Sample records for guide medication selection

  1. Quantitative and qualitative methods in medical education research: AMEE Guide No 90: Part II.

    PubMed

    Tavakol, Mohsen; Sandars, John

    2014-10-01

    Abstract Medical educators need to understand and conduct medical education research in order to make informed decisions based on the best evidence, rather than rely on their own hunches. The purpose of this Guide is to provide medical educators, especially those who are new to medical education research, with a basic understanding of how quantitative and qualitative methods contribute to the medical education evidence base through their different inquiry approaches and also how to select the most appropriate inquiry approach to answer their research questions.

  2. Quantitative and qualitative methods in medical education research: AMEE Guide No 90: Part I.

    PubMed

    Tavakol, Mohsen; Sandars, John

    2014-09-01

    Medical educators need to understand and conduct medical education research in order to make informed decisions based on the best evidence, rather than rely on their own hunches. The purpose of this Guide is to provide medical educators, especially those who are new to medical education research, with a basic understanding of how quantitative and qualitative methods contribute to the medical education evidence base through their different inquiry approaches and also how to select the most appropriate inquiry approach to answer their research questions.

  3. Selected reference aids for small medical libraries.

    PubMed

    Duncan, H F

    1970-04-01

    This annotated list of 178 items is compiled as a guide to the development of the reference collection in a small medical library.Arrangement, following the pattern of the previous revision, is by broad subject groups. Titles are chiefly in English. Textbooks in subject fields have been omitted since these are covered adequately in several comprehensive guides to the literature.

  4. Admission Requirements to Canadian Faculties of Medicine and Their Selection Policies = Conditions d'Admission aux Facultes de Medecine Canadiennes et Leurs Politiques de Selection.

    ERIC Educational Resources Information Center

    Association of Canadian Medical Colleges, Ottawa (Ontario).

    Information is presented to help applicants to Canadian medical colleges realistically assess their chances for gaining admission. The guide is also intended for career counselors in high schools and higher education. One section provides statistics on the following characteristics that are associated with being selected: sex, age, Medical College…

  5. Basic reference aids for small medical libraries.

    PubMed

    Blair, E D

    1967-04-01

    Selected primarily for the small medical library, this list is compiled to serve as a practical guide for the librarian in developing and utilizing an effective reference collection. Arrangement is by broad subject groups; titles chosen are chiefly in English with geographic coverage limited to the United States and Canada. Texts in subject fields have been omitted since these are adequately covered in several comprehensive guides to the literature.

  6. Augmentation of Conventional Medical Management of Moderately Severe or Severe Asthma with Acupuncture and Guided Imagery/Meditation

    PubMed Central

    Mehl-Madrona, Lewis

    2008-01-01

    Objective: I sought to determine if a combination of acupuncture and guided imagery could augment the conventional medical management of moderately severe or severe asthma. Design: This was an early-phase study with a convenience sample of self-selecting patients compared with self—year before, during treatment, and one year after treatment. Setting: Patients were recruited from an outpatient practice. Patients: All participants were adults with moderately severe or severe asthma (class 3 or 4). Interventions: The study employed acupuncture and guided imagery/meditation for a 24-week period. Main Outcome Measures: The main outcome measures were number of days of hospitalization, number of Emergency Department (ED) visits, number of physician visits, days per year taking steroids, puffs per week of inhaled β-agonists, FVC (forced vital capacity), FEV1 (forced expiratory volume in the first second), and FEF25-75 (forced expiratory flow between 25% and 75% of the FVC). Results: With the addition of acupuncture and guided imagery to conventional medical management, members of the study group experienced improvement. The number of hospitalized days and the number of ED visits not leading to hospitalizations decreased, as did number of medical visits and total days taking oral corticosteroids. Parameters of respiratory function improved despite reduced use of inhaled β-agonists. Conclusion: With acupuncture and guided imagery and meditation together, a self-selecting group of patients with moderately severe or severe asthma experienced improvement in respiratory function, taking less medication than before and having fewer emergencies and hospitalizations at a lower cost of care. PMID:21339915

  7. A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.

    PubMed

    McLeod, Fiona; Flowers, Charne

    2006-12-01

    Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.

  8. Use of MCAT Data in Admissions. A Guide for Medical School Admissions Officers and Faculty.

    ERIC Educational Resources Information Center

    Mitchell, Karen J.

    A description of the standardized, multiple-choice Medical College Admission Test (MCAT) and how to use it is offered. Medical school admissions officers medical educators, college faculty members, and practicing physicians are active participants in selecting content, drafting test specifications, and authoring questions for the exam. The MCAT is…

  9. [Development of a standardized guide for optimizing drug adherence information to be dispensed during a pharmaceutical counseling with a multiple myeloma patient: Initial validation].

    PubMed

    Favier-Archinard, Camille; Leguelinel-Blache, Géraldine; Dubois, Florent; Le Gall, Tanguy; Bourquard, Pascal; Passemard, Nadège; Tora, Sandrine; Rey, Aurélie; Rossi, Marie; Chevallier, Thierry; Cousin, Christelle; Favier, Mireille

    2018-05-01

    The safety of the community treatment with oral anticancer therapies is a strong theme of the cancer plan 2014-2019. The objective of this study was to develop a Pharmaceutical Counseling Guide to improve medication adherence in patients treated for multiple myeloma with oral anticancer therapies. A multidisciplinary professional working group selected a list of relevant medication adherence-related items that served as the framework for the design of the pharmaceutical counseling support materials in patient-accessible language. The readability, understanding and memorization of the information were validated in ten patients treated for myeloma. Twelve items were selected for treatment information (5 items), treatment planning (5 items), and adverse drug effects (2 items). A pharmacist guide, a patient guide, a medication schedule, and three self-questionnaires to evaluate medication knowledge and understanding of patients were developed. The patient test resulted in changes in these documents. This study carried out the initial validation of documents to standardize the pharmaceutical counseling for patients treated for myeloma so that it can be reproduced from one patient to another regardless of the pharmacist, by standardizing the information issued. This study needs to be completed by a final validation in myeloma patients, free from oral anticancer therapies. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  10. Going Camping? A Basic Guide to Camping with Students.

    ERIC Educational Resources Information Center

    1977

    Beginning with the "often overlooked areas", this guide to camping trips for secondary students presents initial planning procedures such as: site selection; number of leaders per number of students (2 leaders for each group of 10-12); parental permission forms; transportation arrangements; public school announcements; medical aid expertise and…

  11. Pharmacogenomic Testing for Psychotropic Medication Selection: A Systematic Review of the Assurex GeneSight Psychotropic Test

    PubMed Central

    Brener, Stacey; Holubowich, Corinne

    2017-01-01

    Background A large proportion of the Ontario population lives with a diagnosed mental illness. Nearly 5% of Ontarians have major depressive disorder, and another 5% have another type of depressive disorder, bipolar disorder, schizophrenia, anxiety, or some other disorder not otherwise specified. Medications are commonly used to treat mental illness, but choosing the right medication for each patient is challenging, and more than 40% of patients discontinue their medication within 90 days because of adverse effects or lack of response. The Assurex GeneSight Psychotropic test is a pharmacogenomic panel that provides clinicians with a report to guide medication selection that is unique to each patient based on their individual genetic profile. However, it is uncertain whether guided treatment using GeneSight is effective compared with unguided treatment (usual care). Methods We performed a systematic review to identify English-language studies published before February 22, 2016, that compared GeneSight-guided care and usual care among people with mood disorders, anxiety, or schizophrenia. Primary outcomes of interest were prevention of suicide, remission of depression symptoms, response to depression therapy, depression score, and quality of life. Secondary outcomes of interest were impact on therapeutic decisions and patient and clinician satisfaction. Risk of bias was evaluated, and the quality of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group criteria. Results Four studies met the inclusion criteria. These studies used a version of GeneSight that included the CYP2D6, CYP2C19, CYP1A2, SLC6A4, and HTR2A genes; one of the studies also included CYP2C9. Patients who received the GeneSight test to guide psychotropic medication selection had improved response to depression treatment, greater improvements in measures of depression, and greater patient and clinician satisfaction compared with patients who received treatment as usual. We observed no differences in rates of complete remission from depression. The findings were based on GRADE assessment of low to very low quality evidence, and the body of evidence had several limitations: the included studies used an older version of GeneSight and were limited to a population with major depression, so results may not be generalizable to other versions of the test or different populations such as patients with anxiety or schizophrenia. Conclusions There is uncertainty about the use of GeneSight Psychotropic pharmacogenomic genetic panel to guide medication selection. It was associated with improvements in some patient outcomes, but not others. As well, our confidence in these findings is low because of limitations in the body of evidence. PMID:28515818

  12. 21 CFR 888.4800 - Template for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4800 Template for clinical use. (a... purposes, such as selecting or positioning orthopedic implants or guiding the marking of tissue before...

  13. 21 CFR 888.4800 - Template for clinical use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4800 Template for clinical use. (a... purposes, such as selecting or positioning orthopedic implants or guiding the marking of tissue before...

  14. 21 CFR 888.4800 - Template for clinical use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4800 Template for clinical use. (a... purposes, such as selecting or positioning orthopedic implants or guiding the marking of tissue before...

  15. Strategic outsourcing of clinical services: a model for volume-stressed academic medical centers.

    PubMed

    Billi, John E; Pai, Chih-Wen; Spahlinger, David A

    2004-01-01

    Many academic medical centers have significant capacity constraints and limited ability to expand services to meet demand. Health care management should employ strategic thinking to deal with service demands. This article uses three organizational models to develop a theoretical framework to guide the selection of clinical services for outsourcing.

  16. Taguchi's technique: an effective method for improving X-ray medical radiographic screen performance.

    PubMed

    Vlachogiannis, J G

    2003-01-01

    Taguchi's technique is a helpful tool to achieve experimental optimization of a large number of decision variables with a small number of off-line experiments. The technique appears to be an ideal tool for improving the performance of X-ray medical radiographic screens under a noise source. Currently there are very many guides available for improving the efficiency of X-ray medical radiographic screens. These guides can be refined using a second-stage parameter optimization. based on Taguchi's technique, selecting the optimum levels of controllable X-ray radiographic screen factors. A real example of the proposed technique is presented giving certain performance criteria. The present research proposes the reinforcement of X-ray radiography by Taguchi's technique as a novel hardware mechanism.

  17. Peace through health II: a framework for medical student education.

    PubMed

    Arya, Neil

    2004-01-01

    The world's first university course in Peace through Health (PtH) recently finished at McMaster University, Hamilton, Canada. Medical students and academic staff in Canada and Europe have expressed interest in developing this course for other medical schools. Seven medical students were selected to do an unofficial 'audit' in return for 'in kind' work, developing the course materials for the web and adaptation to the medical curriculum. This article sets out the goals and structure of the course as a guide for similar teaching models.

  18. A medical book collection for physician assistants.

    PubMed

    Grodzinski, A

    2001-07-01

    Selecting resources for physician assistants is challenging and can be overwhelming. Although several core lists exist for nursing, allied health, and medical libraries, judging the scope and level of these resources in relation to the information needs of the physician assistant is difficult. Medical texts can be highly specialized and very expensive, in essence, "overkill" for the needs of the physician assistant. This bibliography is meant to serve as a guide to appropriate medical texts for physician assistants. Titles were selected from the Brandon/Hill list, Doody's Electronic Journal, and various other reference resources. Resources were evaluated based on the subject and scope, audience, authorship, cost, and currency. The collection includes 195 titles from 33 specialty areas. Standard texts in each area are also included.

  19. Podiatric medical resources on the internet: a fifth update.

    PubMed

    Fikar, Charles R

    2006-01-01

    An updated selection of high-quality Internet resources of potential use to the podiatric medical practitioner, educator, resident, and student is presented. Internet search tools and general Internet reference sources are briefly covered, including methods of locating material residing on the "invisible" Web. General medical and podiatric medical resources are emphasized. These Web sites were judged on the basis of their potential to enhance the practice of podiatric medicine in addition to their contribution to education. Podiatric medical students, educators, residents, and practitioners who require a quick reference guide to the Internet may find this article useful.

  20. Selected Health Service Occupations.

    ERIC Educational Resources Information Center

    Coleman, Arthur D.

    Prepared by an occupational analyst of the Utah Department of Employment Security, this manual provides job guides for 39 health service occupations concerned mainly with doctors, nurses, and related hospital-medical-health consultants and services. Classified according to "The Dictionary of Occupational Titles," each occupational…

  1. Doctoring Undercover: updating the educational tradition of shadowing.

    PubMed

    Clark, Claire D

    2017-01-01

    Premedical students are educated in basic biological and health sciences. As a complement to traditional premedical coursework, medical school applicants are encouraged to shadow practitioners, with the hope that observation will introduce students to the culture and practice of healthcare. Yet the shadowing experience varies widely across practitioners and institutions; resources that guide students' critical reflection and structure the experience are scarce. A pilot experiential learning course, Doctoring Undercover: Shadowing and the Culture of Medicine, was developed to fill this gap. The course consisted of three parts: an introduction to medical culture through the disciplines of medical sociology, history, anthropology, and bioethics; a site placement in which students applied these fields' analytical techniques to the study of medical culture and practice; and the development of an online activity guide that other premedical students may adapt to their shadowing circumstances. Students reported that they were exposed to new disciplinary perspectives and interprofessional environments that they would not traditionally encounter. Students' contributions to the shadowing guide encouraged active learning and reflection on the dynamics of effective patient-provider relationships and shadowing experiences. Locally, the class may be scaled for a larger group of premedical students and incorporated into a formal pathway program for premedical students; the content will also be integrated into the clinical medicine course for first-year medical students. Online, the guide will be promoted for use by other institutions and by individuals planning extracurricular shadowing experiences; feedback will be solicited. Tools for evaluating the short- and long-term impact of the course and guide will be developed and validated. Observational and experimental studies of the course's impact should be conducted. ICM: Introduction to Clinical Medicine; SCE: Selective Clinical Experiences.

  2. Frameless, image-guided stereotactic radiosurgery.

    PubMed

    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.

  3. A Guide to the Computerized Medical Data Resources of the Naval Health Research Center.

    DTIC Science & Technology

    1987-04-09

    Selection Test Score o Mental group o Education certificate o SCREEN Score The GCT Score is designed to measure ability to understand verbal relationships...available on some members before that date. For female members this field will contain Armed Forces Women’s Selection Test Scores. Norms provided for 16...the Board are recorded in this file. Finally, disposition by the Board is indicated. Physical Evaluation Board File. Selected data elements in the

  4. New Developments in Insomnia Medications of Relevance to Mental Health Disorders.

    PubMed

    Krystal, Andrew D

    2015-12-01

    Many insomnia medications with high specificity have become available recently. They provide a window into the clinical effects of modulating specific brain systems and establish a new guiding principal for conceptualizing insomnia medications: "mechanism matters." A new paradigm for insomnia therapy in which specific drugs are selected to target the specific type of sleep difficulty for each patient includes administering specific treatments for patients with insomnia comorbid with particular psychiatric disorders. This article reviews insomnia medications and discusses the implications for optimizing the treatment of insomnia occurring comorbid with psychiatric conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59.

    PubMed

    Ten Cate, Th J; Kusurkar, Rashmi A; Williams, Geoffrey C

    2011-01-01

    Self-determination Theory (SDT), designed by Edward Deci and Richard Ryan, serves among the current major motivational theories in psychology. SDT research has been conducted in many areas, among which are education and health care, but its applications in medical education are rare. The potential of SDT to help understand processes in medical education justifies this Guide. SDT is explained in seven principles, one of which is the distinction of three innate psychological needs of human beings: for competence, for autonomy and for relatedness. Further, SDT elaborates how humans tend to internalise regulation of behaviour that initially has been external, in order to develop autonomous, self-determined behaviour. Implications of SDT for medical education are discussed with reference to preparation and selection, curriculum structure, classroom teaching, assessments and examinations, self-directed learning, clinical teaching, students as teachers and researchers, continuing professional development, faculty development and stress among trainees.

  6. Selected medical management of the older rehabilitative patient.

    PubMed

    Lin, John L; Armour, Doris

    2004-07-01

    This self-directed learning module highlights present practices of geriatric medicine that are commonly seen in an inpatient rehabilitation setting. It is a part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. In particular, attention is given to update physiatrists in the geriatric medical advances in pharmacotherapeutic considerations, the management of hypertension, diabetes mellitus, urinary tract infections, and sleep disorders. To update the common present-day medical practices for older persons seen in a rehabilitation setting.

  7. 76 FR 71577 - Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ...] Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication Guides in... guidance for industry entitled ``Medication Guides-- Distribution Requirements and Inclusion in Risk... Requirements and Inclusion in Risk Evaluation and Mitigation Strategies (REMS).'' This guidance provides...

  8. 76 FR 10908 - Draft Guidance for Industry on Medication Guides-Distribution Requirements and Inclusion of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ...] Draft Guidance for Industry on Medication Guides--Distribution Requirements and Inclusion of Medication... a draft guidance for industry entitled ``Medication Guides--Distribution Requirements and Inclusion... Inclusion of Medication Guides in Risk Evaluation and Mitigation Strategies (REMS).'' This draft guidance is...

  9. Drug Safety - Multiple Languages

    MedlinePlus

    ... Expand Section Guide to Over the Counter Medications - English PDF Guide to Over the Counter Medications - Amarɨñña / ... Information Translations Guide to Over the Counter Medications - English PDF Guide to Over the Counter Medications - العربية ( ...

  10. A Guide to Selected National Genetic Voluntary Organizations.

    ERIC Educational Resources Information Center

    National Center for Education in Maternal and Child Health, Washington, DC.

    The directory lists mutual support groups concerned with the medical and psychosocial impacts of genetic disorders and birth defects on affected individuals and families. Each organization included is dedicated to the ongoing emotional, practical, and financial needs of these populations. Entries are categorized by disorder, including: general,…

  11. An Annotated Bibliography for Health Occupations: A Guide for Teachers and Students.

    ERIC Educational Resources Information Center

    Solon, Lindy

    The bibliography is designed to assist teachers and students at the secondary level in selecting printed and audiovisual materials related to health occupations. The 115 items relate to the following occupations: dental assistant, medical laboratory aide, practical nurse, nurse assistant, rehabilitation aide, physical therapy aide, radiologic…

  12. A Guide to Selected National Genetic Voluntary Organizations.

    ERIC Educational Resources Information Center

    National Center for Education in Maternal and Child Health, Washington, DC.

    The directory lists approximately 120 mutual support groups concerned with the medical and psychological impacts of genetic disorders and birth defects on individuals and their families. The groups are dedicated to serving the ongoing emotional, practical, and financial needs of these populations. The entries are arranged alphabetically and…

  13. Medication safety--reliability of preference cards.

    PubMed

    Dawson, Anthony; Orsini, Michael J; Cooper, Mary R; Wollenburg, Karol

    2005-09-01

    A CLINICAL ANALYSIS of surgeons' preference cards was initiated in one hospital as part of a comprehensive analysis to reduce medication-error risks by standardizing and simplifying the intraoperative medication-use process specific to the sterile field. THE PREFERENCE CARD ANALYSIS involved two subanalyses: a review of the information as it appeared on the cards and a failure mode and effects analysis of the process involved in using and maintaining the cards. THE ANALYSIS FOUND that the preference card system in use at this hospital is outdated. Variations and inconsistencies within the preference card system indicate that the use of preference cards as guides for medication selection for surgical procedures presents an opportunity for medication errors to occur.

  14. A Model for Steering with Haptic-Force Guidance

    NASA Astrophysics Data System (ADS)

    Yang, Xing-Dong; Irani, Pourang; Boulanger, Pierre; Bischof, Walter F.

    Trajectory-based tasks are common in many applications and have been widely studied. Recently, researchers have shown that even very simple tasks, such as selecting items from cascading menus, can benefit from haptic-force guidance. Haptic guidance is also of significant value in many applications such as medical training, handwriting learning, and in applications requiring precise manipulations. There are, however, only very few guiding principles for selecting parameters that are best suited for proper force guiding. In this paper, we present a model, derived from the steering law that relates movement time to the essential components of a tunneling task in the presence of haptic-force guidance. Results of an experiment show that our model is highly accurate for predicting performance times in force-enhanced tunneling tasks.

  15. Twelve tips for blueprinting.

    PubMed

    Coderre, Sylvain; Woloschuk, Wayne; McLaughlin, Kevin

    2009-04-01

    Content validity is a requirement of every evaluation and is achieved when the evaluation content is congruent with the learning objectives and the learning experiences. Congruence between these three pillars of education can be facilitated by blueprinting. Here we describe an efficient process for creating a blueprint and explain how to use this tool to guide all aspects of course creation and evaluation. A well constructed blueprint is a valuable tool for medical educators. In addition to validating evaluation content, a blueprint can also be used to guide selection of curricular content and learning experiences.

  16. Medical Secretary and Medical Office Assistant Curriculum Guide.

    ERIC Educational Resources Information Center

    Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.

    This curriculum guide consists of materials for use in teaching a competency-based course to prepare students for employment as medical secretaries or medical office assistants. The first part of the guide contains introductory information, including a description of the development of the guide, an equipment list, a list of criteria for…

  17. Medications during pregnancy: antihypertensives and immunosuppressives.

    PubMed

    Umans, Jason G

    2007-04-01

    Use of prescription and nonprescription medications is common during pregnancy and is required in many women with underlying kidney disease or hypertension and in all with solid-organ allografts. Systematic assessment of drug safety during pregnancy is lacking, as are rigorous and comprehensive studies of pharmacokinetics and pharmacodynamics to guide drug selection and dosing across pregnancy. Renal and hepatic clearances of many drugs change markedly during pregnancy and pitfalls may complicate routine therapeutic monitoring of some drugs during pregnancy. However, available data and clinical experience allow reasonable strategies for selection and dosing of immunosuppressive agents in pregnant transplant recipients and of antihypertensive agents in women with mild or more severe hypertension complicating their pregnancies.

  18. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N

    1975-01-01

    This revised list of 446 books and 137 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure for about $14,500. The cost of only the asterisked items recommended for first purchase totals approximately $4,100. PMID:1095095

  19. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N

    1975-04-01

    This revised list of 446 books and 137 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure for about $14,500. The cost of only the asterisked items recommended for first purchase totals approximately $4,100.

  20. Resources for Topics in Nursing.

    ERIC Educational Resources Information Center

    Riordan, Dale B.

    This guide is intended to help the user become familiar with a selected group of reference tools and resources which are useful in nursing education and practice. It is important for students to use the correct medical or scientific terminology, understand the scope of a topic, and then utilize the tools necessary to research subjects of interest.…

  1. Completeness, accuracy, and readability of Wikipedia as a reference for patient medication information.

    PubMed

    Candelario, Danielle M; Vazquez, Victoria; Jackson, William; Reilly, Timothy

    This study determined the completeness, accuracy, and reading level of Wikipedia patient drug information compared with the corresponding United States product insert medication guides. From the Top 200 Drugs of 2012, the top 33 medications with medication guides were analyzed. Medication guides and Wikipedia pages were downloaded on a single date to ensure continuity of Wikipedia content. To quantify the completeness and accuracy of the Wikipedia medication information, a scoring system was adapted from previously published work and compared with the 7 core domains of medication guides. Wikipedia did not provide patient information that was as complete or accurate as the information within the medication guides: 14.73 out of 42 (SD 5.75). Wikipedia medication pages were written at a significantly higher reading level compared with medication guides (Flesch reading ease score 52.93 vs. 33.24 [P <0.001]; Flesch-Kincaid grade level 10.26 vs. 6.86 [P <0.001]). Wikipedia medication pages include incomplete and inaccurate patient information compared with the corresponding product medication guides. Wikipedia patient drug information was also written at reading levels above that of medication guides and substantially above the average United States consumer health literacy level. As the public use of Wikipedia increases, the need for educating patients about the quality of information on Wikipedia and the availability of adequate patient education resources is ever more important to minimize inaccuracies and incomplete information sharing. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Multimodal Medical Image Fusion by Adaptive Manifold Filter.

    PubMed

    Geng, Peng; Liu, Shuaiqi; Zhuang, Shanna

    2015-01-01

    Medical image fusion plays an important role in diagnosis and treatment of diseases such as image-guided radiotherapy and surgery. The modified local contrast information is proposed to fuse multimodal medical images. Firstly, the adaptive manifold filter is introduced into filtering source images as the low-frequency part in the modified local contrast. Secondly, the modified spatial frequency of the source images is adopted as the high-frequency part in the modified local contrast. Finally, the pixel with larger modified local contrast is selected into the fused image. The presented scheme outperforms the guided filter method in spatial domain, the dual-tree complex wavelet transform-based method, nonsubsampled contourlet transform-based method, and four classic fusion methods in terms of visual quality. Furthermore, the mutual information values by the presented method are averagely 55%, 41%, and 62% higher than the three methods and those values of edge based similarity measure by the presented method are averagely 13%, 33%, and 14% higher than the three methods for the six pairs of source images.

  3. Using an evidence-based approach for system selection at a large academic medical center: lessons learned in selecting an ambulatory EMR at Mount Sinai Hospital.

    PubMed

    Kannry, Joseph; Mukani, Sonia; Myers, Kristin

    2006-01-01

    The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the demonstration process; 2) The process involved rigorous investigation of vendor statements, industry statements and other institution's views of vendors; 3) The initiative focused on user-centric selection, and the survey instrument was scientifically and specifically designed to assess user feedback; 4) There was scientific analysis of validated findings and survey results at all steering meetings; 5) The process included an assessment of vendors' ability to support research by identifying funded and published research; 6) Selection involved meticulous total cost of ownership analysis to assess and compare real costs of implementing a vendor solution; and finally, 7) There were iterative meetings with stakeholders, executives and users to understand needs, address concerns and communicate the vision.

  4. Selected list of Books and Journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1983-01-01

    The relationship of the "Selected List" to collection development is explored in the introduction to this revised list of 559 books and 135 journals. The list is intended as a selection guide for the small or medium-sized library in a hospital or comparable medical facility or as a core collection for a consortium of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries (155 books and 54 journals) are indicated by asterisks. To purchase the entire collection of books and to pay for annual subscriptions would require an expenditure of about $38,900. The cost of only the asterisked items totals approximately $13,200. PMID:6190523

  5. The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

    PubMed

    Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

    2018-06-01

    To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. 75 FR 24711 - Food and Drug Administration Modernization Act of 1997: Modifications to the List of Recognized...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... newer version Indicators - Guidance for the Selection, Use and Interpretation of Results I. Tissue Engineering 15-6 15-16 ASTM F2450-09 Standard Guide for Assessing Withdrawn and replaced Microstructure of Polymeric Scaffolds for with newer version Use in Tissue Engineered Medical Products\\1\\ 15-9 15-17 ASTM...

  7. Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

    ERIC Educational Resources Information Center

    Yang, Jing; Huang, Si-min; Li, Ze-jian; Feng, Lie; Lu, Chun-ting

    2018-01-01

    Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine. Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a…

  8. An emergency medical planning guide for commercial spaceflight events.

    PubMed

    Law, Jennifer; Vanderploeg, James

    2012-09-01

    Commercial spaceflight events transporting paying passengers into space will begin to take place at various spaceports around the country within the next few years. Many spaceports are located in remote areas that are far from major hospitals and trauma centers. Spaceport medical directors should develop emergency medical plans (EMPs) to prepare for potential medical contingencies that may occur during commercial spaceflight events. The aim of this article is to guide spaceport medical directors in emergency medical planning for commercial spaceflight events. This guide is based on our experience and a recently developed EMP for Spaceport America which incorporated a literature review of mass gathering medicine, existing planning guides for mass gathering events, and EMPs for analogous aerospace events. We propose a multipronged approach to emergency medical planning, consisting of event planning, medical reconnaissance, medical personnel, protocols, physical facility and hardware, and documentation. Medical directors should use this guide to develop an emergency medical plan tailored to the resources and constraints specific to their events.

  9. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1979-04-01

    This revised list of 492 books and 138 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. It can also be used as a core list by small hospital library consortia. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $22,500. The cost of only the asterisked items, recommended for first purchase, totals approximately $6,100.

  10. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N

    1977-04-01

    This revised list of 472 books and 138 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. It can also be used as a core list by small hospital library consortia. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $18,200. The cost of only the asterisked items recommended for first purchase totals approximately $4,500.

  11. Medical Assisting Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a medical assisting program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the medical assisting field, such as medical law and ethics, typing,…

  12. Mobile technologies in medical education: AMEE Guide No. 105.

    PubMed

    Masters, Ken; Ellaway, Rachel H; Topps, David; Archibald, Douglas; Hogue, Rebecca J

    2016-06-01

    Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

  13. Prescription data improve the medication history in primary care.

    PubMed

    Glintborg, Bente; Andersen, S K; Poulsen, H E

    2010-06-01

    Incomplete medication lists increase the risk of medication errors and adverse drug effects. In Denmark, dispensing data and pharmacy records are available directly online to treating physicians. We aimed (1) to describe if use of pharmacy records improved the medication history among patients consulting their general practitioner and (2) to characterise inconsistencies between the medication history reported by the patient and the general practitioner's recordings. Patients attending a general practitioner clinic were interviewed about their current medication use. Subsequently, the patients were contacted by phone and asked to verify the medication list previously obtained. Half of the patients were randomly selected for further questioning guided by their dispensing data: during the telephone interview, these patients were asked to clarify whether drugs registered in their pharmacy records were still in use. Pharmacy records show all drugs acquired on prescription from any national pharmacy in the preceding 2 years. The medication list was corrected accordingly. In all patients, the medication lists obtained on the in-clinic and telephone interviews were compared to the general practitioner's registrations. The 150 patients included in the study had a median age of 56 years (range 18-93 years), and 90 (60%) were women. Patients reported use of 849 drugs (median 5, range 0-16) at the in-clinic interview. Another 41 drugs (median 0, range 0-4) were added during the telephone interview. In the subgroup of 75 patients interviewed guided by pharmacy records, additionally 53 drugs (10%) were added to the 474 drugs already mentioned. The 27 patients adding more drugs guided by pharmacy records were significantly older and used more drugs (both p<0.05) than the 48 patients not adding drugs. When the medication lists were compared with the general practitioner's lists, specifically use of over-the-counter products and prescription-only medications from Anatomical Therapeutic Chemical Classification System group J, A, D, N and R were not registered by the general practitioner. Dispensing data provide further improvement to a medication history based on thorough in-clinic and telephone interviews. Use of pharmacy records as a supplement when recording a medication history seems beneficial, especially among older patients treated with polypharmacy.

  14. 46 CFR 154.1435 - Medical first aid guide.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Medical first aid guide. 154.1435 Section 154.1435 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... Equipment § 154.1435 Medical first aid guide. Each vessel must have a copy of the IMO Medical First Aid...

  15. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1985-01-01

    The interrelationship of print and electronic media in the hospital library and the relevance of the "Selected List" in 1985 are discussed in the introduction to this revised list of 583 books and 138 journals. The list is meant to be a selection guide for the small or medium-size library in a hospital or comparable medical facility, or a core collection for a consortium of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by asterisks. To purchase the entire collection of books and to pay for 1985 subscriptions to all the journals would require about $45,200. The cost of only the asterisked items totals approximately $16,100. PMID:3888331

  16. Manual-guided psychosocial treatment. A new virtual requirement for pharmacotherapy trials?

    PubMed

    Carroll, K M

    1997-10-01

    The conduct of randomized clinical trials to evaluate the efficacy of pharmacotherapies for mental disorders is guided by research standards (at a high level of rigor) that govern most design elements, including randomization of subjects, use of placebo controls, formulation and dosage of the therapeutic agent, and monitoring of serum levels. In contrast, no such widely accepted guidelines are recognized for standardization of an essential, if unacknowledged, element of all such studies: the concomitant provision of at least a minimal form of psychosocial treatment. Standardized provision of psychosocial treatments in pharmacotherapy trials will foster replicability of findings and address several common problems (e.g., attrition, medication noncompliance, reduction of error variance, and ethical issues associated with placebo controls). Careful selection and standardization of the psychosocial context in which medications are delivered will improve the validity, precision, and power of pharmacotherapy efficacy research, and should be considered a virtual requirement in research design.

  17. Strategies for integrating computer-based activities into your educational environment: a practical guide.

    PubMed Central

    Miller, J G; Wolf, F M

    1996-01-01

    Strategies for implementing instructional technology are based on recent experiences at the University of Michigan Medical Center. The issues covered include 1) addressing facilities, hardware, and staffing needs, 2) determining learners' skill requirements and appropriate training activities, and 3) selecting and customizing educational software. Many examples are provided, and nine key points for success are emphasized. PMID:8653447

  18. Medical Assisting. A Learning Guide.

    ERIC Educational Resources Information Center

    Meyer, Rosemarie

    This competency-based, individualized learning package, consisting of 50 learning guides, is designed for use by students who are studying to become medical assistants. Included among the topics addressed in the individual learning guides are the following: using and caring for microscopes, understanding medical ethics and law, developing…

  19. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N

    1977-01-01

    This revised list of 472 books and 138 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. It can also be used as a core list by small hospital library consortia. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $18,200. The cost of only the asterisked items recommended for first purchase totals approximately $4,500. PMID:321057

  20. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1979-01-01

    This revised list of 492 books and 138 journals is intended as a selection guide for small or medium-sized hospital libraries or for the small medical library serving a specified clientele. It can also be used as a core list by small hospital library consortia. Books and journals are categorized by subject, with the books being followed by an author index and the journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by an asterisk. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $22,500. The cost of only the asterisked items, recommended for first purchase, totals approximately $6,100. PMID:380695

  1. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1981-04-01

    This revised list of 539 books and 136 journals is intended as a selection guide for small or medium-sized hospital libraries or for small medical libraries in comparable health care facilities. It can also be used as a core list by consortia of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author index and the list of journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries, 137 books and 54 journals, are indicated by asterisks. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $30,000. The cost of only the asterisked items, which are recommended for first purchase, totals approximately $8,900.

  2. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1989-01-01

    In the introduction to this revised list of 607 books and 141 journals, quality assurance programs of health care institutions and patient education are suggested as vehicles for more directly involving the hospital library and its collection in patient care. This list is intended as a selection guide for the small or medium-sized library in a hospital or comparable medical facility, or as a core collection for a consortium of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. To purchase the entire collection of books and to pay for 1989 subscriptions would require about $63,500. The cost of only the asterisked items totals $24,000. PMID:2655782

  3. Medical Administrative Systems. Curriculum Guide.

    ERIC Educational Resources Information Center

    Patton, Jan

    This curriculum guide provides materials for teachers to use in developing a course in medical administrative systems. Following an introductory section that lists the common essential elements of the course, the guide contains seven sections that cover the following course topics: (1) introduction to medical administrative systems; (2) word…

  4. Micromachined actuators/sensors for intratubular positioning/steering

    DOEpatents

    Lee, Abraham P.; Krulevitch, Peter A.; Northrup, M. Allen; Trevino, Jimmy C.

    1998-01-01

    Micromachined thin film cantilever actuators having means for individually controlling the deflection of the cantilevers, valve members, and rudders for steering same through blood vessels, or positioning same within a blood vessel, for example. Such cantilever actuators include tactile sensor arrays mounted on a catheter or guide wire tip for navigation and tissues identification, shape-memory alloy film based catheter/guide wire steering mechanisms, and rudder-based steering devices that allow the selective actuation of rudders that use the flowing blood itself to help direct the catheter direction through the blood vessel. While particularly adapted for medical applications, these cantilever actuators can be used for steering through piping and tubing systems.

  5. Microvalve

    DOEpatents

    Lee, A.P.; Krulevitch, P.A.; Northrup, M.A.; Trevino, J.C.

    1998-10-13

    Micromachined thin film cantilever actuators having means for individually controlling the deflection of the cantilevers, valve members, and rudders for steering same through blood vessels, or positioning same within a blood vessel, for example. Such cantilever actuators include tactile sensor arrays mounted on a catheter or guide wire tip for navigation and tissues identification, shape-memory alloy film based catheter/guide wire steering mechanisms, and rudder-based steering devices that allow the selective actuation of rudders that use the flowing blood itself to help direct the catheter direction through the blood vessel. While particularly adapted for medical applications, these cantilever actuators can be used for steering through piping and tubing systems. 14 figs.

  6. Microvalve

    DOEpatents

    Lee, Abraham P.; Krulevitch, Peter A.; Northrup, M. Allen; Trevino, Jimmy C.

    1998-01-01

    Micromachined thin film cantilever actuators having means for individually controlling the deflection of the cantilevers, valve members, and rudders for steering same through blood vessels, or positioning same within a blood vessel, for example. Such cantilever actuators include tactile sensor arrays mounted on a catheter or guide wire tip for navigation and tissues identification, shape-memory alloy film based catheter/guide wire steering mechanisms, and rudder-based steering devices that allow the selective actuation of rudders that use the flowing blood itself to help direct the catheter direction through the blood vessel. While particularly adapted for medical applications, these cantilever actuators can be used for steering through piping and tubing systems.

  7. Do differentials in the support and advice available at UK schools and colleges influence candidate performance in the medical school admissions interview? A survey of direct school leaver applicants to a UK medical school.

    PubMed

    Lambe, Paul; Waters, Catherine; Bristow, David

    2013-09-01

    To our knowledge, nothing is known about whether differentials in support and advice during preparation for the interview influence candidate performance and thereby contribute to bias in selection for medical school. To assess if differences in advice and support with preparation for the medical school admissions interview given type of school last attended influence interview score achieved by direct school leaver applicants to study on an undergraduate UK medical degree course. Confidential self-completed on-line questionnaire survey. Interview performance was positively related to whether a teacher, tutor or career advisors at the School or College last attended had advised a respondent to prepare for the interview, had advised about the various styles of medical interview used and the types of questions asked, and what resources were available to help in preparation. Respondents from Private/Independent schools were more likely than those from State schools to have received such advice and support. Differentials in access to advice on and support with preparation for the medical school interview may advantage some candidates over others. This inequity would likely be ameliorated by the provision of an authoritative and comprehensive guide to applying to medical school outlining admission requirements and the preparation strategy applicants should use in order to best meet those requirements. The guide could be disseminated to the Principals of all UK schools and colleges and freely available electronic versions signposted in medical school prospectuses and the course descriptor on the Universities and Colleges Admissions Service.

  8. Delivery of inhaled drugs for infants and small children: a commentary on present and future needs.

    PubMed

    Fink, James B

    2012-11-01

    Although the manufacture of inhaled medications is a multibillion dollar industry, virtually no pharmaceutical drug/device combination has been approved for inhalation across the range of pediatric patient ages and sizes. The clinician who treats neonates, infants, or toddlers is often faced with the dilemma of prescribing inhaled medications that may be disease appropriate but have not been approved for use in patients in these age categories. Their use is thus technically "off label," with limited empirical data to guide both dose and device selection. This dilemma requires the prescribing physician to go beyond the limitations of the product label, often without benefit of appropriately designed clinical trials, in an attempt to select safe and effective doses for use with these smallest of patients. The vast majority of drugs approved for inhalation were studied by using aerosol devices designed for older children and adults using a mouthpiece interface, which may not be practical for use in infants and patients aged <4 years. The selection of the most age-appropriate device and interface is critical for the effective administration of the prescribed therapy. In the absence of industry-sponsored clinical trials in neonates, infants, and toddlers, in vitro and in vivo strategies may help guide age-appropriate dosing, device, and interface selection to better inform clinical practice. In this commentary, the challenges in developing and prescribing effective formulations for aerosol delivery across the range of pediatric ages and sizes are explored, with guidance for device and interface selection. Recommendations for future collaborative sharing of in vitro models and age-specific breathing patterns between academic and industry researchers could help regulators and clinicians better understand the impact age and size have on pulmonary drug delivery. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

  9. Guide for Program Planning: Medical Laboratory Technician.

    ERIC Educational Resources Information Center

    Kahler, Carol, Ed.; And Others

    Prepared by the American Association of Junior Colleges and the National Council on Medical Technology Education, this guide discusses programs for career-entry supportive medical laboratory personnel which have been cooperatively planned by junior college personnel and the medical community, particularly pathologists and medical technologists.…

  10. Cytoreductive nephrectomy vs medical therapy as initial treatment: a rational approach to the sequence question in metastatic renal cell carcinoma.

    PubMed

    Spiess, Philippe E; Fishman, Mayer N

    2010-10-01

    Renal cell carcinoma (RCC) can be considered as two distinct entities: localized and metastatic disease. We conducted a review of the scientific literature published within the past decade pertaining to cytoreductive nephrectomy for metastatic RCC. Retrospective data and historical prospective series have demonstrated the survival benefit of debulking nephrectomy in well-selected RCC patients. New medical therapies, including vascular endothelial growth factor and mTOR pathway blocking drugs, are active biological agents, with survival improvement and potential regression of metastatic and primary tumors. Our current therapeutic challenge is the optimal integration of multimodal therapy consisting of systemic therapy and surgery including cytoreductive nephrectomy, debulking, and metastasectomy. Empiric data to guide this decision are limited. The decision concerning whether medical or surgical therapy should be the primary treatment approach selected must be made on an individual basis, taking into account patient performance status, clinical parameters, and physician expertise and recommendations, thus making each case a unique therapeutic challenge.

  11. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1981-01-01

    This revised list of 539 books and 136 journals is intended as a selection guide for small or medium-sized hospital libraries or for small medical libraries in comparable health care facilities. It can also be used as a core list by consortia of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author index and the list of journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries, 137 books and 54 journals, are indicated by asterisks. To purchase the entire collection of books and to pay for annual subscriptions to all the journals would require an expenditure of about $30,000. The cost of only the asterisked items, which are recommended for first purchase, totals approximately $8,900. PMID:7225656

  12. 75 FR 76015 - Compliance Policy Guide Sec. 393.200 Laser(s) as Medical Devices for Facelift, Wrinkle Removal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0551] Compliance Policy Guide Sec. 393.200 Laser(s) as Medical Devices for Facelift, Wrinkle Removal, Acupuncture... Compliance Policy Guide Sec. 393.200 Laser(s) as Medical Devices for Facelift, Wrinkle Removal, Acupuncture...

  13. Medical Typewriting; Business Education: 7705.32.

    ERIC Educational Resources Information Center

    Schull, Amy P.

    This guide describes a course designed to prepare students for employment as medical records clerks capable of handling all types of medical forms and reports, and using and spelling medical terminology correctly. The need for medical typists is critical. The guide contains enrollment guidelines, performance objectives (i.e., type medical…

  14. A guiding framework to maximise the power of the arts in medical education: a systematic review and metasynthesis.

    PubMed

    Haidet, Paul; Jarecke, Jodi; Adams, Nancy E; Stuckey, Heather L; Green, Michael J; Shapiro, Daniel; Teal, Cayla R; Wolpaw, Daniel R

    2016-03-01

    A rich literature describes many innovative uses of the arts in professional education. However, arts-based teaching tends to be idiosyncratic, depending on the interests and enthusiasm of individual teachers, rather than on strategic design decisions. An overarching framework is needed to guide implementation of arts-based teaching in medical education. The objective of this study was to review and synthesise the literature on arts-based education and provide a conceptual model to guide design, evaluation and research of the use of the arts in medical education. A systematic literature review using the PubMed and ERIC databases. Search terms included humanism, art, music, literature, teaching, education, learning processes, pedagogy and curriculum. We selected empirical studies and conceptual articles about the use of creative arts, imagery and symbolism in the context of professional education. Data synthesis involved a qualitative content analysis of 49 included articles, identifying themes related to educational characteristics, processes and outcomes in arts-based education. Four common themes were identified describing (i) unique qualities of the arts that promote learning, (ii) particular ways learners engage with art, (iii) documented short- and long-term learning outcomes arising from arts-based teaching and (iv) specific pedagogical considerations for using the arts to teach in professional education contexts. The arts have unique qualities that can help create novel ways to engage learners. These novel ways of engagement can foster learners' ability to discover and create new meanings about a variety of topics, which in turn can lead to better medical practice. At each of these steps, specific actions by the teacher can enhance the potential for learners to move to the next step. The process can be enhanced when learners participate in the context of a group, and the group itself can undergo transformative change. Future work should focus on using this model to guide process design and outcome measurement in arts-based education. © 2016 John Wiley & Sons Ltd.

  15. V-TECS Guide for Medical Assistant.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This V-TECS (Vocational-Technical Consortium of States) Guide is an extension or continuation of the V-TECS catalog for the occupation of medical assistant. The guide is designed to help South Carolina teachers to promote the art of learning while teaching subject matter. The guide addresses the three domains of learning: psychomotor, cognitive,…

  16. Micromachined actuators/sensors for intratubular positioning/steering

    DOEpatents

    Lee, A.P.; Krulevitch, P.A.; Northrup, M.A.; Trevino, J.C.

    1998-06-30

    Micromachined thin film cantilever actuators having means for individually controlling the deflection of the cantilevers, valve members, and rudders for steering same through blood vessels, or positioning same within a blood vessel, for example. Such cantilever actuators include tactile sensor arrays mounted on a catheter or guide wire tip for navigation and tissues identification, shape-memory alloy film based catheter/guide wire steering mechanisms, and rudder-based steering devices that allow the selective actuation of rudders that use the flowing blood itself to help direct the catheter direction through the blood vessel. While particularly adapted for medical applications, these cantilever actuators can be used for steering through piping and tubing systems. 14 figs.

  17. A model to begin to use clinical outcomes in medical education.

    PubMed

    Haan, Constance K; Edwards, Fred H; Poole, Betty; Godley, Melissa; Genuardi, Frank J; Zenni, Elisa A

    2008-06-01

    The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.

  18. Emergency Medical Services Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  19. Recognizing and Addressing Limited PHarmaceutical literacy: Development of the RALPH interview guide.

