instead integrated specific technological…
ERIC Educational Resources Information Center
Tao, Fumiyo; And Others
Upward mobility programs in the service sector for low-skilled, economically disadvantaged, and dislocated or displaced workers promote employment security, career development, and productivity. Two basic types of upward mobility programs are basic and job-specific skills training. Although 60-80 percent of all employer-sponsored formal training…
20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?
Code of Federal Regulations, 2011 CFR
2011-04-01
... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... Investment Boards for the delivery of the services available through the One-Stop system to MSFW's; and (d... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are the basic components of an NFJP...
20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?
Code of Federal Regulations, 2010 CFR
2010-04-01
... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... Investment Boards for the delivery of the services available through the One-Stop system to MSFW's; and (d... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP...
ERIC Educational Resources Information Center
Berney, Tomi D.; Barrera, Marbella
In its second year, the Bilingual Academic Services and Integrated Career Systems (BASICS) Program served 104 limited-English-proficient students at Bayside High School in Queens (New York City). Project goals were to develop English literacy skills, produce an organizing framework of thinking and language skills across the curriculum, generate a…
Code of Federal Regulations, 2010 CFR
2010-10-01
... (Class B telephone companies); Basic area revenue-Account 5001 (Class A telephone companies). 36.212..., REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Revenues and Certain... companies); Basic area revenue—Account 5001 (Class A telephone companies). (a) Local private line revenues...
Fluid Power/Basic Hydraulics. Instructor's Guide.
ERIC Educational Resources Information Center
Stanbery, Richard
This guide is designed to assist industrial vocational instructors in teaching a course on fluid power and basic hydraulics. Covered in the unit on the basics of fluid power and hydraulics are the following topics: the fundamentals of fluid power and hydraulics, basic hydraulic circuits, and servicing a hydraulic jack. The second unit, consisting…
Frameless, image-guided stereotactic radiosurgery.
Steffey-Stacy, Emily Cassandra
2006-11-01
To trace the evolution from frame-based to frameless image-guided SRS, to discuss the basic radiobiological principle of fractionation, current clinical trial data, and procedural components of the treatment plan. Nursing and medical literature, neurosurgical textbooks, and select internet sites. The CyberKnife (Accuray, Sunnyvale, CA) is the newest machine added to the technologic armamentarium of patient care. Its capacities are only beginning to be explored and the possibilities are limitless, giving hope to countless persons. Technologic advances have necessitated a diversification of nursing roles. Coordination of patient care services requires nurses to advance their knowledge of frameless, image-guided SRS.
Body Area Network BAN--a key infrastructure element for patient-centered medical applications.
Schmidt, Robert; Norgall, Thomas; Mörsdorf, Joachim; Bernhard, Josef; von der Grün, Thomas
2002-01-01
The Body Area Network (BAN) concept enables wireless communication between several miniaturized, intelligent Body Sensor (or actor) Units (BSU) and a single Body Central Unit (BCU) worn at the human body. A separate wireless transmission link from the BCU to a network access point--using different technology--provides for online access to BAN data via usual network infrastructure. BAN is expected to become a basic infrastructure element for service-based electronic health assistance: By integrating patient-attached sensors and control of mobile dedicated actor units, the range of medical workflow can be extended by wireless patient monitoring and therapy support. Beyond clinical use, professional disease management environments, and private personal health assistance scenarios (without financial reimbursement by health agencies/insurance companies), BAN enables a wide range of health care applications and related services.
Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C.
2017-01-01
Abstract Introduction: Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). Methods: A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Results: Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076–16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12–255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. Conclusions: The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting. PMID:28770590
Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C
2017-07-21
Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting.
Employee attitudes toward participation in a work site-based health and wellness clinic.
Bright, David R; Terrell, Sara L; Rush, Michael J; Kroustos, Kelly R; Stockert, Amy L; Swanson, Scott C; DiPietro, Natalie A
2012-10-01
To conduct a needs assessment to determine employee attitudes and barriers toward participation in a multidisciplinary work site-based health and wellness clinic. A 21-question survey was developed and sent electronically to all available (n = 874) employees of a self-insured employer. Of the 303 survey respondents (34.7% response rate), 67.3% (n = 204) individuals indicated a desire to meet with a pharmacist regarding medication information. Medication therapy management (MTM) services most often selected by survey respondents included basic education about each medication and its intended purpose (33%, n = 100); education on self-care (30%, n = 91); and information on generic or less expensive alternative medications and strategies for cost savings (25.1%, n = 76). Eighty-eight (29%) respondents indicated a desire for preventive care counseling to receive guidance on recommended disease screenings, immunizations, and other recommended services. Additional interest was observed in nutrition coaching (n = 131, 43.2%) and exercise programming (n = 272, 89.4%). The majority of respondents indicated a desire to participate in a work site-based health and wellness clinic, regardless of baseline health status or medication use. These data provide insight into the needs and preferences of participants in work site wellness programs and shows the value of a needs assessment.
Service provision in the wake of a new funding model for community pharmacy.
Smith, Alesha J; Scahill, Shane L; Harrison, Jeff; Carroll, Tilley; Medlicott, Natalie J
2018-05-02
Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community pharmacies since introduction of the new funding model, what the barriers are to providing these services. A survey of all community pharmacies were undertaken between August, 2014 and February, 2015. Basic descriptive statistics were completed and group comparisons were made using the chi squared test with significance set at p < 0.05. 528 responses were received. Education and advice on prescription and non-prescription medicines were the two top listed services provided. There were no significant differences in service provision between rural and metro based pharmacies. Many pharmacies were considering introducing new patient centred services. Four of the top ten frequently provided services have no public funding attached. Costs and staff availability are the most common barriers to undertake services, more predominantly in patient centred services. This study was the first to provide an evaluation of service provision in response to a new funding model for New Zealand Community Pharmacies. A broad range of services are being undertaken in New Zealand community pharmacies including patient-centred services. A number of barriers to service provision were identified. This study provides a baseline for the current levels of service provision upon which future studies can compare to and evaluate any changes in service provision with differing funding models going forward.
Rodríguez-Saldana, Joel; Rosales-Campos, Andrea C; Rangel León, Carmen B; Vázquez-Rodríguez, Laura I; Martínez-Castro, Francisco; Piette, John D
2010-12-01
To survey a large sample of type 2 diabetes mellitus (T2DM) patients in Mexico City to determine if patient experience, access to basic services, treatment, and outcomes differed between those with social security coverage and those without. From 2001-2007 a total of 1 000 individuals with T2DM were surveyed in outpatient clinics of the three largest public ophthalmology hospitals in Mexico City. Patients reported information about their health status and receipt of basic diabetes services, such as laboratory glycemic monitoring and diabetes education. Rates were compared between those with (n = 461) and without (n = 539) social security. Almost half of the patients (46%) in these public facilities were social security patients that were unable to access other services and had to pay out-of-pocket for care. Half of respondents were originally identified as potentially diabetic based on symptom complaints (51%), including 11% with visual impairment. Most patients (87.9%) reported that their glycemic level was being monitored exclusively via fasting blood glucose testing or random capillary blood glucose tests; only 5.3% reported ever having a glycated hemoglobin test. While nearly all respondents reported an individual physician encounter ever, only 39% reported ever receiving nutrition counseling and only 21% reported attending one or more sessions of diabetes education in their lifetime. Processes of care and outcomes were no different in patients with and those without social security coverage. In Mexico, the quality of diabetes care is poor. Despite receiving social security, many patients still have to pay out-of-pocket to access needed care. Without policy changes that address these barriers to comprehensive diabetes management, scientific achievements in diagnosis and pharmacotherapy will have limited impact.
Williams, Austin D; Mann, Barry D
2017-02-01
As they enter the clinical years, medical students face large adjustments in the acquisition of medical knowledge. We hypothesized that basic science review related to the topic of journal club papers would increase the educational benefit for third-year medical students. Students were randomized either to participation in a review session about basic science related to the journal club paper, or to no review. After one day, and after three months, students were given a 10-question quiz encompassing the basic science and the clinical implications of the paper. Twenty-six of 50 students were randomized to basic science review. These students scored better on both sections of the quiz one day after journal club, but only on basic science questions after three months. Students who participated in basic science review had better knowledge gain and retention. Educational activities building upon foundational knowledge improves learning on clinical rotations. Copyright © 2016 Elsevier Inc. All rights reserved.
Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F
2016-05-28
Barely a decade after introduction of Ghana's National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the scheme is increasingly threatened by concerns on quality of health service delivery in NHIS-accredited health facilities coupled with stakeholders' discontentment with the operational and administrative challenges confronting the NHIS. The study sought to ascertain whether or not Systematic Community Engagement (SCE) interventions have a significant effect on frontline health workers' perspectives on the NHIS and its impact on quality health service delivery. The study is a randomized cluster trial involving clinical and non-clinical frontline health workers (n = 234) interviewed at baseline and follow-up in the Greater Accra and Western regions of Ghana. Individual respondents were chosen from within each intervention and control groupings. Difference-in-difference estimations and propensity score matching were performed to determine impact of SCE on staff perceptions of the NHIS. The main outcome measure of interest was staff perception of the NHIS based on eight (8) factor-analyzed quality service parameters. Staff interviewed in intervention facilities appeared to perceive the NHIS more positively in terms of its impact on "availability and quality of drugs (p < 0.05)" and "workload on health staff/infrastructure" than those interviewed in control facilities (p < 0.1). Delayed reimbursement of service providers remained a key concern to over 70 % of respondents in control and intervention health facilities. Community engagement in quality service assessment is a potential useful strategy towards empowering communities while promoting frontline health workers' interest, goodwill and active participation in Ghana's NHIS.
