Transport processes in biomedical systems: a roadmap for future research directions.

PubMed

Schmid-Schönbein, Geert W; Diller, Kenneth R

2005-09-01

A workshop was convened at Bethesda, Maryland on May 5 and 6, 2004 under the sponsorship of the NSF and NIH with the objectives of identifying emerging intellectual opportunities and applications in biotransport sciences and of guiding future research in the field. Approximately 50 leading researchers in the fields of fluid, heat, and mass biotransport were presented forward-looking perspectives and discussed how to synthesize broad cross-disciplinary areas: this defined guidelines for a roadmap document. Applications were presented in the context of disease analysis and diagnosis, therapy and prevention, and for physiologic and engineered living systems. The roadmap prioritizes specific research thrusts that reflect projected impacts on intellectuals, medical, and biological advances. Several overarching themes emerged. Most central is the expanded integration of fundamental transport sciences into the understanding of living systems and the great potential of patient specific modeling in designing a broad array of medical procedures.

Theory-guided, empirically supported avenues for intervention on HIV medication nonadherence: findings from the Healthy Living Project.

PubMed

Johnson, Mallory O; Catz, Sheryl L; Remien, Robert H; Rotheram-Borus, Mary Jane; Morin, Stephen F; Charlebois, Edwin; Gore-Felton, Cheryl; Goldsten, Rise B; Wolfe, Hannah; Lightfoot, Marguerita; Chesney, Margaret A

2003-12-01

Adherence to antiretroviral therapy (ART) remains a challenge in efforts to maximize HIV treatment benefits. Previous studies of antiretroviral adherence are limited by low statistical power, homogeneous samples, and biased assessment methods. Based on Social Action Theory and using a large, diverse sample of men and women living with HIV, the objectives of the current study are to clarify correlates of nonadherence to ART and to provide theory-guided, empirically supported direction for intervening on ART nonadherence. Cross-sectional interview study utilizing a computerized interview. Recruited from clinics, agencies, and via media ads in four U.S. cities from June 2000 to January 2002. Two thousand seven hundred and sixty-five HIV-positive adults taking ART. Computer-assessed self-reported antiretroviral adherence. Thirty-two percent reported less than 90% adherence to ART in the prior 3 days. A number of factors were related to nonadherence in univariate analysis. Multivariate analyses identified that being African American, being in a primary relationship, and a history of injection drug use or homelessness in the past year were associated with greater likelihood of nonadherence. Furthermore, adherence self-efficacy, and being able to manage side effects and fit medications into daily routines were protective against nonadherence. Being tired of taking medications was associated with poorer adherence whereas a belief that nonadherence can make the virus stronger was associated with better adherence. Results support the need for multifocused interventions to improve medication adherence that address logistical barriers, substance use, attitudes and expectancies, as well as skills building and self-efficacy enhancement. Further exploration of issues related to adherence for African Americans and men in primary relationships is warranted.

Pathological basis of symptoms and crises in sickle cell disorder: implications for counseling and psychotherapy

PubMed Central

Ilesanmi, Oluwatoyin Olatundun

2010-01-01

Sickle Cell Disorder (SCD) is a congenital hemoglobinopathy. There is little in literature regarding the psychological variables affecting individuals living with SCD and all of the significant people around them. There are also limited numbers of trained clinical psychologists and genetic counselors to cater for the psychotherapeutic needs of individuals living with SCD. Even among those who have been trained, only a few might have fully grasped the complexities of the disease pathology. Early understanding of its pathological nature, sources, types, complications, pathophysiological basis, and clinical severity of symptoms among clinical psychologists, genetic counselors and psychotherapists, as well as general medical practitioners, could guide them in providing holistic care for dealing with and reducing pain among individuals living with SCD. It could allow risk-based counseling for families and individuals. It could also justify the early use of disease-modifying or curative interventions, such as hydroxyurea (HU), chronic transfusions (CTs), or stem-cell transplantation (SCT) by general medical practitioners. Hence, the need for this paper on the pathophysiology of SCD. PMID:22184515

Genetic information: Special or not? Responses from focus groups with members of a health maintenance organization.