    PubMed

    Vervloet, Marcia; van Dijk, Liset; Rademakers, Jany J D J M; Bouvy, Marcel L; De Smet, Peter A G M; Philbert, Daphne; Koster, Ellen S

    2018-04-30

    In the context of medication use, pharmaceutical literacy skills are crucial for appropriate and safe use of medication. Recognition of patients with inadequate pharmaceutical literacy in daily pharmacy practice is difficult. No instrument is yet available to support pharmacists herein. The aim of this study was therefore to develop an interview guide for pharmacists to Recognize and Address Limited PHarmaceutical literacy (RALPH). The RALPH interview guide was constructed in three phases: (1) development including a literature search, expert group discussion, and feasibility test with 15 patients; (2) pilot-test with 421 patients throughout 30 community pharmacies, and (3) final test with 508 patients to optimize the interview guide. The development phase resulted in a first interview guide comprising 15 questions: seven in the functional domain (understanding instructions), four in the communicative domain (finding and understanding medication information) and four in the critical domain (critically analyzing medication information). This version was pilot-tested in 30 pharmacies, with 147 patients during medication reviews and another 274 patients were interviewed while waiting to collect their medication. This test phase led to removal of questions that proved difficult to interpret and to rephrasing some questions. The second version including 11 questions was tested by 109 pharmacists trainees with 508 patients, resulting in the final RALPH interview guide comprising 10 questions, all directly linked to the patient's own medication: three in the functional, three in the communicative and four in the critical domain. Besides instructions on how to use the interview guide, recommendations are provided for pharmacists on how to support patients with limited pharmaceutical literacy skills. The practice-based RALPH interview guide supports pharmacists in recognizing patients with limited pharmaceutical literacy. With this insight, pharmacists can tailor their medication counseling to patients' pharmaceutical literacy level to better support patients in their medication use. Copyright © 2018. Published by Elsevier Inc.

  20. Developing an academic medical library core journal collection in the (almost) post-print era: the Florida State University College of Medicine Medical Library experience

    PubMed Central

    Shearer, Barbara S.; Nagy, Suzanne P.

    2003-01-01

    The Florida State University (FSU) College of Medicine Medical Library is the first academic medical library to be established since the Web's dramatic appearance during the 1990s. A large customer base for electronic medical information resources is both comfortable with and eager to migrate to the electronic format completely, and vendors are designing radical pricing models that make print journal cancellations economically advantageous. In this (almost) post-print environment, the new FSU Medical Library is being created and will continue to evolve. By analyzing print journal subscription lists of eighteen academic medical libraries with similar missions to the community-based FSU College of Medicine and by entering these and selected quality indicators into a Microsoft Access database, a core list was created. This list serves as a selection guide, as a point for discussion with faculty and curriculum leaders when creating budgets, and for financial negotiations in a broader university environment. After journal titles specific to allied health sciences, veterinary medicine, dentistry, pharmacy, library science, and nursing were eliminated from the list, 4,225 unique journal titles emerged. Based on a ten-point scale including SERHOLD holdings and DOCLINE borrowing activity, a list of 449 core titles is identified. The core list has been saved in spreadsheet format for easy sorting by a number of parameters. PMID:12883565

  1. Developing an academic medical library core journal collection in the (almost) post-print era: the Florida State University College of Medicine Medical Library experience.

    PubMed

    Shearer, Barbara S; Nagy, Suzanne P

    2003-07-01

    The Florida State University (FSU) College of Medicine Medical Library is the first academic medical library to be established since the Web's dramatic appearance during the 1990s. A large customer base for electronic medical information resources is both comfortable with and eager to migrate to the electronic format completely, and vendors are designing radical pricing models that make print journal cancellations economically advantageous. In this (almost) post-print environment, the new FSU Medical Library is being created and will continue to evolve. By analyzing print journal subscription lists of eighteen academic medical libraries with similar missions to the community-based FSU College of Medicine and by entering these and selected quality indicators into a Microsoft Access database, a core list was created. This list serves as a selection guide, as a point for discussion with faculty and curriculum leaders when creating budgets, and for financial negotiations in a broader university environment. After journal titles specific to allied health sciences, veterinary medicine, dentistry, pharmacy, library science, and nursing were eliminated from the list, 4,225 unique journal titles emerged. Based on a ten-point scale including SERHOLD holdings and DOCLINE borrowing activity, a list of 449 core titles is identified. The core list has been saved in spreadsheet format for easy sorting by a number of parameters.

  2. Medical Interpreting: Improving Communication with Your Patients.

    ERIC Educational Resources Information Center

    Tebble, Helen

    The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…

  3. Sepsis in Older Adults.

    PubMed

    Rowe, Theresa A; McKoy, June M

    2017-12-01

    Sepsis disproportionally affects older adults with more than 60% of sepsis diagnoses attributed to adults aged 65 years and older. Identifying, diagnosing, and treating sepsis in older individuals remain a challenge for clinicians, and few studies focus specifically on older adults with multiple medical comorbidities. Principles guiding management of sepsis for older adults are generally the same as in younger adults; however, unique considerations particularly pertinent to the care older adults include antimicrobial selection and dosing, delirium management, and goals of care discussions. Other factors, such as medical comorbidities, cognitive impairment, and functional status, impact outcomes more than age alone. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Building blocks for social accountability: a conceptual framework to guide medical schools.

    PubMed

    Preston, Robyn; Larkins, Sarah; Taylor, Judy; Judd, Jenni

    2016-08-26

    This paper presents a conceptual framework developed from empirical evidence, to guide medical schools aspiring towards greater social accountability. Using a multiple case study approach, seventy-five staff, students, health sector representatives and community members, associated with four medical schools, participated in semi-structured interviews. Two schools were in Australia and two were in the Philippines. These schools were selected because they were aspiring to be socially accountable. Data was collected through on-site visits, field notes and a documentary review. Abductive analysis involved both deductive and inductive iterative theming of the data both within and across cases. The conceptual framework for socially accountable medical education was built from analyzing the internal and external factors influencing the selected medical schools. These factors became the building blocks that might be necessary to assist movement to social accountability. The strongest factor was the demands of the local workforce situation leading to innovative educational programs established with or without government support. The values and professional experiences of leaders, staff and health sector representatives, influenced whether the organizational culture of a school was conducive to social accountability. The wider institutional environment and policies of their universities affected this culture and the resourcing of programs. Membership of a coalition of socially accountable medical schools created a community of learning and legitimized local practice. Communities may not have recognized their own importance but they were fundamental for socially accountable practices. The bedrock of social accountability, that is, the foundation for all building blocks, is shared values and aspirations congruent with social accountability. These values and aspirations are both a philosophical understanding for innovation and a practical application at the health systems and education levels. While many of these building blocks are similar to those conceptualized in social accountability theory, this conceptual framework is informed by what happens in practice - empirical evidence rather than prescriptions. Consequently it is valuable in that it puts some theoretical thinking around everyday practice in specific contexts; addressing a gap in the medical education literature. The building blocks framework includes guidelines for social accountable practice that can be applied at policy, school and individual levels.

  5. Infant-Guided, Co-Regulated Feeding in the Neonatal Intensive Care Unit. Part II: Interventions to Promote Neuroprotection and Safety.

    PubMed

    Shaker, Catherine S

    2017-04-01

    Feeding skills of preterm neonates in a neonatal intensive care unit are in an emergent phase of development and require careful support to minimize stress. The underpinnings that influence and enhance both neuroprotection and safety were discussed in Part I. An infant-guided, co-regulated approach to feeding can protect the vulnerable neonate's neurologic development, support the parent-infant relationship, and prevent feeding problems that may endure. Contingent interventions are used to maintain subsystem stability and enhance self-regulation, development, and coping skills. This co-regulation between caregiver and neonate forms the foundation for a positive infant-guided feeding experience. Caregivers select evidence-based interventions contingent to the newborn's communication. When these interventions are then titrated from moment to moment, neuroprotection and safety are fostered. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Units of Instruction. Health Occupations Education. Volume I. [Teacher's Guide].

    ERIC Educational Resources Information Center

    East Texas State Univ., Commerce. Occupational Curriculum Lab.

    Ten units on health occupations are presented in this teacher's guide. The units are the following: recording vital signs; job application and interview; grooming and personal hygiene; health careers; medical careers; medical ethics; medical terminology and abbreviations; medical asepsis; basic patient care (e.g., measuring and recording fluid…

  7. Astronaut Medical Selection and Flight Medicine Care During the Shuttle ERA 1981 to 2011

    NASA Technical Reports Server (NTRS)

    Johnston, S.; Jennings, R.; Stepaniak, P.; Schmid, J.; Rouse, B.; Gray, G.; Tarver, B.

    2011-01-01

    The NASA Shuttle Program began with congressional budget approval in January 5, 1972 and the launch of STS-1 on April 12, 1981 and recently concluded with the landing of STS-135 on July 21, 2011. The evolution of the medical standards and care of the Shuttle Era Astronauts began in 1959 with the first Astronaut selection. The first set of NASA minimal medical standards were documented in 1977 and based on Air Force, Navy, Department of Defense, and the Federal Aviation Administration standards. Many milestones were achieved over the 30 years from 1977 to 2007 and the subsequent 13 Astronaut selections and 4 major expert panel reviews performed by the NASA Flight Medicine Clinic, Aerospace Medicine Board, and Medical Policy Board. These milestones of aerospace medicine standards, evaluations, and clinical care encompassed the disciplines of preventive, occupational, and primary care medicine and will be presented. The screening and retention standards, testing, and specialist evaluations evolved through periodic expert reviews, evidence based medicine, and Astronaut medical care experience. The last decade of the Shuttle Program saw the development of the International Space Station (ISS) with further Space medicine collaboration and knowledge gained from our International Partners (IP) from Russia, Canada, Japan, and the European Space Agencies. The Shuttle Program contribution to the development and implementation of NASA and IP standards and waiver guide documents, longitudinal data collection, and occupational surveillance models will be presented along with lessons learned and recommendations for future vehicles and missions.

  8. Student perceptions of a patient- centered medical training curriculum

    PubMed Central

    Gallentine, Ashley; Salinas-Miranda, Abraham A.; Shaffer-Hudkins, Emily; Hinojosa, Sara; Monroe, Alicia

    2014-01-01

    Objectives To evaluate a patient-centered medical training curriculum, the SELECT program, through perceptions of the inaugural student cohort. Methods Data were collected from two focus groups conducted in the university setting, comprised of fifteen first-year medical students who participated in the SELECT program during its inaugural year. A questioning protocol was used to guide the focus group discussion, which was transcribed and hand-coded through thematic analyses. Results Various themes related to patient-centered care were identified. Students noted changes in their attitudes towards interacting with patients in an empowering and educative manner as a result of communication and motivational interviewing exercises. Additionally, they recognized certain external, structural barriers as well as internal conflict between pragmatism and emotional intelligence that could potentially hinder patient-centered care. The impact of family dynamics and social support on quality of life and health outcomes was acknowledged. Students also emphasized the value of collaborating with multiple health professionals. Lastly, students provided suggestions for program improvement, namely additional simulations, more education regarding other healthcare professionals’ roles, more standardized experiences, and application of principles to acute and primary care. Conclusions Upon completion of the first year of the SELECT program, students gained an appreciation for patient-centered care and various factors and skills that facilitate such care. Additionally, they experienced a dissonance between didactic concepts from the curriculum and observed medical practices. This study highlights the educational benefits of a patient-centered medical curriculum and provides suggestions for future improvement. PMID:25341218

  9. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1991-04-01

    The current financial status of the health care industry is viewed both from its effect on the hospital library collection and the response of the hospital library to the financial crisis. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. As the prices of books and journals continue to soar, the secondary purpose as a core collection for a consortium of small hospital libraries or a network sharing library resources may eventually become its primary use. Books (607) and journals (140) are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. To purchase the entire collection of books and to pay for 1991 subscriptions would require about $77,700. The cost of only the asterisked items totals $29,300.

  10. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1991-01-01

    The current financial status of the health care industry is viewed both from its effect on the hospital library collection and the response of the hospital library to the financial crisis. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. As the prices of books and journals continue to soar, the secondary purpose as a core collection for a consortium of small hospital libraries or a network sharing library resources may eventually become its primary use. Books (607) and journals (140) are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. To purchase the entire collection of books and to pay for 1991 subscriptions would require about $77,700. The cost of only the asterisked items totals $29,300. PMID:2039906

  11. Selected list of books and journals in allied health sciences.

    PubMed Central

    Brandon, A N; Hill, D R

    1984-01-01

    This list of 450 books and 67 journals is intended as a selection guide to be used in a library supporting allied health educational programs and personnel in either an academic or health care setting. Due to the necessity of limiting the scope of coverage because of the large number and wide variety of allied health professions and occupations, the recommended publications are focused mainly on the twenty-six educational programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, in addition to programs in allied dental health and medical secretarial skills. Books are categorized by broad subject followed by an author/editor index; journals are listed alphabetically by title. To purchase the entire collection of books and to pay for annual (1984) journal subscriptions would require a total expenditure of approximately $15,000. PMID:6388696

  12. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1987-01-01

    The impact that the hospital librarian's use of management techniques and comprehension of the highly competitive health care environment can have on collection development and resulting information services in his or her library is reviewed in the introduction to this revised list of 600 books and 139 journals. The list is intended as a selection guide for the small or medium-size library in a hospital or comparable medical facility, or a core collection for a consortium of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase by smaller libraries are indicated by asterisks. To purchase the entire collection of books and to pay for 1987 subscriptions to all journals would require about $52,600. The cost of only the asterisked items totals approximately $21,000. PMID:3594025

  13. Emergency Medical Dispatch. National Standard Curriculum. Instructor Guide. Trainee Guide.

    ERIC Educational Resources Information Center

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

    This guide contains all instructor materials and requirements for the National Highway Traffic Safety Administration (NHTSA), Emergency Medical Dispatch (EMD) National Standard Curriculum. It includes lesson plans, instructional aids, and tools and supporting information designed to elevate trained and experienced public safety telecommunicators…

  14. Influence of gender and other factors on medical student specialty interest.

    PubMed

    Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

    2014-09-12

    Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

  15. Practical Tips for Working as an Expedition Doctor on High-Altitude Expeditions.

    PubMed

    Brants, Anne; Metcalfe, Tracee

    2017-09-01

    Brants, Anne, and Tracee Metcalfe. Practical tips for working as an expedition doctor on high-altitude expeditions. High Alt Med Biol. 18:193-198, 2017.-With the explosion of adventure travel over the past decade, there has been a concurrent increase in mountaineering expeditions to extreme elevations, including many of the 8000-m peaks. This trend has created an increased demand for qualified expedition doctors to provide specialized medical advice and care to climbers and expedition staff. This review is intended to help physicians prepare for work on such expeditions. The authors rely heavily on their own experience and discuss the types of work available on high-altitude expeditions; how to identify a safe and reputable guiding company; personal and medical preparation; priorities in selecting or building an appropriate medical kit; and medical conditions commonly encountered on expeditions. The review concludes by considering ethical dilemmas and other difficult issues unique to this work.

  16. Ontology-guided organ detection to retrieve web images of disease manifestation: towards the construction of a consumer-based health image library.

    PubMed

    Chen, Yang; Ren, Xiaofeng; Zhang, Guo-Qiang; Xu, Rong

    2013-01-01

    Visual information is a crucial aspect of medical knowledge. Building a comprehensive medical image base, in the spirit of the Unified Medical Language System (UMLS), would greatly benefit patient education and self-care. However, collection and annotation of such a large-scale image base is challenging. To combine visual object detection techniques with medical ontology to automatically mine web photos and retrieve a large number of disease manifestation images with minimal manual labeling effort. As a proof of concept, we first learnt five organ detectors on three detection scales for eyes, ears, lips, hands, and feet. Given a disease, we used information from the UMLS to select affected body parts, ran the pretrained organ detectors on web images, and combined the detection outputs to retrieve disease images. Compared with a supervised image retrieval approach that requires training images for every disease, our ontology-guided approach exploits shared visual information of body parts across diseases. In retrieving 2220 web images of 32 diseases, we reduced manual labeling effort to 15.6% while improving the average precision by 3.9% from 77.7% to 81.6%. For 40.6% of the diseases, we improved the precision by 10%. The results confirm the concept that the web is a feasible source for automatic disease image retrieval for health image database construction. Our approach requires a small amount of manual effort to collect complex disease images, and to annotate them by standard medical ontology terms.

  17. Medical Assisting Learning Guides.

    ERIC Educational Resources Information Center

    Meyer, Rose

    Eight student learning guides are provided for a medical assisting program at the secondary, postsecondary, or adult level. Each learning guide is composed of these component parts: a title page that states the task, purpose, program and task numbers, estimated time, and prerequisites; an optional learning contract that includes terminal…

  18. Standards and guidelines for biopolymers in tissue-engineered medical products: ASTM alginate and chitosan standard guides. American Society for Testing and Materials.

    PubMed

    Dornish, M; Kaplan, D; Skaugrud, O

    2001-11-01

    The American Society for Testing and Materials (ASTM) is making a concerted effort to establish standards and guidelines for the entire field of tissue-engineered medical products (TEMPS). Safety, consistency, and functionality of biomaterials used as matrices, scaffolds, and immobilizing agents in TEMPS are a concern. Therefore, the ASTM has established a number of task groups to produce standards and guidelines for such biomaterials. Alginate is a naturally occurring biomaterial used for immobilizing living cells to form an artificial organ, such as encapsulated pancreatic islets. In order to aid in successful clinical applications and to help expedite regulatory approval, the alginate used must be fully documented. The ASTM alginate guide gives information on selection of testing methodologies and safety criteria. Critical parameters such as monomer content, molecular weight, and viscosity, in addition to more general parameters, such as dry matter content, heavy metal content, bioburden, and endotoxin content are described in the ASTM document. In a like manner, the characterization parameters for chitosan, a bioadhesive polycationic polysaccharide, are described in a separate guide. For chitosan, the degree of deacetylation is of critical importance. Control of protein content and, hence, potential for hypersensitivity, endotoxin content, and total bioburden are important in chitosan preparations for TEMPS. Together these two guides represent part of the effort on behalf of the ASTM and other interested parties to ensure quality and standardization in TEMPS.

  19. Development of Methodologic Tools for Planning and Managing Library Services: IV. Bibliography of Studies Selected for Methods and Data Useful to Biomedical Libraries *

    PubMed Central

    Orr, Richard H.

    1970-01-01

    This selective bibliography is intended to serve as a guide to empirical studies reporting data and methods that can be used by medical librarians to assess their own efforts objectively and to improve the effectiveness and efficiency of services they offer. The decision rules that governed selection of items for the bibliography are specified in detail. A total of 178 items published between 1915 and mid-1968 met the selection criteria. The list of items is supplemented by a keyword index derived from titles. Half the items are journal articles; a third of these articles appeared in the Bulletin, and most of the remainder in thirteen other library and information science journals. Most of the non-journal items are technical reports issued by the organization that conducted or sponsored the work. The characteristics of this literature suggest that few medical libraries, unless they are part of a university system that includes the collection of a library or information science school, are likely to have quick access to the literature base needed to support a comprehensive program of self-evaluation studies and the continuing education of their own staff. Regional medical libraries might well undertake to ensure both ready access to, and awareness of, literature on the scientific aspects of librarianship. PMID:4912761

  20. Effects of shade tab arrangement on the repeatability and accuracy of shade selection.

    PubMed

    Yılmaz, Burak; Yuzugullu, Bulem; Cınar, Duygu; Berksun, Semih

    2011-06-01

    Appropriate and repeatable shade matching using visual shade selection remains a challenge for the restorative dentist. The purpose of this study was to evaluate the effect of different arrangements of a shade guide on the repeatability and accuracy of visual shade selection by restorative dentists. Three Vitapan Classical shade guides were used for shade selection. Seven shade tabs from one shade guide were used as target shades for the testing (A1, A4, B2, B3, C2, C4, and D3); the other 2 guides were used for shade selection by the subjects. One shade guide was arranged according to hue and chroma and the second was arranged according to value. Thirteen male and 22 female restorative dentists were asked to match the target shades using shade guide tabs arranged in the 2 different orders. The sessions were performed twice with each guide in a viewing booth. Collected data were analyzed with Fisher's exact test to compare the accuracy and repeatability of the shade selection (α=.05). There were no significant differences observed in the accuracy or repeatability of the shade selection results obtained with the 2 different arrangements. When the hue/chroma-ordered shade guide was used, 58% of the shade selections were accurate. This ratio was 57.6% when the value-ordered shade guide was used. The observers repeated 55.5% of the selections accurately with the hue/chroma-ordered shade guide and 54.3% with the value-ordered shade guide. The accuracy and repeatability of shade selections by restorative dentists were similar when different arrangements (hue/chroma-ordered and value-ordered) of the Vitapan Classical shade guide were used. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  1. Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study

    PubMed Central

    Boruff, Jill T; Bilodeau, Edward

    2012-01-01

    Question: Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? Setting: The guide was created at a library at a research-intensive university with six teaching hospital sites. Objectives: The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Methods: Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Results: Web analytics and survey results demonstrate that the guide is used and the students are satisfied. Conclusion: The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue. PMID:22272160

  2. Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study.

    PubMed

    Boruff, Jill T; Bilodeau, Edward

    2012-01-01

    Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? The guide was created at a library at a research-intensive university with six teaching hospital sites. The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Web analytics and survey results demonstrate that the guide is used and the students are satisfied. The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue.

  3. CT guided transthoracic catheter drainage of intrapulmonary abscess.

    PubMed

    Yunus, Mahira

    2009-10-01

    To determine the efficacy of CT- guided transthoracic catheter drainage of intrapulmonary abscess considering success rate versus complications. This prospective study was carried out at radiology department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia, from 1.1.2003 to 31.12.2005. Nineteen patients were selected for CT guided percutaneous drainage. Under CT guidance catheter placement was carried out using Seldinger technique. Nineteen patients with lung abscess were selected for the percutaneous CT guided drainage. Eight (42.105%) patients encountered no complications and lung abscess completely resolved with no residual cavity. Five (26.31%) patients developed pneumothorax, which was the most common complication of this study. These patients were kept under observation and followed-up by chest X-rays. Three (15.78%) had mild pneumothorax, which resolved and needed no further management, while two (10.52%) patients developed moderate pneumothorax and chest tube was inserted. Two (10.52%) patients developed mild haemoptysis which resolved within two hours, hence, no further management was required. Two (10.52%) patients had residual cavity and surgery was performed. Congenital cystic adenomatoid malformation (CCAM) was found in both cases. Two patients out of nineteen patients (10.52%) developed bronchopleural fistula and were operated. No mortality occurred during or after the procedure. CT allows optimal placement of catheter and hence enables safe and effective percutaneous evacuation of lung abscess. The morbidity and mortality of patients with percutaneous catheter drainage is lower than with surgical resection. Hence, CT guided drainage should be considered the first therapeutic choice in most patients of lung abscess who do not respond to medical therapy.

  4. The application of digital medical 3D printing technology on tumor operation

    NASA Astrophysics Data System (ADS)

    Chen, Jimin; Jiang, Yijian; Li, Yangsheng

    2016-04-01

    Digital medical 3D printing technology is a new hi-tech which combines traditional medical and digital design, computer science, bio technology and 3D print technology. At the present time there are four levels application: The printed 3D model is the first and simple application. The surgery makes use of the model to plan the processing before operation. The second is customized operation tools such as implant guide. It helps doctor to operate with special tools rather than the normal medical tools. The third level application of 3D printing in medical area is to print artificial bones or teeth to implant into human body. The big challenge is the fourth level which is to print organs with 3D printing technology. In this paper we introduced an application of 3D printing technology in tumor operation. We use 3D printing to print guide for invasion operation. Puncture needles were guided by printed guide in face tumors operation. It is concluded that this new type guide is dominantly advantageous.

  5. Using an International Medical Advisory Board to guide clinical governance in a corporate refractive surgery model.

    PubMed

    Vukich, John A

    2009-07-01

    To describe the role played by the International Medical Advisory Board (IMAB) in clinical and corporate governance at Optical Express, a corporate provider of refractive surgery. A review of goals, objectives, and actions of the IMAB. The IMAB has contributed to study design, data analysis, and selection of instruments and procedures. Through interactions with Optical Express corporate and clinical staff, the IMAB has supported management's effort to craft a corporate culture focused on continuous improvement in the safety and visual outcomes of refractive surgery. The IMAB has fashioned significant changes in corporate policies and procedures and has had an impact on corporate culture at Optical Express.

  6. Medical Office Assistant. Post Secondary Curriculum Guide.

    ERIC Educational Resources Information Center

    Simpson, Bruce; And Others

    This curriculum guide provides a model for a postsecondary medical office assistant program. It is divided into 10 sections. Section 1 overviews the philosophy, purpose, and goals for vocational education in Georgia. Contents of section 2 include a definition of the guide's purpose and program objective. Section 3 describes the occupational field,…

  7. Brandon/Hill selected list of print books and journals for the small medical library.

    PubMed

    Hill, D R; Stickell, H N

    2001-04-01

    After thirty-six years of biennial updates, the authors take great pride in being able to publish the nineteenth version (2001) of the "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." This list of 630 books and 143 journals is intended as a selection guide for health sciences libraries or similar facilities. It can also function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals, by an alphabetical title listing. Due to continuing requests from librarians, a "minimal core list" consisting of 81 titles has been pulled out from the 217 asterisked (*) initial-purchase books and marked with daggers (dagger *) before the asterisks. To purchase the entire collection of 630 books and to pay for 143 2001 journal subscriptions would require $124,000. The cost of only the asterisked items, books and journals, totals $55,000. The "minimal core list" book collection costs approximately $14,300.

  8. Brandon/Hill selected list of print books and journals for the small medical library*

    PubMed Central

    Hill, Dorothy R.; Stickell, Henry N.

    2001-01-01

    After thirty-six years of biennial updates, the authors take great pride in being able to publish the nineteenth version (2001) of the “Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library.” This list of 630 books and 143 journals is intended as a selection guide for health sciences libraries or similar facilities. It can also function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals, by an alphabetical title listing. Due to continuing requests from librarians, a “minimal core list” consisting of 81 titles has been pulled out from the 217 asterisked (*) initial-purchase books and marked with daggers (†*) before the asterisks. To purchase the entire collection of 630 books and to pay for 143 2001 journal subscriptions would require $124,000. The cost of only the asterisked items, books and journals, totals $55,000. The “minimal core list” book collection costs approximately $14,300. PMID:11337945

  9. Decision-support models for empiric antibiotic selection in Gram-negative bloodstream infections.

    PubMed

    MacFadden, D R; Coburn, B; Shah, N; Robicsek, A; Savage, R; Elligsen, M; Daneman, N

    2018-04-25

    Early empiric antibiotic therapy in patients can improve clinical outcomes in Gram-negative bacteraemia. However, the widespread prevalence of antibiotic-resistant pathogens compromises our ability to provide adequate therapy while minimizing use of broad antibiotics. We sought to determine whether readily available electronic medical record data could be used to develop predictive models for decision support in Gram-negative bacteraemia. We performed a multi-centre cohort study, in Canada and the USA, of hospitalized patients with Gram-negative bloodstream infection from April 2010 to March 2015. We analysed multivariable models for prediction of antibiotic susceptibility at two empiric windows: Gram-stain-guided and pathogen-guided treatment. Decision-support models for empiric antibiotic selection were developed based on three clinical decision thresholds of acceptable adequate coverage (80%, 90% and 95%). A total of 1832 patients with Gram-negative bacteraemia were evaluated. Multivariable models showed good discrimination across countries and at both Gram-stain-guided (12 models, areas under the curve (AUCs) 0.68-0.89, optimism-corrected AUCs 0.63-0.85) and pathogen-guided (12 models, AUCs 0.75-0.98, optimism-corrected AUCs 0.64-0.95) windows. Compared to antibiogram-guided therapy, decision-support models of antibiotic selection incorporating individual patient characteristics and prior culture results have the potential to increase use of narrower-spectrum antibiotics (in up to 78% of patients) while reducing inadequate therapy. Multivariable models using readily available epidemiologic factors can be used to predict antimicrobial susceptibility in infecting pathogens with reasonable discriminatory ability. Implementation of sequential predictive models for real-time individualized empiric antibiotic decision-making has the potential to both optimize adequate coverage for patients while minimizing overuse of broad-spectrum antibiotics, and therefore requires further prospective evaluation. Readily available epidemiologic risk factors can be used to predict susceptibility of Gram-negative organisms among patients with bacteraemia, using automated decision-making models. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. Visual Outcomes After LASIK Using Topography-Guided vs Wavefront-Guided Customized Ablation Systems.

    PubMed

    Toda, Ikuko; Ide, Takeshi; Fukumoto, Teruki; Tsubota, Kazuo

    2016-11-01

    To evaluate the visual performance of two customized ablation systems (wavefront-guided ablation and topography-guided ablation) in LASIK. In this prospective, randomized clinical study, 68 eyes of 35 patients undergoing LASIK were enrolled. Patients were randomly assigned to wavefront-guided ablation using the iDesign aberrometer and STAR S4 IR Excimer Laser system (Abbott Medical Optics, Inc., Santa Ana, CA) (wavefront-guided group; 32 eyes of 16 patients; age: 29.0 ± 7.3 years) or topography-guided ablation using the OPD-Scan aberrometer and EC-5000 CXII excimer laser system (NIDEK, Tokyo, Japan) (topography-guided group; 36 eyes of 19 patients; age: 36.1 ± 9.6 years). Preoperative manifest refraction was -4.92 ± 1.95 diopters (D) in the wavefront-guided group and -4.44 ± 1.98 D in the topography-guided group. Visual function and subjective symptoms were compared between groups before and 1 and 3 months after LASIK. Of seven subjective symptoms evaluated, four were significantly milder in the wavefront-guided group at 3 months. Contrast sensitivity with glare off at low spatial frequencies (6.3° and 4°) was significantly higher in the wavefront-guided group. Uncorrected and corrected distance visual acuity, manifest refraction, and higher order aberrations measured by OPD-Scan and iDesign were not significantly different between the two groups at 1 and 3 months after LASIK. Both customized ablation systems used in LASIK achieved excellent results in predictability and visual function. The wavefront-guided ablation system may have some advantages in the quality of vision. It may be important to select the appropriate system depending on eye conditions such as the pattern of total and corneal higher order aberrations. [J Refract Surg. 2016;32(11):727-732.]. Copyright 2016, SLACK Incorporated.

  11. Guiding principles for successful innovation in regional medical education development.

    PubMed

    Hays, Richard B

    2006-01-01

    This is an era of extraordinary expansion in medical education in both the developed and developing world. This article reflects on the author's experience in implementing new regional medical education programs, and distils ten principles to guide successful innovation once funding for such development has been achieved.

  12. A Curriculum Guide for Medical Record Technologist. Final Report.

    ERIC Educational Resources Information Center

    Garozzo, Joyce

    This curriculum guide was developed as a result of a project conducted in Pennsylvania to review, update, and revise the vocational-technical manual on file in the Pennsylvania Department of Education and to develop sample curriculum for the preparation of a medical record technologist program using the skills developed in the manual. The guide is…

  13. A Guide for Planning Facilities for Occupational Preparation Programs for Medical X-Ray Technicians. Research 31.

    ERIC Educational Resources Information Center

    Macconnell, James D.; And Others

    The major purpose of this guide is to develop the necessary information for the writing of educational specifications to house medical x-ray technician programs. The guide is also designed to: (1) assist planners in the formation of creative housing solutions for desired educational programs, (2) prevent important considerations from being…

  14. School Site Selection and Approval Guide.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Div. of School Facilities Planning.

    This guide is designed to assist school districts in selecting school sites that provide both a safe and supportive environment for the instructional program and the learning process, and gain state approval for the selected sites. The guide includes a set of selection criteria that have proven helpful to site selection teams, information about…

  15. [Do German articles in medical journals require a"guide to anglicisms"?].

    PubMed

    Huppert, D; Brandt, T

    2013-12-01

    Effective communication of scientific results depends on conceptually clear and precise language, especially with regards to the use of discipline-specific terminology. German scientific language might be more comprehensible if the overuse of anglicisms is avoided. As an example commonly used anglicisms in ten clinical studies published in Der Nervenarzt were selected, listed according to the field of application and evaluated. Adequate German terms are offered for them showing that it is possible to use German terms for most issues and facts.

  16. International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities

    PubMed Central

    DEB, SHOUMITRO; KWOK, HENRY; BERTELLI, MARCO; SALVADOR-CARULLA, LUIS; BRADLEY, ELSPETH; TORR, JENNIFER; BARNHILL, JARRET

    2009-01-01

    Psychotropic medications are used regularly to manage problem behaviours among people with intellectual disabilities. This causes concern because often these medications are used out of their licensed indications in this context. The WPA Section on Psychiatry of Intellectual Disability has recently developed an evidence and consensus-based international guide for practitioners for the use of psychotropic medications for problem behaviours among adults with intellectual disabilities. This guide advises on assessment of behaviours, producing a formulation, initiation of treatment, assessment of out-come and adverse effects, follow-up arrangements, and possibility of discontinuation of treatment. PMID:19812757

  17. Emergency Medical Technician-Ambulance: National Standard Curriculum. Student Study Guide (Third Edition).

    ERIC Educational Resources Information Center

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

    This student study guide is one of three documents prepared for the Emergency Medical Technician (EMT), National Standard Curriculum. The course is designed to develop skills in symptom recognition and in all emergency care procedures and techniques currently considered to be within the responsibilities of an EMT providing emergency medical care…

  18. Basic Training Course/Emergency Medical Technician (Second Edition). Instructor's Lesson Plan.

    ERIC Educational Resources Information Center

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

    This document containing instructor lesson plans is one of three prepared to update a basic training program for emergency medical technicians (EMTs). (A course guide containing planning and management information and a study guide are available separately.) Material covers all emergency medical techniques currently considered to be within the…

  19. Using databases in medical education research: AMEE Guide No. 77.

    PubMed

    Cleland, Jennifer; Scott, Neil; Harrild, Kirsten; Moffat, Mandy

    2013-05-01

    This AMEE Guide offers an introduction to the use of databases in medical education research. It is intended for those who are contemplating conducting research in medical education but are new to the field. The Guide is structured around the process of planning your research so that data collection, management and analysis are appropriate for the research question. Throughout we consider contextual possibilities and constraints to educational research using databases, such as the resources available, and provide concrete examples of medical education research to illustrate many points. The first section of the Guide explains the difference between different types of data and classifying data, and addresses the rationale for research using databases in medical education. We explain the difference between qualitative research and qualitative data, the difference between categorical and quantitative data, and the difference types of data which fall into these categories. The Guide reviews the strengths and weaknesses of qualitative and quantitative research. The next section is structured around how to work with quantitative and qualitative databases and provides guidance on the many practicalities of setting up a database. This includes how to organise your database, including anonymising data and coding, as well as preparing and describing your data so it is ready for analysis. The critical matter of the ethics of using databases in medical educational research, including using routinely collected data versus data collected for research purposes, and issues of confidentiality, is discussed. Core to the Guide is drawing out the similarities and differences in working with different types of data and different types of databases. Future AMEE Guides in the research series will address statistical analysis of data in more detail.

  20. Study guides: effective tools to improve self-directed learning skills of medical students.

    PubMed

    Khabaz Mafinejad, Mahboobeh; Aghili, Rokhsareh; Emami, Zahra; Malek, Mojtaba; Baradaran, Hamidreza; Taghavinia, Mansoureh; Khamseh, Mohammad E

    2014-01-01

    In medicine, there is a rapid development of a knowledge base. Medical professionals need to sustain and advance their competence to practice in response to these varieties. So, there is increased interest in self-directed learning methods. Study guides can make a major contribution to self-directed learning. This study was carried out to evaluate the effect of study guides on improving self-learning skills of medical students in the Iran University of Medical Sciences (IUMS). In this quasi-experimental study, 46 medical students were randomly assigned into two groups; the intervention group and the control group. Both groups participated in a diagnostic test at the beginning of the course (pre-test). The same test was taken at the end of the course (post-test). The intervention group was provided with study guides on thyroid disorders and diabetes. Meanwhile, they continued their routine clinical training. The control group was only involved in the conventional training program. Students in the intervention group were also asked to complete a designed questionnaire in regard to their attitude toward the study guides. At enrollment, there was no statistically significant difference between the two groups. The mean scores of the pre-test for the control group and the intervention group were 6.18 and 6.13 respectively (P=0.9). In the post-test, the mean score of the students in the intervention group was considerably higher: 9.25 vs. 12 (P=0.002). The students in the intervention group found the study guides useful. The study guides were potentially effective in motivating self-learning in this group of medical students and had a remarkable effect on their final score.

  1. A residency clinic chronic condition management quality improvement project.

    PubMed

    Halverson, Larry W; Sontheimer, Dan; Duvall, Sharon

    2007-02-01

    Quality improvement in chronic disease management is a major agenda for improving health and reducing health care costs. A six-component chronic disease management model can help guide this effort. Several characteristics of the "new model" of family medicine described by the Future of Family Medicine (FFM) Project Leadership Committee are promulgated to foster practice changes that improve quality. Our objective was to implement and assess a quality improvement project guided by the components of a chronic disease management model and FFM new model characteristics. Diabetes was selected as a model chronic disease focus. Multiple practice changes were implemented. A mature electronic medical record facilitated data collection and measurement of quality improvement progress. Data from the diabetes registry demonstrates that our efforts have been effective. Significant improvement occurred in five out of six quality indicators. Multidisciplinary teamwork in a model residency practice guided by chronic disease management principles and the FFM new model characteristics can produce significant management improvements in one important chronic disease.

  2. Emergency medical technician-basic : national standard curriculum (instructor's course guide)

    DOT National Transportation Integrated Search

    1994-01-01

    The curriculum, Emergency Medical Technician-Basic: National Standard Curriculum, : is the cornerstone of EMS prehospital training. Presented here is the : instructor's guide. This new curriculum parallels the recommendations of the : National EMS Ed...

  3. Medication Guide

    MedlinePlus

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  4. Psychosocial Interventions to Improve the School Performance of Students with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Tresco, Katy E.; Lefler, Elizabeth K.; Power, Thomas J.

    2010-01-01

    Children with ADHD typically show impairments throughout the school day. A number of interventions have been demonstrated to address both the academic and behavioral impairments associated with this disorder. Although the focus of research has been on classroom-based strategies of intervention for children with ADHD, school-based interventions applicable for non-classroom environments such as lunchrooms and playgrounds are beginning to emerge. This paper provides a brief description of the guiding principles of behavioral intervention, identifies selected strategies to address behavioral and academic concerns, discusses how school contextual factors have an effect on intervention selection and implementation, and considers the effects of using psychosocial interventions in combination with medication. PMID:21152355

  5. Teachers' Drug Reference: A Guide to Medical Conditions and Drugs Commonly Used in School-Aged Children.

    ERIC Educational Resources Information Center

    Agins, Alan P.

    This book provides a guide to approximately 175 drugs used with children. An introduction precedes the three major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, and medications in school.…

  6. Parent & Educators' Drug Reference: A Guide to Common Medical Conditions & Drugs Used in School-Aged Children.

    ERIC Educational Resources Information Center

    Agins, Alan P.

    This book provides a guide to more than 180 drugs used for children. An introduction precedes the four major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, medications in school, and drug…

  7. DeepInfer: open-source deep learning deployment toolkit for image-guided therapy

    NASA Astrophysics Data System (ADS)

    Mehrtash, Alireza; Pesteie, Mehran; Hetherington, Jorden; Behringer, Peter A.; Kapur, Tina; Wells, William M.; Rohling, Robert; Fedorov, Andriy; Abolmaesumi, Purang

    2017-03-01

    Deep learning models have outperformed some of the previous state-of-the-art approaches in medical image analysis. Instead of using hand-engineered features, deep models attempt to automatically extract hierarchical representations at multiple levels of abstraction from the data. Therefore, deep models are usually considered to be more flexible and robust solutions for image analysis problems compared to conventional computer vision models. They have demonstrated significant improvements in computer-aided diagnosis and automatic medical image analysis applied to such tasks as image segmentation, classification and registration. However, deploying deep learning models often has a steep learning curve and requires detailed knowledge of various software packages. Thus, many deep models have not been integrated into the clinical research work ows causing a gap between the state-of-the-art machine learning in medical applications and evaluation in clinical research procedures. In this paper, we propose "DeepInfer" - an open-source toolkit for developing and deploying deep learning models within the 3D Slicer medical image analysis platform. Utilizing a repository of task-specific models, DeepInfer allows clinical researchers and biomedical engineers to deploy a trained model selected from the public registry, and apply it to new data without the need for software development or configuration. As two practical use cases, we demonstrate the application of DeepInfer in prostate segmentation for targeted MRI-guided biopsy and identification of the target plane in 3D ultrasound for spinal injections.

  8. DeepInfer: Open-Source Deep Learning Deployment Toolkit for Image-Guided Therapy.

    PubMed

    Mehrtash, Alireza; Pesteie, Mehran; Hetherington, Jorden; Behringer, Peter A; Kapur, Tina; Wells, William M; Rohling, Robert; Fedorov, Andriy; Abolmaesumi, Purang

    2017-02-11

    Deep learning models have outperformed some of the previous state-of-the-art approaches in medical image analysis. Instead of using hand-engineered features, deep models attempt to automatically extract hierarchical representations at multiple levels of abstraction from the data. Therefore, deep models are usually considered to be more flexible and robust solutions for image analysis problems compared to conventional computer vision models. They have demonstrated significant improvements in computer-aided diagnosis and automatic medical image analysis applied to such tasks as image segmentation, classification and registration. However, deploying deep learning models often has a steep learning curve and requires detailed knowledge of various software packages. Thus, many deep models have not been integrated into the clinical research workflows causing a gap between the state-of-the-art machine learning in medical applications and evaluation in clinical research procedures. In this paper, we propose "DeepInfer" - an open-source toolkit for developing and deploying deep learning models within the 3D Slicer medical image analysis platform. Utilizing a repository of task-specific models, DeepInfer allows clinical researchers and biomedical engineers to deploy a trained model selected from the public registry, and apply it to new data without the need for software development or configuration. As two practical use cases, we demonstrate the application of DeepInfer in prostate segmentation for targeted MRI-guided biopsy and identification of the target plane in 3D ultrasound for spinal injections.

  9. DeepInfer: Open-Source Deep Learning Deployment Toolkit for Image-Guided Therapy

    PubMed Central

    Mehrtash, Alireza; Pesteie, Mehran; Hetherington, Jorden; Behringer, Peter A.; Kapur, Tina; Wells, William M.; Rohling, Robert; Fedorov, Andriy; Abolmaesumi, Purang

    2017-01-01

    Deep learning models have outperformed some of the previous state-of-the-art approaches in medical image analysis. Instead of using hand-engineered features, deep models attempt to automatically extract hierarchical representations at multiple levels of abstraction from the data. Therefore, deep models are usually considered to be more flexible and robust solutions for image analysis problems compared to conventional computer vision models. They have demonstrated significant improvements in computer-aided diagnosis and automatic medical image analysis applied to such tasks as image segmentation, classification and registration. However, deploying deep learning models often has a steep learning curve and requires detailed knowledge of various software packages. Thus, many deep models have not been integrated into the clinical research workflows causing a gap between the state-of-the-art machine learning in medical applications and evaluation in clinical research procedures. In this paper, we propose “DeepInfer” – an open-source toolkit for developing and deploying deep learning models within the 3D Slicer medical image analysis platform. Utilizing a repository of task-specific models, DeepInfer allows clinical researchers and biomedical engineers to deploy a trained model selected from the public registry, and apply it to new data without the need for software development or configuration. As two practical use cases, we demonstrate the application of DeepInfer in prostate segmentation for targeted MRI-guided biopsy and identification of the target plane in 3D ultrasound for spinal injections. PMID:28615794

  10. A guide for the application of analytics on healthcare processes: A dynamic view on patient pathways.

    PubMed

    Lismont, Jasmien; Janssens, Anne-Sophie; Odnoletkova, Irina; Vanden Broucke, Seppe; Caron, Filip; Vanthienen, Jan

    2016-10-01

    The aim of this study is to guide healthcare instances in applying process analytics on healthcare processes. Process analytics techniques can offer new insights in patient pathways, workflow processes, adherence to medical guidelines and compliance with clinical pathways, but also bring along specific challenges which will be examined and addressed in this paper. The following methodology is proposed: log preparation, log inspection, abstraction and selection, clustering, process mining, and validation. It was applied on a case study in the type 2 diabetes mellitus domain. Several data pre-processing steps are applied and clarify the usefulness of process analytics in a healthcare setting. Healthcare utilization, such as diabetes education, is analyzed and compared with diabetes guidelines. Furthermore, we take a look at the organizational perspective and the central role of the GP. This research addresses four challenges: healthcare processes are often patient and hospital specific which leads to unique traces and unstructured processes; data is not recorded in the right format, with the right level of abstraction and time granularity; an overflow of medical activities may cloud the analysis; and analysts need to deal with data not recorded for this purpose. These challenges complicate the application of process analytics. It is explained how our methodology takes them into account. Process analytics offers new insights into the medical services patients follow, how medical resources relate to each other and whether patients and healthcare processes comply with guidelines and regulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Ethnography in qualitative educational research: AMEE Guide No. 80.

    PubMed

    Reeves, Scott; Peller, Jennifer; Goldman, Joanne; Kitto, Simon

    2013-08-01

    Ethnography is a type of qualitative research that gathers observations, interviews and documentary data to produce detailed and comprehensive accounts of different social phenomena. The use of ethnographic research in medical education has produced a number of insightful accounts into its role, functions and difficulties in the preparation of medical students for clinical practice. This AMEE Guide offers an introduction to ethnography - its history, its differing forms, its role in medical education and its practical application. Specifically, the Guide initially outlines the main characteristics of ethnography: describing its origins, outlining its varying forms and discussing its use of theory. It also explores the role, contribution and limitations of ethnographic work undertaken in a medical education context. In addition, the Guide goes on to offer a range of ideas, methods, tools and techniques needed to undertake an ethnographic study. In doing so it discusses its conceptual, methodological, ethical and practice challenges (e.g. demands of recording the complexity of social action, the unpredictability of data collection activities). Finally, the Guide provides a series of final thoughts and ideas for future engagement with ethnography in medical education. This Guide is aimed for those interested in understanding ethnography to develop their evaluative skills when reading such work. It is also aimed at those interested in considering the use of ethnographic methods in their own research work.