Financial anatomy of biomedical research.
Moses, Hamilton; Dorsey, E Ray; Matheson, David H M; Thier, Samuel O
2005-09-21
Public and private financial support of biomedical research have increased over the past decade. Few comprehensive analyses of the sources and uses of funds are available. This results in inadequate information on which to base investment decisions because not all sources allow equal latitude to explore hypotheses having scientific or clinical importance and creates a barrier to judging the value of research to society. To quantify funding trends from 1994 to 2004 of basic, translational, and clinical biomedical research by principal sponsors based in the United States. Publicly available data were compiled for the federal, state, and local governments; foundations; charities; universities; and industry. Proprietary (by subscription but openly available) databases were used to supplement public sources. Total actual research spending, growth rates, and type of research with inflation adjustment. Biomedical research funding increased from 37.1 billion dollars in 1994 to 94.3 billion dollars in 2003 and doubled when adjusted for inflation. Principal research sponsors in 2003 were industry (57%) and the National Institutes of Health (28%). Relative proportions from all public and private sources did not change. Industry sponsorship of clinical trials increased from 4.0 dollars to 14.2 billion dollars (in real terms) while federal proportions devoted to basic and applied research were unchanged. The United States spent an estimated 5.6% of its total health expenditures on biomedical research, more than any other country, but less than 0.1% for health services research. From an economic perspective, biotechnology and medical device companies were most productive, as measured by new diagnostic and therapeutic devices per dollar of research and development cost. Productivity declined for new pharmaceuticals. Enhancing research productivity and evaluation of benefit are pressing challenges, requiring (1) more effective translation of basic scientific knowledge to clinical application; (2) critical appraisal of rapidly moving scientific areas to guide investment where clinical need is greatest, not only where commercial opportunity is currently perceived; and (3) more specific information about sources and uses of research funds than is generally available to allow informed investment decisions. Responsibility falls on industry, government, and foundations to bring these changes about with a longer-term view of research value.
Friedman, B A
2001-08-01
Major forces are now reshaping all businesses on a global basis, including the healthcare and clinical laboratory industries. One of the major forces at work is information technology (IT), which now provides the opportunity to create a new economic and business model for the clinical laboratory industry based on the creation of an integrated vertical meta-network, referred to here as the "total laboratory solution" (TLS). Participants at the most basic level of such a network would include a hospital-based laboratory, a reference laboratory, a laboratory information system/application service provider/laboratory portal vendor, an in vitro diagnostic manufacturer, and a pharmaceutical/biotechnology manufacturer. It is suggested that each of these participants would add value to the network primarily in its area of core competency. Subvariants of such a network have evolved over recent years, but a TLS comprising all or most of these participants does not exist at this time. Although the TLS, enabled by IT and closely akin to the various e-businesses that are now taking shape, offers many advantages from a theoretical perspective over the current laboratory business model, its success will depend largely on (a) market forces, (b) how the collaborative networks are organized and managed, and (c) whether the network can offer healthcare organizations higher quality testing services at lower cost. If the concept is successful, new demands will be placed on hospital-based laboratory professionals to shift the range of professional services that they offer toward clinical consulting, integration of laboratory information from multiple sources, and laboratory information management. These information management and integration tasks can only increase in complexity in the future as new genomic and proteomics testing modalities are developed and come on-line in clinical laboratories.
Barbieri, Raquel Rodrigues; Sales, Anna Maria; Hacker, Mariana Andrea; Nery, José Augusto da Costa; Duppre, Nádia Cristina; Machado, Alice de Miranda; Moraes, Milton Ozório; Sarno, Euzenir Nunes
2016-10-01
We evaluated the profile of patients referred to the Fiocruz Outpatient Clinic, a reference center for the diagnosis and treatment of leprosy in Rio de Janeiro, RJ, and analyzed the origins and outcomes of these referrals. This is an observational retrospective study based on information collected from the Leprosy Laboratory database at Fiocruz, Rio de Janeiro, RJ, Brazil. A total of 1,845 suspected leprosy cases examined at the reference center between 2010 and 2014 were included. The originating health service referrals and diagnostic outcomes were analyzed as well as the clinical and epidemiological data of patients diagnosed with leprosy. Our data show that the profile of the patients treated at the Clinic has changed in recent years. There was an increase in both the proportion of patients with other skin diseases and those who had visited only one health service prior to our Clinic. Among the total 1,845 cases analyzed, the outcomes of 1,380 were linked to other diseases and, in 74% of these cases, a biopsy was not necessary to reach a diagnostic conclusion. A decrease in new leprosy case detection among our patients was also observed. Yet, among the leprosy patients, 40% had some degree of disability at diagnosis. The results of the present study demonstrated the importance of referral centers in support of basic health services within the decentralization strategy. But, the success of the program depends on the advent of new developmental tools to augment diagnostic accuracy for leprosy. However, it should be emphasized that for new diagnostic methods to be developed, a greater commitment on the part of the health care system regarding research is urgently needed.
Watson, Dennis P; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P; Hill, James; Shue, Sarah
2017-01-01
There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.
A Simulation for Teaching the Basic and Clinical Science of Fluid Therapy
ERIC Educational Resources Information Center
Rawson, Richard E.; Dispensa, Marilyn E.; Goldstein, Richard E.; Nicholson, Kimberley W.; Vidal, Noni Korf
2009-01-01
The course "Management of Fluid and Electrolyte Disorders" is an applied physiology course taught using lectures and paper-based cases. The course approaches fluid therapy from both basic science and clinical perspectives. While paper cases provide a basis for application of basic science concepts, they lack key components of genuine clinical…
Koolwijk, Jasper; Fick, Mark; Selles, Caroline; Turgut, Gökhan; Noordergraaf, Jeske I M; Tukkers, Floor S; Noordergraaf, Gerrit J
2015-02-01
To evaluate whether an ophthalmologist-led, non-anesthesia-supported, limited monitoring pathway for phacoemulsification/intraocular lens cataract surgery, can be performed safely with only a medical emergency team providing support. Retrospective, observational, cohort study. All patients who underwent elective phacoemulsification/intraocular lens surgery under topical anesthesia in the ophthalmology outpatient unit between January 1, 2011, and December 31, 2012. Cataract surgery was performed by phacoemulsification under topical anesthesia. The intake process mainly embraced ophthalmic evaluation, obtaining a medical history, and proposing the procedure. A staff ophthalmologist performed the procedure assisted by 2 registered nurses in an independent outpatient clinic operating room within the hospital. The clinical pathway was without dedicated presence of or access to anesthesia service. Perioperative monitoring was limited to blood pressure and plethysmography preoperatively and intraoperatively. Patients were offered supportive care and instructed to avoid fasting and continue all their chronic medication. The primary outcome measure was the incidence of adverse events requiring medical emergency team (MET) interventions throughout the pathway. Secondary outcome measures were surgical ocular complication rates, use of oral sedatives, and reported reasons to perform the surgery in the classical operation room complex. Within the cataract pathway, 6961 cases (4347 patients) were eligible for analysis. Three MET interventions related to the phacoemulsification/intraocular lens pathway occurred in the 2-year study period, resulting in an intervention rate of 0.04%. None of the interventions was intraoperative. All 3 patients were diagnosed as vasovagal collapse and recuperated uneventfully. No hospital admittance was required. Eight other incidents occurred within the general ophthalmology outpatient unit population during the study period. Cataract surgery can be safely performed in an outpatient clinic, in the absence of the anesthesia service and with limited workup and monitoring. Basic first aid and basic life support skills seem to be sufficient in case of an adverse event. An MET provides a generous failsafe for this low-risk procedure. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Satellite services system analysis study: Propellant transfer system
NASA Technical Reports Server (NTRS)
1982-01-01
General servicing requirements, a servicing mission concept and scenario, overall servicing needs, basic servicing equipment, and a general servicing mission configuration layout are addressed. Servicing needs, equipment concepts, system requirements equipment specifications, preliminary designs, and resource requirements for flight hardware for the propellant transfer system are also addressed.
ERIC Educational Resources Information Center
Alamprese, Judith A.; Gwaltney, Margaret K.
2010-01-01
The Adult Education Coordination and Planning (AECAP) guide is designed to assist state adult education staff in forming partnerships at the state level and facilitating coordination at the local level as a lever for expanding and improving the quality of adult basic education (ABE) and workforce development services. Coordination plays a critical…
ERIC Educational Resources Information Center
Kind, Vanessa; Kind, Per Morten
2011-01-01
Around 150 pre-service science teachers (PSTs) participated in a study comparing academic and personal characteristics with their misconceptions about basic chemical ideas taught to 11-16-year-olds, such as particle theory, change of state, conservation of mass, chemical bonding, mole calculations, and combustion reactions. Data, collected by…
ERIC Educational Resources Information Center
Brevard, Eddie, Jr.