PubMed

Diergaarde, Brenda; Bowen, Deborah J; Ludman, Evette J; Culver, Julie O; Press, Nancy; Burke, Wylie

2007-03-15

Genetic information is used increasingly in health care. Some experts have argued that genetic information is qualitatively different from other medical information and, therefore, raises unique social issues. This view, called "genetic exceptionalism," has importantly influenced recent policy efforts. Others have argued that genetic information is like other medical information and that treating it differently may actually result in unintended disparities. Little is known about how the general public views genetic information. To identify opinions about implications of genetic and other medical information among the general population, we conducted a series of focus groups in Seattle, WA. Participants were women and men between ages 18 and 74, living within 30 miles of Seattle and members of the Group Health Cooperative. A structured discussion guide was used to ensure coverage of all predetermined topics. Sessions lasted approximately 2 hr; were audio taped and transcribed. The transcripts formed the basis of the current analysis. Key findings included the theme that genetic information was much like other medical information and that all sensitive medical information should be well protected. Personal choice (i.e., the right to choose whether to know health risk information and to control who else knows) was reported to be of crucial importance. Participants had an understanding of the tensions involved in protecting privacy versus sharing medical information to help another person. These data may guide future research and policy concerning the use and protection of medical information, including genetic information. (c) 2007 Wiley-Liss, Inc.

Community Living Skills Guide: Cooking/Food Preparation.

ERIC Educational Resources Information Center

Nickovich, Marti; Kreps, Alice Roelofs

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Cooking/Food Preparation. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized…

Community Living Skills Guide: Art.

ERIC Educational Resources Information Center

Sobol, Sheila; Kreps, Alice Roelofs

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Art. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized persons to eventual…

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...

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...

A Mobile Gaming Intervention to Increase Adherence to Antiretroviral Treatment for Youth Living With HIV: Development Guided by the Information, Motivation, and Behavioral Skills Model.

PubMed

Whiteley, Laura; Brown, Larry; Lally, Michelle; Heck, Nicholas; van den Berg, Jacob J

2018-04-23

Highly active combination antiretroviral treatment has been shown to markedly improve the health of HIV-infected adolescents and young adults. Adherence to antiretroviral treatment leads to decreased morbidity and mortality and decreases the number of hospitalizations. However, these clinical achievements can only occur when young persons with HIV are adherent to care. Unfortunately, adolescents and young adults have poorer rates of adherence to antiretroviral medications and poorer rates of retention in care than older adults. Novel and engaging digital approaches are needed to help adolescents and young adults living with HIV be adherent to treatment. The aim of this study was to develop an immersive, action-oriented iPhone gaming intervention to improve adherence to antiretroviral medication and treatment. Game development was guided by social learning theory, taking into consideration the perspectives of adolescents and young adults living with HIV. A total of 20 adolescents and young adults were recruited from an HIV care clinic in Rhode Island, and they participated in qualitative interviews guided by the information-motivation-behavioral skills model of behavior change. The mean age of participants was 22 years, 60% (12/20) of the participants identified as male, and 60% (12/20) of the sample reported missing a dose of antiretroviral medication in the previous week. Acceptability of the game was assessed with client service questionnaire and session evaluation form. A number of themes emerged that informed game development. Adolescents and young adults living with HIV desired informational game content that included new and comprehensive details about HIV, details about HIV as it relates to doctors' visits, and general health information. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma; and increasing personal relevance of HIV care. Behavioral skills themes centered on self-efficacy and strategies for medical adherence and self-care. On the client service questionnaire, 10 out of the 11 participants indicated they were "satisfied with the game activities," and 9 out of 11 "would recommend it to a friend." On the session evaluation form, 9 out of 11 agreed that they "learned a lot from the game." We utilized youth feedback, social learning theory (information-motivation-behavioral skills), and agile software development to create a multilevel, immersive, action-oriented iPhone gaming intervention to measure and improve treatment adherence for adolescents and young adults living with HIV. There is a dearth of gaming interventions for this population, and this study is a significant step in working toward the development and testing of an iPhone gaming app intervention to promote adherence to antiretroviral treatment. ClinicalTrials.gov NCT01887210; http://clinicaltrials.gov/ct2/show/NCT01887210 (Archived by WebCite at http://www.webcitation.org/6xHMW0NI1). ©Laura Whiteley, Larry Brown, Michelle Lally, Nicholas Heck, Jacob J van den Berg. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.04.2018.

A Mobile Gaming Intervention to Increase Adherence to Antiretroviral Treatment for Youth Living With HIV: Development Guided by the Information, Motivation, and Behavioral Skills Model