  12. Selected list of books and journals in the allied health sciences.

    PubMed Central

    Brandon, A N; Hill, D R

    1986-01-01

    This list of 450 books and 69 journals is intended as a selection guide to be used in a library supporting allied health educational programs and/or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused mainly on the twenty-three educational programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, and medical secretarial programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (157 books and 27 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1986 subscriptions) would require an expenditure of about $16,700. The cost of only the asterisked items totals $6,700. PMID:3535953

  13. Selected list of books and journals in allied health sciences.

    PubMed Central

    Brandon, A N; Hill, D R

    1990-01-01

    This list of 453 books and 74 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the twenty-six educational programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, medical secretarial, and nutrition programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (179 books and 29 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1990 subscriptions) would require an expenditure of about $21,650. The cost of only the asterisked items totals $9,250. PMID:2393755

  14. Selected list of books and journals in allied health sciences.

    PubMed Central

    Brandon, A N; Hill, D R

    1988-01-01

    This list of 435 books and 76 journals is intended as a selection guide to be used in a library supporting allied health educational programs and/or health personnel in either an academic or health care setting. Because of the impossibility pf covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the twenty-six educational programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, nutrition, and medical secretarial programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (176 books and 29 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1988 subscriptions) would require an expenditure of about $19,000. The cost of only the asterisked items totals $7,900. PMID:3066428

  15. A Guide for Planning Facilities for Occupational Preparation Programs for Dental Laboratory Technicians. Research Series No. 34.

    ERIC Educational Resources Information Center

    Macconnell, James D., And Others

    The twelfth in a series also including guides for facilities for medical x-ray technologist, medical assistant, and medical secretary programs, the document is intended for use in the preparation of educational specifications for facilities for dental laboratory technician programs. Designed for use by those responsible for planning facilities,…

  16. Mary's Story: A Curriculum for Teaching Medical Terminology.

    ERIC Educational Resources Information Center

    Pennsylvania State Univ., University Park. Inst. for the Study of Adult Literacy.

    This packet of materials for a class on medical terminology consists of a collection of stories with highlighted vocabulary, teacher's guide, and student's guide. The materials teach medical terms in a series of stories about a woman named Mary Consola. Each story begins with a list of word parts that will be learned; after the story, new word…

  17. Implementation of an IT-guided checklist to improve the quality of medication history records at hospital admission.

    PubMed

    Huber, Tanja; Brinkmann, Franziska; Lim, Silke; Schröder, Christoph; Stekhoven, Daniel Johannes; Marti, Walter Richard; Egger, Richard Robert

    2017-12-01

    Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.

  18. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 2: rapid-prototype medical modeling and stereolithographic drilling guides requiring bone exposure.

    PubMed

    Rosenfeld, Alan L; Mandelaris, George A; Tardieu, Philippe B

    2006-08-01

    The purpose of this paper is to expand on part 1 of this series (published in the previous issue) regarding the emerging future of computer-guided implant dentistry. This article will introduce the concept of rapid-prototype medical modeling as well as describe the utilization and fabrication of computer-generated surgical drilling guides used during implant surgery. The placement of dental implants has traditionally been an intuitive process, whereby the surgeon relies on mental navigation to achieve optimal implant positioning. Through rapid-prototype medical modeling and the ste-reolithographic process, surgical drilling guides (eg, SurgiGuide) can be created. These guides are generated from a surgical implant plan created with a computer software system that incorporates all relevant prosthetic information from which the surgical plan is developed. The utilization of computer-generated planning and stereolithographically generated surgical drilling guides embraces the concept of collaborative accountability and supersedes traditional mental navigation on all levels of implant therapy.

  19. Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics.

    PubMed

    Ganatra, B; Kalyanwala, S; Elul, B; Coyaji, K; Tewari, S

    2010-01-01

    We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed.

  20. Development of a hospitalist-led-and-directed physical examination curriculum.

    PubMed

    Janjigian, Michael P; Charap, Mitchell; Kalet, Adina

    2012-10-01

    Deficiencies in physical examination skills among medical students, housestaff, and even faculty have been reported for decades, though specifics on how to address this deficit are lacking. Our institution has made a commitment to improving key physical examination competencies across our general medicine faculty. Development of the Merrin Bedside Teaching Program was guided by a comprehensive needs assessment and based on a learner-centered educational model. First, selected faculty fellows achieve expertise through mentorship with a master clinician. They then develop a bedside teaching curriculum in the selected domain and conclude by delivering the curriculum to peer faculty. We have developed curricula in examination of the heart, shoulder, knee, and skin. Currently, curricula are being developed in the examination of the lungs, critical care bedside rounds, and motivational interviewing. Curricula are integrated with educational activities of the internal medicine residency and medical school whenever possible. A hospitalist-led physical examination curriculum is an innovative way to address deficits in physical exam skills at all levels of training, engenders enthusiasm for skills development from faculty and learners, offers scholarship opportunities to general medicine faculty, encourages collaboration within and between institutions, and augments the education of residents and medical students. Copyright © 2012 Society of Hospital Medicine.

  1. Personalized Antidepressant Selection and Pathway to Novel Treatments: Clinical Utility of Targeting Inflammation

    PubMed Central

    Jha, Manish K.; Trivedi, Madhukar H.

    2018-01-01

    Major depressive disorder (MDD) is a chronic condition that affects one in six adults in the US during their lifetime. The current practice of antidepressant medication prescription is a trial-and-error process. Additionally, over a third of patients with MDD fail to respond to two or more antidepressant treatments. There are no valid clinical markers to personalize currently available antidepressant medications, all of which have similar mechanisms targeting monoamine neurotransmission. The goal of this review is to summarize the recent findings of immune dysfunction in patients with MDD, the utility of inflammatory markers to personalize treatment selection, and the potential of targeting inflammation to develop novel antidepressant treatments. To personalize antidepressant prescription, a c-reactive protein (CRP)-matched treatment assignment can be rapidly implemented in clinical practice with point-of-care fingerstick tests. With this approach, 4.5 patients need to be treated for 1 additional remission as compared to a CRP-mismatched treatment assignment. Anti-cytokine treatments may be effective as novel antidepressants. Monoclonal antibodies against proinflammatory cytokines, such as interleukin 6, interleukin 17, and tumor necrosis factor α, have demonstrated antidepressant effects in patients with chronic inflammatory conditions who report significant depressive symptoms. Additional novel antidepressant strategies targeting inflammation include pharmaceutical agents that block the effect of systemic inflammation on the central nervous system. In conclusion, inflammatory markers offer the potential not only to personalize antidepressant prescription but also to guide the development of novel mechanistically-guided antidepressant treatments. PMID:29329256

  2. Decision support system for health care resources allocation

    PubMed Central

    Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

    2017-01-01

    Background A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. Aim The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. Methods To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. Results A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. Conclusion In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff. PMID:28848645

  3. Decision support system for health care resources allocation.

    PubMed

    Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

    2017-06-01

    A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

  4. Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Student Study Guide.

    ERIC Educational Resources Information Center

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

    To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this student guide provides a standardized approach for first responders to traffic accidents to learn emergency medical care. Training is provided in all aspects of emergency medical care required at the scene of a traffic accident.…

  5. Annual Income Tax Guide.

    ERIC Educational Resources Information Center

    Keener, Sandra C.

    1992-01-01

    This annual guide to income tax for parents of children with disabilities covers organizing records; avoiding audits; deducting medical expenses; and considering the impact of recent changes in medical expenses, Social Security numbers for children, child care, earned income credit, and deduction for dependents. (DB)

  6. Precision instrument placement using a 4-DOF robot with integrated fiducials for minimally invasive interventions

    NASA Astrophysics Data System (ADS)

    Stenzel, Roland; Lin, Ralph; Cheng, Peng; Kronreif, Gernot; Kornfeld, Martin; Lindisch, David; Wood, Bradford J.; Viswanathan, Anand; Cleary, Kevin

    2007-03-01

    Minimally invasive procedures are increasingly attractive to patients and medical personnel because they can reduce operative trauma, recovery times, and overall costs. However, during these procedures, the physician has a very limited view of the interventional field and the exact position of surgical instruments. We present an image-guided platform for precision placement of surgical instruments based upon a small four degree-of-freedom robot (B-RobII; ARC Seibersdorf Research GmbH, Vienna, Austria). This platform includes a custom instrument guide with an integrated spiral fiducial pattern as the robot's end-effector, and it uses intra-operative computed tomography (CT) to register the robot to the patient directly before the intervention. The physician can then use a graphical user interface (GUI) to select a path for percutaneous access, and the robot will automatically align the instrument guide along this path. Potential anatomical targets include the liver, kidney, prostate, and spine. This paper describes the robotic platform, workflow, software, and algorithms used by the system. To demonstrate the algorithmic accuracy and suitability of the custom instrument guide, we also present results from experiments as well as estimates of the maximum error between target and instrument tip.

  7. Deprescribing for frail older people - Learning from the case of Mrs. Hansen.

    PubMed

    Granas, Anne Gerd; Stendal Bakken, Marit; Ruths, Sabine; Taxis, Katja

    2017-07-13

    Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being. In Mrs. Hansen's case, the number of (potentially) dangerous medications were reduced, and non-pharmacological alternatives were considered. There were some medicines added, as underprescribing can also be a problem in older people. Deprescribing long-standing treatment can be interpreted by the patient and family as "giving up hope". More clinical evidence and practical communication tools are needed to guide deprescribing decisions, taking medical and patient-centered priorities into account. Studies evaluating such interventions should select outcome measures that are particularly relevant for frail old individuals. Copyright © 2017. Published by Elsevier Inc.

  8. An investor perspective on forming and funding your medical device start-up.

    PubMed

    Mas, Juan-Pablo; Hsueh, Brian

    2017-06-01

    Novel and transformative medical technologies of all forms have the potential to make a significant positive impact on the lives of patients and on the health care system, and one common pathway for guiding such innovations from concept through commercialization is via the formation of a company. For entrepreneurs looking to build a medical technology company, several common challenges await, including questions around how and where to raise funding. Here, we review key considerations for the formation of medical technology companies as viewed through the lens of an investor. We survey common sources of capital for early-stage companies, including grants, angel investors, and venture capital, and offer insights into how to differentiate among them to select the best partners for your start-up׳s needs. Finally, we discuss the critical components of pitching your ideas to potential investors, and offer guidance on best practices and common mistakes. We hope this primer on fundamental concepts and the various health care funding alternatives will prepare entrepreneurs to achieve their mission to improve patients׳ lives through commercialization of their medical innovations. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The complete "how to" guide for selecting a disease management vendor.

    PubMed

    Linden, Ariel; Roberts, Nancy; Keck, Kevin

    2003-01-01

    Decision-makers in health plans, large medical groups, and self-insured employers face many challenges in selecting and implementing disease management programs. One strategy is the "buy" approach, utilizing one or more of the many vendors to provide disease management services for the purchasing organization. As a relatively new field, the disease management vendor landscape is continually changing, uncovering the many uncertainties about demonstrating outcomes, corporate stability, or successful business models. Given the large investment an organization may make in each disease management program (many cost 1 million dollars or more in annual fees for a moderately sized population), careful consideration must be given in selecting a disease management partner. This paper describes, in detail, the specific steps necessary and the issues to consider in achieving a successful contract with a vendor for full-service disease management.

  10. Development of a fresh cadaver model for instruction of ultrasound-guided breast biopsy during the surgery clerkship: pre-test and post-test results among third-year medical students.

    PubMed

    McCrary, Hilary C; Krate, Jonida; Savilo, Christine E; Tran, Melissa H; Ho, Hang T; Adamas-Rappaport, William J; Viscusi, Rebecca K

    2016-11-01

    The aim of our study was to determine if a fresh cadaver model is a viable method for teaching ultrasound (US)-guided breast biopsy of palpable breast lesions. Third-year medical students were assessed both preinstruction and postinstruction on their ability to perform US-guided needle aspiration or biopsy of artificially created masses using a 10-item checklist. Forty-one third-year medical students completed the cadaver laboratory as part of the surgery clerkship. Eight items on the checklist were found to be significantly different between pre-testing and post-testing. The mean preinstruction score was 2.4, whereas the mean postinstruction score was 7.10 (P < .001). Fresh cadaver models have been widely used in medical education. However, there are few fresh cadaver models that provide instruction on procedures done in the outpatient setting. Our model was found to be an effective method for the instruction of US-guided breast biopsy among medical students. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1997-01-01

    The introduction to this revised list (seventeenth version) of 610 books and 141 journals addresses the origin, three decades ago, of the "Selected List of Books and Journals for the Small Medical Library," and the accomplishments of the late Alfred N. Brandon in helping health sciences librarians, and especially hospital librarians, to envision what collection development and a library collection are all about. This list is intended as a selection guide for the small or medium-size library in a hospital or similar facility. More realistically, it can function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Due to continuing requests from librarians, a "minimal core" book collection consisting of 78 titles has been pulled out from the 200 asterisked (*) initial-purchase books and marked with daggers ([symbol: see text]). To purchase the entire collection of books and to pay for 1997 journal subscriptions would require $101,700. The cost of only the asterisked items, books and journals, totals $43,100. The "minimal core" book collection costs $12,600. PMID:9160148

  12. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1997-04-01

    The introduction to this revised list (seventeenth version) of 610 books and 141 journals addresses the origin, three decades ago, of the "Selected List of Books and Journals for the Small Medical Library," and the accomplishments of the late Alfred N. Brandon in helping health sciences librarians, and especially hospital librarians, to envision what collection development and a library collection are all about. This list is intended as a selection guide for the small or medium-size library in a hospital or similar facility. More realistically, it can function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Due to continuing requests from librarians, a "minimal core" book collection consisting of 78 titles has been pulled out from the 200 asterisked (*) initial-purchase books and marked with daggers ([symbol: see text]). To purchase the entire collection of books and to pay for 1997 journal subscriptions would require $101,700. The cost of only the asterisked items, books and journals, totals $43,100. The "minimal core" book collection costs $12,600.

  13. Health Occupations Cluster. Secondary Curriculum Guide.

    ERIC Educational Resources Information Center

    Simpson, Bruce; And Others

    This curriculum guide was designed for use in secondary health occupations education programs in Georgia. It provides a model for organizing vocational instructional content in health occupations, such as nurse, dental assistant, medical lab technician, radiologic technician, emergency medical technician, respiratory therapy assistant, medical…

  14. Alcohol and Drug Abuse Teaching Methodology Guide for Medical Faculty. Medicine 1. Health Professions Education Curriculum Resource Series.

    ERIC Educational Resources Information Center

    Hostetler, Jeptha R.

    This guide, one of a series of publications written for medical faculty to use in designing substance abuse instruction, focuses on the teaching of alcohol and drug abuse intervention in medical and osteopathic schools. Following a brief introducton to the booklet, the career teacher program, which is supported by federal grants, is explained.…

  15. One-stop-shop stroke imaging with functional CT.

    PubMed

    Tong, Elizabeth; Komlosi, Peter; Wintermark, Max

    2015-12-01

    Advanced imaging techniques have extended beyond traditional anatomic imaging and progressed to dynamic, physiologic and functional imaging. Neuroimaging is no longer a mere diagnostic tool. Multimodal functional CT, comprising of NCCT, PCT and CTA, provides a one-stop-shop for rapid stroke imaging. Integrating those imaging findings with pertinent clinical information can help guide subsequent treatment decisions, medical management and follow-up imaging selection. This review article will briefly discuss the indication and utility of each modality in acute stroke imaging. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Potentialities of mass spectrometry (ICP-MS) for actinides determination in urine.

    PubMed

    Bouvier-Capely, C; Ritt, J; Baglan, N; Cossonnet, C

    2004-05-01

    The applicability of inductively coupled plasma-mass spectrometry (ICP-MS) for determining actinides in urine was investigated. Performances of ICP-MS including detection limit and analysis time were studied and compared with alpha spectrometry performances. In the field of individual monitoring of workers, the comparison chart obtained in this study can be used as a guide for medical laboratories to select the most adequate procedure to be carried out depending on the case in question (the radioisotope to be measured, the required sensitivity, and the desired response time).

  17. Evaluation of skill-based training program on rational drug treatment for medical interns

    PubMed Central

    Venkatesan, Murugan; Dongre, Amol R; Ganapathy, Kalaiselvan

    2017-01-01

    Context: A module-based training program for medical interns using World Health Organization guide for good prescription along with the individual feedback on their prescription was developed and implemented. Objective: The objective of the study was to obtain the medical interns’ reactions to newly developed skill-based training program on rational treatment. Study Setting: This study was conducted at the Department of Community Medicine. Participants: A total of 96 medical interns were included in the study. Study Design: A cross-sectional study consisting of retro-prefeedback and open-ended questions about self-assessment of perceived skill on rational treatment. Analysis: Collected data were entered in Epi Info (3.5.4) and analyzed. Results: After training, there was a significant increase in self-perceived posttest scores of setting up the therapeutic objective for the treatment (2.9–4.9), ability to select the correct drug (2.8–5.1), ability to select right dose, schedule, and duration of drugs (2.5–4.9). and overall prescription skill (2.9–4.9). There is a significant decrease in self-perceived scores in the skill of practicing polypharmacy (4.1–2.5). Conclusions: Overall, the training program was taken well and interns perceived their skill on rational treatment was improved as shown by the feedback. PMID:29564272

  18. Medication Guide

    MedlinePlus

    ... before starting any new medication. First-Line Medications: Nicotine Replacement Therapy (NRT) These medications are called "first- ... they might try a "second-line" medication instead. Nicotine replacement therapy (NRT) helps smokers quit by reducing ...

  19. A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

    PubMed

    Gonzalo, Jed D; Graaf, Deanna; Ahluwalia, Amarpreet; Wolpaw, Dan R; Thompson, Britta M

    2018-03-21

    After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews. Data were transcribed verbatim, and a thematic analysis was used to identify themes. Authors discussed drafts of the categorization scheme, and agreed upon results and quotations. Of 36 sites implementing the program, 17 (47%) remained, 8 (22%) significantly modified, and 11 (31%) withdrew from the program. Identified strategies for implementing value-added roles included: student education, patient characteristics, patient selection methods, activities performed, and resources. Six themes influencing program implementation and maintenance included: (1) educational benefit, (2) value added to patient care from student work, (3) mentor time and site capacity, (4) student engagement, (5) working relationship between school, site, and students, and, (6) students' continuity at the site. Health systems science is an emerging focus for medical schools, and educators are challenged to design practice-based roles that enhance education and add value to patient care. Health professions' schools implementing value-added roles will need to invest resources and strategize about best-practice strategies to guide efforts.

  20. Community Guide to Cholesterol Resources.

    ERIC Educational Resources Information Center

    National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD.

    This guide is divided into two sections, one for physicians and the other for patients. The physician section lists different resources including continuing medical education opportunities on the medical and scientific aspects of cholesterol and heart disease and on the physician's role in diagnosis and patient management. Additional materials on…

  1. Nuclear Medicine Technology: A Suggested Postsecondary Curriculum.

    ERIC Educational Resources Information Center

    Technical Education Research Center, Cambridge, MA.

    The purpose of this curriculum guide is to assist administrators and instructors in establishing nuclear medicine technician programs that will meet the accreditation standards of the American Medical Association (AMA) Council on Medical Education. The guide has been developed to prepare nuclear medicine technicians (NMT's) in two-year…

  2. A Teacher's Guide to Selective Service Registration.

    ERIC Educational Resources Information Center

    Selective Service System, Washington, DC.

    This guide is designed to assist high school teachers in their preparation of lessons covering the Selective Service System. The guide is organized into seven chapters. Chapter 1 describes Selective Service as it exists today, explains the registration process and its role in the national defense system, details who must register, and emphasizes…

  3. Developing an evidence-based Guide to Community Preventive Services--methods. The Task Force on Community Preventive Services.

    PubMed

    Briss, P A; Zaza, S; Pappaioanou, M; Fielding, J; Wright-De Agüero, L; Truman, B I; Hopkins, D P; Mullen, P D; Thompson, R S; Woolf, S H; Carande-Kulis, V G; Anderson, L; Hinman, A R; McQueen, D V; Teutsch, S M; Harris, J R

    2000-01-01

    Systematic reviews and evidence-based recommendations are increasingly important for decision making in health and medicine. Over the past 20 years, information on the science of synthesizing research results has exploded. However, some approaches to systematic reviews of the effectiveness of clinical preventive services and medical care may be less appropriate for evaluating population-based interventions. Furthermore, methods for linking evidence to recommendations are less well developed than methods for synthesizing evidence. The Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide) will evaluate and make recommendations on population-based and public health interventions. This paper provides an overview of the Guide's process to systematically review evidence and translate that evidence into recommendations. The Guide reviews evidence on effectiveness, the applicability of effectiveness data, (i.e., the extent to which available effectiveness data is thought to apply to additional populations and settings), the intervention's other effects (i.e., important side effects), economic impact, and barriers to implementation of interventions. The steps for obtaining and evaluating evidence into recommendations involve: (1) forming multidisciplinary chapter development teams, (2) developing a conceptual approach to organizing, grouping, selecting and evaluating the interventions in each chapter; (3) selecting interventions to be evaluated; (4) searching for and retrieving evidence; (5) assessing the quality of and summarizing the body of evidence of effectiveness; (6) translating the body of evidence of effectiveness into recommendations; (7) considering information on evidence other than effectiveness; and (8) identifying and summarizing research gaps. Systematic reviews of and evidence-based recommendations for population-health interventions are challenging and methods will continue to evolve. However, using an evidence-based approach to identify and recommend effective interventions directed at specific public health goals may reduce errors in how information is collected and interpreted, identify important gaps in current knowledge thus guiding further research, and enhance the Guide users' ability to assess whether recommendations are valid and prudent from their own perspectives. Over time, all of these advantages could help to increase agreement regarding appropriate community health strategies and help to increase their implementation.

  4. Use of Low-Literacy Decision Aid to Enhance Knowledge and Reduce Decisional Conflict Among a Diverse Population of Adults With Rheumatoid Arthritis: Results of a Pilot Study.

    PubMed

    Barton, Jennifer L; Trupin, Laura; Schillinger, Dean; Evans-Young, Gina; Imboden, John; Montori, Victor M; Yelin, Edward

    2016-07-01

    Despite innovations in treatment of rheumatoid arthritis (RA), adherence is poor and disparities persist. Shared decision making (SDM) promotes patient engagement and enhances adherence; however, few tools support SDM in RA. Our objective was to pilot a low-literacy medication guide and decision aid to facilitate patient-clinician conversations about RA medications. RA patients were consecutively enrolled into 1 of 3 arms: 1) control; patients received existing medication guide prior to clinic visit, 2) adapted guide prior to visit, and 3) adapted guide prior to plus decision aid during visit. Outcomes were collected immediately postvisit, at 1-week, and at 3- and 6-month interviews. Eligible adults had to have failed at least 1 disease-modifying antirheumatic drug and fulfill 1 of the following: age >65 years, immigrant, non-English speaker, less than high school education, limited health literacy, and racial/ethnic minority. Primary outcomes were knowledge of RA medications, decisional conflict, and acceptability of interventions. The majority of 166 patients were immigrants (66%), non-English speakers (54%), and had limited health literacy (71%). Adequate RA knowledge postvisit in arm 3 was higher (78%) than arm 1 (53%; adjusted odds ratio 2.7, 95% confidence interval 1.2, 6.1). Among patients with a medication change, there was lower (better) mean decisional conflict in arms 2 and 3 (P = 0.03). There were no significant differences in acceptability. A low-literacy medication guide and decision aid was acceptable, improved knowledge, and reduced decisional conflict among vulnerable RA patients. Enhancing knowledge and patient engagement with decision support tools may lead to medication choices better aligned with RA patients' values and preferences. © 2016, American College of Rheumatology.

  5. Recommendations to guide revision of the Guides to the Evaluation of Permanent Impairment. American Medical Association.

    PubMed

    Spieler, E A; Barth, P S; Burton, J F; Himmelstein, J; Rudolph, L

    2000-01-26

    The American Medical Association's Guides to the Evaluation of Permanent Impairment, Fourth Edition, is the most commonly used tool in the United States for rating permanent impairments for disability systems. The Guides, currently undergoing revision, has been the focus of considerable controversy. Criticisms have focused on 2 areas: internal deficiencies, including the lack of a comprehensive, valid, reliable, unbiased, and evidence-based system for rating impairments; and the way in which workers' compensation systems use the ratings, resulting in inappropriate compensation. We focus on the internal deficiencies and recommend that the Guides remains a tool for evaluation of permanent impairment, not disability. To maintain wide acceptance of the Guides, its authors need to improve the validity, internal consistency, and comprehensiveness of the ratings; document reliability and reproducibility of the results; and make the Guides easily comprehensible and accessible to physicians.

  6. Minorities in Medicine: A Guide for Premedical Students.

    ERIC Educational Resources Information Center

    California State Dept. of Health, Sacramento.

    This booklet explains the need for more physicians from underrepresented minority groups and guides the minority student considering a medical career in preparing for and gaining admission to a medical school. Organized in nine sections, the book first introduces the Health Professions Career Opportunity Program and its services which work to…

  7. Guide to Restructuring Medical Manpower Occupations in Hospitals.

    ERIC Educational Resources Information Center

    Goldstein, Harold M.; And Others

    The guide for hospital administrators, chiefs of services, and health personnel in general, suggests ways to evaluate the utilization of manpower and to restructure health manpower occupations. The need to evaluate utilization is outlined in terms of problems faced by health institutions. The experience of the Center for Medical Manpower Studies…

  8. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    PubMed

    Zwikker, Hanneke E; van den Ende, Cornelia H; van Lankveld, Wim G; den Broeder, Alfons A; van den Hoogen, Frank H; van de Mosselaar, Birgit; van Dulmen, Sandra; van den Bemt, Bart J

    2014-03-01

    To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMARDs) were randomized to an intervention or control arm. The intervention consisted, amongst others, of two motivational interviewing-guided group sessions led by the same pharmacist. Control patients received brochures about their DMARDs. Questionnaires were completed up to 12 months follow-up. 123 patients (mean age: 60 years, female: 69%) were randomized. No differences in necessity beliefs and concern beliefs about medication and in medication non-adherence were detected between the intervention and control arm, except at 12 months' follow-up: participants in the intervention arm had less strong necessity beliefs about medication than participants in the control arm (b: -1.0 (95% CI: -2.0, -0.1)). This trial did not demonstrate superiority of our intervention over the control arm in changing beliefs about medication or in improving medication adherence over time. Absent intervention effects might have been due to, amongst others, selection bias and a suboptimal treatment integrity level. Hence, targeting beliefs about medication in clinical practice should not yet be ruled out. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. The implication of integrated training program for medical history education.

    PubMed

    Chen, Shun-Sheng; Chou, Peiyi

    2015-01-01

    A full spectrum of medical education requires not only clinical skills but also humanistic qualities in the medical professionals, which can be facilitated by an integrated training program. An integrated project was created to improve one's medical intellectual and communication competence and to enable them to become docents who can perform well, as well as for development of their humanitarian nature. The aim of this study was to suggest an integrated program that provided approaches for creating positive effects in medical history education. Taiwan Medical Museum conducted a project on medical history lessons and docent training program; 51 participants (24 male and 27 female) attended this plan. Targets took pre-tests before lectures, attended courses of medical history, and then took post-tests. Next, they received a series of lessons on presentation skills and practiced for guiding performance. After all the training processes, the attendees succeeded in all evaluations in order to guide exhibition visitors. Data were analyzed using paired t test. Two types of assessments were followed, i.e., cognitive examination and guiding practice, and both were related to good performance. Reliability (Cronbach's α) was 0.737 for the cognitive examination and 0.87 for the guiding evaluation. It indicated that the integrated program for docent training resulted in a significant difference (p ≦ 0.0001). The participants demonstrated better achievement and knowledge acquisition through the entire process, which led to great performance when approached by the visitors. The whole project helped to shape up a good docent and to accumulate positive learning experiences for medical professionals as well. Therefore, an integrated program is recommended to medical history education in the future.

  10. Nerve monitoring-guided selective hypoglossal nerve stimulation in obstructive sleep apnea patients.

    PubMed

    Heiser, Clemens; Hofauer, Benedikt; Lozier, Luke; Woodson, B Tucker; Stark, Thomas

    2016-12-01

    Selective stimulation of the upper airway is a new therapy for obstructive sleep apnea. The aim of the study was to determine if a selective nerve integrity monitoring (NIM) system could aid in precise placement of the cuff electrode in selective upper-airway stimulation. Single-center, prospective clinical trial. Twenty patients who received a selective upper-airway stimulation system (Inspire Medical Systems, Maple Grove, MN) were implanted by using a NIM system. The tongue motions were recorded during surgery and 2 months postoperatively from the transoral view and by transnasal endoscopy. All patients exhibited consistent protrusion at tongue front and tongue base. The nerve monitoring system helped to place the cuff electrode around the protrusion and stiffening branches, while excluding the retractor branches of the hypoglossal nerve. This report demonstrated a novel use of a NIM system to identify the functional separation between inclusion and exclusion branches of the hypoglossal nerve for implantation of a selective upper-airway stimulation system. 4. Laryngoscope, 126:2852-2858, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Twelve Tips for teaching medical professionalism at all levels of medical education.

    PubMed

    Al-Eraky, Mohamed Mostafa

    2015-01-01

    Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

  12. Introducing medical students to careers in medical education: the student track at an annual medical education conference.

    PubMed

    Blatt, Benjamin; Plack, Margaret; Suzuki, Mari; Arepalli, Sruthi; Schroth, Scott; Stagnaro-Green, Alex

    2013-08-01

    Few avenues exist to familiarize medical students with careers as clinician-educators, and the clinician-educator career pathway has not been well defined. In this article, the authors describe how they integrated a career-oriented student track into the 2011 Northeast Group on Educational Affairs (NEGEA) annual retreat to introduce students to careers in medical education. Annual education conferences are principal sources of educational scholarship, networking, collaboration, and information sharing; as such, they represent attractive venues for early exposure to the culture of medical education. The authors' goal in creating the NEGEA conference student track was to excite students about careers in medical education by providing them with an array of opportunities for active involvement in both student-specific and general conference activities.The authors draw from their experience to provide a guide for recruiting student participants to career-building student tracks. They also offer a guide for developing future student tracks, based on their experience and grounded in social cognitive career theory. Although their focus is on medical education, they believe these guides will be useful for educators planning a conference-based student track in any field.

  13. Association of learning styles with research self-efficacy: study of short-term research training program for medical students.

    PubMed

    Dumbauld, Jill; Black, Michelle; Depp, Colin A; Daly, Rebecca; Curran, Maureen A; Winegarden, Babbi; Jeste, Dilip V

    2014-12-01

    With a growing need for developing future physician scientists, identifying characteristics of medical students who are likely to benefit from research training programs is important. This study assessed if specific learning styles of medical students, participating in federally funded short-term research training programs, were associated with research self-efficacy, a potential predictor of research career success. Seventy-five first-year medical students from 28 medical schools, selected to participate in two competitive NIH-supported summer programs for research training in aging, completed rating scales to evaluate learning styles at baseline, and research self-efficacy before and after training. We examined associations of individual learning styles (visual-verbal, sequential-global, sensing-intuitive, and active-reflective) with students' gender, ranking of medical school, and research self-efficacy. Research self-efficacy improved significantly following the training programs. Students with a verbal learning style reported significantly greater research self-efficacy at baseline, while visual, sequential, and intuitive learners demonstrated significantly greater increases in research self-efficacy from baseline to posttraining. No significant relationships were found between learning styles and students' gender or ranking of their medical school. Assessments of learning styles may provide useful information to guide future training endeavors aimed at developing the next generation of physician-scientists. © 2014 Wiley Periodicals, Inc.

  14. Unmasking identity dissonance: exploring medical students' professional identity formation through mask making.

    PubMed

    Joseph, Kimera; Bader, Karlen; Wilson, Sara; Walker, Melissa; Stephens, Mark; Varpio, Lara

    2017-04-01

    Professional identity formation is an on-going, integrative process underlying trainees' experiences of medical education. Since each medical student's professional identity formation process is an individual, internal, and often times emotionally charged unconscious experience, it can be difficult for educators to understand each student's unique experience. We investigate if mask making can provide learners and educators the opportunity to explore medical students' professional identity formation experiences. In 2014 and 2015, 30 third year medical students created masks, with a brief accompanying written narrative, to creatively express their medical education experiences. Using a paradigmatic case selection approach, four masks were analyzed using techniques from visual rhetoric and the Listening Guide. The research team clearly detected identity dissonance in each case. Each case provided insights into the unique personal experiences of the dissonance process for each trainee at a particular point in their medical school training. We propose that mask making accompanied by a brief narrative reflection can help educators identify students experiencing identity dissonance, and explore each student's unique experience of that dissonance. The process of making these artistic expressions may also provide a form of intervention that can enable educators to help students navigate professional identity formation and identity dissonance experiences.

  15. The economic evaluation of medical devices: challenges.

    PubMed

    Kingkaew, Pritaporn; Teerawattananon, Yot

    2014-05-01

    While many of the principles that guide the economic evaluation of medical devices are somewhat similar to those that guide the evaluation of other health technologies, most outline a methodology that focuses on pharmaceutical products rather providing specific guidance for medical devices. Given that medical devices use a wide range of technologies and can be used for many purposes, conducting an economic analysis for medical devices is not straightforward. The cost and effectiveness of a given technology may depend on a number of factors. The objective of this paper is to provide a summary of issues that need to be addressed before undertaking an economic evaluation of medical devices and to outline a number of suggested approaches for undertaking an economic evaluation of medical devices.

  16. User-Centered Design of the eyeGuide, a Tailored Glaucoma Behavior Change Program

    PubMed Central

    Killeen, Olivia; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P.; Newman-Casey, Paula Anne

    2016-01-01

    PURPOSE We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. PATIENTS Glaucoma patients ≥ age 40 prescribed ≥1 glaucoma medication were included. METHODS The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semi-structured diagnostic and pre-testing interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook and identified key themes using NVivo 10.0 to further refine the eyeGuide. RESULTS Twenty-one glaucoma patients were interviewed; mean age 72 ± 12.4 years, five (24%) African-Americans, nine (43%) with poor self-reported adherence, ten (47.6%) ≥ age 75, ten (47.6%) with poor vision and nine (42.9%) women. Qualitative analysis identified five important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients’ beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a web-based module. Participant feedback resulted in revised content. CONCLUSIONS User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content. PMID:27096721

  17. User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.

    PubMed

    Killeen, Olivia J; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P; Newman-Casey, Paula Anne

    2016-10-01

    We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included. The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide. Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content. User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.

  18. Medical and biohazardous waste generator`s guide: Revision 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1994-09-01

    This Guide describes the procedures required to comply with all federal and state laws and regulations and Lawrence Berkeley Laboratory (LBL) policy applicable to medical and biohazardous waste. The members of the LBL Biological Safety Subcommittee participated in writing these policies and procedures. The procedures and policies in this Guide apply to LBL personnel who work with infectious agents or potentially infectious agents, publicly perceived infectious items or materials (e.g., medical gloves, culture dishes), and sharps (e.g., needles, syringes, razor blades). If medical or biohazardous waste is contaminated or mixed with a hazardous chemical or material, with a radioactive material,more » or with both, the waste will be handled in accordance with the applicable federal and State of California laws and regulations for hazardous, radioactive, or mixed waste.« less

  19. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1993-04-01

    The potential for the hospital library as an accepted patient-focused module is viewed in terms of both the present and the future--or no future--in the introduction to this revised recommended list of 606 books and 143 journals. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. Due to rapidly rising prices, the secondary purpose--a basic collection for a consortium of hospital libraries or a network sharing library resources--may eventually become its primary use. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. For the first time, a "minimal core collection" consisting of 85 books has been broken out from the 200 asterisked initial purchase books. To purchase the entire collection of books and to pay for the 1993 subscriptions would require about $87,000; the cost of only the asterisked books and journals totals $34,800. The "minimal core list" of books costs $11,600.

  20. Selected list of books and journals for the small medical library.

    PubMed

    Brandon, A N; Hill, D R

    1995-04-01

    The complementary informational access roles of the traditional hospital library book and journal collection and the high-tech Internet are viewed from a 1995 perspective. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. As the prices of books and journals continue on an upward spiral, the secondary purpose as a core collection for a consortium of small hospital libraries or a network sharing library resources is fast becoming its primary use. Books (610) and journals (141) are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Due to requests from librarians, a "minimal core" book collection consisting of 82 titles has been pulled out from the 200 asterisked initial-purchase books. To purchase the entire collection of books and to pay for 1995 subscriptions would require $93,300. The cost of only the asterisked items totals $39,000. The "minimal core" book collection costs $12,700.

  1. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1995-01-01

    The complementary informational access roles of the traditional hospital library book and journal collection and the high-tech Internet are viewed from a 1995 perspective. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. As the prices of books and journals continue on an upward spiral, the secondary purpose as a core collection for a consortium of small hospital libraries or a network sharing library resources is fast becoming its primary use. Books (610) and journals (141) are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Due to requests from librarians, a "minimal core" book collection consisting of 82 titles has been pulled out from the 200 asterisked initial-purchase books. To purchase the entire collection of books and to pay for 1995 subscriptions would require $93,300. The cost of only the asterisked items totals $39,000. The "minimal core" book collection costs $12,700. PMID:7599581

  2. Selected list of books and journals for the small medical library.

    PubMed Central

    Brandon, A N; Hill, D R

    1993-01-01

    The potential for the hospital library as an accepted patient-focused module is viewed in terms of both the present and the future--or no future--in the introduction to this revised recommended list of 606 books and 143 journals. Predecessors of this list have been intended as selection guides for a small or medium-size library in a hospital or comparable medical facility. Due to rapidly rising prices, the secondary purpose--a basic collection for a consortium of hospital libraries or a network sharing library resources--may eventually become its primary use. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. For the first time, a "minimal core collection" consisting of 85 books has been broken out from the 200 asterisked initial purchase books. To purchase the entire collection of books and to pay for the 1993 subscriptions would require about $87,000; the cost of only the asterisked books and journals totals $34,800. The "minimal core list" of books costs $11,600. PMID:8472001

  3. Selected list of books and journals in allied health.

    PubMed Central

    Brandon, A N; Hill, D R

    1992-01-01

    This list of 396 books and 77 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Due to the necessity of limiting the scope of coverage because of the large number and wide range of allied health professions and occupations, the recommended publications are focused primarily on the twenty-eight programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, medical secretarial, nutrition, and speech pathology/audiology. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals is followed by an alphabetical title listing. Items suggested for initial purchase (194 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1992 subscriptions) would require an expenditure of about $22,800. The cost of only the asterisked items totals $10,850. PMID:1525616

  4. Selected list of books and journals in allied health.

    PubMed Central

    Brandon, A N; Hill, D R

    1994-01-01

    The U.S. health care system of the twenty-first century will be information driven; allied health literature will be a dynamic part of that information. This list of 415 books and 76 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either a health care or academic setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, focus has been directed primarily to the twenty-eight educational programs accredited by the Committee on Allied Health Education and Accreditation (CAHEA) of the American Medical Association, plus physical therapy, dental allied health, medical secretarial, nutrition, and speech pathology/audiology programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (177 books and 32 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1994 subscriptions) would require an expenditure of about $25,300. PMID:7920334

  5. Is It Time for Entrustable Professional Activities for Residency Program Directors?

    PubMed

    Bing-You, Robert G; Holmboe, Eric; Varaklis, Kalli; Linder, Jo

    2017-06-01

    Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.

  6. Ecological Modeling Guide for Ecosystem Restoration and Management

    DTIC Science & Technology

    2012-08-01

    may result from proposed restoration and management actions. This report provides information to guide environmental planers in selection, development...actions. This report provides information to guide environmental planers in selection, development, evaluation and documentation of ecological models. A

  7. Emergency Medical Services Instructor Training Program. A National Standard Curriculum. Course Guide. First Edition.

    ERIC Educational Resources Information Center

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

    This course guide is designed to aid the course administrator and coordinator in understanding, developing, and implementing all phases of an Emergency Medical Services (EMS) instructor training course. An introduction provides an overview of the training program and the administrator's and coordinator's responsibilities in the organization and…

  8. Emergency Medical Technician-Ambulance: National Standard Curriculum. Course Guide (Third Edition).

    ERIC Educational Resources Information Center

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

    This course guide is intended to assist course coordinators in planning and managing a course to train emergency medical technicians to work with ambulance or other specialized rescue services. Materials are presented to enable students to perform the following functions: recognize the nature and seriousness of the patient's condition or extent of…

  9. Crash Injury Management for Traffic Law Enforcement Officers; Emergency Medical Services; Course Guide.

    ERIC Educational Resources Information Center

    Cleven, Arlene M.

    The course guide has been prepared to aid in planning and conducting a training program in emergency medical care for first responders to traffic accidents (expected to be patrolling law enforcement officers). This document contains a detailed description of the training program; suggestions for course planning including class size, scheduling…

  10. Emergency Medical Services Program Administration Prototype Curriculum: Curriculum Guide.

    ERIC Educational Resources Information Center

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

    The curriculum guide was developed for training administrators (new entrants and incumbents), at the college level, in Emergency Medical Services (EMS) program administration. It is designed to be comprehensive and to include all knowledge and skills needed to perform the functions and tasks involved in EMS administration and management. The brief…

  11. Intrarater repeatability of shade selections with two shade guides.

    PubMed

    Hammad, Ihab A

    2003-01-01

    Color research has shown that shade guides do not always represent the color of natural teeth. Moreover, visual evaluation has been found to be unreliable and inconsistent. This investigation evaluated the effects of 2 shade guides on the intrarater repeatability (reliability) of prosthodontists and general practitioners with regard to shade selection. Ten prosthodontists and ten general practitioners (all men, 35-45 years old) with an average practice experience of 14 years participated in this study. Examiners were tested to eliminate color blindness. Each clinician used Vita Lumin Vacuum and Vitapan 3D-Master shade guides to determine the shades of the maxillary right canines of 20 patients following a standard protocol. The identification codes of the shade tabs were masked to prevent shade memory. All teeth were polished before each shade selection, and the selection process was standardized for controlled lighting and procedures. Shade selections were randomly repeated 1 month later by the same practitioners on the same group of patients in accordance with the same shade-selection protocol. Analysis of variance and t tests for individual comparisons among means were performed (P<.05). Significant interactions were found between the effects of shade guide system and specialty training on intrarater repeatability (P<.0001, analysis of variance). The intrarater repeatability of prosthodontists was significantly higher than that of general practitioners when the Vita Lumin Vacuum shade guide was used (P<.0001, t test). Use of the Vitapan 3D-Master shade guide significantly improved the intrarater repeatability of general practitioners compared with the Vita Lumin Vacuum shade guide (P<.0005). This improvement was not significant, however, among prosthodontists (P=.2861). Within the limitations of this study, the prosthodontists demonstrated superior intrarater repeatability in shade selection, especially when the Vita Lumin Vacuum shade guide was used. Use of the Vitapan 3D-Master shade guide notably improved intrarater repeatability among the general practitioners.

  12. Good medical ethics, from the inside out--and back again.

    PubMed

    Oakley, Justin

    2015-01-01

    I argue here that good medical ethics requires an empirically-informed moral psychology of medical virtue along with sound action-guiding prescriptions for virtuous medical practice. After distinguishing between three levels of justification, I indicate how medical virtue ethics can draw constructively on relevant empirical research in developing feasible and realistic aspirational standards for doctors, and in evaluating how policymakers can support doctors in acting on the virtues that doctors agreed to be guided by when they joined the profession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Canadian Poetry in Selected English-Language Anthologies: An Index and Guide. Occasional Paper Series No. 36.

    ERIC Educational Resources Information Center

    Fee, Margery, Ed.

    Forty-four English language anthologies are included in this index and guide to Canadian poetry. The introduction discusses the selection of the anthologies and the function of the index. The book contains (1) a guide to Canadian poetry anthologies that includes biographical sources, history, and criticism; (2) a selective list of Canadian poetry…

  14. Medical student preferences for self-directed study resources in gross anatomy.

    PubMed

    Choi-Lundberg, Derek L; Low, Tze Feng; Patman, Phillip; Turner, Paul; Sinha, Sankar N

    2016-01-01

    Gross anatomy instruction in medical curricula involve a range of resources and activities including dissection, prosected specimens, anatomical models, radiological images, surface anatomy, textbooks, atlases, and computer-assisted learning (CAL). These resources and activities are underpinned by the expectation that students will actively engage in self-directed study (SDS) to enhance their knowledge and understanding of anatomy. To gain insight into preclinical versus clinical medical students' preferences for SDS resources for learning gross anatomy, and whether these vary on demographic characteristics and attitudes toward anatomy, students were surveyed at two Australian medical schools, one undergraduate-entry and the other graduate-entry. Lecture/tutorial/practical notes were ranked first by 33% of 156 respondents (mean rank ± SD, 2.48 ± 1.38), textbooks by 26% (2.62 ± 1.35), atlases 20% (2.80 ± 1.44), videos 10% (4.34 ± 1.68), software 5% (4.78 ± 1.50), and websites 4% (4.24 ± 1.34). Among CAL resources, Wikipedia was ranked highest. The most important factor in selecting CAL resources was cost (ranked first by 46%), followed by self-assessment, ease of use, alignment with curriculum, and excellent graphics (each 6-9%). Compared with preclinical students, clinical students ranked software and Acland's Video Atlas of Human Anatomy higher and felt radiological images were more important in selecting CAL resources. Along with other studies reporting on the quality, features, and impact on learning of CAL resources, the diversity of students' preferences and opinions on usefulness and ease of use reported here can help guide faculty in selecting and recommending a range of CAL and other resources to their students to support their self-directed study. © 2015 American Association of Anatomists.