An instructor's manual and student activity guide on basic cake decorating are provided in this set of prevocational education materials which focuses on the vocational area of home economics (food services). (This set of materials is one of ninety-two prevocational sets arranged around a cluster of seven vocational offerings: agriculture, home…
Student Services for a New Breed
ERIC Educational Resources Information Center
Simmons, Howard L.; Kochey, Kenneth C.
1975-01-01
Today's student needs services sensitive to his priorities of work and economic security. Suggested services include: transportation services, food services, financial aid for basic physical needs, flexible scheduling, facilities for "lifetime" sports activities, counselors located at community centers, cooperative arrangements with local cultural…
Role of Non-Governmental Organizations for the Development of Basic Education in Punjab, Pakistan
ERIC Educational Resources Information Center
Iqbal, Javed
2010-01-01
The purpose of the study was to investigate the general working structure of non-governmental organizations (NGOs) and to examine the services and facilities provided by NGOs for basic education in Punjab, Pakistan. The population comprised 112 NGOs working for the promotion of basic education in Punjab, 3980 teachers working in basic education…
47 CFR 32.5001 - Basic area revenue.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 2 2011-10-01 2011-10-01 false Basic area revenue. 32.5001 Section 32.5001 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5001 Basic area revenue. (a...
47 CFR 32.5001 - Basic area revenue.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 2 2013-10-01 2013-10-01 false Basic area revenue. 32.5001 Section 32.5001 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5001 Basic area revenue. (a...
47 CFR 32.5001 - Basic area revenue.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 2 2014-10-01 2014-10-01 false Basic area revenue. 32.5001 Section 32.5001 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5001 Basic area revenue. (a...
Translational bioinformatics: linking the molecular world to the clinical world.
Altman, R B
2012-06-01
Translational bioinformatics represents the union of translational medicine and bioinformatics. Translational medicine moves basic biological discoveries from the research bench into the patient-care setting and uses clinical observations to inform basic biology. It focuses on patient care, including the creation of new diagnostics, prognostics, prevention strategies, and therapies based on biological discoveries. Bioinformatics involves algorithms to represent, store, and analyze basic biological data, including DNA sequence, RNA expression, and protein and small-molecule abundance within cells. Translational bioinformatics spans these two fields; it involves the development of algorithms to analyze basic molecular and cellular data with an explicit goal of affecting clinical care.
Routh, S.; el Arifeen, S.; Jahan, S. A.; Begum, A.; Thwin, A. A.; Baqui, A. H.
2001-01-01
The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services. PMID:11242821
Reaching remote areas in Latin America.
Jaimes, R
1994-01-01
Poor communities in remote and inaccessible areas tend to not only be cut off from family planning education and services, but they are also deprived of basic primary health care services. Efforts to bring family planning to such communities and populations should therefore be linked with other services. The author presents three examples of programs to bring effective family planning services to remote communities in Central and South America. Outside of the municipal center in the Tuxtlas region of Mexico, education and health levels are low and people live according to ancient customs. Ten years ago with the help of MEXFAM, the IPPF affiliate in Mexico, two social promoters established themselves in the town of Catemaco to develop a community program of family planning and health care offering education and prevention to improve the quality of people's lives. Through their health brigades taking health services to towns without an established health center, the program has influenced an estimated 100,000 people in 50 villages and towns. The program also has a clinic. In Guatemala, the Family Welfare Association (APROFAM) gave bicycles to 240 volunteer health care workers to facilitate their outreach work in rural areas. APROFAM since 1988 has operated an integrated program to treat intestinal parasites and promote family planning in San Lucas de Toliman, an Indian town close to Lake Atitlan. Providing health care to more than 10,000 people, the volunteer staff has covered the entire department of Solola, reaching each family in the area. Field educators travel on motorcycles through the rural areas of Guatemala coordinating with the health volunteers the distribution of contraceptives at the community level. The Integrated Project's Clinic was founded in 1992 and currently carries out pregnancy and Pap tests, as well as general lab tests. Finally, Puna is an island in the middle of the Gulf of Guayaquil, Ecuador. Women on the island typically have 10-14 pregnancies, families are extremely poor, and the population long had access to neither basic health services nor modern contraceptives and birth control. The Association for Ecuadorian Family Welfare (APROFE) realized the importance of finding some way to provide the residents of Puna with family planning, maternal and child health care, and primary health care. To that end, the organization built a fiberglass boat, installed modern equipment, and hired a doctor, nurse, and sociologist-educator trained in family planning and primary health care who now serve the population.
Code of Federal Regulations, 2010 CFR
2010-10-01
.../project manager. (iv) EVM is not required on contracts for non-developmental engineering support services, steady state operations, basic and applied research, and routine services such as janitorial services or...
The evolution of telemedicine and nano-technology
NASA Astrophysics Data System (ADS)
Park, Dong Kyun; Young Jung, Eun; Chan Moon, Byung
2012-10-01
This paper will cover definition and history of telemedicine, changes in medical paradigm and roll of telemedicine and roll of nano-technology for evolution of telemedicine. Hypothetically, telemedicine is distance communication for medical purpose and modern definition explains telemedicine as `a system of health care delivery in which physicians examine distant patients through the use of telecommunications technology. Medical service will change to personalized medicine based on gene information to prevent and manage diseases due to decrease of acute diseases, population aging and increase of prevalence in chronic diseases, which means current medical services based on manualized treatment for diseases will change to personalized medicine based on individual gene information. Also, international healthcare will be activated to provide high quality medical services with low cost using developed transportation. Moreover, hospital centered medical services will change to patients centered medical service due to increase of patient's rights. Development in sensor technology is required for telemedicine to be applied as basic infrastructure for medical services. Various researches in nano-biosensor field are conducted due to introduction of new technologies. However, most researches are in fundamental levels that requires more researches for stability and clinical usefulness. Nano technology is expected to achieve innovative development and define new criteria for disease prevention and management.
Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals.
Finucane, Anne M; Dima, Alexandra; Ferreira, Nuno; Halvorsen, Marianne
2012-01-01
To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups. In total, 439 participants took part in this study: healthy (n = 131), chronic pain (n = 220), depressed (n = 24) and PTSD (n = 64). The participants completed the trait version of the Basic Emotion Scale. Basic emotion profiles were compared both within each group and between the healthy group and each of the three other groups. Discriminant analysis was used to assess the extent to which basic emotions can be used to classify the participants as belonging to the healthy group or one of the clinical groups. In the healthy group, happiness was experienced more than any other basic emotion. This was not found in the clinical groups. In comparison to the healthy participants, the chronic pain group experienced more fear, anger and sadness, the depressed group reported more sadness and the PTSD group experienced all of the negative emotions more frequently. Discriminant analysis revealed that happiness was the most important variable in determining whether an individual belonged to the healthy group or one of the clinical groups. Anger was found to further discriminate between depressed and chronic pain individuals. The findings demonstrate that basic emotion profile analysis can provide a useful foundation for the exploration of emotional experience both within and between healthy and clinical groups. Copyright © 2011 John Wiley & Sons, Ltd.
Yazici, Hasan; Gogus, Feride; Esen, Fehim; Yazici, Yusuf
2014-06-01
There is concern that self-critique with authors acknowledging limitations of their work is not given due importance in scientific articles. We had the impression that this was more true for articles in basic compared with clinical science. We thus surveyed for the presence of self-critique in the discussion sections of the original articles in three rheumatology journals with attention to differences between the basic and the clinical science articles. The discussion sections of the original articles in January, May, and September 2012 issues of Annals of the Rheumatic Diseases, Arthritis and Rheumatism, and Rheumatology (Oxford) were surveyed (n = 223) after classifying each article as mainly related to clinical or basic science. The discussion sections were electronically scanned by two observers for the presence of the root word "limit" or its derivatives who also read each discussion section for the presence of any limitations otherwise voiced. A limitation discussion in any form was present in only 19 (20.2%) or 29 (30.1%) of 94 basic science vs. 95 (73.6%) or 107 (82.3%) of 129 clinical science articles (P < 0.0001 for either observer). Self-critique, especially lacking in basic science articles, should be given due attention. Copyright © 2014 Elsevier Inc. All rights reserved.
The Top 50 Most Cited Articles in Cartilage Regeneration.
Mc Donald, Ciaran K; Moriarty, Peter; Varzgalis, Manvydas; Murphy, Colin
2017-01-01
The aim of this study was to identify and analyze the top 50 most cited articles in cartilage regeneration. The impact of a scientific journal can be gauged by the total number of citations it has accrued. The top 50 most cited articles involving cartilage regeneration represent the most quoted level of evidence among this new subspecialty. This study aims to identify and analyze the 50 most cited articles in cartilage regeneration. The Web of Science™ citation indexing service was utilized to determine the most frequently cited articles published after 1956 containing "cartilage regeneration" in the "topic" or "title." The 50 most cited articles were included. The number of citations, year of publication, country of article origin, article institution, journal of publication, publication format, and authorship were then calculated for each article. The span of citations ranged from 1287 to 203 citations, with a mean of 361.02 citations per article in question. The articles originated from 11 countries, with the United States contributing 34 articles, followed by Japan with 5 articles. The articles were distributed across 34 high-impact journals. Biomaterials was the journal with the highest number of publications (seven articles) followed by the Journal of Orthopaedic Research (three articles). Of the 50 articles, 2 were clinical observational studies, 47 concerned basic science, and 1 was review article. The most cited articles involving cartilage regeneration are detected in both experimental and clinical research fields. The high ratio of basic science to clinical articles reflects the infancy of this relatively new specialty and that further clinical research is required in this area.