PubMed Central

2018-01-01

Background Highly active combination antiretroviral treatment has been shown to markedly improve the health of HIV-infected adolescents and young adults. Adherence to antiretroviral treatment leads to decreased morbidity and mortality and decreases the number of hospitalizations. However, these clinical achievements can only occur when young persons with HIV are adherent to care. Unfortunately, adolescents and young adults have poorer rates of adherence to antiretroviral medications and poorer rates of retention in care than older adults. Novel and engaging digital approaches are needed to help adolescents and young adults living with HIV be adherent to treatment. Objective The aim of this study was to develop an immersive, action-oriented iPhone gaming intervention to improve adherence to antiretroviral medication and treatment. Methods Game development was guided by social learning theory, taking into consideration the perspectives of adolescents and young adults living with HIV. A total of 20 adolescents and young adults were recruited from an HIV care clinic in Rhode Island, and they participated in qualitative interviews guided by the information-motivation-behavioral skills model of behavior change. The mean age of participants was 22 years, 60% (12/20) of the participants identified as male, and 60% (12/20) of the sample reported missing a dose of antiretroviral medication in the previous week. Acceptability of the game was assessed with client service questionnaire and session evaluation form. Results A number of themes emerged that informed game development. Adolescents and young adults living with HIV desired informational game content that included new and comprehensive details about HIV, details about HIV as it relates to doctors’ visits, and general health information. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma; and increasing personal relevance of HIV care. Behavioral skills themes centered on self-efficacy and strategies for medical adherence and self-care. On the client service questionnaire, 10 out of the 11 participants indicated they were “satisfied with the game activities,” and 9 out of 11 “would recommend it to a friend.” On the session evaluation form, 9 out of 11 agreed that they “learned a lot from the game.” Conclusions We utilized youth feedback, social learning theory (information-motivation-behavioral skills), and agile software development to create a multilevel, immersive, action-oriented iPhone gaming intervention to measure and improve treatment adherence for adolescents and young adults living with HIV. There is a dearth of gaming interventions for this population, and this study is a significant step in working toward the development and testing of an iPhone gaming app intervention to promote adherence to antiretroviral treatment. Trial Registration ClinicalTrials.gov NCT01887210; http://clinicaltrials.gov/ct2/show/NCT01887210 (Archived by WebCite at http://www.webcitation.org/6xHMW0NI1) PMID:29685863

Techniques for Daily Living: Curriculum Guides.

ERIC Educational Resources Information Center

Wooldridge, Lillian; And Others

Presented are specific guides concerning techniques for daily living which were developed by the child care staff at the Illinois Braille and Sight Saving School. The guides are designed for cottage parents of the children, who may have both visual and other handicaps, and show what daily living skills are necessary and appropriate for the…

Community Living Skills Guide: Beginning Woodworking.

ERIC Educational Resources Information Center

Miller, Steve; Smith, Don

This is one of twenty course guides in the Community Living Skills Guide for the College for Living series which provides guidelines and workbook activities for the course, Beginning Woodworking, Use of Basic Hand Tools and Shop Safety. The series of courses for developmentally disabled adults is intended to supplement residential programs and to…

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 ( ...

Practical Divinity and Medical Ethics: Lawful versus Unlawful Medicine in the Writings of William Perkins (1558–1602)

PubMed Central

Gevitz, Norman

2013-01-01

This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between “lawful” and “unlawful” medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons. PMID:22235029

Practical divinity and medical ethics: lawful versus unlawful medicine in the writings of William Perkins (1558-1602).

PubMed

Gevitz, Norman

2013-04-01

This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between "lawful" and "unlawful" medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons.

Developing a novel Poverty in Healthcare curriculum for medical students at the University of Michigan Medical School.

PubMed

Doran, Kelly M; Kirley, Katherine; Barnosky, Andrew R; Williams, Joy C; Cheng, Jason E

2008-01-01

Nearly 90 million Americans live below 200% of the federal poverty threshold. The links between lower socioeconomic status and poor health are clear, and all physicians face the resulting challenges in patient care. Current medical school curricula do not adequately prepare students to address this issue despite recommendations from the Association of American Medical Colleges and the Institute of Medicine. In response, students and faculty at the University of Michigan Medical Center established the Poverty in Healthcare curriculum, which encompasses required learning experiences spanning all four years of undergraduate medical education. This article describes the design and implementation of this curriculum. The authors provide thorough descriptions of the individual learning experiences, including community site visits, longitudinal cases, mini-electives, and family centered experiences. The authors also discuss the history, costs, challenges, and evaluation process related to the Poverty in Healthcare curriculum, including issues specifically related to medical students' involvement in developing and implementing the curriculum. This information may be used as a guide for other medical schools in the development of curricula to address this current gap in medical student education.

Can virtue be taught?