  15. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct...

  16. 21 CFR 870.1330 - Catheter guide wire.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Catheter guide wire. 870.1330 Section 870.1330...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1330 Catheter guide wire. (a) Identification. A catheter guide wire is a coiled wire that is designed to fit inside a...

  17. 21 CFR 870.1330 - Catheter guide wire.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catheter guide wire. 870.1330 Section 870.1330...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1330 Catheter guide wire. (a) Identification. A catheter guide wire is a coiled wire that is designed to fit inside a...

  18. Selection of peptides interfering with protein-protein interaction.

    PubMed

    Gaida, Annette; Hagemann, Urs B; Mattay, Dinah; Räuber, Christina; Müller, Kristian M; Arndt, Katja M

    2009-01-01

    Cell physiology depends on a fine-tuned network of protein-protein interactions, and misguided interactions are often associated with various diseases. Consequently, peptides, which are able to specifically interfere with such adventitious interactions, are of high interest for analytical as well as medical purposes. One of the most abundant protein interaction domains is the coiled-coil motif, and thus provides a premier target. Coiled coils, which consist of two or more alpha-helices wrapped around each other, have one of the simplest interaction interfaces, yet they are able to confer highly specific homo- and heterotypic interactions involved in virtually any cellular process. While there are several ways to generate interfering peptides, the combination of library design with a powerful selection system seems to be one of the most effective and promising approaches. This chapter guides through all steps of such a process, starting with library options and cloning, detailing suitable selection techniques and ending with purification for further down-stream characterization. Such generated peptides will function as versatile tools to interfere with the natural function of their targets thereby illuminating their down-stream signaling and, in general, promoting understanding of factors leading to specificity and stability in protein-protein interactions. Furthermore, peptides interfering with medically relevant proteins might become important diagnostics and therapeutics.

  19. Theory and practice in the design and conduct of graduate medical education.

    PubMed

    Hodges, Brian David; Kuper, Ayelet

    2012-01-01

    Medical education practice is more often the result of tradition, ritual, culture, and history than of any easily expressed theoretical or conceptual framework. The authors explain the importance and nature of the role of theory in the design and conduct of graduate medical education. They outline three groups of theories relevant to graduate medical education: bioscience theories, learning theories, and sociocultural theories. Bioscience theories are familiar to many medical educators but are often misperceived as truths rather than theories. Theories from such disciplines as neuroscience, kinesiology, and cognitive psychology offer insights into areas such as memory formation, motor skills acquisition, diagnostic decision making, and instructional design. Learning theories, primarily emerging from psychology and education, are also popular within medical education. Although widely employed, not all learning theories have robust evidence bases. Nonetheless, many important notions within medical education are derived from learning theories, including self-monitoring, legitimate peripheral participation, and simulation design enabling sustained deliberate practice. Sociocultural theories, which are common in the wider education literature but have been largely overlooked within medical education, are inherently concerned with contexts and systems and provide lenses that selectively highlight different aspects of medical education. They challenge educators to reconceptualize the goals of medical education, to illuminate maladaptive processes, and to untangle problems such as career choice, interprofessional communication, and the hidden curriculum.Theories make visible existing problems and enable educators to ask new and important questions. The authors encourage medical educators to gain greater understanding of theories that guide their educational practices.

  20. Selective Guide to Literature on Software Review Sources. Engineering Literature Guides, Number 8.

    ERIC Educational Resources Information Center

    Bean, Margaret H., Ed.

    This selective literature guide serves as a directory to software evaluation sources for all sizes of microcomputers. Information is provided on review sources and guides which deal with a variety of applications such as library, engineering, school, and business as well as a variety of systems, including DOS and CP/M. This document is intended to…

  1. A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

    PubMed

    Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

  2. The GuideView System for Interactive, Structured, Multi-modal Delivery of Clinical Guidelines

    NASA Technical Reports Server (NTRS)

    Iyengar, Sriram; Florez-Arango, Jose; Garcia, Carlos Andres

    2009-01-01

    GuideView is a computerized clinical guideline system which delivers clinical guidelines in an easy-to-understand and easy-to-use package. It may potentially enhance the quality of medical care or allow non-medical personnel to provide acceptable levels of care in situations where physicians or nurses may not be available. Such a system can be very valuable during space flight missions when a physician is not readily available, or perhaps the designated medical personnel is unable to provide care. Complex clinical guidelines are broken into simple steps. At each step clinical information is presented in multiple modes, including voice,audio, text, pictures, and video. Users can respond via mouse clicks or via voice navigation. GuideView can also interact with medical sensors using wireless or wired connections. The system's interface is illustrated and the results of a usability study are presented.

  3. Treatment of great auricular neuralgia with real-time ultrasound-guided great auricular nerve block

    PubMed Central

    Jeon, Younghoon; Kim, Saeyoung

    2017-01-01

    Abstract Rationale: The great auricular nerve can be damaged by the neck surgery, tumor, and long-time pressure on the neck. But, great auricular neuralgia is very rare condition. It was managed by several medication and landmark-based great auricular nerve block with poor prognosis. Patient concerns: A 25-year-old man presented with a pain in the left lateral neck and auricle. Diagnosis: He was diagnosed with great auricular neuralgia. Interventions: His pain was not reduced by medication. Therefore, the great auricular nerve block with local anesthetics and steroid was performed under ultrasound guidance. Outcomes: Ultrasound guided great auricular nerve block alleviated great auricular neuralgia. Lessons: This medication-resistant great auricular neuralgia was treated by the ultrasound guided great auricular nerve block with local anesthetic agent and steroid. Therefore, great auricular nerve block can be a good treatment option of medication resistant great auricular neuralgia. PMID:28328811

  4. 77 FR 24961 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-26

    ... estimate of 3 minutes per Medication Guide for pharmacists to comply with the requirements is miscalculated... as the estimated burden for pharmacists to distribute Medication Guides to patients. (Comment 2) One... should be a tool to enhance the level of care to consumers, rather than a hindrance to pharmacists in...

  5. Quality in Context: A Guide to Certification and Registration by the Medical Library Association.

    ERIC Educational Resources Information Center

    Fitzsimons, Eileen; Mayfield, M. Kent

    This guide is designed to assist prospective examinees in preparing for the certification/registration examination of the Medical Library Association (MLA). The format of the examination and the types of questions to be found on the examination are discussed, and suggestions for test preparation are provided. Several practice "mini"…

  6. Alcohol and Drug Abuse Curriculum Guides for Pediatrics Faculty: Health Professions Education Curriculum Resources Series, Medicine 4.

    ERIC Educational Resources Information Center

    Milman, Doris H.; And Others

    This document provides two separate curriculum guides for pediatrics faculty to use in teaching medical students. The first section contains the alcohol abuse curriculum guide; the second section contains the drug abuse curriculum guide. The drug abuse guide concentrates on cannabis as a paradigm for all nonalcoholic drugs of abuse. Each guide…

  7. The normalization heuristic: an untested hypothesis that may misguide medical decisions.

    PubMed

    Aberegg, Scott K; O'Brien, James M

    2009-06-01

    Medical practice is increasingly informed by the evidence from randomized controlled trials. When such evidence is not available, clinical hypotheses based on pathophysiological reasoning and common sense guide clinical decision making. One commonly utilized general clinical hypothesis is the assumption that normalizing abnormal laboratory values and physiological parameters will lead to improved patient outcomes. We refer to the general use of this clinical hypothesis to guide medical therapeutics as the "normalization heuristic". In this paper, we operationally define this heuristic and discuss its limitations as a rule of thumb for clinical decision making. We review historical and contemporaneous examples of normalization practices as empirical evidence for the normalization heuristic and to highlight its frailty as a guide for clinical decision making.

  8. Guide Catheter Extension Device Is Effective in Renal Angioplasty for Severely Calcified Lesions

    PubMed Central

    Sugimoto, Takeshi; Nomura, Tetsuya; Hori, Yusuke; Yoshioka, Kenichi; Kubota, Hiroshi; Miyawaki, Daisuke; Urata, Ryota; Kikai, Masakazu; Keira, Natsuya; Tatsumi, Tetsuya

    2017-01-01

    Patient: Male, 69 Final Diagnosis: Atherosclerotic renal artery stenosis Symptoms: None Medication: — Clinical Procedure: — Specialty: Radiology Objective: Unusual setting of medical care Background: The GuideLiner catheter extension device is a monorail-type “Child” support catheter that facilitates coaxial alignment with the guide catheter and provides an appropriate back-up force. This device has been developed in the field of coronary intervention, and now is becoming widely applied in the field of endovascular treatment. However, there has been no report on the effectiveness of the guide catheter extension device in percutaneous transluminal renal angioplasty (PTRA). Case Report: We encountered a case of atherosclerotic subtotal occlusion at the ostium of the left renal artery. Due to the severely calcified orifice and weaker back-up force provided by a JR4 guide catheter, we could not pass any guide-wires through the target lesion. Therefore, we introduced a guide catheter extension device, the GuideLiner catheter, through the guide catheter and achieved good guidewire maneuverability. We finally deployed 2 balloon-expandable stents and successfully performed all PTRA procedures. Conclusions: The guide catheter extension device can be effective in PTRA for severely calcified subtotal occlusion. PMID:28533503

  9. Health Care Economics: A Study Guide for Neuroradiology Fellows, Part 1.

    PubMed

    Weiner, S L; Tu, R; Javan, R; Taheri, M R

    2018-01-01

    Few resources are available in the medical literature for a comprehensive review of current health care economics as it relates to radiologists, specifically framed by topics defined by the Accreditation Council for Graduate Medical Education in the evaluation of neuroradiology fellows. Therefore, we present a comprehensive review article as a study guide for fellows to learn from and gain competence in the Accreditation Council for Graduate Medical Education neuroradiology milestones on health care economics. © 2018 by American Journal of Neuroradiology.

  10. A Selective United Nations Guide.

    ERIC Educational Resources Information Center

    Petty, Johnese G.

    This annotated, selective bibliography is a guide to the history of the United Nations, its publications, and four of the 14 specialized agencies and their publications. It is organized under the following headings: biographies, guides, official records, indexes and abstracts, laws, yearbooks, bibliographies, directories, statistics, periodicals,…

  11. Islamic medical ethics in the 20th century.

    PubMed Central

    Rispler-Chaim, V

    1989-01-01

    While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated. PMID:2614792

  12. Renewed roles for librarians in problem-based learning in the medical curriculum.

    PubMed

    Mi, Misa

    2011-01-01

    Problem-based learning (PBL) is a teaching-learning process or method of instruction that is widely used in medical education curricula. Librarians play important roles as facilitators for PBL as well as guides for information resources. Involvement in PBL activities presents unique opportunities to incorporate library resources and instruction into the medical curriculum. This article reviews the problem-based learning method within the conceptual framework of the learning theory of constructivism. It describes how a medical librarian at a U.S. medical school used emerging technologies to facilitate PBL small group case discussions, guide students to quality information resources, and enhance the learning environment for the PBL process.

  13. Down the Rabbit Hole: Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies.

    PubMed

    Tucci, Veronica; Siever, Kaylin; Matorin, Anu; Moukaddam, Nidal

    2015-11-01

    Patients presenting with behavior or psychiatric complaints may have an underlying medical disorder causing or worsening their symptoms. Misdiagnosing a medical illness as psychiatric can lead to increased morbidity and mortality. A thorough history and physical examination, including mental status, are important to identify these causes and guide further testing. Laboratory and ancillary testing should be guided by what is indicated based on clinical assessment. Certain patient populations and signs and symptoms have a higher association with organic causes of behavioral complaints. Many medical problems can present with or exacerbate psychiatric symptoms, and a thorough medical assessment is imperative. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. 38 CFR 17.154 - Dog-guides and equipment for blind.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

  15. 38 CFR 17.154 - Dog-guides and equipment for blind.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

  16. 38 CFR 17.154 - Dog-guides and equipment for blind.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

  17. Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice.

    PubMed

    Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

    2017-01-01

    During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians' practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine.

  18. Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice

    PubMed Central

    Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

    2017-01-01

    During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians’ practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine. PMID:29282423

  19. Have motivation theories guided the development and reform of medical education curricula? A review of the literature.

    PubMed

    Kusurkar, Rashmi A; Croiset, Gerda; Mann, Karen V; Custers, Eugene; Ten Cate, Olle

    2012-06-01

    Educational psychology indicates that learning processes can be mapped on three dimensions: cognitive (what to learn), affective or motivational (why learn), and metacognitive regulation (how to learn). In a truly student-centered medical curriculum, all three dimensions should guide curriculum developers in constructing learning environments. The authors explored whether student motivation has guided medical education curriculum developments. The authors reviewed the literature on motivation theory related to education and on medical education curriculum development to identify major developments. Using the Learning-Oriented Teaching model as a framework, they evaluated the extent to which motivation theory has guided medical education curriculum developers. Major developments in the field of motivation theory indicate that motivation drives learning and influences students' academic performance, that gender differences exist in motivational mechanisms, and that the focus has shifted from quantity of motivation to quality of motivation and its determinants, and how they stimulate academic motivation. Major developments in medical curricula include the introduction of standardized and regulated medical education as well as problem-based, learner-centered, integrated teaching, outcome-based, and community-based approaches. These curricular changes have been based more on improving students' cognitive processing of content or metacognitive regulation than on stimulating motivation. Motivational processes may be a substantially undervalued factor in curriculum development. Building curricula to specifically stimulate motivation in students may powerfully influence the outcomes of curricula. The elements essential for stimulating intrinsic motivation in students, including autonomy support, adequate feedback, and emotional support, appear lacking as a primary aim in many curricular plans.

  20. Globes: A Librarian's Guide to Selection and Purchase.

    ERIC Educational Resources Information Center

    Coombs, James

    1981-01-01

    Provides a guide for librarians to use in selecting globes by discussing how globes are made, types of globes, special and extraterrestrial globes, selecting criteria, and comparing such features as aesthetic appeal, readability, and currency of political information. A list of globe manufacturers and a selected bibliography are provided. (CHC)

  1. Guide to Understanding Lymphedema

    MedlinePlus

    ... Therapy Expressive Writing Guided Imagery Hypnosis Massage Therapy Medical Marijuana Mindfulness-Based Stress Reduction Yoga and Breast Cancer Getting Started With Yoga Popular Yoga Styles Common ...

  2. Legal Rights of Asbestos Exposure Victims. A Practical Legal Guide for People With Breathing and Other Medical Problems, Possibly Resulting from Exposure to Asbestos.

    ERIC Educational Resources Information Center

    Silberfeld, Roman M.; Hecht, Richard L.

    This practical legal guide for people with breathing and other medical problems, possibly resulting from exposure to asbestos, provides 19 questions and detailed answers about Asbestosis and other diseases resulting from asbestos exposure. Included is information concerning symptoms, difficulty of diagnosis, necessity of a detailed…

  3. Guide to the Family and Medical Leave Act: Questions & Answers. Fourth Edition.

    ERIC Educational Resources Information Center

    National Partnership for Women and Families, Washington, DC.

    The Family and Medical Leave Act of 1993 (FMLA) provided workers with the right to take time off from work to care for their families or themselves without fear of losing their jobs. Although this law is relatively straightforward, some employees and employers may be unsure about how it actually works. This guide is designed to answer many…

  4. Value of Artisanal Simulators to Teach Ultrasound-Guided Percutaneous Biopsy Using a Tru-Cut Needle for Veterinary and Medical Students

    ERIC Educational Resources Information Center

    de Araújo Setin, Raíza; Fortes Cirimbelli, Carolina; Mazeto Ercolin, Anna Carolina; Pires, Sâmara Turbay; Disselli, Tamiris; Ferrarini Nunes Soares Hage, Maria Cristina

    2018-01-01

    The present study aimed to evaluate the applicability of artisanal simulators to teach veterinary and medical students the ultrasound-guided percutaneous biopsy using a tru-cut needle. The artisanal simulators consisted of bovine liver between two layers of commercially available grape gelatin. Students were paired, with one doing the biopsy and…

  5. Developing Korean Academy of Medical Sciences Guideline for Rating the Impairment in Mental and Behavioral Disorders; A Comparative Study of KNPA's New Guidelines and AMA's 6th Guides

    PubMed Central

    Ryu, Seong Gon; Hong, Narei; Hwang, Sun-Chul; Jung, Han-Young; Jeong, Dushin; Rah, Ueon Woo; Suh, Dong-Soo

    2009-01-01

    Quantifying and rating the impairments due to mental and behavior disorders are difficult for their own characteristics. Korean Academy of Medical Sciences (KAMS) is developing guidelines of rating impairment in mental and behavioral disorders based on Korean Neuropsychiatric Association (KNPA)'s new guidelines. We compared the new KNPA's guidelines and the American Medical Association (AMA)'s 6th Guides in assessing impairment due to mental and behavioral disorders to develop new guidelines of KAMS. Two guidelines are different in diagnosing system, applicable disorders, qualification of assessors, application of scales, contents of assessment and rate of impairment of the whole person. Both AMA's and the proposed guidelines have individual merits and characteristics. There is a limitation in using the 6th AMA's Guides in Korean situation. However to improve objectivity in Korean assessment of psychiatric impairment, the new AMA's Guides can serve as a good reference. PMID:19503692

  6. Selecting Students for Training in Health Care. A Practical Guide to Improving Selection Procedures. WHO Offset Publication No. 74.

    ERIC Educational Resources Information Center

    Bennett, Mick; Wakeford, Richard

    This guide is intended to help those responsible for choosing health care trainees to develop and improve their selection procedures. Special reference is given to health workers in maternal and child health. Chapter 1 deals with health care policy implications for selection of trainees, the different functions of selection and conflicts that…

  7. Caregivers' Guide to Medications and Aging

    MedlinePlus

    ... experiencing a medication-related problem. For most older persons, multiple medication use is the norm. Many chronic conditions or diseases— ... www.seniorcarepharmacist.com Practical information about safe medication use for older persons, including a directory of senior care pharmacists across ...

  8. On search guide phrase compilation for recommending home medical products.

    PubMed

    Luo, Gang

    2010-01-01

    To help people find desired home medical products (HMPs), we developed an intelligent personal health record (iPHR) system that can automatically recommend HMPs based on users' health issues. Using nursing knowledge, we pre-compile a set of "search guide" phrases that provides semantic translation from words describing health issues to their underlying medical meanings. Then iPHR automatically generates queries from those phrases and uses them and a search engine to retrieve HMPs. To avoid missing relevant HMPs during retrieval, the compiled search guide phrases need to be comprehensive. Such compilation is a challenging task because nursing knowledge updates frequently and contains numerous details scattered in many sources. This paper presents a semi-automatic tool facilitating such compilation. Our idea is to formulate the phrase compilation task as a multi-label classification problem. For each newly obtained search guide phrase, we first use nursing knowledge and information retrieval techniques to identify a small set of potentially relevant classes with corresponding hints. Then a nurse makes the final decision on assigning this phrase to proper classes based on those hints. We demonstrate the effectiveness of our techniques by compiling search guide phrases from an occupational therapy textbook.

  9. History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus.

    PubMed

    Levine, Marc S; Rubesin, Stephen E

    2017-02-01

    This article reviews the history of the barium swallow from its early role in radiology to its current status as an important diagnostic test in modern radiology practice. Though a variety of diagnostic procedures can be performed to evaluate patients with dysphagia or other pharyngeal or esophageal symptoms, the barium study has evolved into a readily available, non-invasive, and cost-effective technique that can facilitate the selection of additional diagnostic tests and guide decisions about medical, endoscopic, or surgical management. This article focuses on the evolution of fluoroscopic equipment, radiography, and contrast media for evaluating the pharynx and esophagus, the importance of understanding pharyngoesophageal relationships, and major advances that have occurred in the radiologic diagnosis of select esophageal diseases, including gastroesophageal reflux disease, infectious esophagitis, eosinophilic esophagitis, esophageal carcinoma, and esophageal motility disorders.

  10. Guide to Regeneration of Bottomland Hardwoods

    Treesearch

    Martha R. McKevlin

    1992-01-01

    This guide will help landowners, consulting foresters, and public service foresters regenerate bottomland hardwoods. It discusses (1) interpretation of site characteristics, (2) selection of species, and (3) selection of regeneration methods. A dichotomous key for selection of appropriate regeneration methods under various conditions is presented.

  11. [The usefulness of personal digital assistants (Palm and Pocket PC) in the medical field].

    PubMed

    Daher, Ralph; Awada, Hassane

    2007-01-01

    The Personal Digital Assistant (PDA) has become nowadays a powerful and essential tool for many physicians. Its promising success in the near future and the lack of information in regard to its use in Lebanon led to this transverse study. A questionnaire was submitted to the doctors, residents and interns of Hôtel-Dieu de France (HDF) Hospital (Beirut), during March-April 2004 in order to evaluate the use of PDAs, the preferences and the needs of the medical personnel and to propose solutions which can meet its needs. The answers' rate to the questionnaire is 70.3% (303 answers). The PDA possession rate is 3036%; it is significantly more important in physicians compared to surgeons. Among those having a PDA, the operating system Palm dominates with 60% with a current tendency towards the purchase of Pocket PC; the operating system Pocket PC dominates the Phone PDAs. Approximately one third use their PDA ineffectively and admit having difficulties which greatly reduce its use in the medical field. Lexi-Drugs is the most used pharmaceutical guide, Sanford Guide the most used microbiological guide, iSilo the most used medical textbooks reader. More than 85% do not use any program to follow up their patients or read medical journals. Two thirds recognize the beneficial role of the PDA on the quality and the speed of the medical practice, one third consider that it reduces medical errors. The availability of medical programs is significantly more important for Palm. Among the subjects not having a PDA, 47% hope to buy one in the year to come; the possession rate of PDAs is estimated to reach 69.3% in 2010. Computerization of the medical data, installation of a wireless network, courses on the use of PDAs in the medical field, etc., are needs considered to be useful by 60-80% of the responders. Many medical utilities are already computerized. They still have to be presented in a format compatible with PDAs to answer a great part of the needs. A guided hospital policy and an educational program are needed to increase the usefulness of PDAs in the medical field.

  12. Change Detection via Selective Guided Contrasting Filters

    NASA Astrophysics Data System (ADS)

    Vizilter, Y. V.; Rubis, A. Y.; Zheltov, S. Y.

    2017-05-01

    Change detection scheme based on guided contrasting was previously proposed. Guided contrasting filter takes two images (test and sample) as input and forms the output as filtered version of test image. Such filter preserves the similar details and smooths the non-similar details of test image with respect to sample image. Due to this the difference between test image and its filtered version (difference map) could be a basis for robust change detection. Guided contrasting is performed in two steps: at the first step some smoothing operator (SO) is applied for elimination of test image details; at the second step all matched details are restored with local contrast proportional to the value of some local similarity coefficient (LSC). The guided contrasting filter was proposed based on local average smoothing as SO and local linear correlation as LSC. In this paper we propose and implement new set of selective guided contrasting filters based on different combinations of various SO and thresholded LSC. Linear average and Gaussian smoothing, nonlinear median filtering, morphological opening and closing are considered as SO. Local linear correlation coefficient, morphological correlation coefficient (MCC), mutual information, mean square MCC and geometrical correlation coefficients are applied as LSC. Thresholding of LSC allows operating with non-normalized LSC and enhancing the selective properties of guided contrasting filters: details are either totally recovered or not recovered at all after the smoothing. These different guided contrasting filters are tested as a part of previously proposed change detection pipeline, which contains following stages: guided contrasting filtering on image pyramid, calculation of difference map, binarization, extraction of change proposals and testing change proposals using local MCC. Experiments on real and simulated image bases demonstrate the applicability of all proposed selective guided contrasting filters. All implemented filters provide the robustness relative to weak geometrical discrepancy of compared images. Selective guided contrasting based on morphological opening/closing and thresholded morphological correlation demonstrates the best change detection result.

  13. The Environment Film Review. A Critical Guide to Ecology Films.

    ERIC Educational Resources Information Center

    Environment Information Center, New York, NY.

    Critical reviews of more than 600 environmental films selected from a field of several thousand are contained in this reference guide. Designed to provide a comprehensive selection of films covering all aspects of environmental affairs, from air pollution to wildlife, the guide is primarily user-oriented. It consists of two parts: a Review…

  14. Sanitary Landfill. Sludge Treatment and Disposal Course #166. Instructor's Guide [and] Student Workbook.

    ERIC Educational Resources Information Center

    Sharman, Ronald M.

    This lesson is an introduction to disposal of sludge by landfill. A brief explanation of the complete process is provided, including discussions of sludge suitability, site selection, method selection and operation, site closure, and ultimate reuse. The lesson includes an instructor's guide and student workbook. The instructor's guide contains a…

  15. Acoustic guide for noise-transmission testing of aircraft

    NASA Technical Reports Server (NTRS)

    Vaicaitis, Rimas (Inventor)

    1987-01-01

    Selective testing of aircraft or other vehicular components without requiring disassembly of the vehicle or components was accomplished by using a portable guide apparatus. The device consists of a broadband noise source, a guide to direct the acoustic energy, soft sealing insulation to seal the guide to the noise source and to the vehicle component, and noise measurement microphones, both outside the vehicle at the acoustic guide output and inside the vehicle to receive attenuated sound. By directing acoustic energy only to selected components of a vehicle via the acoustic guide, it is possible to test a specific component, such as a door or window, without picking up extraneous noise which may be transmitted to the vehicle interior through other components or structure. This effect is achieved because no acoustic energy strikes the vehicle exterior except at the selected component. Also, since the test component remains attached to the vehicle, component dynamics with vehicle frame are not altered.

  16. Systems Engineering for Space Exploration Medical Capabilities

    NASA Technical Reports Server (NTRS)

    Mindock, Jennifer; Reilly, Jeffrey; Urbina, Michelle; Hailey, Melinda; Rubin, David; Reyes, David; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; hide

    2017-01-01

    Human exploration missions to beyond low Earth orbit destinations such as Mars will present significant new challenges to crew health management during a mission compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its integrative goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system guiding principles, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Mobel-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

  17. Guide to Understanding Triple-Negative Breast Cancer

    MedlinePlus

    ... Therapy Expressive Writing Guided Imagery Hypnosis Massage Therapy Medical Marijuana Mindfulness-Based Stress Reduction Yoga and Breast Cancer Getting Started With Yoga Popular Yoga Styles Common ...

  18. [Dr. Henry Wigderson--the first neurosurgeon in Eretz-Israel].

    PubMed

    Feinsod, Moshe

    2006-07-01

    The vision of Hadassah Medical Organization and the Hebrew University in Jerusalem was to establish a University Hospital where clinical excellence and high academic level will be the hallmark of its departments. More than seventy years ago, guided by this spirit, the leaders of the two institutions attempted to establish a department of neurosurgery, which, at the time in only a few countries, was making its initial steps as an independent discipline. It was only during World War II that Hadassah could bring over a specialist in neurosurgery who worked for nearly three years in the Hadassah Hospital on Mount Scopus. This article describes the way Dr. Henry Wigderson was selected to be the first neurosurgeon in Eretz-Israel, his activities and the incorporation of the idea, in spite of the disappointment caused by his departure, that even at times of distress, neurosurgery is not a luxury but an indispensable part of an forward-looking medical institution.

  19. Kansas Nursing Home Medication Aide Curriculum. Revised.

    ERIC Educational Resources Information Center

    Bartel, Myrna J.; Fornelli, Linda K.

    This curriculum guide is designed to aid Kansas instructors in conducting a course for teaching nursing home medication aides. Covered first are various introductory topics such as the role and responsibilities of medication aides, pharmacodynamics, forms in which medication is now available, common medical abbreviations, mathematics and weights…

  20. Health software: a new CEI Guide for software management in medical environment.

    PubMed

    Giacomozzi, Claudia; Martelli, Francesco

    2016-01-01

    The increasing spread of software components in the healthcare context renders explanatory guides relevant and mandatory to interpret laws and standards, and to support safe management of software products in healthcare. In 2012 a working group has been settled for the above purposes at Italian Electrotechnical Committee (CEI), made of experts from Italian National Institute of Health (ISS), representatives of industry, and representatives of the healthcare organizations. As a first outcome of the group activity, Guide CEI 62-237 was published in February 2015. The Guide incorporates an innovative approach based on the proper contextualization of software products, either medical devices or not, to the specific healthcare scenario, and addresses the risk management of IT systems. The Guide provides operators and manufacturers with an interpretative support with many detailed examples to facilitate the proper contextualization and management of health software, in compliance with related European and international regulations and standards.

  1. Reducing Medication Costs to Prevent Cardiovascular Disease: A Community Guide Systematic Review

    PubMed Central

    Finnie, Ramona K.C.; Acharya, Sushama D.; Jacob, Verughese; Proia, Krista K.; Hopkins, David P.; Pronk, Nicolaas P.; Goetzel, Ron Z.; Kottke, Thomas E.; Rask, Kimberly J.; Lackland, Daniel T.; Braun, Lynne T.

    2015-01-01

    Introduction Hypertension and hyperlipidemia are major cardiovascular disease risk factors. To modify them, patients often need to adopt healthier lifestyles and adhere to prescribed medications. However, patients’ adherence to recommended treatments has been suboptimal. Reducing out-of-pocket costs (ROPC) to patients may improve medication adherence and consequently improve health outcomes. This Community Guide systematic review examined the effectiveness of ROPC for medications prescribed for patients with hypertension and hyperlipidemia. Methods We assessed effectiveness and economics of ROPC for medications to treat hypertension, hyperlipidemia, or both. Per Community Guide review methods, reviewers identified, evaluated, and summarized available evidence published from January 1980 through July 2015. Results Eighteen studies were included in the analysis. ROPC interventions resulted in increased medication adherence for patients taking blood pressure and cholesterol medications by a median of 3.0 percentage points; proportion achieving 80% adherence to medication increased by 5.1 percentage points. Blood pressure and cholesterol outcomes also improved. Nine studies were included in the economic review, with a median intervention cost of $172 per person per year and a median change in health care cost of −$127 per person per year. Conclusion ROPC for medications to treat hypertension and hyperlipidemia is effective in increasing medication adherence, and, thus, improving blood pressure and cholesterol outcomes. Most ROPC interventions are implemented in combination with evidence-based health care interventions such as team-based care with medication counseling. An overall conclusion about the economics of the intervention could not be reached with the small body of inconsistent cost-benefit evidence. PMID:26605708

  2. Select Agent and Toxin Regulations: Beyond the Eighth Edition of the Guide for the Care and Use of Laboratory Animals

    PubMed Central

    Kastenmayer, Robin J; Moore, Rashida M; Bright, Allison L; Torres-Cruz, Rafael; Elkins, William R

    2012-01-01

    In the interval between the publication of the seventh and eighth editions of the Guide for the Care and Use of Laboratory Animals (Guide), much has changed with regard to the regulation and funding of highly pathogenic biologic agents and toxins (Select Agents). Funding of research involving highly pathogenic agents has increased dramatically during this time, thus increasing the demand for facilities capable of supporting this work. The eighth edition of the Guide briefly mentions Select Agents and provides a limited set of references. Here we provide some background information regarding the relevant laws and regulations, as well as an overview of the programmatic requirements pertaining to the use of Select Agents, with a focus on use in animals. PMID:22776191

  3. Impairment Rating Ambiguity in the United States: The Utah Impairment Guides for Calculating Workers' Compensation Impairments

    PubMed Central

    Hunter, Bradley; Bunkall, Larry D.; Holmes, Edward B.

    2009-01-01

    Since the implementation of workers' compensation, accurately and consistently rating impairment has been a concern for the employee and employer, as well as rating physicians. In an attempt to standardize and classify impairments, the American Medical Association (AMA) publishes the AMA Guides ("Guides"), and recently published its 6th edition of the AMA Guides. Common critiques of the AMA Guides 6th edition are that they are too complex, lacking in evidence-based methods, and rarely yield consistent ratings. Many states mandate use of some edition of the AMA Guides, but few states are adopting the current edition due to the increasing difficulty and frustration with their implementation. A clearer, simpler approach is needed. Some states have begun to develop their own supplemental guides to combat problems in complexity and validity. Likewise studies in Korea show that past methods for rating impairment are outdated and inconsistent, and call for measures to adapt current methods to Korea's specific needs. The Utah Supplemental Guides to the AMA Guides have been effective in increasing consistency in rating impairment. It is estimated that litigation of permanent impairment has fallen below 1% and Utah is now one of the least costly states for obtaining workers' compensation insurance, while maintaining a medical fee schedule above the national average. Utah's guides serve as a model for national or international impairment guides. PMID:19503678

  4. Thermal Imaging of Medical Saw Blades and Guides

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dinwiddie, Ralph Barton; Steffner, Thomas E

    2007-01-01

    Better Than New, LLC., has developed a surface treatment to reduce the friction and wear of orthopedic saw blades and guides. The medical saw blades were thermally imaged while sawing through fresh animal bone and an IR camera was used to measure the blade temperature as it exited the bone. The thermal performance of as-manufactured saw blades was compared to surface-treated blades, and a freshly used blade was used for temperature calibration purposes in order to account for any emissivity changes due to organic transfer layers. Thermal imaging indicates that the treated saw blades cut faster and cooler than untreatedmore » blades. In orthopedic surgery, saw guides are used to perfectly size the bone to accept a prosthesis. However, binding can occur between the blade and guide because of misalignment. This condition increases the saw blade temperature and may result in tissue damage. Both treated ad untreated saw guides were also studied. The treated saw guide operated at a significantly lower temperature than untreated guide. Saw blades and guides that operate at a cooler temperature are expected to reduce the amount of tissue damage (thermal necrosis) and may reduce the number of post-operative complications.« less

  5. Hidden benefits of a peer-mentored 'Hospital Orientation Day': first-year medical students' perspectives.

    PubMed

    Barker, Thomas A; Ngwenya, Nothando; Morley, David; Jones, Ellen; Thomas, Cathryn P; Coleman, Jamie J

    2012-01-01

    Entering the clinical environment is potentially stressful for junior medical students. We evaluated first-year medical student feedback on a peer-mentored 'Hospital Orientation Day' designed to provide insight into future clinical training. Using a mixed methodology approach data were collected from first-year medical students. Responses to a questionnaire were used to develop a topic guide for focus groups held the next academic year. The questionnaire was completed by 230 first-year students and 32 second years participated in the interviews. Thematic analysis was used to draw conclusions. Analysis of questionnaire responses indicated that students gained insight into future learning. Focus groups then generated five themes: (1) entering the hospital without fear, (2) linking the present with the future, (3) understanding the culture of learning in the clinical years, (4) a 'Backstage Pass' to the clinical world and (5) peer mentors make or break the day. Using peer mentors during the Hospital Orientation Day allowed insight into future learning. We highlight the importance of student Mentors in the success of hospital orientation. To maximise the benefits for first years, we recommend a mentor selection procedure, mentor training opportunities and incentives to optimise mentor performance.

  6. Brandon/Hill selected list of books and journals for the small medical library.

    PubMed

    Hill, D R

    1999-04-01

    The interrelationship of print and electronic media in the hospital library and its relevance to the "Brandon/Hill Selected List" in 1999 are addressed in the updated list (eighteenth version) of 627 books and 145 journals. This list is intended as a selection guide for the small or medium-size library in a hospital or similar facility. More realistically, it can function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Due to continuing requests from librarians, a "minimal core" book collection consisting of 82 titles has been pulled out from the 214 asterisked (*) initial-purchase books and marked with daggers ([symbol: see text]). To purchase the entire collection of books and to pay for 1999 journal subscriptions would require $114,900. The cost of only the asterisked items, books and journals, totals $49,100. The "minimal core" book collection costs $13,200.

  7. Essentials of an Acceptable School for Medical Record Technicians.

    ERIC Educational Resources Information Center

    American Medical Association, Chicago, IL. Council on Medical Education.

    The Council on Medical Education of the American Medical Association in collaboration with the American Association of Medical Record Librarians establishes standards for medical record technician education, surveys and approves educational programs, and publishes lists of approved programs. The standards presented are intended as a guide for…

  8. An investigation of the questions posted on medical consultation websites.

    PubMed

    Chiu, Ming-Hsin Phoebe

    2016-12-01

    Online medical consultation has recently become a more and more popular alternative venue for healthcare. It allows patients and caregivers to discuss their health problems and symptoms with qualified medical health professionals via the Internet. This study investigates the questions posted on an asynchronous online medical consultation website, Taiwan eDoctor. Five research themes are explored: (1) length of questions, (2) moment of seeking consultation, (3) strategies of communicating chief complaints, (4) purpose of seeking consultation and (5) identity disclosure. Data collection was conducted by randomly selecting 50 resolved consultation Q&As for each of 24 medical specialties, resulting in a total of 1200 entries in the primary data set. Data analysis was conducted qualitatively and quantitatively. Average length of questions was 161.21 words. Online medical consultation was sought when healthy, healthy but not robust, when suspicious of illness, when diagnosed as ill and during treatment/recovery. In communicating chief complaints, consultation seekers were engaged in contextual, focal or emotional communication styles. Nine distinct purposes to seek online consultation were identified and can be broadly interpreted as intellectual, social and emotional. The finding also suggests that more than two-third of questions were asked for by the patients themselves. Through content analysis of questions posted on an online medical consultation website, this study characterises communication patterns during the health information seeking process. These findings can help guide the design of more effective patient-centred online medical consultation services. © 2016 Health Libraries Group.

  9. Preventing microbial biofilms on catheter tubes using ultrasonic guided waves.

    PubMed

    Wang, Huanlei; Teng, Fengmeng; Yang, Xin; Guo, Xiasheng; Tu, Juan; Zhang, Chunbing; Zhang, Dong

    2017-04-04

    Biofilms on indwelling tubes and medical prosthetic devices are among the leading causes of antibiotic-resistant bacterial infections. In this work, a new anti-biofilm catheter prototype was proposed. By combining an endotracheal tube (ET) with a group of ultrasonic guided wave (UGW) transducers, the general idea was to prevent bacteria aggregation with UGW vibrations. Based on quantitative analysis of UGW propagation, detailed approach was achieved through (a) selection of ultrasonic frequency, wave modes and vibration amplitude; and (b) adoption of wave coupling and 45° wave incidence technique. Performance of the proposed UGW-ET prototype was demonstrated via in vitro experiments, during which it deterred deposition of Pseudomonas aeruginosa (P. aeruginosa) biofilms successfully. With current configuration, UGW amplitudes ranged from 0.05-5 nm could be optimal to achieve biofilm prevention. This work sheds a light in the underlying mechanism of ultrasound-mediated biofilm prevention, and will inspire the development of new catheters of better antibacterial capability.

  10. 0.025-inch vs 0.035-inch guide wires for wire-guided cannulation during endoscopic retrograde cholangiopancreatography: A randomized study

    PubMed Central

    Kitamura, Katsuya; Yamamiya, Akira; Ishii, Yu; Sato, Yoshiki; Iwata, Tomoyuki; Nomoto, Tomohiro; Ikegami, Akitoshi; Yoshida, Hitoshi

    2015-01-01

    AIM: To compare the clinical outcomes between 0.025-inch and 0.035-inch guide wires (GWs) when used in wire-guided cannulation (WGC). METHODS: A single center, randomized study was conducted between April 2011 and March 2013. This study was approved by the Medical Ethics Committee at our hospital. Informed, written consent was obtained from each patient prior to study enrollment. Three hundred and twenty-two patients with a naïve papilla of Vater who underwent endoscopic retrograde cholangiopancreatography (ERCP) for the purpose of selective bile duct cannulation with WGC were enrolled in this study. Fifty-three patients were excluded based on the exclusion criteria, and 269 patients were randomly allocated to two groups by a computer and analyzed: the 0.025-inch GW group (n = 109) and the 0.035-inch GW group (n = 160). The primary endpoint was the success rate of selective bile duct cannulation with WGC. Secondary endpoints were the success rates of the pancreatic GW technique and precutting, selective bile duct cannulation time, ERCP procedure time, the rate of pancreatic duct stent placement, the final success rate of selective bile duct cannulation, and the incidence of post-ERCP pancreatitis (PEP). RESULTS: The primary success rates of selective bile duct cannulation with WGC were 80.7% (88/109) and 86.3% (138/160) for the 0.025-inch and the 0.035-inch groups, respectively (P = 0.226). There were no statistically significant differences in the success rates of selective bile duct cannulation using the pancreatic duct GW technique (46.7% vs 52.4% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.884) or in the success rates of selective bile duct cannulation using precutting (66.7% vs 63.6% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.893). The final success rates for selective bile duct cannulation using these procedures were 92.7% (101/109) and 97.5% (156/160) for the 0.025-inch and 0.035-inch groups, respectively (P = 0.113). There were no significant differences in selective bile duct cannulation time (median ± interquartile range: 3.7 ± 13.9 min vs 4.0 ± 11.2 min for the 0.025-inch and 0.035-inch groups, respectively; P = 0.851), ERCP procedure time (median ± interquartile range: 32 ± 29 min vs 30 ± 25 min for the 0.025-inch and 0.035-inch groups, respectively; P = 0.184) or in the rate of pancreatic duct stent placement (14.7% vs 15.6% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.832). The incidence of PEP was 2.8% (3/109) and 2.5% (4/160) for the 0.025-inch and 0.035-inch groups, respectively (P = 0.793). CONCLUSION: The thickness of the GW for WGC does not appear to affect either the success rate of selective bile duct cannulation or the incidence of PEP. PMID:26290646

  11. Design Guide for Interiors

    DTIC Science & Technology

    1997-09-01

    Medical Center. Ft. Lewis, WA. 3. Auditorium, Senior NCO Academy. Gunter AFB, AL. 4. Snack Bar, Senior NCO Academy. Gunter AFB, AL. 5. Atrium, Marshall...and enable people to perform to their maximum potential. ivGuide to Excellent Interiors Clinic Waiting, Minot AFB Auditorium, Gunter AFB Snack Shop...Medical Center. Ft. Lewis, WA. 3. Auditorium, Senior NCO Academy. Gunter AFB, AL. 4. Snack Bar, Senior NCO Academy. Gunter AFB, AL. 5. Atrium, Marshall Hall

  12. 33 CFR 274.3 - References.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Surveillance Guide, U.S. Army Environmental Hygiene Agency, January 1975. (d) Guide for the Medical Surveillance of Pest Controllers, U.S. Army Environmental Hygiene Agency, March 1976, as amended. (e) Pesticide...

  13. 33 CFR 274.3 - References.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Surveillance Guide, U.S. Army Environmental Hygiene Agency, January 1975. (d) Guide for the Medical Surveillance of Pest Controllers, U.S. Army Environmental Hygiene Agency, March 1976, as amended. (e) Pesticide...

  14. Finding the Truth in Medical Imaging: Painting the Picture of Appropriateness for Magnetic Resonance Imaging in Canada.

    PubMed

    Vanderby, Sonia; Peña-Sánchez, Juan Nicolás; Kalra, Neil; Babyn, Paul

    2015-11-01

    Questions about the appropriateness of medical imaging exams, particularly related to magnetic resonance exams, have arisen in recent years. However, the prevalence of inappropriate imaging in Canada is unclear as inappropriate exam proportion estimates are often based on studies from other countries. Hence, we sought to compare and summarize Canadian studies related to magnetic resonance imaging appropriateness. We completed a systematic literature search identifying studies related to magnetic resonance appropriateness in Canada published between 2003 and 2013. Two researchers independently searched and evaluated the literature available. Articles that studied or discussed magnetic resonance appropriateness in Canada were selected based on titles, abstracts, and, where necessary, full article review. Articles relating solely to other modalities or countries were excluded, as were imaging appropriateness guidelines and reviews. Fourteen articles were included: 8 quantitative studies and 6 editorials/commentaries. The quantitative studies reported inappropriate proportions of magnetic resonance exams ranging from 2%-28.5%. Our review also revealed substantial variations among study methods and analyses. Common topics identified among editorials/commentaries included reasons for obtaining imaging in general and for selecting a specific modality, consequences of inappropriate imaging, factors contributing to demand, and suggested means of mitigating inappropriate medical imaging use. The available studies do not support the common claim that 30% of medical imaging exams in Canada are inappropriate. The actual proportion of inappropriate magnetic resonance exams has not yet been established conclusively in Canada. Further research, particularly on a widespread national scale, is needed to guide healthcare policies. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  15. 41 CFR 101-5.303 - Guiding principles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Guiding principles. 101-5... COMPLEXES 5.3-Federal Employee Health Services § 101-5.303 Guiding principles. The following principles will..., the compensation of the employees of the health unit, and other factors of medical economics prevalent...

  16. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct... lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this...

  17. [Assessment of venous thromboembolism risk in hospitalized medical patients. Concordance between PRETEMED guide and the recommendations of the viii conference of the American College of Chest Physicians].

    PubMed

    Gallardo Jiménez, Patricia; Guijarro Merino, Ricardo; Vallejo Herrera, Verónica; Sánchez Morales, David; Villalobos Sánchez, Aurora; Perelló González-Moreno, Juan Ignacio; Gómez-Huelgas, Ricardo

    2012-11-03

    The aim of this study is to evaluate the use of venous thromboembolism prophylaxis in hospitalized medical patients using 2 clinical practice guidelines and to analyze the agreement between them. Cross-sectional study of medical services in a third level hospital. We calculated the thromboembolic risk and the thromboprophylaxis adequacy by implementing the recommendations of viii conference of the American College of Chest Physicians (ACCP) and PRETEMED guide as well as their agreement. One hundred and twenty eight patients were included in the study. According to the PRETEMED guide, 34.4% of patients were low risk, 6.3% moderate and 59.4% high, with appropriate prophylaxis in 72.7% of patients (CI95%: 64.4-79.9), 18.8% (CI95%: 12.7-26.2) were undertreated and 8.6% (CI95%: 4.6-14.4) overtreated. According to ACCP recommendations, 50% of patients were low risk and 50% high, with appropriate prophylaxis in 74.2% of patients (CI95%: 66.1-81.2), 10.9% (CI95%: 6.4-17.3) were undertreated and 14.8% (CI95%: 9.4-21.8) overtreated. When PRETEMED risk was classified into low or moderate-high group versus ACCP risk low or high, the grade of concordance between both guides was 0.68 (CI95%: 0.56-0.81). When PRETEMED risk was classified into low-moderate or high group versus ACCP risk low or high, the grade of concordance between both guides was 0.81 (CI95%: 0.71-0.91). About a quarter of hospitalized medical patients did not receive adequate prophylaxis, showing an important room for improvement. PRETEMED guide and ACCP recommendations differ in risk assessment mainly because PRETEMED guide overestimates the risk of venous thromboembolism since it includes more risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  18. Recognizing pharmaceutical illiteracy in community pharmacy: Agreement between a practice-based interview guide and questionnaire based assessment.