38 CFR 3.315 - Basic eligibility determinations; dependents, loans, education.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Basic eligibility determinations; dependents, loans, education. 3.315 Section 3.315 Pensions, Bonuses, and Veterans' Relief... Ratings and Evaluations; Service Connection § 3.315 Basic eligibility determinations; dependents, loans...
5 CFR 772.101 - Basic authority.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Basic authority. 772.101 Section 772.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.101 Basic authority. This part establishes a mechanism for agencies to provide...
5 CFR 772.101 - Basic authority.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Basic authority. 772.101 Section 772.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.101 Basic authority. This part establishes a mechanism for agencies to provide...
NASA Astrophysics Data System (ADS)
Rahmawati; Rustaman, Nuryani Y.; Hamidah, Ida; Rusdiana, Dadi
2017-02-01
The aim of this study was to explore the use of assessment strategy which can measure problem solving skills of pre-service teachers based on their cognitive style in basic physics course. The sample consisted of 95 persons (male = 15, female = 75). This study used an exploratory research with observation techniques by interview, questionnaire, and test. The results indicated that the lecturer only used paper-pencil test assessment strategy to measure pre-service teachers’ achievement and also used conventional learning strategy. It means that the lecturer did not measure pre-services’ thinking process in learning, like problem solving skills. One of the factors which can influence student problem solving skills is cognitive style as an internal factor. Field Dependent (FD) and Field Independent (FI) are two cognitive styles which were measured with using Group Embedded Figure Test (GEFT) test. The result showed that 82% of pre-service teachers were FD cognitive style and only 18% of pre-service teachers had FI cognitive style. Furthermore, these findings became the fundamental design to develop a problem solving assessment model to measure pre-service teachers’ problem solving skills and process in basic physics course.
NASA Technical Reports Server (NTRS)
1978-01-01
A unified framework for comparing intercity passenger and freight transportation systems is presented. Composite measures for cost, service/demand, energy, and environmental impact were determined. A set of 14 basic measures were articulated to form the foundation for computing the composite measures. A parameter dependency diagram, constructed to explicitly interrelate the composite and basic measures is discussed. Ground rules and methodology for developing the values of the basic measures are provided and the use of the framework with existing cost and service data is illustrated for various freight systems.
Ding, Yan; Smith, Helen J; Fei, Yang; Xu, Biao; Nie, Shaofa; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin
2013-01-01
The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance. To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention. The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province. Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts. Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.
2012-01-01
Background In the majority of China, the Centre for Disease Control (CDC) at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China. Methods This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach. Results The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site. Conclusion The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key words: TB control, service delivery, integration, hospitals, China. PMID:22276746
ERIC Educational Resources Information Center
Irby, Terry R.; And Others
Joliet Junior College's Center for Adult Basic Education and Literacy (CABEL) is responsible for providing adult basic education and support services for adults whose skills in reading and mathematics are below the 12th grade level. Its offerings include instruction in Adult Basic Education (ABE), General Educational Development (GED), English as…
ERIC Educational Resources Information Center
Sengul, Ozge Aydin
2016-01-01
The purpose of the current study is to investigate the pre-service teachers' opinions about science within the context of the basic elements of the education program, such as objectives, content, learning-teaching process and evaluation. The study was designed as a case study, one of the qualitative research methods. The participants of the study…
ERIC Educational Resources Information Center
Gurbuz, Fatih
2016-01-01
The purpose of this research study is to explore pre-service science teachers' misconceptions on basic astronomy subjects and to examine the effect of micro teaching method supported by educational technologies on correcting misconceptions. This study is an action research. Semi- structured interviews were used in the study as a data collection…
ERIC Educational Resources Information Center
Reiff, Tana, Ed.
This guide, which is intended for administrators of programs providing adult basic and literacy education (ABLE) services in Pennsylvania, contains 59 individually authored papers devoted to planning, managing, and improving ABLE programs. The following are among the topics discussed in the guide's five sections: understanding the role of the ABLE…
5 CFR 300.103 - Basic requirements.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic requirements. 300.103 Section 300.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Employment Practices § 300.103 Basic requirements. (a) Job analysis. Each employment practice of the Federal Government generally, and of...
5 CFR 551.401 - Basic principles.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...
5 CFR 870.603 - Conversion of Basic and Optional insurance.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Conversion of Basic and Optional... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Termination and Conversion § 870.603 Conversion of Basic and Optional insurance. (a)(1) When group coverage terminates for any...
Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan
Teich, Jonathan M.; Osheroff, Jerome A.; Pifer, Eric A.; Sittig, Dean F.; Jenders, Robert A.
2005-01-01
Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption. PMID:15802474
Scientific and Ethical Issues in Mitochondrial Donation
Craven, Lyndsey; Murphy, Julie; Turnbull, Doug M.; Taylor, Robert W.; Gorman, Grainne S.; McFarland, Robert
2018-01-01
The development of any novel reproductive technology involving manipulation of human embryos is almost inevitably going to be controversial and evoke sincerely held, but diametrically opposing views. The plethora of scientific, ethical and legal issues that surround the clinical use of such techniques fuels this divergence of opinion. During the policy change that was required to allow the use of mitochondrial donation in the UK, many of these issues were intensely scrutinised by a variety of people and in multiple contexts. This extensive process resulted in the publication of several reports that informed the recommendations made to government. We have been intrinsically involved in the development of mitochondrial donation, from refining the basic technique for use in human embryos through to clinical service delivery, and have taken the opportunity in this article to offer our own perspective on the issues it raises. PMID:29529980
... Tips Info Center Research Topics Federal Policy Glossary Stem Cell Information General Information Clinical Trials Funding Information Current ... Basics » Stem Cell Basics I. Back to top Stem Cell Basics I. Introduction: What are stem cells, and ...
Clinical pharmacology and therapeutics in undergraduate medical education in the UK: current status.
Walley, T; Bligh, J; Orme, M; Breckenridge, A
1994-01-01
1. Medical undergraduate education is currently undergoing major changes in the UK in response to calls for the development of a core curriculum. Teaching in clinical pharmacology and therapeutics will also change to meet these demands. A postal survey was conducted to assess the current status of teaching in these subjects. 2. A questionnaire based on previous similar surveys conducted elsewhere was sent to departments or individuals in 27 medical schools in the UK; 22 (81%) replied. 3. Departmental priorities were defined as (in order): clinical research, undergraduate teaching, basic scientific research and clinical service provision. No change in these priorities in the future was foreseen by respondents. 4. Teaching methods were for the most part traditional, with the lecture as the most widely used and important technique. Specific clinical teaching was conducted by some and was considered very important by them. Teaching by problem solving was much less common. 5. Respondents were asked for free text comments; many of the remarks suggested dissatisfaction with the resources and time currently available for teaching in clinical pharmacology and therapeutics. Some expressed significant concerns that their teaching commitment would be reduced further by the development of the core curriculum. PMID:8186059
Health services under the General Agreement on Trade in Services.
Adlung, R.; Carzaniga, A.
2001-01-01
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215
External quality assessment of urine particle identification: a Northern European experience.
Kouri, Timo T; Makkonen, Pirjo
2015-11-01
External quality assessment (EQA) schemes for urinalysis have been provided by Labquality Ltd, the publicly owned EQA service provider in Finland, since the 1980s. In 2014, the scheme on urine particle identification had 329 participating laboratories, out of which 60% from 19 countries were outside Finland. Each of the four annual web-based rounds were distributed with four Sternheimer-stained images from a single patient sample, as viewed both by bright-field and phase-contrast optics. Participants reported classified categories either at the basic or at the advanced level. Participating laboratories received assessment of their analytical performance as compared to their peers, including reflections from clinical data and preanalytical detail of the specimen. In general, reporting of basic urine particles succeeded in the eight schemes during the years 2013-2014 as follows: red blood cells 82%-92%, white blood cells 82%-97%, squamous epithelial cells 92%-98%, casts 84%-94%, and small epithelial cells 73%-83% (minimum and maximum of expected or accepted reports). This basic level of differentiation is used in routine laboratory reports, or as verification of results produced by automated instruments. Considerable effort is needed to standardise national procedures and reporting formats, in order to improve the shown figures internationally. Future technologies may help to alleviate limitations created by single digital images. Despite improvements, degenerating cells and casts always exhibit intermediate forms creating disputable classifications. That is why assessment of performance should encompass justified acceptable categories into the assessed outcomes. Preanalytical and clinical detail provide essential added value to morphological findings.
Cancer Pharmacogenomics: Integrating Discoveries in Basic, Clinical and Population Sciences to Advance Predictive Cancer Care, a 2010 workshop sponsored by the Epidemiology and Genomics Research Program.