PubMed

Shelton, W

1999-06-01

Applying standards of virtue that define the "good doctor" in a complex and technologically sophisticated health care system is often challenging and sometimes confusing. What are the characteristics of a "good doctor," who wishes to live up to high ethical and professional standards but who also must live and work in a health care system in which moral ambiguity is pervasive? Medical educators are urgently faced with such questions as their schools try to equip students with the skills and capacities required of the virtuous physician. The author describes how Aristotelian concepts of virtue can be used to guide medical educators in defining and teaching virtue. He then discusses how such traits as the ability to tolerate moral differences and ambiguity, the ability to develop thoughtful individual moral positions, and the capacity to respect and understand various cultural traditions may be what might be considered virtues in today's health care system. A "good" doctor, then, would be someone who is thoughtful, fair-minded, respectful of differences, and committed to his or her professional values.

Predicting drug interactions in addiction treatment.

PubMed

Lucas, Catherine J; Patel, Joanne; Martin, Jennifer H

2017-08-01

It is not uncommon to be treating people with addiction who also have significant other health problems, including heart, renal or liver failure, diabetes and vascular disease. These conditions require regular medications to be taken. This can be a problem for people living with addiction and difficult social circumstances affecting compliance, among other issues. Our perspective provides a summary of general pharmacological factors affecting medicine taking in people with addiction problems, to provide a guide for hospital doctors in this setting. © 2017 Royal Australasian College of Physicians.

Social media and communications: developing a policy to guide the flow of information.

PubMed

Midyette, J David; Youngkin, Andrew; Snow-Croft, Sheila

2014-01-01

The use of social media is ubiquitous in the daily lives of nearly three quarters of the population in the United States. This article addresses the process and results of a policy development project for a National Network of Libraries of Medicine Regional Medical Library. Content, scheduling, editing, and author responsibilities are addressed for each of the chosen media outlets, as well as the preparation of prefatory material using an online social media policy development tool.

Community Living Skills Guide: Additional Activities for Nutrition, Cooking, Homemaking, and Family Living.

ERIC Educational Resources Information Center

Nickovich, Marti; Kreps, Alice Roelofs

These activities are intended to supplement materials for three courses available in the Community Living Skills Guide for the College for Living series: Cooking/Food Preparation (CE 024 475), Homemaking and Family Living (CE 024 477), and Nutrition (CE 024 484). These courses for developmentally disabled adults are intended to supplement…

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…

Bioethics and Science.

PubMed

2018-03-01

Bioethics comes in for furious criticism in Stephen Pinker's new book, Enlightenment Now. Pinker argues that scientists are making human lives better and better, and that lives would get still better even faster if bioethicists did not use ideas like informed consent, dignity, sacredness, and social justice to hobble the scientists. Daniel Callahan, a cofounder of The Hastings Center and arguably of bioethics, is perhaps the best living embodiment of a bioethicist who has written about medical progress, and the March-April 2018 issue of the Hastings Center Report turns to him for a review of Pinker's book. In his essay, Callahan describes bioethics as guiding science, addressing problems generated by scientific developments and attempting to head off possible problems, rather than as broadly opposing science. That description of bioethics serves as well as anything to convey the flavor of much of this issue of the Report. © 2018 The Hastings Center.

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.

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education

PubMed Central

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J.A.; Dandorf, Stewart J.; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-01-01

Introduction Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). Conclusion The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills. PMID:27330672

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

PubMed

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills.

Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

PubMed

Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

2017-04-01

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

Evaluating "The Safe Living Guide": A Home Hazard Checklist for Seniors

ERIC Educational Resources Information Center

Sorcinelli, Andrea; Shaw, Lynn; Freeman, Andrew; Cooper, Kim

2007-01-01

Purpose: The purpose of this study was to evaluate the utility and reliability of a home hazard checklist published in Health Canada, "The Safe Living Guide: A Guide to Home Safety for Seniors" (2003). Methods: 76 community-dwelling seniors evaluated the guide, and inter-rater reliability was determined through comparison of ratings of…

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.

Current and future contraceptive options for women living with HIV

PubMed Central

Patel, Rena C.; Bukusi, Elizabeth A.; Baeten, Jared M.

2018-01-01

Introduction Among women living with HIV, half of the pregnancies are unintended. Effective contraception can prevent unintended pregnancies and consequently reduce maternal mortality and perinatal transmission of HIV. While contraceptive options available for all women also apply to women living with HIV, specific considerations exist to the use of contraception by women living with HIV. Areas covered First, general principles guiding the use of contraception among women living with HIV are discussed, such as choice, method mix, relative effectiveness, and drug-drug interactions. Second, a detailed discussion of each contraceptive method and issues surrounding the use of that method, such as drug-drug interactions, follows. Third, future contraceptive options in advanced development for use by women or men are briefly discussed. Expert opinion Contraceptive methods available to all women should also be accessible to women living with HIV. When the relative effectiveness of a contraceptive method is reduced, for example due to drug-drug interactions with antiretrovirals, the method should still be made available to women living with HIV with the appropriate information sharing and counseling. Greater research on various aspects of contraceptive use by women living with HIV and more comprehensive testing of co-administration of hormonal contraceptives and common medications used by these women are warranted. PMID:28891343

Current and future contraceptive options for women living with HIV.