    PubMed

    Koster, Ellen S; Philbert, Daphne; van Dijk, Liset; Rademakers, Jany; de Smet, Peter A G M; Bouvy, Marcel L; Vervloet, Marcia

    2018-02-02

    Patients with limited pharmaceutical literacy are at increased risk of drug-related problems. Recognizing these patients in daily practice is difficult. The Recognition and Addressing of Limited Pharmaceutical Literacy (RALPH) interview guide was developed as practical set of questions to recognize patients with limited pharmaceutical literacy in daily pharmacy practice. To compare agreement between pharmaceutical literacy measured with the RALPH guide and a validated general health literacy questionnaire. In addition, we provide insight into patients' pharmaceutical literacy using the RALPH interview guide. Structured face-to-face interviews with patients who visited a community pharmacy to fill a prescription for themselves were conducted. The interview included the RALPH guide as well as the Functional Communicative Critical Health Literacy (FCCHL) questionnaire to measure general health literacy. Functional, communicative and critical skills were measured and agreement between two methods was calculated. Data were collected from 508 patients. Patients with limited pharmaceutical literacy, indicated by the RALPH questions, also had a lower general health literacy level according to FCCHL scores. Agreement between the RALPH guide and FCCHL questionnaire was moderate (∼60%) for the three health literacy domains. Most patients (>90%) had correct understanding of frequency and timing of medication use, but 25% did not understand warnings or precautions correctly. Finding understandable information (39%), assessing information applicability (50%) and reliability (64%) were mentioned as difficult by patients. Patients experienced difficulties with more complex skills, e.g. interpretation of warnings or precautions when using a medicine, finding and analyzing medication information. Whereas the FCCHL questionnaire is useful to assess general health literacy, the RALPH interview guide provides insight in the level of skills needed for good medication use and is more suitable for use in a medication specific context such as community pharmacy. Context specific assessment of skills is important to provide tailored pharmaceutical care. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Teaching Conflict: Professionalism and Medical Education.

    PubMed

    Holloway, K J

    2015-12-01

    Resistance by physicians, medical researchers, medical educators, and medical students to pharmaceutical industry influence in medicine is often based on the notion that physicians (guided by the ethics of their profession) and the industry (guided by profit) are in conflict. This criticism has taken the form of a professional movement opposing conflict of interest (COI) in medicine and medical education and has resulted in policies and guidelines that frame COI as the problem and outline measures to address this problem. In this paper, I offer a critique of this focus on COI that is grounded in a broader critique of neo-liberalism, arguing it individualizes the relationship between physicians and industry, too neatly delineates between the two entities, and reduces the network of social, economic, and political relations to this one dilemma.

  20. Medical Research | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn Javascript on. Feature: Medical Research Research Results in the News: A Users Guide Past ... scientists the most reliable results. Where was the research done? Scientists at a medical school or large ...

  1. Participation in medicine by graduates of medical schools in the United Kingdom up to 25 years post graduation: national cohort surveys.

    PubMed

    Goldacre, Michael J; Lambert, Trevor W

    2013-05-01

    To determine--as a guide to assess outcomes of medical education, and for medical workforce planning--whether the great majority of graduates from UK medical schools eventually practice medicine. The authors estimated the level of participation in medicine, in selected years after graduation, of nine cohorts (graduating between 1974 and 2002, inclusive) of graduates from medical schools in the United Kingdom. Their estimation is based on survey-garnered data combined with national employment data, and it uses the statistical method of capture-recapture analysis. This method provides both a lower likely limit and an upper likely limit of the percentage of doctors practicing in medicine. The lower and upper limits depend, essentially, on a range of assumptions about nonresponders. The authors estimate that at least 90% of graduates from UK medical schools work in medicine for many years after graduation. Women are only slightly less likely than men to follow a medical career. To illustrate, of the doctors who lived in the United Kingdom before medical school, at 10 years after graduation, between 95.6% and 98.8% of men were in medicine, as were between 91.9% and 93.3% of women. UK medical graduates from homes outside the United Kingdom were less likely to work in the National Health Service and more likely to pursue a career outside the United Kingdom, but were not appreciably less likely than graduates from UK homes to work in medicine. UK-trained doctors rarely give up a medical career within 25 years of graduation.

  2. A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV.

    PubMed

    Valera, Pamela; McClernon, F Joseph; Burkholder, Greer; Mugavero, Michael J; Willig, James; O'Cleirigh, Conall; Cropsey, Karen L

    2017-07-01

    Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.

  3. Prediction task guided representation learning of medical codes in EHR.

    PubMed

    Cui, Liwen; Xie, Xiaolei; Shen, Zuojun

    2018-06-18

    There have been rapidly growing applications using machine learning models for predictive analytics in Electronic Health Records (EHR) to improve the quality of hospital services and the efficiency of healthcare resource utilization. A fundamental and crucial step in developing such models is to convert medical codes in EHR to feature vectors. These medical codes are used to represent diagnoses or procedures. Their vector representations have a tremendous impact on the performance of machine learning models. Recently, some researchers have utilized representation learning methods from Natural Language Processing (NLP) to learn vector representations of medical codes. However, most previous approaches are unsupervised, i.e. the generation of medical code vectors is independent from prediction tasks. Thus, the obtained feature vectors may be inappropriate for a specific prediction task. Moreover, unsupervised methods often require a lot of samples to obtain reliable results, but most practical problems have very limited patient samples. In this paper, we develop a new method called Prediction Task Guided Health Record Aggregation (PTGHRA), which aggregates health records guided by prediction tasks, to construct training corpus for various representation learning models. Compared with unsupervised approaches, representation learning models integrated with PTGHRA yield a significant improvement in predictive capability of generated medical code vectors, especially for limited training samples. Copyright © 2018. Published by Elsevier Inc.

  4. Teaching diversity to medical undergraduates: Curriculum development, delivery and assessment. AMEE GUIDE No. 103.

    PubMed

    Dogra, Nisha; Bhatti, Farah; Ertubey, Candan; Kelly, Moira; Rowlands, Angela; Singh, Davinder; Turner, Margot

    2016-01-01

    The aim of this Guide is to support teacher with the responsibility of designing, delivering and/or assessing diversity education. Although, the focus is on medical education, the guidance is relevant to all healthcare professionals. The Guide begins by providing an overview of the definitions used and the principles that underpin the teaching of diversity as advocated by Diversity and Medicine in Health (DIMAH). Following an outline of these principles we highlight the difference between equality and diversity education. The Guide then covers diversity education throughout the educational process from the philosophical stance of educators and how this influences the approaches used through to curriculum development, delivery and assessment. Appendices contain practical examples from across the UK, covering lesson plans and specific exercises to deliver teaching. Although, diversity education remains variable and fragmented there is now some momentum to ensure that the principles of good educational practice are applied to diversity education. The nature of this topic means that there are a range of different professions and medical disciplines involved which leads to a great necessity for greater collaboration and sharing of effective practice.

  5. Developing a virtual community for health sciences library book selection: Doody's Core Titles.

    PubMed

    Shedlock, James; Walton, Linda J

    2006-01-01

    The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.

  6. Natural Selection in Cancer Biology: From Molecular Snowflakes to Trait Hallmarks

    PubMed Central

    Fortunato, Angelo; Boddy, Amy; Mallo, Diego; Aktipis, Athena; Maley, Carlo C.; Pepper, John W.

    2017-01-01

    Evolution by natural selection is the conceptual foundation for nearly every branch of biology and increasingly also for biomedicine and medical research. In cancer biology, evolution explains how populations of cells in tumors change over time. It is a fundamental question whether this evolutionary process is driven primarily by natural selection and adaptation or by other evolutionary processes such as founder effects and drift. In cancer biology, as in organismal evolutionary biology, there is controversy about this question and also about the use of adaptation through natural selection as a guiding framework for research. In this review, we discuss the differences and similarities between evolution among somatic cells versus evolution among organisms. We review what is known about the parameters and rate of evolution in neoplasms, as well as evidence for adaptation. We conclude that adaptation is a useful framework that accurately explains the defining characteristics of cancer. Further, convergent evolution through natural selection provides the only satisfying explanation both for how a group of diverse pathologies have enough in common to usefully share the descriptive label of “cancer” and for why this convergent condition becomes life-threatening. PMID:28148564

  7. Natural Selection in Cancer Biology: From Molecular Snowflakes to Trait Hallmarks.

    PubMed

    Fortunato, Angelo; Boddy, Amy; Mallo, Diego; Aktipis, Athena; Maley, Carlo C; Pepper, John W

    2017-02-01

    Evolution by natural selection is the conceptual foundation for nearly every branch of biology and increasingly also for biomedicine and medical research. In cancer biology, evolution explains how populations of cells in tumors change over time. It is a fundamental question whether this evolutionary process is driven primarily by natural selection and adaptation or by other evolutionary processes such as founder effects and drift. In cancer biology, as in organismal evolutionary biology, there is controversy about this question and also about the use of adaptation through natural selection as a guiding framework for research. In this review, we discuss the differences and similarities between evolution among somatic cells versus evolution among organisms. We review what is known about the parameters and rate of evolution in neoplasms, as well as evidence for adaptation. We conclude that adaptation is a useful framework that accurately explains the defining characteristics of cancer. Further, convergent evolution through natural selection provides the only satisfying explanation both for how a group of diverse pathologies have enough in common to usefully share the descriptive label of "cancer" and for why this convergent condition becomes life-threatening. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

  8. Medications and Older Adults

    MedlinePlus

    ... Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide ... Expert Search Search AAAAI Breadcrumb navigation Home ▸ Conditions & Treatments ▸ Library ▸ Allergy Library ▸ Medications and older adults Share | Medications and ...

  9. The theoretical basis for practice-relevant medication use research: patient-centered/behavioral theories.

    PubMed

    Blalock, Susan J

    2011-12-01

    There is an urgent need for research to improve the quality of medication use among those who require pharmacotherapy. To describe how behavioral science theories can help to achieve this goal. We begin by describing what a theory is and the functions that theories serve. We then provide 8 guiding principles that are crucial for investigators to understand if they are to use theory appropriately. We conclude by discussing the need for a new model of patient medication self-management that incorporates information concerning factors operating at all levels of the ecological framework, ranging from patient-level to societal-level factors. The 8 guiding principles discussed are the following: (1) There is no single theory that is appropriate for guiding all medication use research; (2) Behavioral science theories are probabilistic, not deterministic; (3) When trying to influence a health behavior, the health behavior of interest must be defined precisely; (4) Many factors outside of patient control influence patient medication use; (5) Every patient is unique; (6) Patient motivation is a fundamental ingredient required to optimize medication use, especially when maintenance of long term behavior is the goal; (7) Health care providers can have a profound effect on patient medication use, and this effect can operate through several possible causal pathways; and (8) When planning an intervention to optimize medication use, it is important to develop a conceptual model that links intervention inputs to the ultimate outcomes that are desired. Medication use can be influenced by a wide variety of factors acting at different levels of the ecological model. The quality of research on medication use could be improved by development of an ecological model specific to medication self-management. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis

    PubMed Central

    Matsuyama, Masato; Ishii, Hiroshi; Kuraoka, Kensuke; Yukisawa, Seigo; Kasuga, Akiyoshi; Ozaka, Masato; Suzuki, Sho; Takano, Kouichi; Sugiyama, Yuko; Itoi, Takao

    2013-01-01

    AIM: To clarify the effectiveness and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC). METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events. RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P = 0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P = 0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%). CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC. PMID:23613631

  11. Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance.

    PubMed

    Hillen, Travis J; Talbert, Robert J; Friedman, Michael V; Long, Jeremiah R; Jennings, Jack W; Wessell, Daniel E; Baker, Jonathan C

    2017-07-01

    The purpose of this study is to evaluate the histopathologic diagnostic yield, sample size, procedural time, and dose-length product (DLP) for the biopsy of CT-occult lesions found at MRI or PET or both. A retrospective review of our radiology information system for biopsies of CT-occult lesions using CT guidance from January 1, 2010, through December 31, 2014, was performed and compared with a selection of CT-guided biopsies of CT-evident bone lesions during the same period. The data were then evaluated for diagnostic yield of histopathologic diagnosis, procedural time, use of sedation medication, DLP, and size of specimens obtained. A total of 30 CT-occult biopsies met the inclusion criteria. Twenty-seven of those biopsies had results that were concordant with the patient's primary histopathologic diagnosis, imaging findings, and clinical course. In the CT-evident lesion group, concordant histopathologic abnormalities were identified in 27 of 30 patients. There was a statistically significant increase in number of samples obtained for the CT-evident lesions compared with CT-occult lesions. There was no statistically significant difference in total specimen length, DLP, number of CT scans, procedural time, or use of sedation medication between the CT-occult and CT-evident biopsy groups. Biopsy of CT-occult lesions using anatomic landmarks achieves diagnostic yields similar to those for CT-guided biopsy of CT-evident lesions.

  12. Stakeholder engagement: a key component of integrating genomic information into electronic health records

    PubMed Central

    Hartzler, Andrea; McCarty, Catherine A.; Rasmussen, Luke V.; Williams, Marc S.; Brilliant, Murray; Bowton, Erica A.; Clayton, Ellen Wright; Faucett, William A.; Ferryman, Kadija; Field, Julie R.; Fullerton, Stephanie M.; Horowitz, Carol R.; Koenig, Barbara A.; McCormick, Jennifer B.; Ralston, James D.; Sanderson, Saskia C.; Smith, Maureen E.; Trinidad, Susan Brown

    2014-01-01

    Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine. PMID:24030437

  13. Medical Assistant Curriculum.

    ERIC Educational Resources Information Center

    Jaeger, Mildred

    Intended to serve as a guide to school personnel responsible for curriculum development, the course outline is designed to prepare high school students for entry into the medical field as an assistant in a doctor's office. Contents are divided into three areas: medical secretary, medical technician, and doctor's assistant (patient management).…

  14. Selective and self-guided micro-ablation of tissue with plasmonic nanobubbles

    PubMed Central

    Lukianova-Hleb, Ekaterina Y.; Koneva, Irina I.; Oginsky, Alexander O.; La Francesca, Saverio; Lapotko, Dmitri O.

    2010-01-01

    Background The accuracy, selectivity and safety of surgical and laser methods for tissue elimination are often limited at microscale. Materials and methods We developed a novel agent, the plasmonic nanobubble (PNB), for optically guided selective elimination of the target tissue with micrometer precision. PNBs were tested in vitro in the two different models of superficial tumors and vascular plaques. Results PNBs were selectively generated around gold nanoparticles (delivered to the target tissues) with short laser pulses. Monolayers of cancerous cells and atherosclerotic plaque tissue were eliminated with PNBs with micrometer accuracy and without thermal and mechanical damage to collateral normal tissues. The effect of the PNB was dynamically controlled through the fluence of laser pulses (532 nm, duration 0.5 and 10 ns) and was guided through the optical scattering by PNB. Conclusions plasmonic nanobubbles were shown to provide precise, tunable, selective and guided ablation of tissue at a microcscopic level and could be employed as a new generation of surgical tools. PMID:21176913

  15. Selective and self-guided micro-ablation of tissue with plasmonic nanobubbles.

    PubMed

    Lukianova-Hleb, Ekaterina Y; Koneva, Irina I; Oginsky, Alexander O; La Francesca, Saverio; Lapotko, Dmitri O

    2011-03-01

    The accuracy, selectivity, and safety of surgical and laser methods for tissue elimination are often limited at microscale. We developed a novel agent, the plasmonic nanobubble (PNB), for optically guided selective elimination of the target tissue with micrometer precision. PNBs were tested in vitro in the two different models of superficial tumors and vascular plaques. PNBs were selectively generated around gold nanoparticles (delivered to the target tissues) with short laser pulses. Monolayers of cancerous cells and atherosclerotic plaque tissue were eliminated with PNBs with micrometer accuracy and without thermal and mechanical damage to collateral normal tissues. The effect of the PNB was dynamically controlled through the fluence of laser pulses (532 nm, duration 0.5 and 10 ns) and was guided through the optical scattering by PNB. Plasmonic nanobubbles were shown to provide precise, tunable, selective, and guided ablation of tissue at a microscopic level and could be employed as a new generation of surgical tools. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Grounded theory in medical education research: AMEE Guide No. 70.

    PubMed

    Watling, Christopher J; Lingard, Lorelei

    2012-01-01

    Qualitative research in general and the grounded theory approach in particular, have become increasingly prominent in medical education research in recent years. In this Guide, we first provide a historical perspective on the origin and evolution of grounded theory. We then outline the principles underlying the grounded theory approach and the procedures for doing a grounded theory study, illustrating these elements with real examples. Next, we address key critiques of grounded theory, which continue to shape how the method is perceived and used. Finally, pitfalls and controversies in grounded theory research are examined to provide a balanced view of both the potential and the challenges of this approach. This Guide aims to assist researchers new to grounded theory to approach their studies in a disciplined and rigorous fashion, to challenge experienced researchers to reflect on their assumptions, and to arm readers of medical education research with an approach to critically appraising the quality of grounded theory studies.

  17. Brandon/Hill selected list of print books and journals in allied health.

    PubMed

    Hill, Dorothy R; Stickell, Henry N

    2003-01-01

    This list of 434 books and 79 journals is intended as a selection guide for print literature to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number of and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and recognized by the American Medical Association and other accrediting bodies. Books and journals are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (169 books and 32 journals) are indicated by asterisks. To purchase the entire collection of books and journals (2002 subscriptions) would require an expenditure of about $36,744. The cost of only the asterisked items totals $14,465.

  18. Brandon/Hill selected list of print books and journals in allied health.

    PubMed

    Hill, D R; Stickell, H N

    2000-07-01

    This list of 424 books and 77 journals is intended as a selection guide for print literature to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and recognized by the American Medical Association and other accrediting bodies. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (167 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (2000 subscriptions) would require an expenditure of about $31,970. The cost of only the asterisked items totals $12,515.

  19. Psychological impact of abortion: methodological and outcomes summary of empirical research between 1966 and 1988.

    PubMed

    Rogers, J L; Stoms, G B; Phifer, J L

    1989-01-01

    A systematic "roadmap" through the medical literature that empirically examines the incidence of psychological sequelae of induced abortion is presented. Because outcome incidence rates and methodological profiles vary substantially across studies, selective use of articles from this literature without an accompanying rationale for that selectivity could foster erroneous conclusions. Information compiled here can facilitate a rapid methodological critique of citations in abortion-related materials. Investigations published in English between January 1966 and April 1988 that quantitatively examined psychological sequelae using prospective, retrospective, or comparative methodologies are summarized in tables to produce a synopsis of the demographics, methodological limitations, and gross statistical features of each article. This quantitative guide is designed to facilitate appropriate use of the current literature, provide needed background to assess positions arising from the currently available data, and provide methodological focus for planning better studies in the future.

  20. Brandon/Hill selected list of print books and journals in allied health*†

    PubMed Central

    Hill, Dorothy R.; Stickell, Henry N.

    2003-01-01

    This list of 434 books and 79 journals is intended as a selection guide for print literature to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number of and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and recognized by the American Medical Association and other accrediting bodies. Books and journals are categorized by subject; the book list is followed by an author/editor index and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (169 books and 32 journals) are indicated by asterisks. To purchase the entire collection of books and journals (2002 subscriptions) would require an expenditure of about $36,744. The cost of only the asterisked items totals $14,465. PMID:12568155

  1. Brandon/Hill selected list of print books and journals in allied health*

    PubMed Central

    Hill, Dorothy R.; Stickell, Henry N.

    2000-01-01

    This list of 424 books and 77 journals is intended as a selection guide for print literature to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and recognized by the American Medical Association and other accrediting bodies. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (167 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (2000 subscriptions) would require an expenditure of about $31,970. The cost of only the asterisked items totals $12,515. PMID:10928707

  2. Scale-ups, scarcity, and selections: the experience of doctors in South Africa.

    PubMed

    Bayer, Ronald; Oppenheimer, Gerald M

    2007-10-01

    To present the ethical and clinical experience of public sector physicians during the post-Apartheid period in South Africa, who were faced with poverty, medical scarcity and unexpected government resistance in treating individuals with HIV infection. Oral history interviews with 73 physicians from major cities, mine company clinics, and rural hospitals selected because of their long-standing commitment to treating people with AIDS. The onset of the government's 'rollout' of antiretroviral therapy (ART) in 2003, providing drugs to public sector patients, has not put an end to the rationing of care that characterised the pre-ART period. Subsequently, rules were established to guide such rationing in an equitable fashion. But there are occasions when doctors override their own rules, demonstrating the complex interplay between principles of equity and the claims of moral duty to patients, especially in instances of life and death.

  3. Tailoring implementation strategies for evidence-based recommendations using computerised clinical decision support systems: protocol for the development of the GUIDES tools.

    PubMed

    Van de Velde, Stijn; Roshanov, Pavel; Kortteisto, Tiina; Kunnamo, Ilkka; Aertgeerts, Bert; Vandvik, Per Olav; Flottorp, Signe

    2016-03-05

    A computerised clinical decision support system (CCDSS) is a technology that uses patient-specific data to provide relevant medical knowledge at the point of care. It is considered to be an important quality improvement intervention, and the implementation of CCDSS is growing substantially. However, the significant investments do not consistently result in value for money due to content, context, system and implementation issues. The Guideline Implementation with Decision Support (GUIDES) project aims to improve the impact of CCDSS through optimised implementation based on high-quality evidence-based recommendations. To achieve this, we will develop tools that address the factors that determine successful CCDSS implementation. We will develop the GUIDES tools in four steps, using the methods and results of the Tailored Implementation for Chronic Diseases (TICD) project as a starting point: (1) a review of research evidence and frameworks on the determinants of implementing recommendations using CCDSS; (2) a synthesis of a comprehensive framework for the identified determinants; (3) the development of tools for use of the framework and (4) pilot testing the utility of the tools through the development of a tailored CCDSS intervention in Norway, Belgium and Finland. We selected the conservative management of knee osteoarthritis as a prototype condition for the pilot. During the process, the authors will collaborate with an international expert group to provide input and feedback on the tools. This project will provide guidance and tools on methods of identifying implementation determinants and selecting strategies to implement evidence-based recommendations through CCDSS. We will make the GUIDES tools available to CCDSS developers, implementers, researchers, funders, clinicians, managers, educators, and policymakers internationally. The tools and recommendations will be generic, which makes them scalable to a large spectrum of conditions. Ultimately, the better implementation of CCDSS may lead to better-informed decisions and improved care and patient outcomes for a wide range of conditions. PROSPERO, CRD42016033738.

  4. Prevalence and associated factors of stress, anxiety and depression among emergency medical officers in Malaysian hospitals.

    PubMed

    Yahaya, Siti Nasrina; Wahab, Shaik Farid Abdull; Yusoff, Muhammad Saiful Bahribin; Yasin, Mohd Azhar Mohd; Rahman, Mohammed Alwi Abdul

    2018-01-01

    Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals. A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale. The highest prevalence was anxiety (28.6%) followed by depression (10.7%) and stress (7.9%). Depression, anxiety and stress between seven hospitals were not significantly different ( P >0.05). Male medical officers significantly experienced more anxiety symptoms than female medical officers ( P =0.0022), however depression and stress symptoms between male and female medical officers were not significantly different ( P >0.05). Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals ( P >0.05). The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers' anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition.

  5. A systematic review of service-learning in medical education: 1998-2012.

    PubMed

    Stewart, Trae; Wubbena, Zane C

    2015-01-01

    PHENOMENON: In the United States, the Affordable Care Act has increased the need for community-centered pedagogy for medical education such as service-learning, wherein students connect academic curriculum and reflections to address a community need. Yet heterogeneity among service-learning programs suggests the need for a framework to understand variations among service-learning programs in medical education. A qualitative systematic review of literature on service-learning and medical education was conducted for the period between 1998 and 2012. A two-stage inclusion criteria process resulted in articles (n = 32) on service-learning and Doctor of Medicine or Doctor of Osteopathic Medicine being included for both coding and analysis. Focused and selective coding were employed to identify recurring themes and subthemes from the literature. The findings of the qualitative thematic analysis of service-learning variation in medical education identified a total of seven themes with subthemes. The themes identified from the analysis were (a) geographic location and setting, (b) program design, (c) funding, (d) participation, (e) program implementation, (f) assessment, and (g) student outcomes. Insights: This systematic review of literature confirmed the existence of program heterogeneity among service-learning program in medical education. However, the findings of this study provide key insights into the nature of service-learning in medical education building a framework for which to organize differences among service-learning programs. A list of recommendations for future areas of inquiry is provided to guide future research.

  6. Medical Terminology of the Respiratory System. Medical Records. Instructional Unit for the Medical Transcriptionist.

    ERIC Educational Resources Information Center

    Gosman, Minna L.

    Following an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for…

  7. Medical Terminology of the Musculoskeletal System. Medical Records. Instructional Unit for the Medical Transcriber.

    ERIC Educational Resources Information Center

    Gosman, Minna L.

    Following an analysis of the task of transcribing as practiced in a health facility, this study guide was developed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for a…

  8. Five-Year Outcomes with PCI Guided by Fractional Flow Reserve.

    PubMed

    Xaplanteris, Panagiotis; Fournier, Stephane; Pijls, Nico H J; Fearon, William F; Barbato, Emanuele; Tonino, Pim A L; Engstrøm, Thomas; Kääb, Stefan; Dambrink, Jan-Henk; Rioufol, Gilles; Toth, Gabor G; Piroth, Zsolt; Witt, Nils; Fröbert, Ole; Kala, Petr; Linke, Axel; Jagic, Nicola; Mates, Martin; Mavromatis, Kreton; Samady, Habib; Irimpen, Anand; Oldroyd, Keith; Campo, Gianluca; Rothenbühler, Martina; Jüni, Peter; De Bruyne, Bernard

    2018-05-22

    Background We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Methods Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization. Results A total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; P<0.001). The difference was driven by urgent revascularizations, which occurred in 6.3% of the patients in the PCI group as compared with 21.1% of those in the medical-therapy group (hazard ratio, 0.27; 95% CI, 0.18 to 0.41). There were no significant differences between the PCI group and the medical-therapy group in the rates of death (5.1% and 5.2%, respectively; hazard ratio, 0.98; 95% CI, 0.55 to 1.75) or myocardial infarction (8.1% and 12.0%; hazard ratio, 0.66; 95% CI, 0.43 to 1.00). There was no significant difference in the rate of the primary end point between the PCI group and the registry cohort (13.9% and 15.7%, respectively; hazard ratio, 0.88; 95% CI, 0.55 to 1.39). Relief from angina was more pronounced after PCI than after medical therapy. Conclusions In patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).

  9. Guide for Training Medical Laboratory Technicians. Fourth Edition.

    ERIC Educational Resources Information Center

    American Medical Technologists, Park Ridge, IL.

    This document is intended to assist educators in the development of medical laboratory technician training programs. The following elements are included in the document: (1) an introduction; (2) the American Medical Technologists' Code of Ethics; (3) suggested curricula for medical laboratory technician programs for a 12-month course and an…

  10. Control-value theory: using achievement emotions to improve understanding of motivation, learning, and performance in medical education: AMEE Guide No. 64.

    PubMed

    Artino, Anthony R; Holmboe, Eric S; Durning, Steven J

    2012-01-01

    In this AMEE Guide, we consider the emergent theoretical and empirical work on human emotion and how this work can inform the theory, research, and practice of medical education. In the Guide, we define emotion, in general, and achievement emotions, more specifically. We describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun 2006), and we distinguish between different types of achievement emotions, their proximal antecedents, and their consequences for motivation, learning, and performance. Next, we review the empirical support for control-value theory from non-medical fields and suggest several important implications for educational practice. In this section, we highlight the importance of designing learning environments that foster a high degree of control and value for students. Finally, we end with a discussion of the need for more research on achievement emotions in medical education, and we propose several key research questions we believe will facilitate our understanding of achievement emotions and their impact on important educational outcomes.

  11. Rule-Based Categorization Deficits in Focal Basal Ganglia Lesion and Parkinson’s Disease Patients

    PubMed Central

    Ell, Shawn W.; Weinstein, Andrea; Ivry, Richard B.

    2010-01-01

    Patients with basal ganglia (BG) pathology are consistently found to be impaired on rule-based category learning tasks in which learning is thought to depend upon the use of an explicit, hypothesis-guided strategy. The factors that influence this impairment remain unclear. Moreover, it remains unknown if the impairments observed in patients with degenerative disorders such as Parkinson's disease (PD) are also observed in those with focal BG lesions. In the present study, we tested patients with either focal BG lesions or PD on two categorization tasks that varied in terms of their demands on selective attention and working memory. Individuals with focal BG lesions were impaired on the task in which working-memory demand was high and performed similarly to healthy controls on the task in which selective-attention demand was high. In contrast, individuals with PD were impaired on both tasks, and accuracy rates did not differ between on- and off-medication states for a subset of patients who were also tested after abstaining from dopaminergic medication. Quantitative, model-based analyses attributed the performance deficit for both groups in the task with high working-memory demand to the utilization of suboptimal strategies, whereas the PD-specific impairment on the task with high selective-attention demand was driven by the inconsistent use of an optimal strategy. These data suggest that the demands on selective attention and working memory affect the presence of impairment in patients with focal BG lesions and the nature of the impairment in patients with PD. PMID:20600196

  12. Medication communication through documentation in medical wards: knowledge and power relations.

    PubMed

    Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

    2014-09-01

    Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.

  13. Developing a virtual community for health sciences library book selection: Doody's Core Titles

    PubMed Central

    Shedlock, James; Walton, Linda J.

    2006-01-01

    Purpose: The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. Setting/Participants/Resources: The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Brief Description: Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. Results/Outcome: The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Evaluation Method: Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services. PMID:16404471

  14. Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

    PubMed

    Ma, Irene W Y; Arishenkoff, Shane; Wiseman, Jeffrey; Desy, Janeve; Ailon, Jonathan; Martin, Leslie; Otremba, Mirek; Halman, Samantha; Willemot, Patrick; Blouw, Marcus

    2017-09-01

    Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.

  15. CYP2C19 LOF and GOF-Guided Antiplatelet Therapy in Patients with Acute Coronary Syndrome: A Cost-Effectiveness Analysis.

    PubMed

    Jiang, Minghuan; You, Joyce H S

    2017-02-01

    This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y 12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y 12 inhibitor, wild-type patients receiving clopidogrel). Model outcomes included clinical event rates, quality-adjusted life-years (QALYs) gained and direct medical costs from perspective of US healthcare provider. Base-case analysis found nonfatal myocardial infarction (5.62%) and stent thrombosis (1.2%) to be the lowest in universal alternative P2Y 12 inhibitor arm, whereas nonfatal stroke (0.72%), cardiovascular death (2.42%), and major bleeding (2.73%) were lowest in LOF/GOF-guided group. LOF/GOF-guided arm gained the highest QALYs (7.5301 QALYs) at lowest life-long cost (USD 76,450). One-way sensitivity analysis showed base-case results were subject to the hazard ratio of cardiovascular death in carriers versus non-carriers of LOF allele and hazard ratio of cardiovascular death in non-carriers of LOF allele versus general patients. In probabilistic sensitivity analysis of 10,000 Monte Carlo simulations, LOF/GOF-guided therapy, universal alternative P2Y 12 inhibitor, and universal clopidogrel were the preferred strategy (willingness-to-pay threshold = 50,000 USD/QALY) in 99.07%, 0.04%, and 0.89% of time, respectively. Using both CYP2C19 GOF and LOF alleles to select antiplatelet therapy appears to be the preferred antiplatelet strategy over universal clopidogrel and universal alternative P2Y 12 inhibitor therapy for ACS patients with PCI.

  16. Health Occupations Education: Suggested Curriculum Guide for Nursing Assistant. Curriculum Guide-3.

    ERIC Educational Resources Information Center

    Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

    The curriculum guide, developed to serve as a statewide model for nursing assistant programs, offers teaching suggestions for nursing assistant courses in the public schools. It is designed for 270 hours of theory and 200 hours of clinical instruction. There are 11 units of instruction: orientation; human behavior; medical communication skills;…

  17. A Programmed Enterprise Analysis Teaching Guide for Selected Farm Enterprises in North Dakota: Prepared as Part of the Farm Management Education In-Service Workshop.

    ERIC Educational Resources Information Center

    North Dakota State Board for Vocational Education, Bismarck.

    The series of programmed teaching guides for the enterprise analysis of selected enterprises was prepared by the participants in a Farm Management Education In-Service Workshop at North Dakota State University. The guide should be useful to teachers of adult Farm Managment classes in helping to teach farmers to make a thorough analysis of the…

  18. Attitudes Toward Placebo Use in Lebanon.

    PubMed

    Abou-Mrad, Fadi; Tarabey, Lubna

    2015-05-01

    Placebo use, both in clinical trials and patient care, is a problematic ethical issue surrounded by opposing arguments from those who advocate its use versus those who do not. This problematic aspect of placebo is more challenging in Lebanon where religious ideologies dominate people's beliefs, and where laws that guide medical care are vague. This paper aims to highlight the cultural ideologies that dominate medical care and the perspectives of people associated with the field. The method relied on semi-structured interviews with religious leaders, representatives of society and healthcare professionals. Panel discussions incorporating healthcare professionals, academics, scientists and medical researchers were also organized. The legal environment in Lebanon is characterized by lack of an appropriate legislative guideline that categorically clarifies the value of the human person in medical care. There is a lack of a common ethical standard within a society characterized by social and political dissent. The culturally upheld principles and actual application of the principles of ethics surrounding patient autonomy were overviewed. Medical practitioners failed to agree to a general outline that should guide the use of placebo where it became evident that each practitioner adopted a subjective framework which ultimately undermines patient autonomy. The paper proposes that until a new legislative code that clarifies ethical principles properly guiding medical care is coined, the process of placebo use will continue to be subject to the paternalistic assessments of medical professionals. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  19. Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.

    ERIC Educational Resources Information Center

    Gosman, Minna L.

    Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…

  20. Waveform analysis-guided treatment versus a standard shock-first protocol for the treatment of out-of-hospital cardiac arrest presenting in ventricular fibrillation: results of an international randomized, controlled trial.

    PubMed

    Freese, John P; Jorgenson, Dawn B; Liu, Ping-Yu; Innes, Jennifer; Matallana, Luis; Nammi, Krishnakant; Donohoe, Rachael T; Whitbread, Mark; Silverman, Robert A; Prezant, David J

    2013-08-27

    Ventricular fibrillation (VF) waveform properties have been shown to predict defibrillation success and outcomes among patients treated with immediate defibrillation. We postulated that a waveform analysis algorithm could be used to identify VF unlikely to respond to immediate defibrillation, allowing selective initial treatment with cardiopulmonary resuscitation in an effort to improve overall survival. In a multicenter, double-blind, randomized study, out-of-hospital cardiac arrest patients in 2 urban emergency medical services systems were treated with automated external defibrillators using either a VF waveform analysis algorithm or the standard shock-first protocol. The VF waveform analysis used a predefined threshold value below which return of spontaneous circulation (ROSC) was unlikely with immediate defibrillation, allowing selective treatment with a 2-minute interval of cardiopulmonary resuscitation before initial defibrillation. The primary end point was survival to hospital discharge. Secondary end points included ROSC, sustained ROSC, and survival to hospital admission. Of 6738 patients enrolled, 987 patients with VF of primary cardiac origin were included in the primary analysis. No immediate or long-term survival benefit was noted for either treatment algorithm (ROSC, 42.5% versus 41.2%, P=0.70; sustained ROSC, 32.4% versus 33.4%, P=0.79; survival to admission, 34.1% versus 36.4%, P=0.46; survival to hospital discharge, 15.6% versus 17.2%, P=0.55, respectively). Use of a waveform analysis algorithm to guide the initial treatment of out-of-hospital cardiac arrest patients presenting in VF did not improve overall survival compared with a standard shock-first protocol. Further study is recommended to examine the role of waveform analysis for the guided management of VF.

  1. Evaluation of a training programme to induct medical students in delivering public health talks

    PubMed Central

    Tan, Ngiap Chuan; Mitesh, Shah; Koh, Yi Ling Eileen; Ang, Seng Bin; Chan, Hian Hui Vincent; How, Choon How; Tay, Ee Guan; Hwang, Siew Wai

    2017-01-01

    INTRODUCTION It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution. METHODS The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student’s peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity. RESULTS A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students. CONCLUSION The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff. PMID:26891745

  2. Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study.

    PubMed

    Moyimane, Merriam Bautile; Matlala, Sogo France; Kekana, Mokoko Percy

    2017-01-01

    Medical equipment is an essential health intervention tool used by nurses for prevention, diagnosis and treatment of disease and for rehabilitation of patients. However, access to functioning medical equipment is a challenge in low- and middle-income countries. The World Health Organization estimated that 50 to 80 percent of medical equipment in developing countries is not working, creating a barrier to the ability of the health system to deliver health services to patients. This study explored and described the lived experiences of nurses working at a district hospital with a critical shortage of medical equipment. A qualitative, exploratory, phenomenological and descriptive study design was used. A purposive sampling was used to select participants and due to saturation of data 14 nurses participated in the study. Research ethics were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped and field notes were taken. Voice recordings were transcribed verbatim and Tesch's open coding method was used for data analysis. Findings were confirmed by an independent coder. Critical shortage of medical equipment at the hospital occurred in the form of unavailability of equipment, low quality and poor maintenance of the few that were available. Shortage impacted negatively on nursing care, nursing profession and the hospital. Nurses should be provided with functional medical equipment in order to provide quality nursing care. Management, leadership and governance structures should be strengthened to ensure that procurement and maintenance plans for medical equipment are developed and implemented.

  3. Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study

    PubMed Central

    Moyimane, Merriam Bautile; Matlala, Sogo France; Kekana, Mokoko Percy

    2017-01-01

    Introduction Medical equipment is an essential health intervention tool used by nurses for prevention, diagnosis and treatment of disease and for rehabilitation of patients. However, access to functioning medical equipment is a challenge in low- and middle-income countries. The World Health Organization estimated that 50 to 80 percent of medical equipment in developing countries is not working, creating a barrier to the ability of the health system to deliver health services to patients. This study explored and described the lived experiences of nurses working at a district hospital with a critical shortage of medical equipment. Methods A qualitative, exploratory, phenomenological and descriptive study design was used. A purposive sampling was used to select participants and due to saturation of data 14 nurses participated in the study. Research ethics were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped and field notes were taken. Voice recordings were transcribed verbatim and Tesch’s open coding method was used for data analysis. Findings were confirmed by an independent coder. Results Critical shortage of medical equipment at the hospital occurred in the form of unavailability of equipment, low quality and poor maintenance of the few that were available. Shortage impacted negatively on nursing care, nursing profession and the hospital. Conclusion Nurses should be provided with functional medical equipment in order to provide quality nursing care. Management, leadership and governance structures should be strengthened to ensure that procurement and maintenance plans for medical equipment are developed and implemented. PMID:29515718

  4. Sociology: A Student's Guide to Reference Sources.

    ERIC Educational Resources Information Center

    Waiser, Joni, Comp.

    This guide lists selective reference sources which are useful for research in sociology. The guide is arranged by document type: guides, dictionaries, encyclopedias, directories and biographical sources, statistics, book reviews, theses and dissertations, general social science bibliographies, sociology bibliographies, special subject…

  5. Advances in Mid-Infrared Spectroscopy for Chemical Analysis

    NASA Astrophysics Data System (ADS)

    Haas, Julian; Mizaikoff, Boris

    2016-06-01

    Infrared spectroscopy in the 3-20 μm spectral window has evolved from a routine laboratory technique into a state-of-the-art spectroscopy and sensing tool by benefitting from recent progress in increasingly sophisticated spectra acquisition techniques and advanced materials for generating, guiding, and detecting mid-infrared (MIR) radiation. Today, MIR spectroscopy provides molecular information with trace to ultratrace sensitivity, fast data acquisition rates, and high spectral resolution catering to demanding applications in bioanalytics, for example, and to improved routine analysis. In addition to advances in miniaturized device technology without sacrificing analytical performance, selected innovative applications for MIR spectroscopy ranging from process analysis to biotechnology and medical diagnostics are highlighted in this review.

  6. Understanding risk evaluation and mitigation strategies in organ transplantation.

    PubMed

    Gabardi, Steven

    2011-07-01

    The United States Food and Drug Administration (FDA) Amendments Act of 2007 mandated that Risk Evaluation and Mitigation Strategies (REMS) be required of manufacturers. These REMS are strategies implemented to manage known or potential risks associated with drugs and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product, including once the product becomes available as generic. The elements of an individual REMS program consist of three levels: medication guide or patient package insert, communication plan, and elements to assure safe use (ETASU). A medication guide or patient package insert is used to help prevent serious adverse events, aid in patient decision making, and enhance drug adherence. Communication plans are used to educate health care providers and to encourage their compliance with REMS. The ETASU is a restrictive process that is implemented when it is deemed necessary to ensure that patients have safe access to products with known serious risks that would otherwise be unavailable. To review the components of REMS and specifically assess their impact on health care providers practicing within the organ transplantation arena, a literature search of the MEDLINE database (January 2007-December 2010) was performed, and published materials from the FDA and its Web site were also reviewed. In transplantation, REMS programs exist for both everolimus (medication guide and communication plan) and sirolimus (medication guide). The FDA has stated that all mycophenolic acid derivatives will be subject to a proposed REMS that has not yet been approved; however, both branded mycophenolic acid agents already have approved medication guides. The REMS are a permanent fixture in the development and marketing of pharmaceutical agents, and their further implementation in solid organ transplantation is inevitable. Transplantation providers should take a proactive role in patient education and implementation of REMS within the therapeutic area. It is imperative for health care providers to realize that the ultimate goals of REMS are to reduce the potential for serious risks and to make outcomes from the treatment of disease more predictable.

  7. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module X. Medical Emergencies.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on medical emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Ten units of study are presented: (1) diabetic emergencies; (2) anaphylactic reactions; (3) exposure to environmental extremes; (4) alcoholism and drug abuse; (5) poisoning and…

  8. A Medical Ethics Assessment of the Case of Terri Schiavo

    ERIC Educational Resources Information Center

    Preston, Tom; Kelly, Michael

    2006-01-01

    The social, legal, and political discussion about the decision to stop feeding and hydration for Terri Schiavo lacked a medical ethics assessment. The authors used the principles of medical indications, quality of life, patient preference, and contextual features as a guide to medical decision-making in this case. Their conclusions include the…

  9. Pilot study of quality of care training and knowledge in Sub-Saharan African medical schools

    PubMed Central

    Abbas, Yasmin; Odunleye, Temitope; Broughton, Edward; Bossert, Thomas

    2017-01-01

    Objectives To identify the level of knowledge and competencies related to quality of care during medical education in sub-Saharan African medical schools.  Methods A cross-sectional study design was utilized to examine the capacity of medical schools in sub-Saharan African (SSA) countries to teach about the concepts of quality of care and the inclusion of these concepts in their curriculum. A purposeful convenience sampling technique was used to select participants from 25 medical schools in 5 sub-Saharan African countries. Respondents included medical school deans or senior academic personnel.  A survey was developed using the Institute of Medicine’s definition of quality of care as the guiding framework.  Sample means and summary statistics were used to present the results of the survey responses. Results While 45% of the schools surveyed are teaching on at least one of the six domains of the Institute of Medicine’s definition of quality of care, there are some schools who report not teaching about quality at all, or that they “do not know”. Despite these low numbers, when asked about topics related to quality of care, many schools are teaching applied management related topics and almost all schools teach about equity and patient-centered care. Conclusions The results have important impacts both for incorporating quality of care into medical education and for practitioners.  The tool developed for this study can be used in future qualitative and quantitative studies to further understanding of how to improve the teaching and learning about quality of care in medical schools. Keywords: quality of care, medical schools, sub-Saharan Africa, medical errors, healthcare improvement PMID:28753130

  10. Strengthening the Role of Nurses in Medical Device Development.

    PubMed

    Castner, Jessica; Sullivan, Suzanne S; Titus, Albert H; Klingman, Karen J

    2016-01-01

    Medical devices and innovative technology promise to revolutionize health care. Despite the importance of involving nurses in the collaborative medical device development processes, there are few learning opportunities in nursing programs. The purpose of this article is to provide a conceptual guide for nurse educators and researchers to engage nursing expertise in medical device development processes. A review of the literature guided the creation of the "Strengthening the Role of Nurses in Medical Device Development Roadmap" model. The model was used to describe how nurses can be engaged in multidisciplinary design of medical devices. An academic transdisciplinary team piloted the application of the model. The model includes the stages of needs assessment, planned brainstorm, feasibility determination, concept design, and prototype building. A transdisciplinary team case study of improving an asthma home-monitoring devices illustrates effective application of the model. Nurse leaders in the academic setting can effectively use the "Strengthening the Role of Nurses in Medical Device Development Roadmap" to inform their engagement of nurses in early medical device development and innovation processes. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Systematic Sensor Selection Strategy (S4) User Guide

    NASA Technical Reports Server (NTRS)

    Sowers, T. Shane

    2012-01-01

    This paper describes a User Guide for the Systematic Sensor Selection Strategy (S4). S4 was developed to optimally select a sensor suite from a larger pool of candidate sensors based on their performance in a diagnostic system. For aerospace systems, selecting the proper sensors is important for ensuring adequate measurement coverage to satisfy operational, maintenance, performance, and system diagnostic criteria. S4 optimizes the selection of sensors based on the system fault diagnostic approach while taking conflicting objectives such as cost, weight and reliability into consideration. S4 can be described as a general architecture structured to accommodate application-specific components and requirements. It performs combinational optimization with a user defined merit or cost function to identify optimum or near-optimum sensor suite solutions. The S4 User Guide describes the sensor selection procedure and presents an example problem using an open source turbofan engine simulation to demonstrate its application.