Integrated Medical Curriculum: Advantages and Disadvantages
Quintero, Gustavo A.; Vergel, John; Arredondo, Martha; Ariza, María-Cristina; Gómez, Paula; Pinzon-Barrios, Ana-Maria
2016-01-01
Most curricula for medical education have been integrated horizontally and vertically–-vertically between basic and clinical sciences. The Flexnerian curriculum has disappeared to permit integration between basic sciences and clinical sciences, which are taught throughout the curriculum. We have proposed a different form of integration where the horizontal axis represents the defined learning outcomes and the vertical axis represents the teaching of the sciences throughout the courses. We believe that a mere integration of basic and clinical sciences is not enough because it is necessary to emphasize the importance of humanism as well as health population sciences in medicine. It is necessary to integrate basic and clinical sciences, humanism, and health population in the vertical axis, not only in the early years but also throughout the curriculum, presupposing the use of active teaching methods based on problems or cases in small groups. PMID:29349303
Cognition before curriculum: rethinking the integration of basic science and clinical learning.
Kulasegaram, Kulamakan Mahan; Martimianakis, Maria Athina; Mylopoulos, Maria; Whitehead, Cynthia R; Woods, Nicole N
2013-10-01
Integrating basic science and clinical concepts in the undergraduate medical curriculum is an important challenge for medical education. The health professions education literature includes a variety of educational strategies for integrating basic science and clinical concepts at multiple levels of the curriculum. To date, assessment of this literature has been limited. In this critical narrative review, the authors analyzed literature published in the last 30 years (1982-2012) using a previously published integration framework. They included studies that documented approaches to integration at the level of programs, courses, or teaching sessions and that aimed to improve learning outcomes. The authors evaluated these studies for evidence of successful integration and to identify factors that contribute to integration. Several strategies at the program and course level are well described but poorly evaluated. Multiple factors contribute to successful learning, so identifying how interventions at these levels result in successful integration is difficult. Evidence from session-level interventions and experimental studies suggests that integration can be achieved if learning interventions attempt to link basic and clinical science in a causal relationship. These interventions attend to how learners connect different domains of knowledge and suggest that successful integration requires learners to build cognitive associations between basic and clinical science. One way of understanding the integration of basic and clinical science is as a cognitive activity occurring within learners. This perspective suggests that learner-centered, content-focused, and session-level-oriented strategies can achieve cognitive integration.
Muscatello, Maria Rosaria A; Scimeca, Giuseppe; Pandolfo, Gianluca; Micò, Umberto; Romeo, Vincenzo M; Mallamace, Domenico; Mento, Carmela; Zoccali, Rocco; Bruno, Antonio
2014-04-01
Executive cognitive functions (ECFs) and other cognitive impairments, such as lower IQ and verbal deficits, have been associated with the pattern of antisocial and delinquent behavior starting in childhood (early-onset), but not with late-onset antisocial behavior. Beyond objective measures of ECF, basic symptoms are prodromal, subjectively experienced cognitive, perceptual, affective, and social disturbances, associated with a range of psychiatric disorders, mainly with psychosis. The goal of the present study was to examine ECF and basic symptoms in a sample of late-onset juvenile delinquents. Two-hundred nine male adolescents (aged 15-20 years) characterized by a pattern of late-onset delinquent behavior with no antecedents of Conduct Disorder, were consecutively recruited from the Social Services of the Department of Juvenile Justice of the city of Messina (Italy), and compared with nonantisocial controls matched for age, educational level, and socio-demographic features on measures for ECF dysfunction and basic symptoms. Significant differences between late-onset offenders (completers=147) and control group (n=150) were found on ECF and basic symptoms measures. Chi-square analysis showed that a significantly greater number of late-onset offending participants scored in the clinical range on several ECF measures. Executive cognitive impairment, even subtle and subclinical, along with subjective symptoms of cognitive dysfunction (basic symptom), may be contributing factor in the development and persistence of antisocial behaviors displayed by late-onset adolescent delinquents. The findings also suggest the need for additional research aimed to assess a broader range of cognitive abilities and specific vulnerability and risk factors for late-onset adolescent offenders. Copyright © 2014 Elsevier Inc. All rights reserved.
Postgraduate education in noninvasive laser therapy
NASA Astrophysics Data System (ADS)
Navratil, Leos; Kymplova, Jaroslava; Navratilova, Blanka
2002-10-01
Non-invasive lasertherapy became today an appreciated treatment method. To avoid its degradation, it is necessary that every physician, who indicates it, would pass out the basic course in these problems. So the error danger by its application would be reduced. As we have verified, in every country the education process is different; we don't consider this fact as right. In the Czech Republic the Radiobiologic Society of Czech Medical Society J. E. Purkynje in co-operation with the Institute of Further Physician's Education, having wide experiences in postgraduate education, organizes already five years such courses. The basic course has 20 lessons, in which the graduates are acquainted with physical base of laser, hygienic rulings for working with laser and biologic changes induced by low level laser in the tissue in vivo. A considerable attention is dedicated to clinical practice and practical education on clinical departments in the fields of dermatology, physiotherapy, stomatology and gynaecology. This course is completed with a lecture of the recent marketing in health service. Participants document their knowledge's in the closing test. Every physician can perfect his knowledge's in a continuation course. Our experiences proved that the education in phototherapy in Czech Republic is on high level in comparison with number of other countries.
42 CFR 410.74 - Physician assistants' services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Physician assistants' services. 410.74 Section 410... Physician assistants' services. (a) Basic rule. Medicare Part B covers physician assistants' services only... physically present when the physician assistant is performing the services unless required by State law...
42 CFR 410.74 - Physician assistants' services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 2 2013-10-01 2013-10-01 false Physician assistants' services. 410.74 Section 410... Physician assistants' services. (a) Basic rule. Medicare Part B covers physician assistants' services only... physically present when the physician assistant is performing the services unless required by State law...
42 CFR 410.74 - Physician assistants' services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 2 2014-10-01 2014-10-01 false Physician assistants' services. 410.74 Section 410... Physician assistants' services. (a) Basic rule. Medicare Part B covers physician assistants' services only... physically present when the physician assistant is performing the services unless required by State law...
42 CFR 410.74 - Physician assistants' services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 2 2012-10-01 2012-10-01 false Physician assistants' services. 410.74 Section 410... Physician assistants' services. (a) Basic rule. Medicare Part B covers physician assistants' services only... physically present when the physician assistant is performing the services unless required by State law...
42 CFR 410.74 - Physician assistants' services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Physician assistants' services. 410.74 Section 410... Physician assistants' services. (a) Basic rule. Medicare Part B covers physician assistants' services only... physically present when the physician assistant is performing the services unless required by State law...
The second 'D.D.S.' degree: a formula for practice success.
Paquette, Jacinthe M; Sheets, Cherilyn G
2004-09-01
Planning for success is critical in clinical dentistry and in the management of a dental practice. Dentists need to apply basic business principles to planning their dental careers as they develop a vision, deliver quality products and services, and surpass patients,' staff members' and their own expectations. By applying general business management principles, dental practices can develop a logical, systematic approach to the management of a professional services business. For many dental professionals, these concepts were not learned in an undergraduate dental educational program and need to be mastered after professional school. Ideally, each dentist will establish a philosophical course that provides direction to the practice of dentistry. For a private dental practitioner, part of his or her goal is to create a tangible, transferable asset and a solid business plan that can benefit the practitioner in the present, as well as in the future practice transition.
Web based aphasia test using service oriented architecture (SOA)
NASA Astrophysics Data System (ADS)
Voos, J. A.; Vigliecca, N. S.; Gonzalez, E. A.
2007-11-01
Based on an aphasia test for Spanish speakers which analyze the patient's basic resources of verbal communication, a web-enabled software was developed to automate its execution. A clinical database was designed as a complement, in order to evaluate the antecedents (risk factors, pharmacological and medical backgrounds, neurological or psychiatric symptoms, brain injury -anatomical and physiological characteristics, etc) which are necessary to carry out a multi-factor statistical analysis in different samples of patients. The automated test was developed following service oriented architecture and implemented in a web site which contains a tests suite, which would allow both integrating the aphasia test with other neuropsychological instruments and increasing the available site information for scientific research. The test design, the database and the study of its psychometric properties (validity, reliability and objectivity) were made in conjunction with neuropsychological researchers, who participate actively in the software design, based on the patients or other subjects of investigation feedback.
Medical education and training in Nepal: SWOT analysis.
Dixit, H; Marahatta, S B
2008-01-01
To analyse the impact of the medical colleges that have been set up within the last two decades by production of the doctors and the effect on the health of the people. SWOT (strength, weakness, opportunities and threats) analysis of medical education in Nepal has been done by reviewing medical manpower produced by the different institutions in the undergraduate and postgraduate (PG) categories, their registration with the Nepal Medical Council in terms of the existing health scenario of the country. Shows severe shortage of basic sciences teachers. In the clinical areas ophthalmic manpower and services provided are exemplary. There are shortages and shortcomings in all areas if standard health care is to be provided to the Nepalese. There is a long way to go to provide the expected educational and medical services to foreigners prepared to pay more to avail of this in Nepal.
A simulation for teaching the basic and clinical science of fluid therapy.