PubMed

Patel, Rena C; Bukusi, Elizabeth A; Baeten, Jared M

2018-01-01

Among women living with HIV, half of the pregnancies are unintended. Effective contraception can prevent unintended pregnancies and consequently reduce maternal mortality and perinatal transmission of HIV. While contraceptive options available for all women also apply to women living with HIV, specific considerations exist to the use of contraception by women living with HIV. Areas covered: First, general principles guiding the use of contraception among women living with HIV are discussed, such as choice, method mix, relative effectiveness, and drug-drug interactions. Second, a detailed discussion of each contraceptive method and issues surrounding the use of that method, such as drug-drug interactions, follows. Third, future contraceptive options in advanced development for use by women or men are briefly discussed. Expert opinion: Contraceptive methods available to all women should also be accessible to women living with HIV. When the relative effectiveness of a contraceptive method is reduced, for example due to drug-drug interactions with antiretrovirals, the method should still be made available to women living with HIV with the appropriate information sharing and counseling. Greater research on various aspects of contraceptive use by women living with HIV and more comprehensive testing of co-administration of hormonal contraceptives and common medications used by these women are warranted.

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.

[Independent Living Skills: Guides and Curriculum Materials.

ERIC Educational Resources Information Center

Cosby, Jane

The author offers curriculums, teaching guides, assessment instruments, and course descriptions for teaching independent living skills to handicapped adolescents and young adults. A guide on cooking and eating is designed to teach students how to use cooking utensils, cook healthy meals, plan nutritious meals, shop wisely, and budget food…

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

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,…

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study

PubMed Central

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-01-01

Objective While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. Design We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. Setting We interviewed participants at Japan Clubs and their offices. Participants 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. Results We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. Conclusions The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. PMID:27006344

Feline aggression toward family members: a guide for practitioners.

PubMed

Bain, Melissa; Stelow, Elizabeth

2014-05-01

Feline aggression toward people is a common and potentially dangerous problem. Proper diagnosis of the underlying cause of the aggression is key in effective treatment. A complete history, including information on the people in the home, other pets, and specific incidents, is necessary to make this diagnosis. A comprehensive treatment plan typically includes management, enhancement of the cat's living environment, techniques for replacing the aggressive behavior with more appropriate behaviors, and, potentially, medication. The treatment plan must reflect the abilities and commitment of the owner. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

Community Living Skills: Nutrition I.

ERIC Educational Resources Information Center

Kreps, Alice Roelofs; Dreith, Rita Vallero

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Nutrition I. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized persons to…

Do Medical Students' Narrative Representations of "The Good Doctor" Change Over Time? Comparing Humanism Essays From a National Contest in 1999 and 2013.

PubMed

Rutberg, Pooja C; King, Brandy; Gaufberg, Elizabeth; Brett-MacLean, Pamela; Dinardo, Perry; Frankel, Richard M

2017-04-01

To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession. The authors noted a highly similar distribution of primary and secondary relational themes for essays from 1999 and 2013. The majority of the essays emphasized the centrality of the doctor-patient relationship. Student essays focused little on teamwork, systems innovation, or technology use-all important developments in contemporary medicine. Medical students' narrative reflections are increasingly used as rich sources of information about the lived experience of medical education. The findings reported here suggest that medical students understand the "good doctor" as a relational being, with an enduring emphasis on the doctor-patient relationship. Medical education would benefit from including an emphasis on the relational aspects of medicine. Future research should focus on relational learning as a pedagogical approach that may support the formation of caring, effective physicians embedded in a complex array of relationships within clinical, community, and larger societal contexts.

Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

ERIC Educational Resources Information Center

Quinlan, Susan E.

Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

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...

'It's hard but you've just gotta get on with it'--The experiences of growing-up with a liver transplant.

PubMed

Wright, Jessica; Elwell, Laura; McDonagh, Janet E; Kelly, Deirdre A; Wray, Jo

2015-01-01

The successful evolution of paediatric liver transplantation means that increasing numbers of young people survive into adulthood. Non-adherence to medication regimens leading to liver dysfunction, graft loss and patient death are prevalent in this vulnerable group. Insight into young people's experiences of living with a liver transplant (LTx) is vital to improve outcomes and guide future work in this area. Through semi-structured interviews, this study explored the experiences of living with a LTx for 13 young people transplanted as children and adolescents. Interviews were analysed using interpretative phenomenological analysis, revealing that young people felt different from their peers as a result of their LTx. Young people's perceptions of their scar, experiences of illness symptoms and taking medications acted as triggers of differences. This led to an ongoing struggle to be normal when faced with typical activities for young people and to attempts to take back control. Findings support the implementation of routine psychosocial screening to identify additional support needs and the development of a peer mentoring programme to allow young people to gain social support, thus reducing feelings of being different. It is hoped that such initiatives will have positive consequences for quality of life, self-management and adherence to medications.