  12. Feasibility of Implementing a Comprehensive Warfarin Pharmacogenetics Service

    PubMed Central

    Nutescu, Edith A.; Drozda, Katarzyna; Bress, Adam P.; Galanter, William L.; Stevenson, James; Stamos, Thomas D.; Desai, Ankit A.; Duarte, Julio D.; Gordeuk, Victor; Peace, David; Kadkol, ShriHari S.; Dodge, Carol; Saraf, Santosh; Garofalo, John; Krishnan, Jerry A.; Garcia, Joe G.N.; Cavallari, Larisa H.

    2013-01-01

    Objective To determine the procedural feasibility of a pharmacist-led interdisciplinary service for providing genotype-guided warfarin dosing for hospitalized patients newly starting warfarin. Design Prospective observational study Setting 483-bed hospital affiliated with a large academic institution Participants Eighty patients started on warfarin and managed by a newly implemented pharmacogenetics service. Intervention Routine warfarin genotyping and clinical pharmacogenetics consultation Measurements and Main Results The primary outcomes were percent of genotype-guided dose recommendations available prior to the second warfarin dose and adherence of the medical staff to doses recommended by the pharmacogenetics service. Of 436 genotype orders during the first 6 months of the service, 190 were deemed appropriate. For 80 patients on the service who consented to data collection, 77% of genotypes were available prior to the second warfarin dose. The median (range) time from the genotype order to the genotype result was 26 (7 to 80) hours, and the time to genotype-guided dosing recommendation was 30 (7 to 80) hours. Seventy-three percent of warfarin doses ordered by the medical staff were within 0.5 mg of the dose recommended by the pharmacogenetics consult service. Conclusions Providing routine genotype-guided warfarin dosing supported by a pharmacogenetics consult service is feasible from a procedural standpoint, with the majority of genotypes available prior to the second warfarin dose and good adherence to genotype-guided dose recommendations by the medical staff. PMID:23864527

  13. Initial development of the Systems Approach to Home Medication Management (SAHMM) model.

    PubMed

    Doucette, William R; Vinel, Shanrae'l; Pennathur, Priyadarshini

    Adverse drug events and medication nonadherence are two problems associated with prescription medication use for chronic conditions. These issues often develop because patients have difficulty managing their medications at home. To guide patients and providers for achieving safe and effective medication use at home, the Systems Approach to Home Medication Management (SAHMM) model was derived from a systems engineering model for health care workplace safety. To explore how well concepts from the SAHMM model can represent home medication management by using patient descriptions of how they take prescription medications at home. Twelve patients were interviewed about home medication management using an interview guide based on the factors of the SAHMM model. Each interview was audio-taped and then transcribed verbatim. Interviews were coded to identify themes for home medication management using MAXQDA for Windows. SAHMM concepts extracted from the coded interview transcripts included work system components of person, tasks, tools & technology, internal environment, external environment, and household. Concepts also addressed work processes and work outcomes for home medication management. Using the SAHMM model for studying patients' home medication management is a promising approach to improving our understanding of the factors that influence patient adherence to medication and the development of adverse drug events. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Delamination Defect Detection Using Ultrasonic Guided Waves in Advanced Hybrid Structural Elements

    NASA Astrophysics Data System (ADS)

    Yan, Fei; Qi, Kevin ``Xue''; Rose, Joseph L.; Weiland, Hasso

    2010-02-01

    Nondestructive testing for multilayered structures is challenging because of increased numbers of layers and plate thicknesses. In this paper, ultrasonic guided waves are applied to detect delamination defects inside a 23-layer Alcoa Advanced Hybrid Structural plate. A semi-analytical finite element (SAFE) method generates dispersion curves and wave structures in order to select appropriate wave structures to detect certain defects. One guided wave mode and frequency is chosen to achieve large in-plane displacements at regions of interest. The interactions of the selected mode with defects are simulated using finite element models. Experiments are conducted and compared with bulk wave measurements. It is shown that guided waves can detect deeply embedded damages inside thick multilayer fiber-metal laminates with suitable mode and frequency selection.

  15. [Analysis of images in Japanese book Fukusho-Kiran (Medical Book Focusing on Abdominal Palpation) and Fukusho-Kiran yoku (Supplement to Medical Book Focusing on Abdominal Palpation)].

    PubMed

    Zhang, Lijun; DI, Kan; Song, Yuanliang

    2014-09-01

    Hukusyo-kiran (Medical Book Focusing on Abdominal Palpation) and Hukusyo-kiran yoku (Supplement to Medical Book Focusing on Abdominal Palpation) are two typical monographs of Fukushin (abdominal palpation), with a total of 148 images about abdominal palpation. These images can be divided into 5 kinds: locations, theories, techniques, diseases and medicines, with its own system covering the theories, principles, prescriptions and medicines of abdominal palpation. It can be used as a guide for clinicians to differentiate the locations and qualities of diseases, confirm the principles of treatment, guide the usage of medicines, and predict the prognosis, with the rather high theoretic and academic value, deserving further research and analysis for the modern scholars.

  16. Medical technology management: from planning to application.

    PubMed

    David, Y; Jahnke, E

    2005-01-01

    Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations.

  17. Using "big data" to guide implementation of a web and mobile adaptive learning platform for medical students.

    PubMed

    Menon, Ashwin; Gaglani, Shiv; Haynes, M Ryan; Tackett, Sean

    2017-09-01

    Adaptive learning platforms (ALPs) can revolutionize medical education by making learning more efficient, but their potential has not been realized because students do not use them persistently. We applied educational data mining methods to study United States medical students who used an ALP called Osmosis ( www.osmosis.org ) from 1 August 2014 to 31 July 2015. Multivariate logistic regressions modeled persistence on Osmosis as the dependent variable and Osmosis-collected variables as predictors. The 6787 students included in our analysis responded to a total of 887,193 items, with 2138 (31.5%) using Osmosis persistently. Number of items per student, mobile device use, subscription payment, and group membership were independently associated with persisting (p < 0.001 in all models). Persistent users rated quality more favorably (p < 0.01) but were not more confident in answer selections (p = 0.80). While persisters were more accurate than non-persisters (55% (SD 18%) vs 52% (SD 22%), p < 0.001), after adjusting for number of items, lower accuracy was associated with persistent use (OR 0.93 [95% CI 0.90-0.97], p < 0.01). Our study of a large sample of U.S. medical students illustrates big data medical education research and provides guidance for improving implementation of ALPs and further investigation.

  18. Identifying Educational Practices Supported by Rigorous Evidence: A Guide to the Selection of Evidence-Based Practices

    ERIC Educational Resources Information Center

    Regional Resource Center Program, 2014

    2014-01-01

    One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…

  19. N-terminal pro brain natriuretic peptide-guided management in patients with heart failure and preserved ejection fraction: findings from the Trial of Intensified versus standard medical therapy in elderly patients with congestive heart failure (TIME-CHF).

    PubMed

    Maeder, Micha T; Rickenbacher, Peter; Rickli, Hans; Abbühl, Heidi; Gutmann, Marc; Erne, Paul; Vuilliomenet, André; Peter, Martin; Pfisterer, Matthias; Brunner-La Rocca, Hans-Peter

    2013-10-01

    To assess the effects of an NT-proBNP-guided medical management on 18-month outcomes in patients with heart failure (HF) and preserved LVEF ( HFpEF). Patients with HFpEF (LVEF >45%; n = 123) and HF with reduced LVEF (HFrEF; LVEF ≤45%; n = 499) with age ≥60 years, NYHA class ≥ II, and elevated NT-proBNP (>400 ng/L or >800 ng/L depending on age) were randomized to medical therapy titrated only to reduce symptoms to NYHA ≤II (symptom-guided) or also to reduce NT-proBNP below the inclusion threshold (NT-proBNP-guided) during a 6-month period. Patients were followed for an additional 12 months. Despite similar treatment escalation, NT-proBNP reduction and symptom relief were less in HFpEF than in HFrEF. Hospitalization-free survival at 18 months was worse in HFpEF than in HFrEF (P = 0.02), while survival and HF hospitalization-free survival did not differ. Among HFpEF patients, NT-proBNP reduction and symptom relief were similar in the symptom-guided (n = 59) and NT-proBNP-guided (n = 64) group despite more aggressive treatment in the NT-proBNP-guided group. In contrast to effects in HFrEF, NT-proBNP-guided management tended to worsen 18-month outcomes in HFpEF, with P-values for the interactions between LVEF stratum and management strategy of 0.2 for hospitalization-free survival, 0.03 for survival, and 0.01 for HF hospitalization-free survival. Outcomes in HFpEF were not better than in HFrEF, and opposite effects of NT-proBNP-guided management were observed in HFpEF compared with HFrEF. These preliminary findings suggest that, in contrast to HFrEF, NT-proBNP-guided therapy may not be beneficial in HFpEF. Trial registration ISRCTN43596477.

  20. Ethical precepts for medical volunteerism: including local voices and values to guide RHD surgery in Rwanda.

    PubMed

    Coors, Marilyn E; Matthew, Thomas L; Matthew, Dayna B

    2015-10-01

    At the invitation of the Rwandan Government, Team Heart, a team of American healthcare professionals, performs volunteer rheumatic heart disease (RHD) surgery in Rwanda every year, and confronts ethical concerns that call for cultural sensitivity. This article describes how five standard bioethical precepts are applied in practice in medical volunteerism related to RHD surgery in Rwanda. The content for the applied precepts stems from semiscripted, transcribed conversations with the authors, two Rwandan cardiologists, a Rwandan nurse and a Rwandan premedical student. The conversations revealed that the criteria for RHD surgical selection in Rwanda are analogous to the patient-selection process involving material scarcity in the USA. Rwandan notions of benefit and harm focus more attention on structural issues, such as shared benefit, national reputation and expansion of expertise, than traditional Western notions. Harm caused by inadequate patient follow-up remains a critical concern. Gender disparities regarding biological and social implications of surgical valve choices impact considerations of justice. Individual agency remains important, but not central to Rwandan concepts of justice, transparency and respect, particularly regarding women. The Rwandan understanding of standard bioethical precepts is substantively similar to the traditionally recognised interpretation with important contextual differences. The communal importance of improving the health of a small number of individuals may be underestimated in previous literature. Moreover, openness and the incorporation of Rwandan stakeholders in difficult ethical choices and long-term contributions to indigenous medical capacity appear to be valued by Rwandans. These descriptions of applied precepts are applicable to different medical missions in other emerging nations following a similar process of inclusion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Patients’ perspectives on the medical primary–secondary care interface: systematic review and synthesis of qualitative research

    PubMed Central

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-01-01

    Objectives To synthesise the published literature on the patient experience of the medical primary–secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Design Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients’ perspectives of the medical primary–secondary care interface. Setting International primary–secondary care interface. Data sources EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Eligibility criteria for selecting studies Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients’ perspectives of the medical primary–secondary care interface. Review methods The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary–secondary care interface from the patients’ perspective emerged: barriers to care, communication, coordination, and ‘relationships and personal value’. Conclusions and implications of key findings Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. Trial registration number PROSPERO CRD42014009486. PMID:26474939

  2. Advances in aortic disease management: a year in review.

    PubMed

    Garg, Vinay; Ouzounian, Maral; Peterson, Mark D

    2016-03-01

    The medical and surgical management of aortic disease is continually changing in search for improved outcomes. Our objective is to highlight recent advances in a few select areas pertaining to aortic disease and aortic surgery: the genetics of aortopathy, medical therapy of aortic aneurysms, advances in cardiac imaging, and operative strategies for the aortic arch. As our understanding of the genetic basis for aortopathy continues to improve, routine genetic testing may be of value in assessing patients with genetically triggered forms of aortic disease. With regard to medical advances, treating patients with Marfan syndrome with either losartan or atenolol at an earlier stage in their disease course improves outcomes. In addition, novel imaging indices such as wall shear stress and aortic stiffness assessed by MRI may become useful markers of aortopathy and warrant further study. With regard to the optimal technique for cerebral perfusion in aortic arch surgery, high-quality data are still lacking. Finally, in patients with complex, multilevel aortic disease, the frozen elephant trunk is a viable single-stage option compared with the conventional elephant trunk, although with an increased risk for spinal cord injury. Based on recent advances, continued studies in genetics, cardiac imaging, and surgical trials will further elucidate the etiology of aortopathy and ultimately guide management, both medically and surgically.

  3. Entree Production Guides for Modified Diets at Walter Reed Army Medical Center. Part 4. Meat Substitute Entrees

    DTIC Science & Technology

    1979-06-01

    numbers of vegetarian patients. Part V, Renal Diets , consists of eight very carefully weighed entrees and one dessert. These items are designed to give...WORDS (Conthmae an, revee side It nocesary and Identify by black number) \\ ~FOOD PREPARATION MEAT SUBSTITUTE MODIFIED DIETS COOK-FEEZE SYSTEMS SENSORY...Unsrfnounced I:! I *1C: -r Lii ENTREE PRODUCTION GUIDES FOR MODIFIED DIETS AT WALTER REED ARMY MEDICAL CENTER PART III: DENTAL LIQUID ENTREES FOREWORD

  4. Construction of a high-tech operating room for image-guided surgery using VR.

    PubMed

    Suzuki, Naoki; Hattori, Asaki; Suzuki, Shigeyuki; Otake, Yoshito; Hayashibe, Mitsuhiro; Kobayashi, Susumu; Nezu, Takehiko; Sakai, Haruo; Umezawa, Yuji

    2005-01-01

    This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans.

  5. A Guide to Southern Pine Seed Sources

    Treesearch

    Clark W. Lantz; John F. Kraus

    1987-01-01

    The selection of an appropriate seed source is critical for successful southern pine plantations. Guides for selection of seed sources are presented for loblolly, slash, longleaf, Virginia, shortleaf, and sand pines. Separate recommendations are given for areas where fusiform-rust hazard is high.

  6. Planning emergency medical communications

    DOT National Transportation Integrated Search

    1996-06-01

    This technical bulletin summarizes a two volume publication entitled "Planning Emergency Medical Communications." Volume One, the State Level Planning Guide, contains general background information about a two tiered approach to EMS communications pl...

  7. Depression: What You Need to Know

    MedlinePlus

    ... warnings, patient medication guides, or newly approved medications. Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. There ...

  8. Design and performance frameworks for constructing problem-solving simulations.

    PubMed

    Stevens, Ron; Palacio-Cayetano, Joycelin

    2003-01-01

    Rapid advancements in hardware, software, and connectivity are helping to shorten the times needed to develop computer simulations for science education. These advancements, however, have not been accompanied by corresponding theories of how best to design and use these technologies for teaching, learning, and testing. Such design frameworks ideally would be guided less by the strengths/limitations of the presentation media and more by cognitive analyses detailing the goals of the tasks, the needs and abilities of students, and the resulting decision outcomes needed by different audiences. This article describes a problem-solving environment and associated theoretical framework for investigating how students select and use strategies as they solve complex science problems. A framework is first described for designing on-line problem spaces that highlights issues of content, scale, cognitive complexity, and constraints. While this framework was originally designed for medical education, it has proven robust and has been successfully applied to learning environments from elementary school through medical school. Next, a similar framework is detailed for collecting student performance and progress data that can provide evidence of students' strategic thinking and that could potentially be used to accelerate student progress. Finally, experimental validation data are presented that link strategy selection and use with other metrics of scientific reasoning and student achievement.

  9. Design and Performance Frameworks for Constructing Problem-Solving Simulations

    PubMed Central

    Stevens, Ron; Palacio-Cayetano, Joycelin

    2003-01-01

    Rapid advancements in hardware, software, and connectivity are helping to shorten the times needed to develop computer simulations for science education. These advancements, however, have not been accompanied by corresponding theories of how best to design and use these technologies for teaching, learning, and testing. Such design frameworks ideally would be guided less by the strengths/limitations of the presentation media and more by cognitive analyses detailing the goals of the tasks, the needs and abilities of students, and the resulting decision outcomes needed by different audiences. This article describes a problem-solving environment and associated theoretical framework for investigating how students select and use strategies as they solve complex science problems. A framework is first described for designing on-line problem spaces that highlights issues of content, scale, cognitive complexity, and constraints. While this framework was originally designed for medical education, it has proven robust and has been successfully applied to learning environments from elementary school through medical school. Next, a similar framework is detailed for collecting student performance and progress data that can provide evidence of students' strategic thinking and that could potentially be used to accelerate student progress. Finally, experimental validation data are presented that link strategy selection and use with other metrics of scientific reasoning and student achievement. PMID:14506505

  10. Medical Information for the Vocational Rehabilitation Counselor--A Training Guide.

    ERIC Educational Resources Information Center

    Phelps, William R.

    This paper presents information helpful to the vocational rehabilitation counselor and can be utilized in training programs for the newly employed untrained vocational rehabilitation practitioner. Areas covered include medical terminology, common prefixes and suffixes, speciality boards; paramedic professions, and medical education. Undergraduate…

  11. Gastroenterology - Evolution of specialty choice in recent years.

    PubMed

    Curbelo, José; Galván-Román, José-María; Sánchez-Lasheras, Fernando; Romeo, Jose María; Fernández-Somoano, Ana; Villacampa, Tomás; Baladrón, Jaime

    2017-09-01

    Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization. The median consecutive number involved in the choice of Gastroenterology training has decreased year after year, and this specialty is now positioned among the five most commonly selected residency programs in 2015. The median number of hospitals with a higher number of beds, adult liver transplantation activities and dedicated GI bleeding units is significantly lower. This is also true when centers are analyzed according to the presence of specific Gastroenterology on-call shifts for residents or their association with medical schools. Data from the past five years highlight Madrid, Aragón and the Basque Country as the autonomous communities where Gastroenterology is the most popular. Centers selected by candidates with the lowest median consecutive numbers from 2011-2015 included the university hospitals Ramón y Cajal, Santiago de Compostela and Gregorio Marañón. Gastroenterology has gradually escalated in the ranking of residency choices and is now one of the five most popular options. Potential residents prefer larger centers with complex-care patients and more research activity.

  12. Age as a Determinant to Select an Anesthesia Method for Tympanostomy Tube Insertion in a Pediatric Population

    PubMed Central

    Jung, Kihwan; Kim, Hojong

    2015-01-01

    Background and Objectives To evaluate the relationship between age and anesthesia method used for tympanostomy tube insertion (TTI) and to provide evidence to guide the selection of an appropriate anesthesia method in children. Subjects and Methods We performed a retrospective review of children under 15 years of age who underwent tympanostomy tube insertion (n=159) or myringotomy alone (n=175) under local or general anesthesia by a single surgeon at a university-based, secondary care referral hospital. Epidermiologic data between local and general anesthesia groups as well as between TTI and myringotomy were analyzed. Medical costs were compared between local and general anesthesia groups. Results Children who received local anesthesia were significantly older than those who received general anesthesia. Unilateral tympanostomy tube insertion was performed more frequently under local anesthesia than bilateral. Logistic regression modeling showed that local anesthesia was more frequently applied in older children (odds ratio=1.041) and for unilateral tympanostomy tube insertion (odds ratio=8.990). The cut-off value of age for local anesthesia was roughly 5 years. Conclusions In a pediatric population at a single medical center, age and whether unilateral or bilateral procedures were required were important factors in selecting an anesthesia method for tympanostomy tube insertion. Our findings suggest that local anesthesia can be preferentially considered for children 5 years of age or older, especially in those with unilateral otitis media with effusion. PMID:26185791

  13. Otitis Media with Effusion in Young Children. Clinical Practice Guideline, Quick Reference Guide for Clinicians, [and] Parent Guide, Consumer Version, Number 12.

    ERIC Educational Resources Information Center

    Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

    Otitis media with effusion and its related hearing loss have been associated with delayed language development, particularly if the disease is recurrent or of long duration, although available data are insufficient to establish a causal linkage. This guide presents recommendations based on extensive reviews of the relevant medical and…

  14. Thyroid Cancer

    MedlinePlus

    ... are here Home > Types of Cancer > Thyroid Cancer Thyroid Cancer This is Cancer.Net’s Guide to Thyroid Cancer. Use the menu below to choose the Overview/ ... social workers, and patient advocates. Cancer.Net Guide Thyroid Cancer Introduction Statistics Medical Illustrations Risk Factors Symptoms and ...

  15. Vaginal Cancer Overview

    MedlinePlus

    ... are here Home > Types of Cancer > Vaginal Cancer Vaginal Cancer This is Cancer.Net’s Guide to Vaginal Cancer. Use the menu below to choose the ... social workers, and patient advocates. Cancer.Net Guide Vaginal Cancer Introduction Statistics Medical Illustrations Risk Factors and ...

  16. General equations for optimal selection of diagnostic image acquisition parameters in clinical X-ray imaging.

    PubMed

    Zheng, Xiaoming

    2017-12-01

    The purpose of this work was to examine the effects of relationship functions between diagnostic image quality and radiation dose on the governing equations for image acquisition parameter variations in X-ray imaging. Various equations were derived for the optimal selection of peak kilovoltage (kVp) and exposure parameter (milliAmpere second, mAs) in computed tomography (CT), computed radiography (CR), and direct digital radiography. Logistic, logarithmic, and linear functions were employed to establish the relationship between radiation dose and diagnostic image quality. The radiation dose to the patient, as a function of image acquisition parameters (kVp, mAs) and patient size (d), was used in radiation dose and image quality optimization. Both logistic and logarithmic functions resulted in the same governing equation for optimal selection of image acquisition parameters using a dose efficiency index. For image quality as a linear function of radiation dose, the same governing equation was derived from the linear relationship. The general equations should be used in guiding clinical X-ray imaging through optimal selection of image acquisition parameters. The radiation dose to the patient could be reduced from current levels in medical X-ray imaging.

  17. Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses.

    PubMed

    Petranovic, Milena; Gilman, Matthew D; Muniappan, Ashok; Hasserjian, Robert P; Digumarthy, Subba R; Muse, Victorine V; Sharma, Amita; Shepard, Jo-Anne O; Wu, Carol C

    2015-10-01

    The purpose of this study was to evaluate the diagnostic yield and accuracy of CT-guided percutaneous biopsy of anterior mediastinal masses and assess prebiopsy characteristics that may help to select patients with the highest diagnostic yield. Retrospective review of all CT-guided percutaneous biopsies of the anterior mediastinum conducted at our institution from January 2003 through December 2012 was performed to collect data regarding patient demographics, imaging characteristics of biopsied masses, presence of complications, and subsequent surgical intervention or medical treatment (or both). Cytology, core biopsy pathology, and surgical pathology results were recorded. A per-patient analysis was performed using two-tailed t test, Fisher's exact test, and Pearson chi-square test. The study cohort included 52 patients (32 men, 20 women; mean age, 49 years) with mean diameter of mediastinal mass of 6.9 cm. Diagnostic yield of CT-guided percutaneous biopsy was 77% (40/52), highest for thymic neoplasms (100% [11/11]). Non-diagnostic results were seen in 12 of 52 patients (23%), primarily in patients with lymphoma (75% [9/12]). Fine-needle aspiration yielded the correct diagnosis in 31 of 52 patients (60%), and core biopsy had a diagnostic rate of 77% (36/47). None of the core biopsies were discordant with surgical pathology. There was no statistically significant difference between the diagnostic and the nondiagnostic groups in patient age, lesion size, and presence of necrosis. The complication rate was 3.8% (2/52), all small self-resolving pneumothoraces. CT-guided percutaneous biopsy is a safe diagnostic procedure with high diagnostic yield (77%) for anterior mediastinal lesions, highest for thymic neoplasms (100%), and can potentially obviate more invasive procedures.

  18. Creation of the selection list for the Experiment Scheduling Program (ESP)

    NASA Technical Reports Server (NTRS)

    Deuermeyer, B. L.; Shannon, R. E.; Underbrink, A. J., Jr.

    1986-01-01

    The efforts to develop a procedure to construct selection groups to augment the Experiment Scheduling Program (ESP) are summarized. Included is a User's Guide and a sample scenario to guide in the use of the software system that implements the developed procedures.

  19. Mode perturbation method for optimal guided wave mode and frequency selection.

    PubMed

    Philtron, J H; Rose, J L

    2014-09-01

    With a thorough understanding of guided wave mechanics, researchers can predict which guided wave modes will have a high probability of success in a particular nondestructive evaluation application. However, work continues to find optimal mode and frequency selection for a given application. This "optimal" mode could give the highest sensitivity to defects or the greatest penetration power, increasing inspection efficiency. Since material properties used for modeling work may be estimates, in many cases guided wave mode and frequency selection can be adjusted for increased inspection efficiency in the field. In this paper, a novel mode and frequency perturbation method is described and used to identify optimal mode points based on quantifiable wave characteristics. The technique uses an ultrasonic phased array comb transducer to sweep in phase velocity and frequency space. It is demonstrated using guided interface waves for bond evaluation. After searching nearby mode points, an optimal mode and frequency can be selected which has the highest sensitivity to a defect, or gives the greatest penetration power. The optimal mode choice for a given application depends on the requirements of the inspection. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Brandon/Hill selected list of books and journals for the small medical library.

    PubMed Central

    Hill, D R

    1999-01-01

    The interrelationship of print and electronic media in the hospital library and its relevance to the "Brandon/Hill Selected List" in 1999 are addressed in the updated list (eighteenth version) of 627 books and 145 journals. This list is intended as a selection guide for the small or medium-size library in a hospital or similar facility. More realistically, it can function as a core collection for a library consortium. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Due to continuing requests from librarians, a "minimal core" book collection consisting of 82 titles has been pulled out from the 214 asterisked (*) initial-purchase books and marked with daggers ([symbol: see text]). To purchase the entire collection of books and to pay for 1999 journal subscriptions would require $114,900. The cost of only the asterisked items, books and journals, totals $49,100. The "minimal core" book collection costs $13,200. PMID:10219475

  1. Adapting Comparative Effectiveness Research Summaries for Delivery to Patients and Providers through a Patient Portal

    PubMed Central

    McDougald Scott, Amanda M.; Jackson, Gretchen Purcell; Ho, Yun-Xian; Yan, Zhou; Davison, Coda; Rosenbloom, S. Trent

    2013-01-01

    Despite increases in the scientific evidence for a variety of medical treatments, a gap remains in the adoption of best medical practices. This manuscript describes a process for adapting published summary guides from comparative effectiveness research to render them concise, targeted to audience, and easily actionable; and a strategy for disseminating such evidence to patients and their physicians through a web-based portal and linked electronic health record. This project adapted summary guides about oral medications for adults with type 2 diabetes to a fifth-grade literacy level and modified the resulting materials based on evaluations with the Suitability Assessment of Materials instrument. Focus groups and individual interviews with patients, diabetes providers, and health literacy experts were employed to evaluate and enhance the adapted summary guide. We present the lessons learned as general guidelines for the creation of concise, targeted, and actionable evidence and its delivery to both patients and providers through increasingly prevalent health information technologies. PMID:24551387

  2. Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis.

    PubMed

    Krishnan, Prakash; Tarricone, Arthur; K-Raman, Purushothaman; Majeed, Farhan; Kapur, Vishal; Gujja, Karthik; Wiley, Jose; Vasquez, Miguel; Lascano, Rheoneil A; Quiles, Katherine G; Distin, Tashanne; Fontenelle, Ran; Atallah-Lajam, Farah; Kini, Annapoorna; Sharma, Samin

    2018-01-01

    The aim of this study was to compare 1-year outcomes for patients with femoropopliteal in-stent restenosis using directional atherectomy guided by intravascular ultrasound (IVUS) versus directional atherectomy guided by angiography. This was a retrospective analysis for patients with femoropopliteal in-stent restenosis treated with IVUS-guided directional atherectomy versus directional atherectomy guided by angiography from a single center between March 2012 and February 2016. Clinically driven target lesion revascularization was the primary endpoint and was evaluated through medical chart review as well as phone call follow up. Directional atherectomy guided by IVUS reduces clinically driven target lesion revascularization for patients with femoropopliteal in-stent restenosis.

  3. Creating a Portable Hospital/Medical Play Corner: A Guide for Teachers of Young Children.

    ERIC Educational Resources Information Center

    Patton, Sarah; Dye, Victor C.

    Ways in which early childhood educators can help children prepare for medical events through play are suggested in this pamphlet. Three qualities are seen as essential to a valuable hospital/medical play experience: (1) a focus on the child's current medical interests and experiences, (2) inclusion of information about a child's forthcoming or…

  4. Medical students are afraid to include abortion in their future practices: in-depth interviews in Maharastra, India.

    PubMed

    Sjöström, Susanne; Essén, Birgitta; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

    2016-01-12

    Unsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education. We used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach. The participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students' attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future. To increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

  5. Preparing to Enter Medical School.

    ERIC Educational Resources Information Center

    Peterson, Shailer

    A guide for students who are seeking admission to medical school is presented. The comprehensive coverage includes basic facts about medicine as well as specific requirements about the following areas: facts about health careers, treating patients, and nonpatient-oriented fields of medicine; the demands of medical education; planning a premedical…

  6. Medical Impairment and Computational Reduction to a Single Whole Person Impairment (WPI) Rating Value

    NASA Astrophysics Data System (ADS)

    Artz, Jerry; Alchemy, John; Weilepp, Anne; Bongiovanni, Michael; Siddhartha, Kumar

    2014-03-01

    A medical, biophysics, engineering collaboration has produced a standardized cloud-based application for creating automated WPI ratings. The project assigns numerical values to injuries/illness in accordance with the American Medical Association Guides to the Evaluation of Permanent Impairment, Fifth Edition, AMA Press handbook, 5th edition (with 63 medical contributors and 89 medical reviewers). The AMA Guide serves as the industry standard for assigning impairment values for 32 US states and 190 other countries. Clinical medical data is collected using a menu-driven user interface which is computationally combined into a single numeric value. A medical doctor performs a biometric analysis and enters the quantitative data into a mobile device. The data is analyzed using proprietary validation algorithms, and a WPI Impairment rating is created. The findings are imbedded into a formalized medicolegal report in a matter of minutes. This particular presentation will concentrate upon the WPI rating of the spine--cervical, thoracic, and lumbar. Both common rating techniques will be presented--i.e., Diagnosis Related Estimates (DRE) and Range of Motion (ROM).

  7. Evaluation of an optimized shade guide made from porcelain powder mixtures.

    PubMed

    Wang, Peng; Wei, Jiaqiang; Li, Qing; Wang, Yining

    2014-12-01

    Color errors associated with current shade guides and problems with color selection and duplication are still challenging for restorative dentists. The purpose of this study was to evaluate an optimized shade guide for visual shade duplication. Color distributions (L*, a*, and b*) of the maxillary left central incisors of 236 participants, whose ages ranged from 20 to 60, were measured with a spectrophotometer. Based on this color map, an optimized shade guide was designed with 14 shade tabs evenly distributed within the given color range of the natural incisors. The shade tabs were fabricated with porcelain powder mixtures and conventional laboratory procedures. A comparison of shade duplication by using the optimized and Vitapan Classical shade guides was conducted. Thirty Chinese participants were involved, and the colors of the left maxillary incisors were selected by using 2 shade guides. Metal ceramic crowns were fabricated according to the results of the shade selection. The colors of the shade tabs, natural teeth, and the ceramic crowns were measured with a spectrophotometer. The color differences among the natural teeth, the shade tabs, and the corresponding metal ceramic crowns were calculated and analyzed (α=.017). Significant differences were found in both phases of shade determination and shade duplication (P<.017). The total number of color errors with the optimized shade guide was 3.5, which was significantly less than that of Vitapan, 5.1 (P<.001). The optimized shade guide system improved performance not only in the color selection phase but also in the color of the fabricated crowns. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  8. Recurrence and Survival Outcomes After Percutaneous Thermal Ablation of Oligometastatic Melanoma.

    PubMed

    White, Mariah L; Atwell, Thomas D; Kurup, A Nicholas; Schmit, Grant D; Carter, Rickey E; Geske, Jennifer R; Kottschade, Lisa A; Pulido, Jose S; Block, Matthew S; Jakub, James W; Callstrom, Matthew R; Markovic, Svetomir N

    2016-03-01

    To evaluate focal treatment of melanoma metastases and to explore whether any potential extended survival benefit exists in a select patient population. All patients who underwent image-guided local thermal ablation of metastatic melanoma over an 11-year period (January 1, 2002, to December 31, 2013) were retrospectively identified using an internally maintained clinical registry. Only patients with oligometastatic stage IV disease amenable to complete ablation of all clinical disease at the time of ablation were included in the analysis. Overall survival and median progression-free survival periods were calculated. Thirty-three patients with primary ocular or nonocular melanoma had 66 metastases treated in the lungs, liver, bones, or soft tissues. Eleven (33%) patients were on systemic medical therapy at the time of the procedure. The median survival time was 3.8 years (range, 0.5-10.5 years), with a 4-year estimated survival of 44.1% (95% CI, 28%-68%). Local recurrence at the ablation site developed in 15.1% (5 of 33) of the patients and 13.6% of the tumors (9 of 66). The median progression-free survival time was 4.4 months (95% CI, 1.4 months to 10.5 years), with an estimated 1-year progression-free survival of 30.3% (95% CI, 18%-51%). A subgroup analysis identified 11 patients with primary ocular melanoma and 22 with nonocular melanoma, with a median survival time of 3.9 years (range, 0.9-4.7 years) and 3.8 years (range, 0.5-10.5 years), respectively (P=.58). There were no major complications and no deaths within 30 days of the procedure. Selective use of image-guided thermal ablation of oligometastatic melanoma may provide results similar to surgical resection in terms of technical effectiveness and oncologic outcomes with minimal risk. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  9. Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

    PubMed

    Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

    2013-12-01

    Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P<0.05). For usual care, there was no change in daily defined dose (all P>0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P<0.001). Intervention was associated with cessation of medication in 23 (16%) patients versus 3 (2%) in usual care (P<0.001). Despite this, there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness (all P>0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

  10. Breast Cancer Overview

    MedlinePlus

    ... are here Home > Types of Cancer > Breast Cancer Breast Cancer This is Cancer.Net’s Guide to Breast Cancer. Use the menu below to choose the Overview/ ... social workers, and patient advocates. Cancer.Net Guide Breast Cancer Introduction Statistics Medical Illustrations Risk Factors and Prevention ...

  11. The Learning Environment Counts: Longitudinal Qualitative Analysis of Study Strategies Adopted by First-Year Medical Students in a Competency-Based Educational Program.

    PubMed

    Bierer, S Beth; Dannefer, Elaine F

    2016-11-01

    The move toward competency-based education will require medical schools and postgraduate training programs to restructure learning environments to motivate trainees to take personal ownership for learning. This qualitative study explores how medical students select and implement study strategies while enrolled in a unique, nontraditional program that emphasizes reflection on performance and competence rather than relying on high-stakes examinations or grades to motivate students to learn and excel. Fourteen first-year medical students volunteered to participate in three, 45-minute interviews (42 overall) scheduled three months apart during 2013-2014. Two medical educators used structured interview guides to solicit students' previous assessment experiences, preferred learning strategies, and performance monitoring processes. Interviews were digitally recorded and transcribed verbatim. Participants confirmed accuracy of transcripts. Researchers independently read transcripts and met regularly to discuss transcripts and judge when themes achieved saturation. Medical students can adopt an assessment for learning mind-set with faculty guidance and implement appropriate study strategies for mastery-learning demands. Though students developed new strategies at different rates during the year, they all eventually identified study and performance monitoring strategies to meet learning needs. Students who had diverse learning experiences in college embraced mastery-based study strategies sooner than peers after recognizing that the learning environment did not reward performance-based strategies. Medical students can take ownership for their learning and implement specific strategies to regulate behavior when learning environments contain building blocks emphasized in self-determination theory. Findings should generalize to educational programs seeking strategies to design learning environments that promote self-regulated learning.

  12. Prevalence and associated factors of stress, anxiety and depression among emergency medical officers in Malaysian hospitals

    PubMed Central

    Yahaya, Siti Nasrina; Wahab, Shaik Farid Abdull; Yusoff, Muhammad Saiful Bahribin; Yasin, Mohd Azhar Mohd; Rahman, Mohammed Alwi Abdul

    2018-01-01

    BACKGROUND: Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals. METHODS: A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale. RESULTS: The highest prevalence was anxiety (28.6%) followed by depression (10.7%) and stress (7.9%). Depression, anxiety and stress between seven hospitals were not significantly different (P>0.05). Male medical officers significantly experienced more anxiety symptoms than female medical officers (P=0.0022), however depression and stress symptoms between male and female medical officers were not significantly different (P>0.05). Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals (P>0.05). CONCLUSION: The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers’ anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition. PMID:29796141

  13. Assessing quality of life in diabetes: I. A practical guide to selecting the best instruments and using them wisely.

    PubMed

    Fisher, Lawrence; Tang, Tricia; Polonsky, William

    2017-04-01

    The rapid development of new medications and devices in diabetes research and clinical care has led to an increased need to assess their impact on health-related quality of life (HRQOL). Unfortunately, the lack of consensus definitions and guidelines has led to the use of HRQOL measures that are often imprecise and inappropriate. The goal of this report is to provide a practical structure to the definition and measurement of HRQOL in diabetes research and clinical care. Following a brief historical background to provide context, we define HRQOL and provide a three-step framework for scale selection: identify the specific, proximal intervention targets; decide how reaching these targets will affect HRQOL; and select appropriate measures based on sample diversity, the intervention and the targets using a 2×2 grid (generic vs. diabetes specific measures; global vs. component measures). Practical tips for scale selection include: gaining patient input to document important potential HRQOL effects, varying scale selection by patient characteristics, considering common HRQOL measurement problems, and considering the timing of HRQOL assessment. We emphasize the importance of a careful, planned evaluation of HRQOL in diabetes, rather than an "off the shelf" approach. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. The Evaluation and Management of Adult Intracerebral Hemorrhage.

    PubMed

    Cai, Xuemei; Rosand, Jonathan

    2015-12-01

    Intracerebral hemorrhage (ICH) is the most disabling and deadly form of stroke. Although mortality remains high, new data suggest that outcomes can be improved with standardized medical care. In this review, the authors outline the most up-to-date knowledge, including the results of the latest phase III clinical trials on the specialized care needed to treat patients with ICH. They provide an overview on how to achieve rapid diagnosis and the initial steps of intervention to reduce hematoma volume or prevent expansion by modifying potentially treatable conditions, such as underlying vascular etiologies, blood pressure control, and coagulopathies. Grading scales can help identify patients at risk for hematoma expansion and functional disabilities and guide clinical decision making. Other medical management topics important to recovery and prevention of secondary brain injury include seizure prevention and treatment, glycemic control, temperature control, and deep venous thrombosis prophylaxis and treatment. Treatment options in surgery are also possible in select patients; there are emerging studies regarding minimally invasive surgery for the management of ICH. These aggressive therapies are essential to lower the morbidity and mortality of patients presenting with ICH. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis.

    PubMed

    So, Sokpoleak; Patel, Rita M; Orebaugh, Steven L

    2017-03-01

    Ultrasound use has expanded dramatically among the medical specialties for diagnostic and interventional purposes, due to its affordability, portability, and practicality. This imaging modality, which permits real-time visualization of anatomic structures and relationships in vivo, holds potential for pre-clinical instruction of students in anatomy and physical diagnosis, as well as providing a bridge to the eventual use of bedside ultrasound by clinicians to assess patients and guide invasive procedures. In many studies, but not all, improved understanding of anatomy has been demonstrated, and in others, improved accuracy in selected aspects of physical diagnosis is evident. Most students have expressed a highly favorable impression of this technology for anatomy education when surveyed. Logistic issues or obstacles to the integration of ultrasound imaging into anatomy teaching appear to be readily overcome. The enthusiasm of students and anatomists for teaching with ultrasound has led to widespread implementation of ultrasound-based teaching initiatives in medical schools the world over, including some with integration throughout the entire curriculum; a trend that likely will continue to grow. Anat Sci Educ 10: 176-189. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  16. Integrative medicine for managing the symptoms of lupus nephritis: A protocol for systematic review and meta-analysis.

    PubMed

    Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

    2018-03-01

    Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. PROSPERO 2018 CRD42018085205.

  17. MedlinePlus Guide to Healthy Web Surfing

    MedlinePlus

    ... medical advisory board is composed of attorneys and accountants is not medically authoritative. Look for a description ... to see if the site is supported by public funds, donations or by commercial advertising. Advertisements should ...

  18. Driver fitness medical guidelines.

    DOT National Transportation Integrated Search

    2009-09-01

    This guide provides guidance to assist licensing agencies in making decisions about an individuals fitness for driving. This is the first attempt to produce a consolidated document covering medical conditions included in the task agreement between...

  19. Critical reading and critical thinking--study design and methodology: a personal approach on how to read the clinical literature.

    PubMed

    Lipman, Timothy O

    2013-04-01

    The volume of medical literature grows exponentially. Yet we are faced with the necessity to make clinical decisions based on the availability and quality of scientific information. The general strength (reliability, robustness) of any interpretation that guides us in clinical decision making is dependent on how information was obtained. All information and medical studies and, consequently, all conclusions are not created equal. It is incumbent upon us to be able to assess the quality of the information that guides us in the care of our patients. Being able to assess medical literature critically requires use of critical reading and critical thinking skills. To achieve these skills, to be able to analyze medical literature critically, takes a combination of education and practice, practice, and more practice.

  20. International Adaptation: Psychosocial and parenting experiences of caregivers who travel to the United States to obtain acute medical care for their seriously ill child

    PubMed Central

    Margolis, Rachel; Ludi, Erica; Pao, Maryland; Wiener, Lori

    2013-01-01

    Despite the increasing trend of travel for medical purposes, little is known about the experience of parents and other caregivers who come to the United States specifically to obtain medical treatment for their seriously ill child. In this exploratory, descriptive qualitative study, we used a semi-structured narrative guide to conduct in-depth interviews with 22 Spanish or English-speaking caregivers about the challenges encountered and adaptation required when entering a new medical and cultural environment. Caregivers identified the language barrier and transnational parenting as challenges while reporting hospital staff and their own families as major sources of support. Using the results of the study as a guide, clinical and program implications are provided and recommendations for social work practice discussed. PMID:23947542

  1. Autonomy, religion and clinical decisions: findings from a national physician survey.

    PubMed

    Lawrence, R E; Curlin, F A

    2009-04-01

    Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors' decisions. Associations between physicians' religious characteristics and their weighting of the criteria were also examined. Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. Physicians were asked how much weight should be given to the following: (1) the patient's expressed wishes and values, (2) the physician's own judgment about what is in the patient's best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Response rate 51% (446/879). Half of physicians (55%) gave the patient's expressed wishes and values "the highest possible weight". In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient's expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the "highest possible weight", versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians' decisions as much as is often recommended in the ethics literature.

  2. Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

    PubMed

    Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

    2018-01-01

    Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

  3. Daily Living Skills at Your Fingertips. Daily Living Skills for 0-4 Level Adult Basic Education Students. Curriculum and Teacher Guide.

    ERIC Educational Resources Information Center

    Greene, Margret

    A curriculum and teacher guide are provided for a program to teach daily living skills to 0-4 level adult basic education students. The guide presents a method of instruction and lists the materials provided. Teaching plans (content outlines) are provided for these areas: cooking, housekeeping, laundry, leisure skills, and medication awareness. A…

  4. Medical School Admissions: The Insider's Guide. 4th Revised Edition.

    ERIC Educational Resources Information Center

    Zebala, John A.; And Others

    This revised and updated handbook written by recent medical school graduates offers a firsthand account of successful strategies for the medical school admissions process. Six chapters discuss the following topics: (1) premedical preparation (planning undergraduate study and picking the right college); (2) power techniques for higher grades…

  5. Basis of Accreditation for Educational Programs in Allied Medical Disciplines.

    ERIC Educational Resources Information Center

    Canadian Medical Association, Ottawa (Ontario).

    Designed as a guide to accreditation for educational programs in the allied medical disciplines in Canada, this report provides educators with guidelines, general requirements and requirements for specific programs. Following information on the organization, structure, goals and terminology of accreditation of allied medical programs in Canada,…

  6. The Medically Fragile Child in the School Setting. Second Edition.

    ERIC Educational Resources Information Center

    American Federation of Teachers, Washington, DC.

    This guide for teachers whose classes include a medically fragile child considers roles and responsibilities of teachers with these students, teachers' rights as school employees, and possible solutions and protections for local unions to pursue. Chapter 1 provides an overview. It defines "medically fragile," summarizes legal…

  7. Bilingual Medical Phrase Book (In English and Vietnamese).

    ERIC Educational Resources Information Center

    Thuy, Vuong G.

    This guide offers Vietnamese refugees and immigrants with limited English proficiency a short-cut, word-for-word bilingual reference tool for dealing with medical problems and situations in English-language environments. Seven chapters deal with different issues of the medical encounter and five appendixes present specialized terms and…

  8. Bilingual Medical Phrase Book (In English and Cambodian (Khmer)).

    ERIC Educational Resources Information Center

    Thuy, Vuong G.