Rawson, Richard E; Dispensa, Marilyn E; Goldstein, Richard E; Nicholson, Kimberley W; Vidal, Noni Korf
2009-09-01
The course "Management of Fluid and Electrolyte Disorders" is an applied physiology course taught using lectures and paper-based cases. The course approaches fluid therapy from both basic science and clinical perspectives. While paper cases provide a basis for application of basic science concepts, they lack key components of genuine clinical cases that, by nature, are diverse, change over time, and respond in unique ways to therapeutic interventions. We developed a dynamic model using STELLA software that simulates normal and abnormal fluid and electrolyte balance in the dog. Students interact, not with the underlying model, but with a user interface that provides sufficient data (skin turgor, chemistry panel, etc.) for the clinical assessment of patients and an opportunity for treatment. Students administer fluids and supplements, and the model responds in "real time," requiring regular reassessment and, potentially, adaptation of the treatment strategy. The level of success is determined by clinical outcome, including improvement, deterioration, or death. We expected that the simulated cases could be used to teach both the clinical and basic science of fluid therapy. The simulation provides exposure to a realistic clinical environment, and students tend to focus on this aspect of the simulation while, for the most part, ignoring an exploration of the underlying physiological basis for patient responses. We discuss how the instructor's expertise can provide sufficient support, feedback, and scaffolding so that students can extract maximum understanding of the basic science in the context of assessing and treating at the clinical level.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 45 Public Welfare 1 2013-10-01 2013-10-01 false Basic policy. 17.2 Section 17.2 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.2 Basic policy. All adverse information release to news media shall be factual in content and...
Code of Federal Regulations, 2010 CFR
2010-10-01
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Basic policy. 17.2 Section 17.2 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.2 Basic policy. All adverse information release to news media shall be factual in content and...
Code of Federal Regulations, 2012 CFR
2012-10-01
... 45 Public Welfare 1 2012-10-01 2012-10-01 false Basic policy. 17.2 Section 17.2 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.2 Basic policy. All adverse information release to news media shall be factual in content and...
Code of Federal Regulations, 2014 CFR
2014-10-01
... 45 Public Welfare 1 2014-10-01 2014-10-01 false Basic policy. 17.2 Section 17.2 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.2 Basic policy. All adverse information release to news media shall be factual in content and...
Code of Federal Regulations, 2011 CFR
2011-10-01
... 45 Public Welfare 1 2011-10-01 2011-10-01 false Basic policy. 17.2 Section 17.2 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.2 Basic policy. All adverse information release to news media shall be factual in content and...
42 CFR 417.800 - Payment to HCPPs: Definitions and basic rules.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to HCPPs: Definitions and basic rules. 417... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS... and basic rules. (a) Definitions. As used in this subpart, unless the context indicates otherwise...
5 CFR 534.603 - Rates of basic pay.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Rates of basic pay. 534.603 Section 534.603 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.603 Rates of basic pay. (a) The...
Evaluation of a case-based urology learning program.
Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C
2013-12-01
To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
2015-06-15
The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less
MO-A-213-01: 2015 Economics Update Part 1
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dirksen, B.
2015-06-15
The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less
MO-A-213-02: 2015 Economics Update Part 2
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fontenot, J.
2015-06-15
The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less
Developing practical knowledge content of emergency nursing professionals.
Chu, Wen; Hsu, Li-Ling
2011-06-01
There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.
Exploring disparities in prenatal care between refugees and local South African women.
Kibiribiri, Edith T; Moodley, Dhayendre; Groves, Allison K; Sebitloane, Motshedisi H
2016-02-01
To explore possible disparities in prenatal care between refugees and South African women attending public health facilities in an urban setting in South Africa. A cross-sectional, mixed methods study was conducted at four public health clinics providing prenatal services in Durban between January 29, 2013, and June 15, 2013. Pretested client-satisfaction questionnaires were administered to 200 women attending immunization services at the clinics whose infants were aged 6 months or younger. An additional 16 refugees participated in in-depth interviews. Finally, a maternity chart audit was conducted to compare the quality of basic prenatal care. Among the women enrolled, 78 (39.0%) were refugees and 122 (61.0%) were South African citizens. Dissatisfaction was reported by 23 (19.3%) of 119 citizens and 32 (43.2%) of 74 refugees (P<0.001). However, the maternity chart audit of 68 participants (31 refugees, 37 citizens) did not reveal significant disparities in the quality of prenatal care. The most recurring categories arising in the in-depth interviews were linguistic barriers and the challenges faced when using informal interpreters. There were no significant disparities in prenatal care; however, refugees unable to communicate in the local languages reported that they were not provided with relevant health information and occasionally faced restricted access to prenatal services. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Hadi, Abdullahel
2003-01-01
OBJECTIVE: To assess the role of management practices for acute respiratory infections (ARIs) in improving the competency of community health volunteers in diagnosing and treating acute respiratory infections among children. METHODS: Data were collected by a group of research physicians who observed the performance of a sample of 120 health volunteers in 10 sub-districts in Bangladesh in which Bangladesh Rural Advancement Committee (BRAC) had run a community-based ARI control programme since mid-1992. Standardized tests were conducted until the 95% interphysician reliability on the observation of clinical examination was achieved. FINDINGS:The sensitivity, specificity, and overall agreement rates in diagnosing and treating ARIs were significantly higher among the health volunteers who had basic training and were supervised routinely than among those who had not. CONCLUSION: Diagnosis and treatment of ARIs at the household level in developing countries are possible if intensive basic training and the close supervision of service providers are ensured. PMID:12764514
Estapé-Garrastazu, Estela S; Noboa-Ramos, Carlamarie; De Jesús-Ojeda, Lizbelle; De Pedro-Serbiá, Zulmarie; Acosta-Pérez, Edna; Camacho-Feliciano, Delia M
2014-10-01
A preliminary needs assessment was conducted among faculty and students of three minority medical and health science institutions comprising the Puerto Rico Clinical and Translational Research Consortium (PRCTRC). The Web-based survey was focused on evaluating the training interests in the clinical and translational research core areas and competencies developed by the National Institutes of Health-Clinical and Translational Sciences Award. The survey was the result of a team effort of three PRCTRC key function's leaderships: Multidisciplinary Training and Career Development, Tracking and Evaluation and Community Research and Engagement. The questionnaire included 45 items distributed across five content areas including demographics, research training needs, training activities coordination and knowledge about the services offered by the PRCTRC. Analysis of research needs includes a sample distribution according to professor, assistant/associate professor and graduate students. The thematic area with highest response rate among the three groups was: "Identify major clinical/public health problems and relevant translational research questions," with the competency "Identify basic and preclinical studies that are potential testable clinical research hypothesis." These preliminary results will guide the training and professional development of the new generation of clinical and translational researchers needed to eliminate health disparities. © 2014 The Authors. Clinical and Translational Science Published by Wiley Periodicals, Inc.
Training fellows in paediatric cardiology: the Harvard experience.
Brown, David W; Allan, Catherine K; Newburger, Jane W
2016-12-01
The Fellowship Program of the Department of Cardiology at Boston Children's Hospital seeks to train academically oriented leaders in clinical care and laboratory and clinical investigation of cardiovascular disease in the young. The core clinical fellowship involves 3 years in training, comprising 24 months of clinical rotations and 12 months of elective and research experience. Trainees have access to a vast array of research opportunities - clinical, basic, and translational. Clinical fellows interested in basic science may reverse the usual sequence and start their training in the laboratory, deferring clinical training for 1 or more years. An increasing number of clinical trainees apply to spend a fourth year as a senior fellow in one of the subspecialty areas of paediatric cardiology. From the founding of the Department to the present, we have maintained a fundamental and unwavering commitment to training and education in clinical care and research in basic science and clinical investigation, as well as to the training of outstanding young clinicians and investigators.
ERIC Educational Resources Information Center
Haryati, Sri
2014-01-01
The study aims at analyzing the achievement of Minimum Service Standards (MSS) in Basic Education through a case study at Magelang Municipality. The findings shall be used as a starting point to predict the needs to meet MMS by 2015 and to provide strategies for achievement. Both primary and secondary data were used in the study investigating the…
Digital Microwave System Design Guide.
1984-02-01
traffic analysis is a continuous effort, setting parameters for subsequent stages of expansion after the system design is finished. 2.1.3 Quality of...operational structure of the user for whom he is providing service. 2.2.3 Quality of Service. In digital communications, the basic performance parameter ...the basic interpretation of system performance is measured in terms of a single parameter , throughput. Throughput can be defined as the number of
Dennis, Matthew J
2010-05-01
It is the premise of this paper that the need for medical and basic science instruction in dentistry will increase over time. However, student and faculty appreciation of the relevance and significance of medicine and basic science to clinical dentistry has been elusive, largely due to difficulties linking biomedical science instruction and clinical dental instruction. The scope of traditional procedure based oral surgery instruction can be expanded in an attempt to bridge the medical science-clinical gap. Topics such as health status evaluation, medical risk assessment, and a variety of other biomedical issues can be presented to students in a way which imparts specific dental meaning to basic medical science in real-life clinical situations. Using didactic and chair side instruction in an oral surgery clinical environment, students are confronted with the need to understand these issues and how they relate to the patients they encounter who present for dental care.
Translating orthopaedic basic science into clinical relevance.
Madry, Henning
2014-12-01
In orthopaedic and trauma surgery, the rapid evolution of biomedical research has fundamentally changed the perception of the musculoskeletal system. Here, the rigor of basic science and the art of musculoskeletal surgery have come together to create a new discipline -experimental orthopaedics- that holds great promise for the causative cure of many orthopaedic conditions. The Journal of Experimental Orthopaedics intends to bridge the gap between orthopaedic basic science and clinical relevance, to allow for a fruitful clinical translation of excellent and important investigations in the field of the entire musculoskeletal system.