Independent Living Evaluation-Training Program. Reprint Series No. 16.

ERIC Educational Resources Information Center

Van Soest, Eileen; And Others

Intended to be used both as a guide for general program direction and as an individual evaluation and training tool this rehabilitation training guide includes materials and evaluation devices for use with mentally and/or physically handicapped clients on basic, intermediate and advanced living center levels. The eight independent living skill…

Learning to Live Safely: Persisting Life Situation No. 6. A Resource Guide for the Wisconsin EMR Curriculum.

ERIC Educational Resources Information Center

Quackenboss, Rita, Ed.; And Others

Presented in the resource guide for the Wisconsin curriculum for educable mentally retarded students are safety education teaching units. Learning to Live Safely" is the sixth in a series of persisting life situations. The guide lists behavioral objectives, activities, and annotated resource materials (with distributors' addresses) for…

Exploring digital professionalism.

PubMed

Ellaway, Rachel H; Coral, Janet; Topps, David; Topps, Maureen

2015-01-01

The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

Re-entry experiences of Black men living with HIV/AIDS after release from prison: Intersectionality and implications for care.

PubMed

Sun, Shufang; Crooks, Natasha; Kemnitz, Rebecca; Westergaard, Ryan P

2018-06-12

Both the HIV epidemic and incarceration disproportionately affect Black men in the United States. A critical period for incarcerated Black men living with HIV/AIDS is re-entry into the community, which is often associated with adverse health outcomes. Additionally, Black men living with HIV/AIDS involved in the criminal justice system are burdened by multiple, intersecting disadvantaged identities and social positions. This study aimed to examine community re-entry experiences among Black men living with HIV/AIDS from an intersectional perspective. In-depth, semi-structured interviews were conducted with 16 incarcerated Black men in Wisconsin, at pre-release from prison and six months after re-entry. Thematic analysis guided by intersectionality theory was used to analyze interview transcripts. Seven emerged themes included Intersectional Identities and Social Positions, Family Support, Neighborhood Violence, Relationship with Law Enforcement, Employment, Mental Health Concerns, and Medical Care and Medication Management. Intersecting identities and social positions interact with factors at multiple levels to inform health and HIV care. A conceptual framework was developed to illustrate relationships among themes. Findings demonstrate the relevance of intersectionality theory in HIV care with Black men involved in criminal justice system. Incorporating a social-ecological perspective into intersectionality framework could be useful in theoretical and empirical research. Disenfranchised communities may particularly benefit from interventions that address community- and systemic-level issues. Copyright © 2018 Elsevier Ltd. All rights reserved.

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…

From early detection to rehabilitation in the community: reading beyond the blog testimonies of survivors' quality of life and prostate cancer representation.

PubMed

Zanchetta, Margareth Santos; Cognet, Marguerite; Lam-Kin-Teng, Mary Rachel; Dumitriu, Marie Elisabeth; Renaud, Lise; Rhéaume, Jacques

2016-12-16

Survivors' testimonies can reveal much about men's experiences of prostate cancer and impacts on their quality of life (QOL) during the clinical trajectory of the disease. These survivors' shared thoughts and views were hypothesized to reflect salient features of their lived social representation of prostate cancer. We explored the content of testimonies posted by men to a public blog hosted by a French national prostate cancer patients' association. The study question, "What do French bloggers' testimonies reveal about their lived experiences with prostate cancer, especially regarding their quality of life in community settings, that underpin their social representation of prostate cancer?" guided the exploration and analysis of the textual data. The aims were to better understand men's experiences and predominant thoughts and views, to elucidate patients' behaviours, and to enlighten medical policy and practice. Explore issues of QOL as reported by French prostate cancer survivors in a public blog by: (a) identifying the salient aspects and issues of the experience of living with prostate cancer from the perspective of survivors; and (b) analyzing the content in the posted testimonies regarding perceived and lived impacts of prostate cancer on QOL. A critical ethnographic study guided the selection of textual data from 196 male bloggers' testimonies about prostate cancer posted in the period from 2008 to 2013. Media content analysis method was undertaken on blog testimonies, framed by a multidimensional conceptual framework of QOL. Testimonies focused mainly on medical care and rehabilitation, recovery, health education and self-care, as well as on a global vision of prostate cancer and its impacts on personal views of manhood and masculinity. The language used indicated that political, educative and compassionate discourses were intertwined to create a complex representation of the experience and effects of prostate cancer; this multi-faceted representation can inform the public and professional debate about men's capacity to provide emotional support and problem-solve within a community of interest. Findings, while based on data limited to mostly one-time entries to a French blog, contribute to understanding a unique, collective expression of men's lived experiences of prostate cancer. These anonymous survivors shared their varied reactions, ways of coping, and thoughts on needed change.