    This guide offers Cambodian refugees and immigrants with limited English proficiency a short-cut, word-for-word bilingual reference tool for dealing with medical problems and situations in English-language environments. Seven chapters deal with different issues of the medical encounter and five appendixes present specialized terms and…

  9. Navy Occupational Health Information Management System (NOHIMS). Medical Exam Scheduling Module. Operators’ Guide

    DTIC Science & Technology

    1987-01-16

    Management System (NOHIMS) Industrial Hygiene (IH) Component database in order to perform these functions: (1) enroll and remove employees from Medical...The Medical Examination Scheduling (MES) module consists of a list of options that allow users to access the Navy Occupational Health Information

  10. Seafood Products Teacher Resource Guide.

    ERIC Educational Resources Information Center

    Wheeler, Jacqueline D., Ed.; Hebard, Chieko E., Ed.

    This guide presents practical information about the characteristics and uses of seafood. The material can be used in several ways: as a seafood products program and teaching guide for home economics teachers, home demonstration club leaders, and extension agents; as a practical guide to the selection and preparation of seafood for consumers; and…

  11. Computer Applications in Instruction: A Teacher's Guide to Selection and Use.

    ERIC Educational Resources Information Center

    Edwards, Judith B.; And Others

    Intended for upper elementary and secondary teachers in all subject areas, this guide provides practical advice on determining the appropriate application of computer technology and on the selection of specific, subject-related computer-based instruction units. Under the heading of hardware and software, topics discussed include communicating with…

  12. Public Administration: A Bibliography of Selected Reference Sources.

    ERIC Educational Resources Information Center

    Brustman, Mary Jane

    This guide presents an annotated list of selected reference sources in public administration. All of the sources listed are found at the Graduate Library for Public Affairs and Policy (GLPP) located at the State University of New York, Albany. Detailed, exhaustive guides in literature, research, indexes, abstracts, statistical sources, government…

  13. A Planning Guide for Instructional Networks, Part I.

    ERIC Educational Resources Information Center

    Daly, Kevin F.

    1994-01-01

    Discusses three phases in implementing a master plan for a school-based local area network (LAN): (1) network software selection; (2) hardware selection, network topology, and site preparation; and (3) implementation time table. Sample planning and specification worksheets and a list of planning guides are included. (Contains six references.) (KRN)

  14. ARBA Guide to Biographical Resources 1986-1997.

    ERIC Educational Resources Information Center

    Wick, Robert L., Ed.; Mood, Terry Ann, Ed.

    This guide provides a representative selection of biographical dictionaries and related works useful to the reference and collection development processes in all types of libraries. Three criteria were used in selection: (1) each item included was published within the past 12 years; (2) each item has been included in American Reference Books…

  15. Feasibility of implementing a comprehensive warfarin pharmacogenetics service.

    PubMed

    Nutescu, Edith A; Drozda, Katarzyna; Bress, Adam P; Galanter, William L; Stevenson, James; Stamos, Thomas D; Desai, Ankit A; Duarte, Julio D; Gordeuk, Victor; Peace, David; Kadkol, Shrihari S; Dodge, Carol; Saraf, Santosh; Garofalo, John; Krishnan, Jerry A; Garcia, Joe G N; Cavallari, Larisa H

    2013-11-01

    To determine the procedural feasibility of a pharmacist-led interdisciplinary service for providing genotype-guided warfarin dosing for hospitalized patients newly starting warfarin. Prospective observational study. A 438-bed tertiary care hospital affiliated with a large academic institution. Eighty patients who started warfarin therapy and were managed by a newly implemented pharmacogenetics service. All patients received routine warfarin genotyping and clinical pharmacogenetics consultation. The primary outcomes were percentage of genotype-guided dose recommendations available prior to the second warfarin dose and adherence of the medical staff to doses recommended by the pharmacogenetics service. Of 436 genotype orders placed during the first 6 months of the service, 190 (44%) were deemed appropriate. For the 80 patients on the service who consented to data collection, 76% of the genotypes were available prior to the second warfarin dose. The median (range) time from genotype order to genotype result was 26 hours (7-80 hrs), and the time to genotype-guided dose recommendation was 30 hours (7-80 hrs). A total of 73% of warfarin doses ordered by the medical staff were within 0.5 mg of the daily dose recommended by the pharmacogenetics consult service. Providing routine genotype-guided warfarin dosing supported by a pharmacogenetics consult service is feasible from a procedural standpoint, with most genotypes available prior to the second warfarin dose and good adherence to genotype-guided dose recommendations by the medical staff. © 2013 Pharmacotherapy Publications, Inc.

  16. Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians.

    PubMed

    Billaux, Mathilde; Borget, Isabelle; Prognon, Patrice; Pineau, Judith; Martelli, Nicolas

    2016-06-01

    Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders' perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as 'new', 'safe' and 'effective', whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital-based health technology assessment has been developed to support decisions. However, little is known about the different perceptions of innovative medical devices among practitioners and how different perceptions may affect decision making. What does this paper add? This paper compares and understands the perceptions of two groups of health professionals concerning innovative devices in the university hospital environment. What are the implications for practitioners? Such a comparison of viewpoints could facilitate improvements in current practices and decision-making processes in local health technology assessment for these medical products.

  17. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module II. Human Systems and Patient Assessment.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on human systems and patient assessment is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Four units are presented: (1) medical terminology, which covers some common prefixes and suffixes and the use of the medical dictionary; (2) an overview of the…

  18. Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis

    PubMed Central

    Krishnan, Prakash; Tarricone, Arthur; K-Raman, Purushothaman; Majeed, Farhan; Kapur, Vishal; Gujja, Karthik; Wiley, Jose; Vasquez, Miguel; Lascano, Rheoneil A.; Quiles, Katherine G.; Distin, Tashanne; Fontenelle, Ran; Atallah-Lajam, Farah; Kini, Annapoorna; Sharma, Samin

    2017-01-01

    Background: The aim of this study was to compare 1-year outcomes for patients with femoropopliteal in-stent restenosis using directional atherectomy guided by intravascular ultrasound (IVUS) versus directional atherectomy guided by angiography. Methods and results: This was a retrospective analysis for patients with femoropopliteal in-stent restenosis treated with IVUS-guided directional atherectomy versus directional atherectomy guided by angiography from a single center between March 2012 and February 2016. Clinically driven target lesion revascularization was the primary endpoint and was evaluated through medical chart review as well as phone call follow up. Conclusions: Directional atherectomy guided by IVUS reduces clinically driven target lesion revascularization for patients with femoropopliteal in-stent restenosis. PMID:29265002

  19. Optimal qualifications, staffing and scope of practice for first responder nurses in disaster.

    PubMed

    Yin, Huahua; He, Haiyan; Arbon, Paul; Zhu, Jingci; Tan, Jing; Zhang, Limei

    2012-01-01

    To explore: the selection criteria for first responder nurses during disaster; scope of practice for disaster relief nurses; appropriate nurse - medical practitioner ratio at the disaster site. Nurses are key members of disaster response medical teams. A scarcity of literature exists relating to nurses attending disasters, their qualifications, experience, scope of practice and appropriate staffing ratios. Qualitative and quantitative data were collected via survey using self-developed questionnaires. Participants were 95 medical workers, who participated in emergency rescue teams following the 2008 Wenchuan earthquake in China. A response rate of 93·7% achieved. The questionnaire included questions relating to nurses: previous experience in disaster relief; scope of practice at the disaster site; optimal ratio of medical practitioners to nurses in disaster relief teams. Following a disaster, first responder nurses considered most suitable were those with at least three years clinical experience, particularly in the emergency department or having emergency rescue skills training. The scope of practice for disaster relief nurses was different to that of nurses working in a hospital. The majority of participants reported insufficient nurses during the relief effort, concluding the optimal ratio of medical practitioner to nurse should range between 1:1-1:2 depending on the task and situation. At the scene of disaster, the preferred first responder nurses were nurses: with emergency rescue training; experienced in the emergency department; with at least three years clinical experience. The scope of practice for first responder nurses needs to be extended. Appropriate nurse - medical practitioner ratios in responding medical teams is dependant on the specific medical requirements of the disaster. The recommendations made by this study provide a guide to ensure that nurses can contribute effectively as essential members of first responder emergency disaster relief teams. © 2011 Blackwell Publishing Ltd.

  20. Image-guided tissue engineering

    PubMed Central

    Ballyns, Jeffrey J; Bonassar, Lawrence J

    2009-01-01

    Replication of anatomic shape is a significant challenge in developing implants for regenerative medicine. This has lead to significant interest in using medical imaging techniques such as magnetic resonance imaging and computed tomography to design tissue engineered constructs. Implementation of medical imaging and computer aided design in combination with technologies for rapid prototyping of living implants enables the generation of highly reproducible constructs with spatial resolution up to 25 μm. In this paper, we review the medical imaging modalities available and a paradigm for choosing a particular imaging technique. We also present fabrication techniques and methodologies for producing cellular engineered constructs. Finally, we comment on future challenges involved with image guided tissue engineering and efforts to generate engineered constructs ready for implantation. PMID:19583811

  1. Missouri Autism Resource Guide. Fall 1998.

    ERIC Educational Resources Information Center

    Missouri State Dept. of Elementary and Secondary Education, Jefferson City.

    This resource guide provides information on organizations, publications, legislation, and other resources relating to autism. Sections include: (1) commonly used disability acronyms and definitions; (2) the educational definition of autism; (3) the medical definition of autism; (4) special education offices and special services of the Missouri…

  2. Understanding Tourette Syndrome: An Educators' Guide for the Inclusive Classroom.

    ERIC Educational Resources Information Center

    Knight, Diane

    1999-01-01

    This guide to Tourette Syndrome addresses prevalence and etiology, associated behaviors (such as obsessive-compulsive disorder and attention deficit hyperactivity disorder), treatment approaches and medication, and classroom management techniques (such as handling tic release/stress and managing hyperactivity/controlling attentional impulses). (DB)

  3. The Guide for Choosing Native American Parenting Curricula.

    ERIC Educational Resources Information Center

    Wingo, Robin R.; Mertensmeyer, Carol

    This guide is designed to help professionals working with Native American parents to be better prepared to select culturally sensitive materials, to program more effectively, and to draw from the richness within the Native American culture. The guide is one in a series of culturally specific guides produced as part of ParentLink's Review of…

  4. International Guide to Highway Transportation Information: Volume 2 - Websites

    DOT National Transportation Integrated Search

    2013-10-01

    "This guide addresses the selection and use of axle loading defaults for Mechanistic-Empirical Pavement Design Guide (MEPDG) applications. The defaults were developed based on weigh-in-motion (WIM) data from the Long- Term Pavement Performance (LTPP)...

  5. Guide for the Establishment and Evaluation of Services for Selective Dissemination of Information.

    ERIC Educational Resources Information Center

    Poncelet, J.

    This guide describes the components of a selective dissemination of information (SDI) service which is designed to give developing countries access to international sources of bibliographic information and provides guidelines for the establishment and evaluation of this type of service. It defines the main features of a computerized documentation…

  6. Reference Guide for Teaching Selected Duty Areas from Business, Marketing and Management Occupations.

    ERIC Educational Resources Information Center

    Rich, John H.

    This reference guide was designed to assist business, marketing, and management educators in locating textbook/instructional materials for use in teaching duty areas and task lists for grades 11-14. Duty areas and task lists are matched with selected textbook/instructional publications for the secretarial, general office clerk, and information…

  7. A Guide to Courseware Authoring Options in ESL/FL Instruction.

    ERIC Educational Resources Information Center

    Hampson, S. L.

    A guide to courseware authoring aids for computer-assisted language instruction (CALIS) gives suggestions for the selection and use of programing options and provides an annotated listing of those options. Introductory sections discuss the use of computer-assisted language teaching, the selection of quality courseware, the types of authoring aids…

  8. Deal or No Deal? Evaluating Big Deals and Their Journals

    ERIC Educational Resources Information Center

    Blecic, Deborah D.; Wiberley, Stephen E., Jr.; Fiscella, Joan B.; Bahnmaier-Blaszczak, Sara; Lowery, Rebecca

    2013-01-01

    This paper presents methods to develop metrics that compare Big Deal journal packages and the journals within those packages. Deal-level metrics guide selection of a Big Deal for termination. Journal-level metrics guide selection of individual subscriptions from journals previously provided by a terminated deal. The paper argues that, while the…

  9. Acquired Immune Deficiency Syndrome, AIDS: A Selected Bibliography of Federal Government Publications. Research Guide 90 104.

    ERIC Educational Resources Information Center

    Alexander, Margaret

    This research guide presents a selected bibliography of federal government publications about the Acquired Immune Deficiency Syndrome (AIDS). These documents are listed in five categories: (1) Bibliographies (7); (2) Congressional Publications (69 hearings and reports); (3) Executive Branch Publications (43 reports); (4) Federal Government…

  10. Medical and Graphic Arts Unit; a Guide to Organizing a Medical and Graphic Arts Unit in Health Science Educational Institutions. Monograph 2.

    ERIC Educational Resources Information Center

    Smith, Herbert R., Jr.

    This monograph describes the role of medical and graphic arts units within the comprehensive communications departments of health science educational institutions. Historical trends and contemporary practices are described. Suggestions are made for: organizational structure; services and activities; staff requirements; budget; facility…

  11. PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

    ERIC Educational Resources Information Center

    Office of Economic Opportunity, Washington, DC.

    HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

  12. MEDICAL LABORATORY ASSISTANT, A SUGGESTED GUIDE FOR A TRAINING PROGRAM.

    ERIC Educational Resources Information Center

    Office of Education (DHEW), Washington, DC.

    INFORMATION IS GIVEN TO ASSIST IN ORGANIZING AND ADMINISTERING A TRAINING PROGRAM FOR MEDICAL LABORATORY ASSISTANTS IN A VARIETY OF SETTINGS AND TO PROVIDE GUIDANCE IN ESTABLISHING NEW PROGRAMS AND IN EVALUATING EXISTING ONES. THE MATERIAL WAS PREPARED UNDER THE DIRECTION OF THE NATIONAL COMMITTEE FOR CAREERS IN MEDICAL TECHNOLOGY. PATHOLOGISTS…

  13. Basic Training Program for Emergency Medical Technician Ambulance: Course Guide.

    ERIC Educational Resources Information Center

    Fucigna, Joseph T.; And Others

    In an effort to upgrade or further develop the skills levels of all individuals involved in the emergency medical care service, this training program was developed for the National Highway Safety Bureau. This specific course is an attempt to organize, conduct, and standardize a basic training course for emergency medical technicians (EMTs). The…

  14. Students and Psychotropic Medication: The School's Role. A Resources Aid Packet.

    ERIC Educational Resources Information Center

    California Univ., Los Angeles. Center for Mental Health in Schools.

    School professionals encountering students on medication are confronted with a variety of procedures and issues related to medication administration, monitoring, and effects. This resource aid is designed to provide a brief overview guide to this topic and some procedural tools. Section 1 provides an overview perspective, guidelines, and tools…

  15. Development of an Instrument to Measure Medical Students' Attitudes toward People with Disabilities

    ERIC Educational Resources Information Center

    Symons, Andrew B.; Fish, Reva; McGuigan, Denise; Fox, Jeffery; Akl, Elie A.

    2012-01-01

    As curricula to improve medical students' attitudes toward people with disabilities are developed, instruments are needed to guide the process and evaluate effectiveness. The authors developed an instrument to measure medical students' attitudes toward people with disabilities. A pilot instrument with 30 items in four sections was administered to…

  16. Teaching and Learning of Medical Biochemistry According to Clinical Realities: A Case Study

    ERIC Educational Resources Information Center

    Jabaut, Joshua M.; Dudum, Ramzi; Margulies, Samantha L.; Mehta, Akshita; Han, Zhiyong

    2016-01-01

    To foster medical students to become physicians who will be lifelong independent learners and critical thinkers with healthy skepticism and provide high-quality patient care guided by the best evidence, teaching of evidence-based medicine (EBM) has become an important component of medical education. Currently, the teaching and learning of…

  17. Basic Workshops for Medical Record Clerical Personnel.

    ERIC Educational Resources Information Center

    Intermountain Regional Medical Program, Salt Lake City, UT.

    This curriculum guide is an outline of the content for basic workshop training sessions of hospital medical record personnel. Following a two-page topical outline of five content areas, there is a detailed presentation of this content as follows: (1) the medical record and its contribution to patient care (Joint Commission for Accreditation of…

  18. YouTube videos as a teaching tool and patient resource for infantile spasms.

    PubMed

    Fat, Mary Jane Lim; Doja, Asif; Barrowman, Nick; Sell, Erick

    2011-07-01

    The purpose of this study was to assess YouTube videos for their efficacy as a patient resource for infantile spasms. Videos were searched using the terms infantile spasm, spasm, epileptic spasm, and West syndrome. The top 25 videos under each term were selected according to set criteria. Technical quality, diagnosis of infantile spasms, and suitability as a teaching resource were assessed by 2 neurologists using the Medical Video Rating Scale. There were 5858 videos found. Of the 100 top videos, 46% did not meet selection criteria. Mean rating for technical quality was 4.0 of 5 for rater 1 and 3.9 of 5 for rater 2. Raters found 60% and 64% of videos to accurately portray infantile spasms, respectively, with significant agreement (Cohen κ coefficient = 0.75, P < .001). Ten videos were considered excellent examples (grading of 5 of 5) by at least 1 rater. YouTube may be used as an excellent patient resource for infantile spasms if guided search practices are followed.

  19. In search of patient characteristics that may guide empirically based treatment selection for personality disorder patients-a concept map approach.

    PubMed

    van Manen, J G; Kamphuis, J H; Goossensen, A; Timman, R; Busschbach, J J V; Verheul, R

    2012-08-01

    Using the concept map method, this study aimed to summarize and describe patient characteristics pertinent to treatment selection for patients with personality disorders (PDs). Initial patient characteristics were derived from the research literature and a survey among Dutch expert clinicians. Concept mapping is a formalized conceptualization procedure that describes the underlying cognitive structures people use in complex tasks, such as treatment allocation. Based on expert opinions of 29 Dutch clinicians, a concept map was generated that yielded eight domains of patient characteristics, i.e., Severity of symptoms, Severity of personality pathology, Ego-adaptive capacities, Motivation and working alliance, Social context, Social demographic characteristics, Trauma, and Treatment history and medical condition. These domains can be ordered along two bipolar axes, running from internal to external concepts and from vulnerability to strength concepts, respectively. Our findings may serve as input for the delineation of algorithms for patient-treatment matching research in PD.

  20. Selected list of books and journals in allied health *

    PubMed Central

    Brandon, Alfred N.; Hill, Dorothy R.

    1996-01-01

    This list of 410 books and 76 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and described in the AMA's Allied Health and Rehabilitation Professions Education Directory, plus physical therapy, dental allied health, medical secretarial, nutrition, and speech pathology/audiology programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (163 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1996 subscriptions) would require an expenditure of about $26,740. The cost of only the asterisked items totals $11,160. PMID:16018053

  1. Brandon/Hill selected list of books and journals in allied health.

    PubMed Central

    Hill, D R; Stickell, H N

    1998-01-01

    This list of 410 books and 78 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and described in the AMA's Health Professions Education Directory, 1997-1998, plus physical therapist and medical secretary. Some programs do not have their own specific literatures. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (160 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1998 subscriptions) would require an expenditure of about $29,180. The cost of only the asterisked items total $11,390. PMID:9803286

  2. Brandon/Hill selected list of books and journals in allied health.

    PubMed

    Hill, D R; Stickell, H N

    1998-10-01

    This list of 410 books and 78 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and described in the AMA's Health Professions Education Directory, 1997-1998, plus physical therapist and medical secretary. Some programs do not have their own specific literatures. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (160 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1998 subscriptions) would require an expenditure of about $29,180. The cost of only the asterisked items total $11,390.

  3. DNA-Templated Introduction of an Aldehyde Handle in Proteins.

    PubMed

    Kodal, Anne Louise B; Rosen, Christian B; Mortensen, Michael R; Tørring, Thomas; Gothelf, Kurt V

    2016-07-15

    Many medical and biotechnological applications rely on protein labeling, but a key challenge is the production of homogeneous and site-specific conjugates. This can rarely be achieved by simple residue-specific random labeling, but generally requires genetic engineering. Using site-selective DNA-templated reductive amination, we created DNA-protein conjugates with control over labeling stoichiometry and without genetic engineering. A guiding DNA strand with a metal-binding functionality facilitates site-selectivity by directing the coupling of a second reactive DNA strand in the vicinity of a protein metal-binding site. We demonstrate DNA-templated reductive amination for His6 -tagged proteins and metal-binding proteins, including IgG1 antibodies. We also used a cleavable linker between the DNA and the protein to remove the DNA and introduce a single aldehyde on the protein. This functions as a handle for further modifications with desired labels. In addition to directing the aldehyde positioning, the DNA provides a straightforward route for purification between reaction steps. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Motivation in medical education.

    PubMed

    Pelaccia, Thierry; Viau, Rolland

    2017-02-01

    Motivation is a concept which has fascinated researchers for many decades. The field of medical education has become interested in motivation recently, having always assumed that medical students must be motivated because of their commitment to highly specific training, leading to a very specific profession. However, motivation is a major determinant of the quality of learning and success, the lack of which may well explain why teachers sometimes observe medical students who are discouraged, have lost interest or abandon their studies, with a feeling of powerlessness or resignation. After describing the importance of motivation for learning in medicine, this Guide will define the concept of motivation, setting it within the context of a social cognitive approach. In the second part of this Guide, recommendations are made, based upon the so-called "motivational dynamic model", which provides a multitude of various strategies with positive effects on students' motivation to learn.

  5. Reliability of the American Medical Association guides' model for measuring spinal range of motion. Its implication for whole-person impairment rating.

    PubMed

    Nitschke, J E; Nattrass, C L; Disler, P B; Chou, M J; Ooi, K T

    1999-02-01

    Repeated measures design for intra- and interrater reliability. To determine the intra- and interrater reliability of the lumbar spine range of motion measured with a dual inclinometer, and the thoracolumbar spine range of motion measured with a long-arm goniometer, as recommended in the American Medical Association Guides. The American Medical Association Guides (2nd and 4th editions) recommend using measurements of thoracolumbar and lumbar range of movement, respectively, to estimate the percentage of permanent impairment in patients with chronic low back pain. However, the reliability of this method of estimating impairment has not been determined. In all, 34 subjects participated in the study, 21 women with a mean age of 40.1 years (SD, +/- 11.1) and 13 men with a mean age of 47.7 years (SD, +/- 12.1). Measures of thoracolumbar flexion, extension, lateral flexion, and rotation were obtained with a long-arm goniometer. Lumbar flexion, extension, and lateral flexion were measured with a dual inclinometer. Measurements were taken by two examiners on one occasion and by one examiner on two occasions approximately 1 week apart. The results showed poor intra- and interrater reliability for all measurements taken with both instruments. Measurement error expressed in degrees showed that measurements taken by different raters exhibited systematic as well as random differences. As a result, subjects measured by two different examiners on the same day, with either instrument, could give impairment ratings ranging between 0% and 18% of the whole person (excluding rotation), in which percentage impairment is calculated using the average range of motion and the average systematic and random error in degrees for the group for each movement (flexion, extension, and lateral flexion). The poor reliability of the American Medical Association Guides' spinal range of motion model can result in marked variation in the percentage of whole-body impairment. These findings have implications for compensation bodies in Australia and other countries that use the American Medical Association Guides' procedure to estimate impairment in chronic low back pain patients.

  6. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment.

    PubMed

    Ellaway, Rachel; Masters, Ken

    2008-06-01

    In just a few years, e-learning has become part of the mainstream in medical education. While e-learning means many things to many people, at its heart it is concerned with the educational uses of technology. For the purposes of this guide, we consider the many ways that the information revolution has affected and remediated the practice of healthcare teaching and learning. Deploying new technologies usually introduces tensions, and e-learning is no exception. Some wish to use it merely to perform pre-existing activities more efficiently or faster. Others pursue new ways of thinking and working that the use of such technology affords them. Simultaneously, while education, not technology, is the prime goal (and for healthcare, better patient outcomes), we are also aware that we cannot always predict outcomes. Sometimes, we have to take risks, and 'see what happens.' Serendipity often adds to the excitement of teaching. It certainly adds to the excitement of learning. The use of technology in support of education is not, therefore, a causal or engineered set of practices; rather, it requires creativity and adaptability in response to the specific and changing contexts in which it is used. Medical Education, as with most fields, is grappling with these tensions; the AMEE Guide to e-Learning in Medical Education hopes to help the reader, whether novice or expert, navigate them. This Guide is presented both as an introduction to the novice, and as a resource to more experienced practitioners. It covers a wide range of topics, some in broad outline, and others in more detail. Each section is concluded with a brief 'Take Home Message' which serves as a short summary of the section. The Guide is divided into two parts. The first part introduces the basic concepts of e-learning, e-teaching, and e-assessment, and then focuses on the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. The second part examines technical, management, social, design and other broader issues in e-learning, and it ends with a review of emerging forms and directions in e-learning in medical education.

  7. Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

    PubMed

    Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

    2015-11-01

    There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

  8. Targeted Radiation Therapy for Cancer Initiative

    DTIC Science & Technology

    2016-09-01

    grant continues to facilitate continuing medical education for the staff at MAMC on image -guided radiotherapy. A site visit to the Varian Medical ...CONTRACTING ORGANIZATION: Geneva Foundation Tacoma, WA REPORT DATE: September 2016 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research...98402 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort

  9. TH-AB-BRA-02: Automated Triplet Beam Orientation Optimization for MRI-Guided Co-60 Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nguyen, D; Thomas, D; Cao, M

    2016-06-15

    Purpose: MRI guided Co-60 provides daily and intrafractional MRI soft tissue imaging for improved target tracking and adaptive radiotherapy. To remedy the low output limitation, the system uses three Co-60 sources at 120° apart, but using all three sources in planning is considerably unintuitive. We automate the beam orientation optimization using column generation, and then solve a novel fluence map optimization (FMO) problem while regularizing the number of MLC segments. Methods: Three patients—1 prostate (PRT), 1 lung (LNG), and 1 head-and-neck boost plan (H&NBoost)—were evaluated. The beamlet dose for 180 equally spaced coplanar beams under 0.35 T magnetic field wasmore » calculated using Monte Carlo. The 60 triplets were selected utilizing the column generation algorithm. The FMO problem was formulated using an L2-norm minimization with anisotropic total variation (TV) regularization term, which allows for control over the number of MLC segments. Our Fluence Regularized and Optimized Selection of Triplets (FROST) plans were compared against the clinical treatment plans (CLN) produced by an experienced dosimetrist. Results: The mean PTV D95, D98, and D99 differ by −0.02%, +0.12%, and +0.44% of the prescription dose between planning methods, showing same PTV dose coverage. The mean PTV homogeneity (D95/D5) was at 0.9360 (FROST) and 0.9356 (CLN). R50 decreased by 0.07 with FROST. On average, FROST reduced Dmax and Dmean of OARs by 6.56% and 5.86% of the prescription dose. The manual CLN planning required iterative trial and error runs which is very time consuming, while FROST required minimal human intervention. Conclusions: MRI guided Co-60 therapy needs the output of all sources yet suffers from unintuitive and laborious manual beam selection processes. Automated triplet orientation optimization is shown essential to overcome the difficulty and improves the dosimetry. A novel FMO with regularization provides additional controls over the number of MLC segments and treatment time. Varian Medical Systems; NIH grant R01CA188300; NIH grant R43CA183390.« less

  10. Efficacy of video-guided laryngoscope in airway management skills of medical students.

    PubMed

    Peirovifar, Ali; Mahmoodpoor, Ata; Golzari, Samad Ej; Soleimanpour, Hassan; Eslampour, Yashar; Fattahi, Vahid

    2014-10-01

    Video-guided laryngoscopy, though unproven in achieving better success rates of laryngoscopy outcome and intubation, seems to provide better glottic visualization compared with direct laryngoscopy. The objective of this study was to compare the efficacy of video-guided laryngoscope (VGL) in the airway management skills of medical students. Medical students throughout their anesthesiology rotations were enrolled in this study. All students received standard training in the airway management during their course and were randomly allocated into two 20 person groups. In Group D, airway management was performed by direct laryngoscopy via Macintosh blade and in Group G intubation was performed via VGL. Time to intubation, number of laryngoscopy attempts and success rate were noted. Successful intubation was considered as the primary outcome. All data were analyzed using SPSS 16 software. Chi-square and Fisher's exact test were used for analysis of categorical variables. For analyzing continuous variables independent t-test was used. P < 0.05 was considered as statistically significant. Number of laryngoscopy attempts was less in Group G in comparison to Group D; this, however, was statistically insignificant (P: 0.18). Time to intubation was significantly less in Group G as compared to Group D (P: 0.02). Successful intubation in Group G was less frequently when compared to Group D (P: 0.66). Need for attending intervention, esophageal intubation and hypoxemic events during laryngoscopy were less in Group G; this, however, was statistically insignificant. The use of video-guided laryngoscopy improved the first attempt success rate, time to intubation, laryngoscopy attempts and airway management ability of medical students compared to direct laryngoscopy.

  11. Explaining the role of organizational culture on succession-planning at the Ministry of Health and Medical Education: A qualitative study

    PubMed Central

    Mehrtak, Mohammad; Farzaneh, Esmaeil; Habibzadeh, Shahram; Kamran, Aziz; Zandian, Hamed; Mahdavi, Abdollah

    2017-01-01

    Background Developing and guiding new knowledge are futile unless the organizational culture can also be transformed. Future leaders cannot emerge out of an organizational environment that is not conducive to the accumulation of experiences. Objective The aim of this study was to explore the role of organizational culture in creating a succession-planning system at the Ministry of Health and Medical Education in 2014. Methods The present qualitative framework analysis held interviews with 23 director generals, administrative directors and deputies from the headquarters of the Iranian Ministry of Health and Medical Education in 2014 who were selected through snowball sampling. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive techniques. Results The cultural factors affecting succession-planning at the Ministry of Health and Medical Education were identified and classified under three main areas, including the cultural factors related to the directors with four themes (Directors’ job security, Constructive competition, Transparency and trust development, Creating opportunities), to the personnel with four themes (Organizational identity and loyalty, Trust in the organization, Talent and merit, Peer envy) and to the system with two themes (Values and beliefs, Politicization). Conclusion Findings of the study show that establishment and institutionalization of the succession planning to the Ministry of Health and Medical Education is deeply affected by the components of organizational culture. Accordingly, unprofessional organization culture can deprive the organization of numerous advantages in multiple-succession planning. PMID:29403623

  12. Explaining the role of organizational culture on succession-planning at the Ministry of Health and Medical Education: A qualitative study.

    PubMed

    Mehrtak, Mohammad; Farzaneh, Esmaeil; Habibzadeh, Shahram; Kamran, Aziz; Zandian, Hamed; Mahdavi, Abdollah

    2017-11-01

    Developing and guiding new knowledge are futile unless the organizational culture can also be transformed. Future leaders cannot emerge out of an organizational environment that is not conducive to the accumulation of experiences. The aim of this study was to explore the role of organizational culture in creating a succession-planning system at the Ministry of Health and Medical Education in 2014. The present qualitative framework analysis held interviews with 23 director generals, administrative directors and deputies from the headquarters of the Iranian Ministry of Health and Medical Education in 2014 who were selected through snowball sampling. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive techniques. The cultural factors affecting succession-planning at the Ministry of Health and Medical Education were identified and classified under three main areas, including the cultural factors related to the directors with four themes (Directors' job security, Constructive competition, Transparency and trust development, Creating opportunities), to the personnel with four themes (Organizational identity and loyalty, Trust in the organization, Talent and merit, Peer envy) and to the system with two themes (Values and beliefs, Politicization). Findings of the study show that establishment and institutionalization of the succession planning to the Ministry of Health and Medical Education is deeply affected by the components of organizational culture. Accordingly, unprofessional organization culture can deprive the organization of numerous advantages in multiple-succession planning.

  13. Minnesota Career Focus. Careers & Training: A Guide for Adults.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Economic Security, St. Paul.

    This guide to Minnesota training resources for adults seeking new employment opportunities provides an overview of careers, wages, job availability, and necessary training. Occupations are described in these areas: medical careers; office professions; technical careers; art, writing, and media careers; service careers---food, hair, police;…

  14. Health Occupations Education--A Curriculum Guide.

    ERIC Educational Resources Information Center

    Clanton, Kaye Reames

    Developed to provide curriculum materials that secondary Health Occupations Education (HOE) teachers/coordinators can use in organizing their individual programs, this curriculum guide contains performance-based units covering the majority of a four-semester program of study in HOE. The following topics are covered: medical ethics, law, and…

  15. Postoperative seizure outcome-guided machine learning for interictal electrocorticography in neocortical epilepsy.

    PubMed

    Park, Seong-Cheol; Chung, Chun Kee

    2018-06-01

    The objective of this study was to introduce a new machine learning guided by outcome of resective epilepsy surgery defined as the presence/absence of seizures to improve data mining for interictal pathological activities in neocortical epilepsy. Electrocorticographies for 39 patients with medically intractable neocortical epilepsy were analyzed. We separately analyzed 38 frequencies from 0.9 to 800 Hz including both high-frequency activities and low-frequency activities to select bands related to seizure outcome. An automatic detector using amplitude-duration-number thresholds was used. Interictal electrocorticography data sets of 8 min for each patient were selected. In the first training data set of 20 patients, the automatic detector was optimized to best differentiate the seizure-free group from not-seizure-free-group based on ranks of resection percentages of activities detected using a genetic algorithm. The optimization was validated in a different data set of 19 patients. There were 16 (41%) seizure-free patients. The mean follow-up duration was 21 ± 11 mo (range, 13-44 mo). After validation, frequencies significantly related to seizure outcome were 5.8, 8.4-25, 30, 36, 52, and 75 among low-frequency activities and 108 and 800 Hz among high-frequency activities. Resection for 5.8, 8.4-25, 108, and 800 Hz activities consistently improved seizure outcome. Resection effects of 17-36, 52, and 75 Hz activities on seizure outcome were variable according to thresholds. We developed and validated an automated detector for monitoring interictal pathological and inhibitory/physiological activities in neocortical epilepsy using a data-driven approach through outcome-guided machine learning. NEW & NOTEWORTHY Outcome-guided machine learning based on seizure outcome was used to improve detections for interictal electrocorticographic low- and high-frequency activities. This method resulted in better separation of seizure outcome groups than others reported in the literature. The automatic detector can be trained without human intervention and no prior information. It is based only on objective seizure outcome data without relying on an expert's manual annotations. Using the method, we could find and characterize pathological and inhibitory activities.

  16. Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

    DOT National Transportation Integrated Search

    2007-01-01

    This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting : effective, science-based traffic safety countermeasures for major highway safety problem areas. : The guide describes major strategies and countermeasures t...

  17. Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

    DOT National Transportation Integrated Search

    2005-01-01

    This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

  18. Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

    DOT National Transportation Integrated Search

    2009-01-01

    This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

  19. Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

    DOT National Transportation Integrated Search

    2008-01-01

    This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

  20. Producing a socially accountable medical school: AMEE Guide No. 109.

    PubMed

    Boelen, Charles; Pearson, David; Kaufman, Arthur; Rourke, James; Woollard, Robert; Marsh, David C; Gibbs, Trevor

    2016-11-01

    Health systems worldwide are confronted with challenges due to increased demand from their citizens, an aging population, a variety of health risks and limited resources. Key health stakeholders, including academic institutions and medical schools, are urged to develop a common vision for a more efficient and equitable health sector. It is in this environment that Boelen and Heck defined the concept of the "Social Accountability of Medical Schools" - a concept that encourages schools to produce not just highly competent professionals, but professionals who are equipped to respond to the changing challenges of healthcare through re-orientation of their education, research and service commitments, and be capable of demonstrating a positive effect upon the communities they serve. Social Accountability calls on the academic institution to demonstrate an impact on the communities served and thus make a contribution for a just and efficient health service, through mutually beneficial partnerships with other healthcare stakeholders. The purpose of this Guide is to explore the concept of Social Accountability, to explain it in more detail through examples and to identify ways to overcome obstacles to its development. Although in the Guide reference is frequently made to medical schools, the concept is equally applicable to all forms of education allied to healthcare.

  1. The learning environment in remediation: a review.

    PubMed

    Cleland, Jennifer; Cilliers, Francois; van Schalkwyk, Susan

    2018-02-01

    The focus of this concise article is how best to support students to achieve success at medical school. Our aim is not to provide a guide to remediating under-performance in medical students. This, in our view, implies an approach that fundamentally is about quick fixes for addressing individual student deficits, such as intensive coaching of clinical skills to help a student scrape through a resit examination. Instead, we believe that student success is not solely the result of individual factors but rather relies on a complex range of factors, including the provision of a supportive environment. We drew on our knowledge of a wide range of literature related to remediation and other medical education structures and functions. Our aim was to take a different perspective on the different dimensions of 'remediation' - the structural, curricular, ideological and individual - to consider how best to provide a supportive environment for all learners to progress towards the required outcomes. Medical students are becoming increasingly diverse and medical curricula must create learning environments that support all students to thrive. Effective remediation should not be about intensive 'teaching to test' after examination failure. Rather, both the context and the individual have a role to play in ensuring the selection, teaching, assessment and feedback practices support the learning journeys of individuals. We provide guidance for faculty member development and engaging with students to help achieve this goal. Effective remediation should not be about intensive 'teaching to test' after examination failure. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. Requirements for Medical Modeling Languages

    PubMed Central

    van der Maas, Arnoud A.F.; Ter Hofstede, Arthur H.M.; Ten Hoopen, A. Johannes

    2001-01-01

    Objective: The development of tailor-made domain-specific modeling languages is sometimes desirable in medical informatics. Naturally, the development of such languages should be guided. The purpose of this article is to introduce a set of requirements for such languages and show their application in analyzing and comparing existing modeling languages. Design: The requirements arise from the practical experience of the authors and others in the development of modeling languages in both general informatics and medical informatics. The requirements initially emerged from the analysis of information modeling techniques. The requirements are designed to be orthogonal, i.e., one requirement can be violated without violation of the others. Results: The proposed requirements for any modeling language are that it be “formal” with regard to syntax and semantics, “conceptual,” “expressive,” “comprehensible,” “suitable,” and “executable.” The requirements are illustrated using both the medical logic modules of the Arden Syntax as a running example and selected examples from other modeling languages. Conclusion: Activity diagrams of the Unified Modeling Language, task structures for work flows, and Petri nets are discussed with regard to the list of requirements, and various tradeoffs are thus made explicit. It is concluded that this set of requirements has the potential to play a vital role in both the evaluation of existing domain-specific languages and the development of new ones. PMID:11230383

  3. [Demand for environmental medical advice at public health offices: experiences in the district aachen public health office].

    PubMed

    Wiesmüller, G A; Etschenberg, W; Koch, T; Konteye, C; Zahmel, J

    2002-03-01

    Since November, 1999 environmental medical advice is offered to interested citizens in the Aachen district at the District Aachen Public Health Office in cooperation with the outpatient unit of environmental medicine (UEM) of the Institute of Hygiene and Environmental Medicine of the University Hospital at Aachen, Germany. Advisory cases are documented in a data bank of Microsoft(R) Access 97. Until now, all advisory cases between November, 1999 and March, 2001 have been descriptively analysed. In this period, 34 personal and two telephonic advices were performed. The frequency of advisory activities is in the lower rang of published experiences in environmental medicine. Age distribution, more frequent advice utilization by women than by men and predominance of unspecific health disorders are comparable with published environmental medical experiences. However, in respect of suspected exposures, unspecific indoor-related environmental factors are predominant. In the past this was true for wood preservatives. Judgement about possible relationships between suspected environmental factors and health disorders or diseases was positive among 11.8 % of the persons seeking advice. This percentage is higher than published experiences which mostly show values below 10 %. It must be considered that this judgement depends primarily on the physician. Other reasons may be the too small number of advice seeking persons and selective influences. Furthermore, a definite judgement can be made only after environmental medical diagnostics (biological monitoring, local inspection, ambient monitoring) and differential diagnostics. Conspicuously, 76.5 % of the advisory cases had no contact to environmental medicine prior to the environmental medical advice at the Aachen District Public Health Office. This points to an information deficit about possibilities to clarify questions concerning environmental medicine in the population. In this context a regional guide on environmental medicine may be helpful. The environmental medical advice for citizens is an excellent example of a successful cooperation between a public health office and an university, which have different special experience in environmental hygiene and environmental medicine. This cooperation brings selectively citizens seeking for advice in environment-related health risks and disorders to practitioners specialised in environmental medicine.

  4. Health Education a Conceptual Approach. Growing and Developing, Interacting, Decision Making. Concept 10: Food Selecting and Eating Patterns Are Determined by Physical, Social, Mental, Economic, and Cultural Factors. Teacher-Student Resources.

    ERIC Educational Resources Information Center

    Creswell, William H., Jr.; And Others

    The following resource guide is one in a series which presents extensive bibliographic material oriented around a specific concept, in this guide, food selection and eating patterns. A section is devoted to selected materials related to the concept; grade levels for which each resource might be useful are indicated beside each citation. A second…

  5. Systematic Review Methodology for the Fatigue in Emergency Medical Services Project

    DOT National Transportation Integrated Search

    2018-01-11

    Background: Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available e...

  6. User's guide for the Skylab integrated medical data analysis system

    NASA Technical Reports Server (NTRS)

    Grounds, D. J.; Archer, G. T.; Marks, V. J.

    1975-01-01

    Capabilities of the Skylab Integrated Medical Data Analysis System (SIMDAS) are described and illustrated. User's instructions are also given for the operation of this system on the UNIVAC 1100 Series Demand System at the Johnson Space Center.

  7. 21 CFR 208.20 - Content and format of a Medication Guide.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) A statement of the risks to mothers and fetuses from the use of the drug during pregnancy, if... approved under section 505 of the act, the following verbatim statement: “Call your doctor for medical...

  8. 21 CFR 208.20 - Content and format of a Medication Guide.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) A statement of the risks to mothers and fetuses from the use of the drug during pregnancy, if... approved under section 505 of the act, the following verbatim statement: “Call your doctor for medical...

  9. 21 CFR 208.20 - Content and format of a Medication Guide.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) A statement of the risks to mothers and fetuses from the use of the drug during pregnancy, if... approved under section 505 of the act, the following verbatim statement: “Call your doctor for medical...

  10. 21 CFR 208.20 - Content and format of a Medication Guide.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) A statement of the risks to mothers and fetuses from the use of the drug during pregnancy, if... approved under section 505 of the act, the following verbatim statement: “Call your doctor for medical...

  11. A unique contact lens-related airline aircraft accident : final report.

    DOT National Transportation Integrated Search

    2000-05-01

    INTRODUCTION. The use of contact lenses to satisfy the distant visual acuity requirements for obtaining a civil airman medical certificate has been permitted since 1976. According to the Federal Aviation Administration's "Guide for Aviation Medical E...

  12. Generic Medications: Are They the Same?

    MedlinePlus

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  13. Patient selection for day case-eligible surgery: identifying those at high risk for major complications.

    PubMed

    Mathis, Michael R; Naughton, Norah N; Shanks, Amy M; Freundlich, Robert E; Pannucci, Christopher J; Chu, Yijia; Haus, Jason; Morris, Michelle; Kheterpal, Sachin

    2013-12-01

    Due to economic pressures and improvements in perioperative care, outpatient surgical procedures have become commonplace. However, risk factors for outpatient surgical morbidity and mortality remain unclear. There are no multicenter clinical data guiding patient selection for outpatient surgery. The authors hypothesize that specific risk factors increase the likelihood of day case-eligible surgical morbidity or mortality. The authors analyzed adults undergoing common day case-eligible surgical procedures by using the American College of Surgeons' National Surgical Quality Improvement Program database from 2005 to 2010. Common day case-eligible surgical procedures were identified as the most common outpatient surgical Current Procedural Terminology codes provided by Blue Cross Blue Shield of Michigan and Medicare publications. Study variables included anthropometric data and relevant medical comorbidities. The primary outcome was morbidity or mortality within 72 h. Intraoperative complications included adverse cardiovascular events; postoperative complications included surgical, anesthetic, and medical adverse events. Of 244,397 surgeries studied, 232 (0.1%) experienced early perioperative morbidity or mortality. Seven independent risk factors were identified while controlling for surgical complexity: overweight body mass index, obese body mass index, chronic obstructive pulmonary disease, history of transient ischemic attack/stroke, hypertension, previous cardiac surgical intervention, and prolonged operative time. The demonstrated low rate of perioperative morbidity and mortality confirms the safety of current day case-eligible surgeries. The authors obtained the first prospectively collected data identifying risk factors for morbidity and mortality with day case-eligible surgery. The results of the study provide new data to advance patient-selection processes for outpatient surgery.

  14. Self-Assessment of Graduate Programs in the Biomedical Sciences: Narrative Guide and Companion Survey Instruments. Report of the Task Force on Benchmarks of Success in Graduate Programs: AAMC GREAT Group.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    The purpose of this guide, developed by the Association of American Medical Colleges group on Graduate Research, Education, and Training (GREAT), is to outline a model process by which graduate programs can measure program success and that can be adapted to particular circumstances and priorities. The first sections of the guide examine the…

  15. Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey.