Modular Laboratories—Cost-Effective and Sustainable Infrastructure for Resource-Limited Settings
Bridges, Daniel J.; Colborn, James; Chan, Adeline S. T.; Winters, Anna M.; Dengala, Dereje; Fornadel, Christen M.; Kosloff, Barry
2014-01-01
High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. PMID:25223943
Teaching Skills to Promote Clinical Reasoning in Early Basic Science Courses
ERIC Educational Resources Information Center
Elizondo-Omana, Rodrigo Enrique; Morales-Gomez, Jesus Alberto; Morquecho-Espinoza, Orlando; Hinojosa-Amaya, Jose Miguel; Villarreal-Silva, Eliud Enrique; Garcia-Rodriguez, Maria de los Angeles; Guzman-Lopez, Santos
2010-01-01
Basic and superior reasoning skills are woven into the clinical reasoning process just as they are used to solve any problem. As clinical reasoning is the central competence of medical education, development of these reasoning skills should occur throughout the undergraduate medical curriculum. The authors describe here a method of teaching…
42 CFR 410.60 - Outpatient physical therapy services: Conditions.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 2 2012-10-01 2012-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...
42 CFR 410.60 - Outpatient physical therapy services: Conditions.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 2 2013-10-01 2013-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...
42 CFR 410.60 - Outpatient physical therapy services: Conditions.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...
42 CFR 410.60 - Outpatient physical therapy services: Conditions.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...
42 CFR 410.60 - Outpatient physical therapy services: Conditions.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 2 2014-10-01 2014-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...
5 CFR 842.306 - Military service.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Military service. 842.306 Section 842.306... EMPLOYEES RETIREMENT SYSTEM-BASIC ANNUITY Credit for Service § 842.306 Military service. (a) Except as...' Retirement System Act of 1986, an employee's or Member's military service is creditable if it was performed...
15 CFR 946.4 - Menu of services.
Code of Federal Regulations, 2010 CFR
2010-01-01
... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE REGULATIONS OF THE NATIONAL WEATHER SERVICE MODERNIZATION OF THE NATIONAL WEATHER SERVICE § 946.4 Menu of services. The following are the basic weather...) Marine Forecasts, Statements, and Warnings (g) Hydrologic Forecasts and Warnings (h) Fire Weather...
15 CFR 946.4 - Menu of services.
Code of Federal Regulations, 2013 CFR
2013-01-01
... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE REGULATIONS OF THE NATIONAL WEATHER SERVICE MODERNIZATION OF THE NATIONAL WEATHER SERVICE § 946.4 Menu of services. The following are the basic weather...) Marine Forecasts, Statements, and Warnings (g) Hydrologic Forecasts and Warnings (h) Fire Weather...
A measure of South Africa's health care.
de Selincourt, K
Nurses provide the bulk of health care in South Africa. For example, in 1 of the biggest and poorest townships Khayelitsha, nurses treat malnourished mothers and children and offer primary health care services. Physicians tend to work in township clinics on a part-time basis and supervise nurse-advised treatments over the telephone. Most physicians do not speak the language of the people living in the township which is Xhosa. Thus they often depend on a nurse to serve as interpreter for Xhosa-speaking patients which takes the nurse away from her duties. Some clinics never receive physician supervision or services. Nurses spend much of their time sharing their skills and knowledge with clients. Nutrition workers and other staff back up nurses at the clinics. They sometimes are mothers whose children were at one time malnourished. Since they have the basic skills and knowledge, clinic staff provide treatment for straightforward conditions such as scabies. Nurses working in hospital in Khayelitsha also have many responsibilities. For example, they do the initial psychiatric assessment and decide whether to send a patient immediately to Valkenburg Psychiatric Hospital or to schedule the patient for an appointment with the physician at the satellite psychiatric clinic at Khayelitsha Hospital where psychiatrists come only twice/week. They sometimes make home visits which results in them also providing primary care. Unlike nurses not working in the hospital, the nurses at the hospital have good medical support. Both black and white nurses in South Africa work in the same clinics despite the country's policy of separateness. A shortage of nurses is 1 reason for this integration. Black nurses still encounter discrimination when applying for jobs and, until recently, made less money for the same work than white nurses.
Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne
2017-07-03
The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress. An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress. Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention. Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.
Kashiwagi, Masayo; Tamiya, Nanako; Murata, Masako
2015-08-01
The purpose of the present study was to identify characteristics of visiting nurse agencies (VNA) in Japan with high home death rates by a prefecture-wide survey. A cross-sectional study of visiting nurse agencies (n = 101) in Ibaraki Prefecture, Japan, was completed. Data included the basic characteristics of each VNA, the type of services provided, level of coordination with other service providers, total number of VNA patients who died per year and place of death and contractual relationship with home-care supporting clinics providing end-of-life care services in the home 24 h a day. The VNA characteristics were analyzed by logistic regression, using the home death rate per VNA as a dependent variable. A total 69 agencies, excluding those that did not report number of deaths (n = 14) and those without deaths during the year (n = 6), were analyzed. The median home death rate of the 69 VNA was 29.8%. The results of logistic regression analysis showed that higher home death rate was significantly associated with lack of attachment to a hospital, existence of a contractual relationship with home-care supporting clinics and existence of an interactive information exchange through telephone/face-to-face communication with attending physicians. In order to increase the home death rate of people using VNA, policymakers must consider establishing home-based service systems within the community that can provide home end-of-life care services 24 h a day, and support the interactive exchange of information between the visiting nurse and the attending physician. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Geriatrics Society.
Reflections on scientific collaboration between basic researchers and clinicians.
Muia, J; Casari, C
2016-10-01
Early career researchers face uncertainties with respect to their job prospects due to dwindling job markets, decreased availability of funding and undefined career paths. As basic researchers and clinicians tend to have different approaches to scientific problems, there are many advantages from successful collaborations between them. Here, we discuss how collaborations between basic and clinical scientists should be promoted early in their careers. To achieve this, researchers, both basic and clinical, must be proactive during their training and early stages of their careers. Mentors can further augment collaborative links in many ways. We suggest that universities and institutions might reassess their involvement in promoting collaborations between basic and clinical researchers. We hope that this paper will serve as a reminder of the importance of such collaborations, and provide the opportunity for all members of the scientific community to reflect on and ameliorate their own contributions. © 2016 International Society on Thrombosis and Haemostasis.
[Complex chronic care situations and socio-health coordination].
Morilla Herrera, Juan Carlos; Morales Asencio, José Miguel; Kaknani, Shakira; García Mayor, Silvia
2016-01-01
Patient-centered healthcare is currently one of the most pursued goals in health services. It is necessary to ensure a sufficient level of cooperative and coordinated work between different providers and settings, including family and social and community resources. Clinical integration occurs when the care provided by health professionals and providers is integrated into a single coherent process through different professions using shared guidelines and protocols. Such coordination can be developed at three levels: macro, which involves the integration of one or more of the three basic elements that support health care (the health plan, primary care and specialty care), with the aim of reducing fragmentation of care; meso, where health and social services are coordinated to provide comprehensive care to elderly and chronic patients; and micro, aimed to improve coordination in individual patients and caregivers. The implementation of new roles, such as Advanced Practice Nursing, along with improvements in family physicians' problem-solving capacity in certain processes, or modifying the place of provision of certain services are key to ensure services adapted to the requirements of chronic patients. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
A Real-World Community Health Worker Care Coordination Model for High-Risk Children.
Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W
2018-04-01
Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.
How Will Big Data Improve Clinical and Basic Research in Radiation Therapy?
Rosenstein, Barry S.; Capala, Jacek; Efstathiou, Jason A.; Hammerbacher, Jeff; Kerns, Sarah; Kong, Feng-Ming (Spring); Ostrer, Harry; Prior, Fred W.; Vikram, Bhadrasain; Wong, John; Xiao, Ying
2015-01-01
Historically, basic scientists and clinical researchers have transduced reality into data so that they might explain or predict the world. Because data are fundamental to their craft, these investigators have been on the front lines of the Big Data deluge in recent years. Radiotherapy data are complex and longitudinal data sets are frequently collected to track both tumor and normal tissue response to therapy. As basic, translational and clinical investigators explore with increasingly greater depth the complexity of underlying disease processes and treatment outcomes, larger sample populations are required for research studies and greater quantities of data are being generated. In addition, well-curated research and trial data are being pooled in public data repositories to support large-scale analyses. Thus, the tremendous quantity of information produced in both basic and clinical research in radiation therapy can now be considered as having entered the realm of Big Data. PMID:26797542
Lisk, Kristina; Agur, Anne M R; Woods, Nicole N
2017-12-01
Several studies have shown that cognitive integration of basic and clinical sciences supports diagnostic reasoning in novices; however, there has been limited exploration of the ways in which educators can translate this model of mental activity into sound instructional strategies. The use of self-explanation during learning has the potential to promote and support the development of integrated knowledge by encouraging novices to elaborate on the causal relationship between clinical features and basic science mechanisms. To explore the effect of this strategy, we compared diagnostic efficacy of teaching students (n = 71) the clinical features of four musculoskeletal pathologies using either (1) integrated causal basic science descriptions (BaSci group); (2) integrated causal basic science descriptions combined with self-explanation prompts (SE group); (3) basic science mechanisms segregated from the clinical features (SG group). All participants completed a diagnostic accuracy test immediately after learning and 1-week later. The results showed that the BaSci group performed significantly better compared to the SE (p = 0.019) and SG groups (p = 0.004); however, no difference was observed between the SE and SG groups (p = 0.91). We hypothesize that the structure of the self-explanation task may not have supported the development of a holistic conceptual understanding of each disease. These findings suggest that integration strategies need to be carefully structured and applied in ways that support the holistic story created by integrated basic science instruction in order to foster conceptual coherence and to capitalize on the benefits of cognition integration.