A systematic review of health literacy interventions for people living with HIV

PubMed Central

Perazzo, Joseph; Reyes, Darcel; Webel, Allison

2017-01-01

Health literacy significantly impacts health-related outcomes among people living with HIV. Our aim was to systematically review current literature on health literacy interventions for people living with HIV. The authors conducted a thorough literature search following the PRISMA statement and the AMSTAR checklist as a guide, and found six studies that met inclusion/exclusion criteria. The majority of these interventions were designed to improve HIV treatment adherence as well as HIV knowledge and treatment-related skills, with one study focusing on e-Health literacy. Several of the studies demonstrated trends toward improvement in medication adherence, but most did not achieve statistical significance primarily due to methodological limitations. Significant improvements in knowledge, behavioral skills, and e-Health literacy were found following interventions (p = 0·001–0·05). Health literacy interventions have the potential to promote HIV-related knowledge, behavioral skills, and self-management practices. More research is needed to assess the efficacy of interventions to promote a variety of self-management practices. PMID:26864691

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…

Green Thumbs: A Kid's Activity Guide to Indoor and Outdoor Gardening.

ERIC Educational Resources Information Center

Carlson, Laurie

This guide contains indoor and outdoor gardening activities for children. The activities teach children how plants live and grow; how the weather, temperature, and seasons affect all living things; how living things come out of seeds and soil; how the birds, earthworms, bees, and toads help in the garden; and how the whole environment works…

Life Management: Moving Out! Solving Practical Problems for Independent Living. Utah Home Economics and Family Life Curriculum Guide.

ERIC Educational Resources Information Center

Utah State Office of Education, Salt Lake City.

This guide, which has been developed for Utah's home economics and family life education program, contains materials for use in teaching a life management course emphasizing the problem-solving skills required for independent living. Discussed first are the assumptions underlying the curriculum, development of the guide, and suggestions for its…

Predicting activities of daily living for cancer patients using an ontology-guided machine learning methodology.

PubMed

Min, Hua; Mobahi, Hedyeh; Irvin, Katherine; Avramovic, Sanja; Wojtusiak, Janusz

2017-09-16

Bio-ontologies are becoming increasingly important in knowledge representation and in the machine learning (ML) fields. This paper presents a ML approach that incorporates bio-ontologies and its application to the SEER-MHOS dataset to discover patterns of patient characteristics that impact the ability to perform activities of daily living (ADLs). Bio-ontologies are used to provide computable knowledge for ML methods to "understand" biomedical data. This retrospective study included 723 cancer patients from the SEER-MHOS dataset. Two ML methods were applied to create predictive models for ADL disabilities for the first year after a patient's cancer diagnosis. The first method is a standard rule learning algorithm; the second is that same algorithm additionally equipped with methods for reasoning with ontologies. The models showed that a patient's race, ethnicity, smoking preference, treatment plan and tumor characteristics including histology, staging, cancer site, and morphology were predictors for ADL performance levels one year after cancer diagnosis. The ontology-guided ML method was more accurate at predicting ADL performance levels (P < 0.1) than methods without ontologies. This study demonstrated that bio-ontologies can be harnessed to provide medical knowledge for ML algorithms. The presented method demonstrates that encoding specific types of hierarchical relationships to guide rule learning is possible, and can be extended to other types of semantic relationships present in biomedical ontologies. The ontology-guided ML method achieved better performance than the method without ontologies. The presented method can also be used to promote the effectiveness and efficiency of ML in healthcare, in which use of background knowledge and consistency with existing clinical expertise is critical.

"Everybody Knows Everybody Else's Business"-Privacy in Rural Communities.

PubMed

Leung, Janni; Smith, Annetta; Atherton, Iain; McLaughlin, Deirdre

2016-12-01

Patients have a right to privacy in a health care setting. This involves conversational discretion, security of medical records and physical privacy of remaining unnoticed or unidentified when using health care services other than by those who need to know or whom the patient wishes to know. However, the privacy of cancer patients who live in rural areas is more difficult to protect due to the characteristics of rural communities. The purpose of this article is to reflect on concerns relating to the lack of privacy experienced by cancer patients and health care professionals in the rural health care setting. In addition, this article suggests future research directions to provide much needed evidence for educating health care providers and guiding health care policies that can lead to better protection of privacy among cancer patients living in rural communities.