    PubMed

    Fleet, Richard; Poitras, Julien; Archambault, Patrick; Tounkara, Fatoumata Korika; Chauny, Jean-Marc; Ouimet, Mathieu; Gauthier, Josée; Dupuis, Gilles; Tanguay, Alain; Lévesque, Jean-Frédéric; Simard-Racine, Geneviève; Haggerty, Jeannie; Légaré, France

    2015-12-23

    Rural emergency departments (EDs) constitute crucial safety nets for the 20% of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED management Guide". The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide. We selected EDs offering 24/7 medical coverage, with hospitalization beds, located in rural or small towns. We collected data via telephone, paper, and online surveys with rural ED/hospital staff. Data were also collected from Québec's Ministry of Health databases and from Statistics Canada. We computed descriptive statistics, ANOVA and t-tests were used to examine the relationship between ED census, services and inter-facility transfer requirements. A total of 23 of Québec's 26 rural EDs (88%) consented to participate in the study. The mean annual ED visits was 18 813 (Standard Deviation = 6 151). Thirty one percent of ED physicians were recent graduates with fewer than 5 years of experience. Only 6 % had residency training or certification in emergency medicine. Teams have good local access (24/7) to diagnostic equipment such as CT scanner (74%), intensive unit care (78%) and general surgical services (78%), but limited access to other consultants. Sixty one percent of participants have reported good knowledge of the provincial ED management Guide, but only 23% of them have used the guidelines. Furthermore, more than 40% of EDs were more than 300 km from levels 1 to 2 trauma centers, and only 30% had air transport access. Rural EDs in Québec are staffed by relatively new graduates working as solo physicians in well-resourced and moderately busy (by rural standards) EDs. The provincial ED management Guide may have contributed to this model of service attribution. However, the majority of rural ED staff report limited knowledge or use of the provincial ED management Guide and increased efforts at disseminating this Guide are warranted.

  16. Increasing Planting Stock by Family Selection in California Ponderosa Pine

    Treesearch

    James L. Jenkison

    1975-01-01

    In the absence of test information to the contrary, the accepted guide for selecting seed for reforestation is "local source is best." This guide prevents plantation failures that result from using stock that is not adapted to the local environment, and it reflects the pronounced variation in growth and survival demonstrated in provenance trials (Silen 1970...

  17. How To Select an Event Management System: A Guide to Selecting the Most Effective Resource Management System for College Union and Student Activities Professionals.

    ERIC Educational Resources Information Center

    Anderson, Scott; Raasch, Kevin

    2002-01-01

    Provides an evaluation template for student activities professionals charged with evaluating competitive event scheduling software. Guides staff in making an informed decision on whether to retain event management technology provided through an existing vendor or choose "best-of-breed" scheduling software. (EV)

  18. Making the Most of Your School Site. School Buildings Planning, Design, and Construction Series No. 2.

    ERIC Educational Resources Information Center

    Odell, John H.

    A school construction guide offers key personnel in school development projects information on the complex task of master planning and construction of schools in Australia. This chapter of the guide provides advice on site selection covering selection criteria; traffic issues; and site services, such as water, power, and sewer. Additionally…

  19. A Selected Bibliography of Dictionaries. General Information Series, No. 9. Indochinese Refugee Education Guides.

    ERIC Educational Resources Information Center

    Center for Applied Linguistics, Arlington, VA.

    This is a selected, annotated bibliography of dictionaries useful to Indochinese refugees. The purpose of this guide is to provide the American teacher or sponsor with information on the use, limitations and availability of monolingual and bilingual dictionaries which can be used by refugees. The bibliography is preceded by notes on problems with…

  20. Countermeasures that work : a highway safety countermeasure guide for state highway safety offices, fifth edition, 2010.

    DOT National Transportation Integrated Search

    2010-01-01

    This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting : effective, science-based traffic safety countermeasures for major highway safety problem areas. : The guide: : o describes major strategies and countermeasu...

  1. A Parent Guide To Understanding the Effects of Ritalin (Methylphenidate Hydrochloride).

    ERIC Educational Resources Information Center

    Villegas, Orlando; And Others

    This guide provides information to help parents decide whether their child with attention deficit hyperactivity disorder (ADHD) should take methylphenidate hydrochloride (Ritalin). Information is provided in a question-and-answer format on various concerns, including: the meaning of ADHD, whether Ritalin is overprescribed, when this medication is…

  2. The Harvard Medical School Guide to Suicide Assessment and Intervention. First Edition.

    ERIC Educational Resources Information Center

    Jacobs, Douglas G., Ed.

    Written by several experts, this multidimensional compendium of current research and thought provides a hands-on guide for psychiatrists, psychotherapists, primary care physicians, counselors, and other professionals faced with the need to assess risk and relate to potentially suicidal clients. Part 1, "Assessment," includes two…

  3. Topic Outlines in Microbiology: An Instructor's Guide for Junior and Community Colleges.

    ERIC Educational Resources Information Center

    American Society for Microbiology, Washington, DC.

    This resource guide presents subject matter organized in outline form for four topical areas: introductory microbiology; medical microbiology; microbial genetics; and microbial physiology. The first two units comprise the two most frequently taught microbiology courses in community and junior colleges. The outlines for microbial genetics and…

  4. Validating the Modified Drug Adherence Work-Up (M-DRAW) Tool to Identify and Address Barriers to Medication Adherence.

    PubMed

    Lee, Sun; Bae, Yuna H; Worley, Marcia; Law, Anandi

    2017-09-08

    Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW) was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often). The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity) in patients taking one or more prescription medication(s) for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 "adherers" (65.4%), and into the intervention group of nine "unintentional and intentional non-adherers" (34.6%). Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74) for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p < 0.05). The current study did not investigate construct validity due to small sample size and challenges on follow-up with patients. Future testing of the tool will include construct validation.

  5. A Machine Learning Approach to Identifying Placebo Responders in Late-Life Depression Trials.

    PubMed

    Zilcha-Mano, Sigal; Roose, Steven P; Brown, Patrick J; Rutherford, Bret R

    2018-01-11

    Despite efforts to identify characteristics associated with medication-placebo differences in antidepressant trials, few consistent findings have emerged to guide participant selection in drug development settings and differential therapeutics in clinical practice. Limitations in the methodologies used, particularly searching for a single moderator while treating all other variables as noise, may partially explain the failure to generate consistent results. The present study tested whether interactions between pretreatment patient characteristics, rather than a single-variable solution, may better predict who is most likely to benefit from placebo versus medication. Data were analyzed from 174 patients aged 75 years and older with unipolar depression who were randomly assigned to citalopram or placebo. Model-based recursive partitioning analysis was conducted to identify the most robust significant moderators of placebo versus citalopram response. The greatest signal detection between medication and placebo in favor of medication was among patients with fewer years of education (≤12) who suffered from a longer duration of depression since their first episode (>3.47 years) (B = 2.53, t(32) = 3.01, p = 0.004). Compared with medication, placebo had the greatest response for those who were more educated (>12 years), to the point where placebo almost outperformed medication (B = -0.57, t(96) = -1.90, p = 0.06). Machine learning approaches capable of evaluating the contributions of multiple predictor variables may be a promising methodology for identifying placebo versus medication responders. Duration of depression and education should be considered in the efforts to modulate placebo magnitude in drug development settings and in clinical practice. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Applying quantitative benefit-risk analysis to aid regulatory decision making in diagnostic imaging: methods, challenges, and opportunities.

    PubMed

    Agapova, Maria; Devine, Emily Beth; Bresnahan, Brian W; Higashi, Mitchell K; Garrison, Louis P

    2014-09-01

    Health agencies making regulatory marketing-authorization decisions use qualitative and quantitative approaches to assess expected benefits and expected risks associated with medical interventions. There is, however, no universal standard approach that regulatory agencies consistently use to conduct benefit-risk assessment (BRA) for pharmaceuticals or medical devices, including for imaging technologies. Economics, health services research, and health outcomes research use quantitative approaches to elicit preferences of stakeholders, identify priorities, and model health conditions and health intervention effects. Challenges to BRA in medical devices are outlined, highlighting additional barriers in radiology. Three quantitative methods--multi-criteria decision analysis, health outcomes modeling and stated-choice survey--are assessed using criteria that are important in balancing benefits and risks of medical devices and imaging technologies. To be useful in regulatory BRA, quantitative methods need to: aggregate multiple benefits and risks, incorporate qualitative considerations, account for uncertainty, and make clear whose preferences/priorities are being used. Each quantitative method performs differently across these criteria and little is known about how BRA estimates and conclusions vary by approach. While no specific quantitative method is likely to be the strongest in all of the important areas, quantitative methods may have a place in BRA of medical devices and radiology. Quantitative BRA approaches have been more widely applied in medicines, with fewer BRAs in devices. Despite substantial differences in characteristics of pharmaceuticals and devices, BRA methods may be as applicable to medical devices and imaging technologies as they are to pharmaceuticals. Further research to guide the development and selection of quantitative BRA methods for medical devices and imaging technologies is needed. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  7. Let's 'play' with molecular pharmacology.

    PubMed

    Choudhury, Supriyo; Pradhan, Richeek; Sengupta, Gairik; Das, Manisha; Chatterjee, Manojit; Roy, Ranendra Kumar; Chatterjee, Suparna

    2015-01-01

    Understanding concepts of molecular mechanisms of drug action involves sequential visualization of physiological processes and drug effects, a task that can be difficult at an undergraduate level. Role-play is a teaching-learning methodology whereby active participation of students as well as clear visualization of the phenomenon is used to convey complex physiological concepts. However, its use in teaching drug action, a process that demands understanding of a second level of complexity over the physiological process, has not been investigated. We hypothesized that role-play can be an effective and well accepted method for teaching molecular pharmacology. In an observational study, students were guided to perform a role-play on a selected topic involving drug activity. Students' gain in knowledge was assessed comparing validated pre- and post-test questionnaires as well as class average normalized gain. The acceptance of role-play among undergraduate medical students was evaluated by Likert scale analysis and thematic analysis of their open-ended written responses. Significant improvement in knowledge (P < 0.001) was noted in the pre- to post-test knowledge scores, while a high gain in class average normalized score was evident. In Likert scale analysis, most students (93%) expressed that role-play was an acceptable way of teaching. In a thematic analysis, themes of both strengths and weaknesses of the session emerged. Role-play can be effectively utilized while teaching selected topics of molecular pharmacology in undergraduate medical curricula.

  8. Can Item Keyword Feedback Help Remediate Knowledge Gaps?

    PubMed

    Feinberg, Richard A; Clauser, Amanda L

    2016-10-01

    In graduate medical education, assessment results can effectively guide professional development when both assessment and feedback support a formative model. When individuals cannot directly access the test questions and responses, a way of using assessment results formatively is to provide item keyword feedback. The purpose of the following study was to investigate whether exposure to item keyword feedback aids in learner remediation. Participants included 319 trainees who completed a medical subspecialty in-training examination (ITE) in 2012 as first-year fellows, and then 1 year later in 2013 as second-year fellows. Performance on 2013 ITE items in which keywords were, or were not, exposed as part of the 2012 ITE score feedback was compared across groups based on the amount of time studying (preparation). For the same items common to both 2012 and 2013 ITEs, response patterns were analyzed to investigate changes in answer selection. Test takers who indicated greater amounts of preparation on the 2013 ITE did not perform better on the items in which keywords were exposed compared to those who were not exposed. The response pattern analysis substantiated overall growth in performance from the 2012 ITE. For items with incorrect responses on both attempts, examinees selected the same option 58% of the time. Results from the current study were unsuccessful in supporting the use of item keywords in aiding remediation. Unfortunately, the results did provide evidence of examinees retaining misinformation.

  9. [The constructivist epistemological belief about scientific knowledge varies according to the year of training in medical students but not in students of other health careers].

    PubMed

    Lazcano, Ximena; Villalón, Francisco; Vera, Soledad; Conget, Paulette

    2017-09-01

    To optimize the teaching-learning process it is fundamental to know the representations that students have regarding knowledge. Epistemological beliefs are implicit theories that guide the practical actions of people. To characterize and compare epistemological beliefs regarding the nature and acquisition of scientific knowledge of health career students. Between 2012 and 2013, 726 students coursing first, third or fifth year from six health careers answered a validated questionnaire that includes closed and open questions aimed to characterize their epistemological beliefs about scientific knowledge. Irrespective of the career, when students had to select predefined answers, most of them appeared as constructivists (61%). On the other hand, when they had to argue, the majority seemed objectivist (47%). First-year medical students have the highest frequency of constructivist epistemological beliefs (56%). Paradoxically, the lowest percentage is found (34%) in the fifth year. The students of the health careers, in particular those of Medicine, recognize that knowledge is not acquired immediately (83%) and that its distribution is shared (92%). Discordance between selections and arguments suggests that epistemological sophistication is achieved declaratively but not practically. The lower proportion of students who presented constructivist beliefs in the fifth year compared to first year of Medicine could be associated with the pedagogical approaches used in the different cycles of the career.

  10. [Kampo Medicine in the New Model Core Curriculum of Pharmaceutical Education].

    PubMed

    Kobayashi, Yoshinori

    2016-01-01

    What should we educate for Kampo medicine in the model core curriculum of pharmaceutical education? The curricular core should be discussed considering the points mentioned below. (1) Positioning of Kampo medicine in the Japanese medical care system. Kampo medicine is an authorized medical care category in the National Health Insurance (NHI) program in Japan. The NHI drug price list carries 148 Kampo formulations. According to the report of the Japan Kampo Medicines Manufacturers Association in 2011, approximately 90% of Japanese physicians prescribe Kampo medicines. (2) Differences between Kampo medicine and western medicine: In Kampo medicine, the most suitable formula among various Kampo formulas to normalize the psychophysical state of individual patients is selected. In other words, if there is a complaint, there are always some treatments. (3) A strong point of Kampo medicine: Kampo medicine enables physicians to deal with difficult-to-treat conditions by western medicine alone. Also, by using the scale of Kampo medicine, each patient can grasp his or her own systemic state and improve their lifestyle. To extend healthy life expectancy, a basic knowledge of Kampo medicine may play a significant role in integrated health care. "The guide book of the approval standards for OTC Kampo products", "the pharmaceutical advanced educational guideline", and "the manual of the exam questions preparation for registered sales clerks" should also be consulted before selecting the area and contents that should be covered.

  11. When four principles are too many: bloodgate, integrity and an action-guiding model of ethical decision making in clinical practice.

    PubMed

    Muirhead, William

    2012-04-01

    Medical ethical analysis remains dominated by the principlist account first proposed by Beauchamp and Childress. This paper argues that the principlist model is unreflective of how ethical decisions are taken in clinical practice. Two kinds of medical ethical decisions are distinguished: biosocial ethics and clinical ethics. It is argued that principlism is an inappropriate model for clinical ethics as it is neither sufficiently action-guiding nor does it emphasise the professional integrity of the clinician. An alternative model is proposed for decision making in the realm of clinical ethics.

  12. The Need for Specialty Curricula Based on Core Competencies: A White Paper of the Conjoint Committee on Continuing Medical Education

    ERIC Educational Resources Information Center

    Jackson, Marcia J.; Gallis, Harry A.; Gilman, Stuart C.; Grossman, Michael; Holzman, Gerald B.; Marquis, Damon; Trusky, Sandra K.

    2007-01-01

    At present there is no curriculum to guide physician lifelong learning in a prescribed, deliberate manner. The Conjoint Committee on Continuing Medical Education, a group representing 16 major stakeholder organizations in continuing medical education, recommends that each specialty society and corresponding board reach consensus on the…

  13. Mathematics for the Workplace. Applications from Medical Laboratory Technology. A Teacher's Guide.

    ERIC Educational Resources Information Center

    Wallace, Johnny M.; Jones, Dallas

    This module presents a real-world context in which mathematics skills are used as part of a daily routine. The context is the medical laboratory technology field, and the module aims to help students develop the ability to use mathematics computations while performing tasks similar to those performed by a medical technologist. Materials in the…

  14. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XV. Telemetry and Communications.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on telemetry and communications is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Two units of study are presented: (1) emergency medical services communications systems (items of equipment and such radio communications concepts as frequency allocation,…

  15. A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

    ERIC Educational Resources Information Center

    Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

    1997-01-01

    Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

  16. Legal Implications of Models of Individual and Group Treatment by Professionals.

    ERIC Educational Resources Information Center

    Lynch, Patrick D.

    Although medical malpractice suits are based on a model of treatment of an individual by a professional, educational malpractice suits are based on a group treatment model. When the medical model and the teaching model are compared, the contrasts are so great that medical malpractice principles are not a reliable guide to the emerging law of…

  17. Oral Medications: Proper Use and Administration. Book 1, Bosnian and Russian. Book 2, Nuer and Spanish.

    ERIC Educational Resources Information Center

    Anoka County Community Health and Environmental Services, Coon Rapids, MN.

    These two guides provide information in English, Bosnian, Russian, Nuer, and Spanish on the proper use and administration of oral medications. Topics covered include the reasons for taking medication, information on the prescription label, following special instructions, asking questions of the pharmacist, safe storage of medicine, child-proof…

  18. Guide to Facilities, Capabilities, and Programs of Medical Schools in the United States.

    ERIC Educational Resources Information Center

    Mayeda, Tadashi A.

    The information in this document was gathered to aid analysts and designers of the proposed Biomedical Communications Network (BCN) of the National Library of Medicine. The current capabilities and facilities of medical schools in areas of activity impinging on the concept and role of BCN are summarized. Medical schools are listed geographically…

  19. Systems Engineering for Space Exploration Medical Capabilities

    NASA Technical Reports Server (NTRS)

    Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris; hide

    2017-01-01

    Human exploration missions that reach destinations beyond low Earth orbit, such as Mars, will present significant new challenges to crew health management. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system goals, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Model-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

  20. Cost-utility analysis of great saphenous vein ablation with radiofrequency, foam and surgery in the emerging health-care setting of Thailand.

    PubMed

    Siribumrungwong, Boonying; Noorit, Pinit; Wilasrusmee, Chumpon; Leelahavarong, Pattara; Thakkinstian, Ammarin; Teerawattananon, Yot

    2016-09-01

    To conduct economic evaluations of radiofrequency ablation, ultrasound-guided foam sclerotherapy and surgery for great saphenous vein ablation. A cost-utility and cohort analysis from societal perspective was performed to estimate incremental cost-effectiveness ratio. Transitional probabilities were from meta-analysis. Direct medical, direct non-medical, indirect costs, and utility were from standard Thai costings and cohort. Probabilistic sensitivity analysis was performed to assess parameter uncertainties. Seventy-seven patients (31 radiofrequency ablation, 19 ultrasound-guided foam sclerotherapy, and 27 surgeries) were enrolled from October 2011 to February 2013. Compared with surgery, radiofrequency ablation costed 12,935 and 20,872 Baht higher, whereas ultrasound-guided foam sclerotherapy costed 6159 lower and 1558 Bath higher for outpatient and inpatient, respectively. At one year, radiofrequency ablation had slightly lower quality-adjusted life-year, whereas ultrasound-guided foam sclerotherapy yielded additional 0.025 quality-adjusted life-year gained. Because of costing lower and greater quality-adjusted life-year than other compared alternatives, outpatient ultrasound-guided foam sclerotherapy was an option being dominant. Probabilistic sensitivity analysis resulted that at the Thai ceiling threshold of 160,000 Baht/quality-adjusted life-year gained, ultrasound-guided foam sclerotherapy had chances of 0.71 to be cost-effective. Ultrasound-guided foam sclerotherapy seems to be cost-effective for treating great saphenous vein reflux compared to surgery in Thailand at one-year results. © The Author(s) 2015.

  1. Austin Community College Study Guide Series.

    ERIC Educational Resources Information Center

    Academic Therapy, 1989

    1989-01-01

    A series of study guides, which were developed to assist students in improving study and library skills, is reproduced for teachers' use. The guides cover test-taking skills; writing business letters; selecting a writing topic; plagiarism; developing search strategies; documentation; and locating dictionaries, periodical articles, books,…

  2. Using the Medical Research Council framework for development and evaluation of complex interventions in a low resource setting to develop a theory-based treatment support intervention delivered via SMS text message to improve blood pressure control.

    PubMed

    Bobrow, Kirsten; Farmer, Andrew; Cishe, Nomazizi; Nwagi, Ntobeko; Namane, Mosedi; Brennan, Thomas P; Springer, David; Tarassenko, Lionel; Levitt, Naomi

    2018-01-23

    Several frameworks now exist to guide intervention development but there remains only limited evidence of their application to health interventions based around use of mobile phones or devices, particularly in a low-resource setting. We aimed to describe our experience of using the Medical Research Council (MRC) Framework on complex interventions to develop and evaluate an adherence support intervention for high blood pressure delivered by SMS text message. We further aimed to describe the developed intervention in line with reporting guidelines for a structured and systematic description. We used a non-sequential and flexible approach guided by the 2008 MRC Framework for the development and evaluation of complex interventions. We reviewed published literature and established a multi-disciplinary expert group to guide the development process. We selected health psychology theory and behaviour change techniques that have been shown to be important in adherence and persistence with chronic medications. Semi-structured interviews and focus groups with various stakeholders identified ways in which treatment adherence could be supported and also identified key features of well-regarded messages: polite tone, credible information, contextualised, and endorsed by identifiable member of primary care facility staff. Direct and indirect user testing enabled us to refine the intervention including refining use of language and testing of interactive components. Our experience shows that using a formal intervention development process is feasible in a low-resource multi-lingual setting. The process enabled us to pre-test assumptions about the intervention and the evaluation process, allowing the improvement of both. Describing how a multi-component intervention was developed including standardised descriptions of content aimed to support behaviour change will enable comparison with other similar interventions and support development of new interventions. Even in low-resource settings, funders and policy-makers should provide researchers with time and resources for intervention development work and encourage evaluation of the entire design and testing process. The trial of the intervention is registered with South African National Clinical Trials Register number (SANCTR DOH-27-1212-386; 28/12/2012); Pan Africa Trial Register (PACTR201411000724141; 14/12/2013); ClinicalTrials.gov ( NCT02019823 ; 24/12/2013).

  3. Russian Lyric Diction: A Practical Guide with Introduction and Annotations and a Bibliography with Annotations on Selected Sources

    ERIC Educational Resources Information Center

    Grayson, Craig M.

    2012-01-01

    The purpose of this dissertation is twofold-to investigate, in brief, the available guides to Russian lyric diction and to present my own comprehensive guide, which gives singers the tools to prepare the pronunciation of Russian vocal pieces independently. The survey examines four guides to Russian lyric diction found in popular anthologies or…

  4. Multispectral Image Enhancement Through Adaptive Wavelet Fusion

    DTIC Science & Technology

    2016-09-14

    13. SUPPLEMENTARY NOTES 14. ABSTRACT This research developed a multiresolution image fusion scheme based on guided filtering . Guided filtering can...effectively reduce noise while preserving detail boundaries. When applied in an iterative mode, guided filtering selectively eliminates small scale...details while restoring larger scale edges. The proposed multi-scale image fusion scheme achieves spatial consistency by using guided filtering both at

  5. Library Research Guide to Sociology. Illustrated Search Strategy and Sources. ("Library Research Guides" Series, No. 5).

    ERIC Educational Resources Information Center

    McMillan, Patricia; Kennedy, James R., Jr.

    One in a series, this guide takes the college student through the steps involved in a thorough, systematic research of any topic in sociology. Beginning with the basics, the guide covers selecting a topic, locating an authoritative summary of the topic, taking clear notes, and narrowing the topic. Subsequent chapters cover the use of general…

  6. Guide to Civil War Books: An Annotated Selection of Modern Works on the War between the States.

    ERIC Educational Resources Information Center

    Barbuto, Domenica M.; Kreisel, Martha

    This guide to Civil War books provides help in locating information about a specific person, battle, or campaign, as well as social or political conditions during the Civil War period. Teachers and librarians will find it useful when developing assignments or guiding students to sources for their research. This resource guide brings together books…

  7. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study.

    PubMed

    Fanning, Laura; Jones, Nick; Manias, Elizabeth

    2016-04-01

    The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital. Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377-bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity. A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor. The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting. © 2015 John Wiley & Sons, Ltd.

  8. Near-IR Image-Guided Laser Ablation of Demineralization on Tooth Occlusal Surfaces

    PubMed Central

    Tom, Henry; Chan, Kenneth H.; Darling, Cynthia L.; Fried, Daniel

    2016-01-01

    Introduction Studies have shown that reflectance images at near-IR wavelengths coincident with higher water absorption are well-suited for image-guided laser ablation of carious lesions since the contrast between sound and demineralized enamel is extremely high and interference from stains is minimized. The objective of this study was to demonstrate that near-IR reflectance images taken at a wavelength range of 1,500–1,700 nm can be used to guide a 9.3 μm CO2 laser for the selective ablation of early demineralization on tooth occlusal surfaces. Methods The occlusal surfaces of ten sound human molars were used in this in vitro study. Shallow simulated caries lesions with random patterns and varying depth and position were produced on tooth occlusal surfaces. Sequential near-IR reflectance images at 1,500–1,700 nm were used to guide the laser for the selective removal of the demineralized enamel. Digital microscopy and polarization sensitive optical coherence tomography (PS-OCT) were used to assess selectivity. Results Images taken before and after lesion removal suggest that the demineralized areas were removed with high selectivity. Although the estimated volume of tissue ablated was typically higher than the initial lesion volume measured with PS-OCT, the volume of enamel removed by the laser correlated well with the initial lesion volume. Conclusion Sequential near-IR reflectance images at 1,500–1,700 nm can be used to guide a 9.3 μm CO2 laser for the selective ablation of early demineralization on tooth occlusal surfaces. PMID:26763111

  9. Effect of repetitive feedback on residents' communication skills improvement.

    PubMed

    Labaf, Ali; Jamali, Kazem; Jalili, Mohammad; Baradaran, Hamid R; Eizadi, Parisa

    2014-01-01

    To evaluate the effect of frequent feedback on residents' communication skills as measured by a standardized checklist. Five medical students were recruited in order to assess twelve emergency medicine residents' communication skills during a one-year period. Students employed a modified checklist based on Calgary-Cambridge observation guide. The checklist was designed by faculty members of Tehran University of Medical Science, used for assessment of students' communication skills. 24 items from 71 items of observational guide were selected, considering study setting and objects. Every two months an expert faculty, based on descriptive results of observation, gave structured feedback to each resident during a 15-minute private session. Total mean score for baseline observation standing at 20.58 was increased significantly to 28.75 after feedbacks. Results markedly improved on "gathering information" (T1=5.5, T6=8.33, P=0.001), "building relationship" (T1=1.5, T6=4.25, P<0.001) and "closing the session" (T1=0.75, T6=2.5, P=0.001) and it mildly dropped on "understanding patients view" (T1=3, T6=2.33, P=0.007) and "providing structure" (T1=4.17, T6=4.00, P=0.034). Changes in result of "initiating the session" and "explanation and planning" dimensions are not statically significant (P=0.159, P=0.415 respectively). Frequent feedback provided by faculty member can improve residents' communication skills. Feedback can affect communication skills educational programs, and it can be more effective if it is combined with other educational methods.

  10. Exploring patient values in medical decision making: a qualitative study.

    PubMed

    Lee, Yew Kong; Low, Wah Yun; Ng, Chirk Jenn

    2013-01-01

    Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes. We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28-67 years old. Our sample comprised 9 women and 12 men. Three main themes, 'treatment-specific values', 'life goals and philosophies', and 'personal and social background', emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients' decisions were influenced by sociocultural (e.g. religious background) and personal backgrounds (e.g. family situations). This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients' priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values.

  11. Ambulatory Morning Report: A Case-Based Method of Teaching EBM Through Experiential Learning.

    PubMed

    Luciano, Gina L; Visintainer, Paul F; Kleppel, Reva; Rothberg, Michael B

    2016-02-01

    Evidence-based medicine (EBM) skills are important to daily practice, but residents generally feel unskilled incorporating EBM into practice. The Kolb experiential learning theory, as applied to curricular planning, offers a unique methodology to help learners build an EBM skill set based on clinical experiences. We sought to blend the learner-centered, case-based merits of the morning report with an experientially based EBM curriculum. We describe and evaluate a patient-centered ambulatory morning report combining the User's Guides to the Medical Literature approach to EBM and experiential learning theory in the internal medicine department at Baystate Medical Center. The Kolb experiential learning theory postulates that experience transforms knowledge; within that premise we designed a curriculum to build EBM skills incorporating residents' patient encounters. By developing structured clinical questions based on recent clinical problems, residents activate prior knowledge. Residents acquire new knowledge through selection and evaluation of an article that addresses the structured clinical questions. Residents then apply and use new knowledge in future patient encounters. To assess the curriculum, we designed an 18-question EBM test, which addressed applied knowledge and EBM skills based on the User's Guides approach. Of the 66 residents who could participate in the curriculum, 61 (92%) completed the test. There was a modest improvement in EBM knowledge, primarily during the first year of training. Our experiential curriculum teaches EBM skills essential to clinical practice. The curriculum differs from traditional EBM curricula in that ours blends experiential learning with an EBM skill set; learners use new knowledge in real time.

  12. Autonomy, religion and clinical decisions: findings from a national physician survey

    PubMed Central

    Lawrence, R E; Curlin, F A

    2010-01-01

    Background Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. PMID:19332575

  13. Ethics of clinical trials.

    PubMed

    Iyalomhe, G B S; Imomoh, P A

    2007-01-01

    Although clinical trials are conducted far more ethically and safer now than they were some decades ago, the elimination of gross abuses has tended to highlight more subtle ethical problems. Therefore, research in man, especially clinical drug trials, must now take into account ethical and legal requirements. This review examines the progress of clinical trial ethics, highlights the major ethical principles and challenges involved in the conduct of clinical trials, and suggests measures to ensure scientifically and ethically sound clinical trials. An internet search and a perusal of the literature on the history of clinical trials, medical ethics and good clinical practice, reveal that apart from laying a general principle, the Oath of Hippocrates did not provide a guide on the specific ethical problems involved in undertaking research, an important arm of advancement in medical knowledge. Hence, to avert continued ethical abuses of subjects during clinical research, the current reference guideliNe--the Helsinki Declaration of 1964 (revised in 1975), was adopted by the World Medical Assembly. It emphasized four major principles: autonomy, nonmaleficience, beneficence and justice. In applying these principles, the researcher must obtain a written free and well informed consent from patients who should be aware of their right to withdraw from trial at any moment. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. He must ethically monitor and assess risks and benefits of the trial throughout its duration and use a fair procedure in selecting research subjects and must respect the concept of inviolability of the human person. Ethical challenges confronting clinical trials include the appropriateness of the proposed research, obtaining free informed consent, use of medications after completion of drug trials, drug toxicities and long-term side effects as well as the release and publication of research result. To improve protection for research subjects and have ethically sound clinical trials, there is need to adhere to global standards and legislations; establish, strengthen and empower regulatory bodies; develop partnership among stakeholders; intensify public enlightenment and train research personnel.

  14. An Analysis of the Selection and Training of Guiding Teachers in an Urban Teacher Education Program

    ERIC Educational Resources Information Center

    Lopez, Carmen Lizette

    2012-01-01

    In response to a growing trend towards alternative teacher education programs, this study aims to direct the focus on traditional teacher preparation programs. The purpose of this study is to analyze the processes of how classroom teachers are selected, trained, and supported as guiding teachers in one urban teacher education program. The…

  15. Programming Design Guide for Computer Implementation of Job Aid for Selecting Instructional Setting. Final Report.

    ERIC Educational Resources Information Center

    Schulz, Russel E.; And Others

    This Programming Design Guide (PDG) was developed to permit the offline Job Aid for Selecting Instructional Setting, which is one of 13 job aids presently available for use with the Instructional Systems Development (ISD) model, to be available in an inquiry-type, online version. It is intended to provide computer programmers with all of the…

  16. ON TEACHING THE BIBLE AS LITERATURE, A GUIDE TO SELECTED BIBLICAL NARRATIVES FOR SECONDARY SCHOOLS. INDIANA UNIVERSITY ENGLISH CURRICULUM STUDY SERIES.

    ERIC Educational Resources Information Center

    ACKERMAN, JAMES S.; HAWLEY, JANE STOUDER

    WRITTEN FOR USE WITH SECONDARY SCHOOL STUDENTS, THIS GUIDE TO THE SECULAR AND OBJECTIVE TEACHING OF BIBLICAL LITERATURE EMPHASIZES THE HISTORICAL AND LITERARY CONTEXT OF THE BIBLE RATHER THAN THEOLOGICAL INTERPRETATIONS, AND PRESENTS HISTORICAL, TEXTUAL, AND CULTURAL BACKGROUND MATERIAL FOR SELECTED OLD TESTAMENT NARRATIVES. PART 1 OF THE GUIDE…

  17. Selective removal of demineralized enamel using a CO2 laser coupled with near-IR reflectance imaging

    NASA Astrophysics Data System (ADS)

    Tom, Henry; Chan, Kenneth H.; Saltiel, Daniel; Fried, Daniel

    2015-02-01

    Detection and diagnosis of early dental caries lesions can be difficult due to variable tooth coloration, staining of the teeth and poor contrast between sound and demineralized enamel. These problems can be overcome by using near-infrared (NIR) imaging. Previous studies have demonstrated that lasers can be integrated with NIR imaging devices, allowing image-guided ablation. The aim of this study was to demonstrate that NIR light at 1500 - 1700 nm can be used to guide a 9.3-μm CO2 laser for the selective ablation of early demineralization on tooth occlusal surfaces. The occlusal surfaces of ten sound human molars were used in this in-vitro study. Shallow simulated caries lesions of varying depth and position were produced on tooth occlusal surfaces using a demineralization solution. Sequential NIR reflectance images at 1500 - 1700 nm were used to guide the laser for selective ablation of the lesion areas. Digital microscopy and polarization sensitive optical coherence tomography (PS-OCT) were used to assess the selectivity of removal. This study demonstrates that high contrast NIR reflectance images can be used for the image-guided laser ablation of early demineralization from tooth occlusal surfaces.

  18. English Literature: A Student's Guide to Serial Bibliographies.

    ERIC Educational Resources Information Center

    McGill Univ., Montreal (Quebec). McLennan Library.

    This selected guide to serial bibliographies covering English language literature is based on an essay bibliography by David E. Pownall. Other bibliographies of serial bibliographies which were consulted include "A Reference Guide to English Studies,""Periodicals Containing Reviews and Bibliographies,""Serial Bibliographies in the Humanities and…

  19. Business and Marketing Cluster. Task Analyses.

    ERIC Educational Resources Information Center

    Henrico County Public Schools, Glen Allen, VA. Virginia Vocational Curriculum and Resource Center.

    Developed in Virginia, this publication contains task analysis guides to support selected tech prep programs that prepare students for careers in the business and marketing cluster. Guides are included for accounting systems, legal systems administration, office systems technology, and retail marketing. Each task analyses guide has the following…

  20. Web Feet Guide to Search Engines: Finding It on the Net.

    ERIC Educational Resources Information Center

    Web Feet, 2001

    2001-01-01

    This guide to search engines for the World Wide Web discusses selecting the right search engine; interpreting search results; major search engines; online tutorials and guides; search engines for kids; specialized search tools for various subjects; and other specialized engines and gateways. (LRW)

  1. Measurement Practice Guide

    ERIC Educational Resources Information Center

    College and Career Readiness and Success Center, 2014

    2014-01-01

    This discussion guide is part of a larger practice guide designed to help state education agencies (SEAs) define measurement goals, select college and career readiness measures and indicators designed to support those goals, and use the data gathered with those measures and indicators to make informed decisions about college and career readiness…

  2. Microcomputers: Software Evaluation. Evaluation Guides. Guide Number 17.

    ERIC Educational Resources Information Center

    Gray, Peter J.

    This guide discusses three critical steps in selecting microcomputer software and hardware: setting the context, software evaluation, and managing microcomputer use. Specific topics addressed include: (1) conducting an informal task analysis to determine how the potential user's time is spent; (2) identifying tasks amenable to computerization and…

  3. 76 FR 59420 - Proposed Information Collection; Alaska Guide Service Evaluation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... Office of Management and Budget (OMB) to approve the information collection (IC) described below. As... lands, we issue permits for commercial guide services, including big game hunting, sport fishing... information during the competitive selection process for big game and sport fishing guide permits to evaluate...

  4. Tongue tie

    MedlinePlus

    ... Lawrence RM, eds. Breastfeeding: A Guide for the Medical Profession . 8th ed. Philadelphia, PA: Elsevier; 2016:874-878. ... M. is also a founding member of Hi-Ethics and subscribes to the principles of ... not be used during any medical emergency or for the diagnosis or treatment of ...

  5. Negotiating 'depression' in primary care: a qualitative study.

    PubMed

    McPherson, Susan; Armstrong, David

    2009-10-01

    Psychiatry has provided primary care physicians with tools for recognising and labelling mild, moderate or severe 'depression'. General practitioners (GPs) in the UK have been guided to manage depression within primary care and to prescribe anti-depressants as a first-line treatment. The present study aimed to examine how GPs would construct 'depression' when asked to talk about those anomalous patients for whom the medical frontline treatment did not appear to be effective. Twenty purposively selected GPs were asked in an interview to talk about their experience and management of patients with depression who did not respond to anti-depressants. GPs initially struggled to identify a group, but then began to construct a category of person with a pre-medicalised status characterised by various deviant features such as unpleasant characters and personalities, manipulative tendencies, people with entrenched social problems unable to fit in with other people and relate to people normally. GPs also responded in non-medical ways including feeling unsympathetic, breaking confidentiality and prescribing social interventions. In effect, in the absence of an effective medical treatment, depression appeared to become demedicalised. The implications of this process are discussed in relation to patients' subsequent access or lack of access to services and the way in which these findings highlight the processes by which medicine frames disease.

  6. Integrative medicine for managing the symptoms of lupus nephritis

    PubMed Central

    Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

    2018-01-01

    Abstract Background: Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. Methods and analyses: The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. Dissemination: This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. Trial registration number: PROSPERO 2018 CRD42018085205 PMID:29595669

  7. Evaluating health service quality: using importance performance analysis.

    PubMed

    Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila

    2017-08-14

    Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.

  8. Tinnitus and sound intolerance: evidence and experience of a Brazilian group.

    PubMed

    Onishi, Ektor Tsuneo; Coelho, Cláudia Couto de Barros; Oiticica, Jeanne; Figueiredo, Ricardo Rodrigues; Guimarães, Rita de Cassia Cassou; Sanchez, Tanit Ganz; Gürtler, Adriana Lima; Venosa, Alessandra Ramos; Sampaio, André Luiz Lopes; Azevedo, Andreia Aparecida; Pires, Anna Paula Batista de Ávila; Barros, Bruno Borges de Carvalho; Oliveira, Carlos Augusto Costa Pires de; Saba, Clarice; Yonamine, Fernando Kaoru; Medeiros, Ítalo Roberto Torres de; Rosito, Letícia Petersen Schmidt; Rates, Marcelo José Abras; Kii, Márcia Akemi; Fávero, Mariana Lopes; Santos, Mônica Alcantara de Oliveira; Person, Osmar Clayton; Ciminelli, Patrícia; Marcondes, Renata de Almeida; Moreira, Ronaldo Kennedy de Paula; Torres, Sandro de Menezes Santos

    Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  9. Development of the implant surgical technique and assessment rating system

    PubMed Central

    Park, Jung-Chul; Hwang, Ji-Wan; Lee, Jung-Seok; Jung, Ui-Won; Choi, Seong-Ho; Cho, Kyoo-Sung; Chai, Jung-Kiu

    2012-01-01

    Purpose There has been no attempt to establish an objective implant surgical evaluation protocol to assess residents' surgical competence and improve their surgical outcomes. The present study presents a newly developed assessment and rating system and simulation model that can assist the teaching staffs to evaluate the surgical events and surgical skills of residents objectively. Methods Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed regarding surgical competence and assessment tools. Particularly, medical journals reporting rating and evaluation protocols for various types of medical surgeries were thoroughly analyzed. Based on these studies, an implant surgical technique assessment and rating system (iSTAR) has been developed. Also, a specialized dental typodont was developed for the valid and reliable assessment of surgery. Results The iSTAR consists of two parts including surgical information and task-specific checklists. Specialized simulation model was subsequently produced and can be used in combination with iSTAR. Conclusions The assessment and rating system provided may serve as a reference guide for teaching staffs to evaluate the residents' implant surgical techniques. PMID:22413071

  10. Design of high-fidelity haptic display for one-dimensional force reflection applications

    NASA Astrophysics Data System (ADS)

    Gillespie, Brent; Rosenberg, Louis B.

    1995-12-01

    This paper discusses the development of a virtual reality platform for the simulation of medical procedures which involve needle insertion into human tissue. The paper's focus is the hardware and software requirements for haptic display of a particular medical procedure known as epidural analgesia. To perform this delicate manual procedure, an anesthesiologist must carefully guide a needle through various layers of tissue using only haptic cues for guidance. As a simplifying aspect for the simulator design, all motions and forces involved in the task occur along a fixed line once insertion begins. To create a haptic representation of this procedure, we have explored both physical modeling and perceptual modeling techniques. A preliminary physical model was built based on CT-scan data of the operative site. A preliminary perceptual model was built based on current training techniques for the procedure provided by a skilled instructor. We compare and contrast these two modeling methods and discuss the implications of each. We select and defend the perceptual model as a superior approach for the epidural analgesia simulator.

  11. Contents of a core library in continuing medical education: a Delphi study.

    PubMed

    Olson, Curtis A; Tooman, Tricia R; Leist, James C

    2005-01-01

    In developing their professional competence, those who are interested in the practice of continuing medical education (CME) should recognize the knowledge base that defines their field. This study systematically identifies and organizes a list of books and journals comprising a core library (100 books/15 journals) for CME professionals. The Delphi method was applied to elicit and combine the judgments of a fifty member panel considered knowledgeable about the CME field. The panelists participated in three iterations of the survey to first identify and then rank order nominated works. Separate ranked lists were created for books and journals. Forty-four participants completed the study (88% response rate). 268 books and 34 journals were identified. Mean ratings ranged from 4.78 (high) to 1.50 (low). The results of the study reflect the panel's judgment. The list is not definitive; instead, it describes what a select group of individuals knowledgeable about the CME field considered important. The list should therefore be seen as a general guide and a resource to facilitate decision-making, not as a prescription for creating a library.

  12. Utilizing visual art to enhance the clinical observation skills of medical students.

    PubMed

    Jasani, Sona K; Saks, Norma S

    2013-07-01

    Clinical observation is fundamental in practicing medicine, but these skills are rarely taught. Currently no evidence-based exercises/courses exist for medical student training in observation skills. The goal was to develop and teach a visual arts-based exercise for medical students, and to evaluate its usefulness in enhancing observation skills in clinical diagnosis. A pre- and posttest and evaluation survey were developed for a three-hour exercise presented to medical students just before starting clerkships. Students were provided with questions to guide discussion of both representational and non-representational works of art. Quantitative analysis revealed that the mean number of observations between pre- and posttests was not significantly different (n=70: 8.63 vs. 9.13, p=0.22). Qualitative analysis of written responses identified four themes: (1) use of subjective terminology, (2) scope of interpretations, (3) speculative thinking, and (4) use of visual analogies. Evaluative comments indicated that students felt the exercise enhanced both mindfulness and skills. Using visual art images with guided questions can train medical students in observation skills. This exercise can be replicated without specially trained personnel or art museum partnerships.

  13. Career Planner: A Guide for Students with Disabilities.

    ERIC Educational Resources Information Center

    Smith, Gwen J.; And Others

    Intended as a guide for students with disabilities who wish to enter the work force, this handbook is designed to help gather both information about the student and information to help choose a job. Chapter 1 concerns collecting health/medical information. Chapter 2 focuses on collecting vocational information--information about general job…

  14. Career Planner. A Guide for Students with Disabilities. Second Edition.

    ERIC Educational Resources Information Center

    Smith, Gwen J.; And Others

    This handbook is intended as a guide for disabled career planners who wish to enter the work force. The introduction presents basic steps for gathering information about oneself and about jobs. Chapter 1 discusses collecting health/medical information. A sample form is provided. Chapter 2 focuses on collecting vocational information, which…

  15. Child Health Encyclopedia: The Complete Guide for Parents.

    ERIC Educational Resources Information Center

    Feinbloom, Richard I., Ed.

    This book is one of a series of health-related publications for parents written by members of the staff of the Boston Children's Medical Center. A reference guide for parents seeking information on health, safety, and diseases affecting children, the book discusses specific diseases as well as health problems related to contemporary society.…

  16. Medical Assisting. Secondary Level Curriculum.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Occupational and Career Education.

    This curriculum guide is intended to prepare students for entry-level employment in the health care industry. The two-year program, designed to be used in high schools in New York City, will prepare students to assist in various health career settings such as doctors' offices, hospital clinics, and group practice facilities. The curriculum guide,…

  17. Adolescents with Chronic Illnesses--Issues for School Personnel. Second Edition. CYDLINE Reviews.

    ERIC Educational Resources Information Center

    Minnesota Univ., Minneapolis. National Center for Youth with Disabilities.

    This resource guide covers the psychosocial and health concerns of adolescents with chronic illnesses. In a section titled "Bibliographic Information," the guide describes 12 books on general medical and social aspects, three resources on demographics, four resources on school issues, and 14 resources on psychosocial and family issues. A section…

  18. Una guia a los padres acerca del sistema educacional = A Parent's Guide to Education. Spanish Edition.

    ERIC Educational Resources Information Center

    Rowch, Nancy

    A guide for Spanish-speaking parents of elementary and secondary school students in Nebraska provides in Spanish, and then in English, information concerning education in the state. Topics covered include: state policy concerning enrolling children in school, medical requirements for enrollment and attendance, the school curriculum requirements…

  19. Comparative Analysis Between Guided Self-Instruction and Conventional Lectures in Neuroanatomy

    ERIC Educational Resources Information Center

    de Carvalho, Claudio A. F.; And Others

    1977-01-01

    A study using 60 first-year medical students in the Santo Amaro Faculty of Medicine, San Paulo, Brazil, found that self-instructional methods such as guided self-instruction or discussion groups are not superior to conventional classes. Self-instruction does have the advantages of low cost and easy applicability. (LBH)

  20. Commitments: A Guide to Community Involvement Programs at The George Washington University.

    ERIC Educational Resources Information Center

    George Washington Univ., Washington, DC.

    This guide to community involvement programs sponsored by the George Washington University provides a synopsis and a contact person for 33 general university programs, 38 medical school and hospital programs, eight National Law Center programs, eight School of Engineering and Applied Science programs, and two programs of the Division of…

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