Batman, Angela M.; Miles, Michael F.
2015-01-01
Alcohol use disorder (AUD) and its sequelae impose a major burden on the public health of the United States, and adequate long-term control of this disorder has not been achieved. Molecular and behavioral basic science research findings are providing the groundwork for understanding the mechanisms underlying AUD and have identified multiple candidate targets for ongoing clinical trials. However, the translation of basic research or clinical findings into improved therapeutic approaches for AUD must become more efficient. Translational research is a multistage process of streamlining the movement of basic biomedical research findings into clinical research and then to the clinical target populations. This process demands efficient bidirectional communication across basic, applied, and clinical science as well as with clinical practitioners. Ongoing work suggests rapid progress is being made with an evolving translational framework within the alcohol research field. This is helped by multiple interdisciplinary collaborative research structures that have been developed to advance translational work on AUD. Moreover, the integration of systems biology approaches with collaborative clinical studies may yield novel insights for future translational success. Finally, appreciation of genetic variation in pharmacological or behavioral treatment responses and optimal communication from bench to bedside and back may strengthen the success of translational research applications to AUD. PMID:26259085
Translating Alcohol Research: Opportunities and Challenges.
Batman, Angela M; Miles, Michael F
2015-01-01
Alcohol use disorder (AUD) and its sequelae impose a major burden on the public health of the United States, and adequate long-term control of this disorder has not been achieved. Molecular and behavioral basic science research findings are providing the groundwork for understanding the mechanisms underlying AUD and have identified multiple candidate targets for ongoing clinical trials. However, the translation of basic research or clinical findings into improved therapeutic approaches for AUD must become more efficient. Translational research is a multistage process of stream-lining the movement of basic biomedical research findings into clinical research and then to the clinical target populations. This process demands efficient bidirectional communication across basic, applied, and clinical science as well as with clinical practitioners. Ongoing work suggests rapid progress is being made with an evolving translational framework within the alcohol research field. This is helped by multiple interdisciplinary collaborative research structures that have been developed to advance translational work on AUD. Moreover, the integration of systems biology approaches with collaborative clinical studies may yield novel insights for future translational success. Finally, appreciation of genetic variation in pharmacological or behavioral treatment responses and optimal communication from bench to bedside and back may strengthen the success of translational research applications to AUD.
Basic science in a predoctoral family practice curriculum.
Davies, T C; Barnett, B L
1978-02-01
A course in applied basic science was designed with topic material organized according to anatomic body regions. Details of the diagnostic method were explained early in the course, and clinical procedures for data gathering and problem analyzing were followed while the significance of basic science knowledge in dealing with clinical situations was described. A collection of 35mm slides constituted the focal point of the course. The authors conducted the course together and an atmosphere of intellectual honesty was developed through open discussion between faculty and students. Student curiosity was respected and rewarded. Summaries of the discussions were prepared retrospectively by the faculty instructors for review gy the students. This experience proved that family physicians can demonstrate effectively the relevance of basic science to clinical medicine.
Whitmore, Susan C.; Grefsheim, Suzanne F.; Rankin, Jocelyn A.
2008-01-01
Background The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. Purpose This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. Brief description The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. Results/outcomes NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. Evaluation method High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training, and service components. Anecdotal evidence has also indicated a favorable response to the programme. PMID:18494648
Whitmore, Susan C; Grefsheim, Suzanne F; Rankin, Jocelyn A
2008-06-01
The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme, including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. RESULTS / OUTCOMES: NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training and service components. Anecdotal evidence has also indicated a favourable response to the programme.
Computer Literacy Project. A General Orientation in Basic Computer Concepts and Applications.
ERIC Educational Resources Information Center
Murray, David R.
This paper proposes a two-part, basic computer literacy program for university faculty, staff, and students with no prior exposure to computers. The program described would introduce basic computer concepts and computing center service programs and resources; provide fundamental preparation for other computer courses; and orient faculty towards…
Job-Related Basic Skills: Cases and Conclusions.
ERIC Educational Resources Information Center
Sticht, Thomas G.; Mikulecky, Larry
This monograph describes the job-related basic skills requirements of the work force and explores ways of developing and improving the reading, writing, and computational abilities of workers. The paper first examines trends that are influencing the demand for basic skills, such as the decline in youth population and the increase in service and…
41 CFR 301-73.106 - What are the basic services that should be covered by a TMS?
Code of Federal Regulations, 2010 CFR
2010-07-01
..., confirmation of reservations, etc.). (b) Provide basic management information, such as— (1) Number of... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the basic... Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 73...
42 CFR 431.810 - Basic elements of the Medicaid eligibility quality control (MEQC) program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Basic elements of the Medicaid eligibility quality control (MEQC) program. 431.810 Section 431.810 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Quality Control Medicaid Eligibility Quality Control (meqc) Program § 431.810 Basic...
41 CFR 102-73.10 - What is the basic real estate acquisition policy?
Code of Federal Regulations, 2013 CFR
2013-07-01
... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What is the basic real...
41 CFR 102-73.10 - What is the basic real estate acquisition policy?
Code of Federal Regulations, 2012 CFR
2012-01-01
... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What is the basic real...
41 CFR 102-73.10 - What is the basic real estate acquisition policy?
Code of Federal Regulations, 2014 CFR
2014-01-01
... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What is the basic real...
41 CFR 102-73.10 - What is the basic real estate acquisition policy?
Code of Federal Regulations, 2010 CFR
2010-07-01
... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic real...
41 CFR 102-73.10 - What is the basic real estate acquisition policy?
Code of Federal Regulations, 2011 CFR
2011-01-01
... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What is the basic real...
It Never Hurts To Go Back and Remind Ourselves about the Basics in Newspaper Journalism.
ERIC Educational Resources Information Center
Konkle, Bruce E.
2002-01-01
Suggests knowing the basics is critical if newspaper advisers and staffs are to move their newspaper into the best, excellent, superior, above average, all-everything category a scholastic press evaluation service may award. Discusses the basic areas of writing, design, photojournalism, advertising, and overall coverage. (RS)
Outline of Services for the Blind.
ERIC Educational Resources Information Center
Journal of Visual Impairment and Blindness, 1992
1992-01-01
Sixteen separate but related charts present an outline of basic administrative relationships of governmental and private organization programs and services for the blind. Major divisions include the federal Departments of Education, Health and Human Services, and Defense; consumer support groups; colleges and universities; client services; and…
Yamazaki, Yuka; Uka, Takanori; Marui, Eiji
2017-09-15
In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences. This study examines the professional and personal fulfillment expressed by Japanese female medical doctors who hold positions in Basic Sciences. Topics include career advancement, interest in medical research, and greater flexibility for parenting. A cross-sectional questionnaire survey was distributed at all 80 medical schools in Japan, directed to 228 female medical doctors whose academic rank was assistant professor or higher in departments of Basic Sciences in 2012. Chi-square tests and the binary logistic regression model were used to investigate the impact of parenthood on career satisfaction, academic rank, salary, etc. The survey response rate of female physicians in Basic Sciences was 54.0%. Regardless of parental status, one in three respondents cited research interest as their rationale for entering Basic Sciences, well over twice other motivations. A majority had clinical experience, with clinical duties maintained part-time by about half of respondents and particularly parents. Only one third expressed afterthoughts about relinquishing full-time clinical practice, with physicians who were parents expressing stronger regrets. Parental status had little effect on academic rank and income within the Basic Sciences, CONCLUSION: Scientific curiosity and a desire to improve community health are hallmarks of those choosing a challenging career in medicine. Therefore, it is unsurprising that interest in research is the primary motivation for a female medical doctor to choose a career in Basic Sciences. Additionally, as with many young professionals with families, female doctors seek balance in professional and private lives. Although many expressed afterthoughts relinquishing a full-time clinical practice, mothers generally benefited from greater job flexibility, with little significant effect on career development and income as Basic Scientists.
Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami
2015-06-01
Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. Copyright © 2015. Published by Elsevier Ireland Ltd.
Summary of speakers and events from the 2006 ICMAOI conference, focused on presenting basic, epidemiologic, and clinical aspects of research on malignancies in HIV-infected and other immunosuppressed individuals.
Summary of speakers and events from the 2005 ICMAOI conference, focused on presenting basic, epidemiologic, and clinical aspects of research on malignancies in HIV-infected and other immunosuppressed individuals.
Summary of speakers and events from the 2002 ICMAOI conference, focused on presenting basic, epidemiologic, and clinical aspects of research on malignancies in HIV-infected and other immunosuppressed individuals.
Summary of speakers and events from the 2005 ICMAOI conference, focused on presenting basic, epidemiologic, and clinical aspects of research on malignancies in HIV-infected and other immunosuppressed individuals.