Changes for the new AMA Guides to impairment ratings, 6th Edition: implications and applications for physician disability evaluations.

PubMed

Rondinelli, Robert D

2009-07-01

U.S. Disability Systems share a common procedural approach to the determination of disability for purposes of compensation. The structural and anatomical consequences of the injury or disease are defined and measured according to medical impairment, which is used to estimate the individual's loss in terms of their capacity to perform activities of daily living (ADLs) and, presumptively, their losses in terms of vocational and non-vocational pursuits and quality of life. The physician is traditionally empowered to rate the severity of impairment in terms of a percentage loss to the "whole person" and according to criteria specific to each disability system. Often, the impairment percentage so derived, then is directly translated into a monetary sum for purposes of compensating these losses. The AMA periodically publishes and updates a physician impairment rating guide (the AMA Guides). The 6th Edition, published in 2008, incorporates the definitions and terminology of the ICF and provides a simple means of assessment of ADLs as part of the rating process. It also has shifted the ratings criteria towards a diagnosis-based approach, ostensibly to improve inter-rater consistency and reliability. Further work is needed to refine and validate ADL-based functional assessment tools applicable to medical impairment ratings, and to demonstrate the levels of consistency and reliability of the new rating method. Of equal importance, operational standardization across systems is also needed to enable common criteria and metrics to be developed and applied when determining the non-medical aspects of disability according to vocational and non-vocational pursuits and quality of life. Impairment ratings cannot be optimally designed to serve as the singular determinant of, nor be held solely accountable for, the disability awards.

Design, Planning and Management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón.

PubMed

Fuente-Martín, C de la; Fuente Martín, B de la; Grifol-Clar, E

2017-12-01

The design and management of a Hospital Custody Unit at Hospital Universitario Fundación Alcorcón, to focus the aim of this study on specialized medical care for extra-penitentiary patients who have suffered from a disease. We are building a new space to facilitate their daily lives at hospital and we want to offer a double function to the patients that consists of a custody space and a health rehabilitation space. We carried out a scientific literature search on the international and national databases, about Hospital Custody Units or Restricted Access Units. The language of the reviews that we checked was English and Spanish. We wrote the Action Guide of the Hospital Custody Unit for the design, planning and management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón. (We included complementary bibliographic material and the Quick Guide in the Unit). The Hospital Custody Unit will be compatible with medical activity, occupational safety and the custody of patients that are in prison. We thus require consensus with police departments about custody protocols along with assistance from the clinicians' teams at penitentiary centers and referral hospitals. Furthermore, it is important to step up special care for mental health and to promote telemedicine and new technologies to streamline medical care along with coordination with healthcare professionals.

Use of Opioid Analgesics in Older Australians.

PubMed

Veal, Felicity C; Bereznicki, Luke R E; Thompson, Angus J; Peterson, Gregory M

2015-08-01

To identify potential medication management issues associated with opioid use in older Australians. Retrospective cross-sectional review of the utilization of analgesics in 19,581 people who underwent a medication review in Australia between 2010 and 2012. Australian residents living in the community deemed at risk for adverse medication outcomes or any resident living fulltime in an aged care facility. Patient characteristics in those taking regularly dosed opioids and not and those taking opioid doses >120 mg and ≤120 mg MEQ/day were compared. Multivariable binary logistic regression was used to analyze the association between regular opioid and high dose opioid usage and key variables. Additionally, medication management issues associated with opioids were identified. Opioids were taken by 31.8% of patients, with 22.1% taking them regularly. Several major medication management issues were identified. There was suboptimal use of multimodal analgesia, particularly a low use of non-opioid analgesics, in patients taking regular opioids. There was extensive use (45%) of concurrent anxiolytics/hypnotics among those taking regular opioid analgesics. Laxative use in those prescribed opioids regularly was low (60%). Additionally, almost 12% of patients were taking doses of opioid that exceeded Australian recommendations. A significant evidence to practice gap exists regarding the use of opioids amongst older Australians. These findings highlight the need for a quick reference guide to support prescribers in making appropriate decisions regarding pain management in older patients with persistent pain. This should also be combined with patient and caregiver education about the importance of regular acetaminophen to manage persistent pain. Wiley Periodicals, Inc.

Development of a Bridge Construction Live Load Analysis Guide

DOT National Transportation Integrated Search

2012-12-01

This project was sponsored through the Wisconsin Highway Research Program and its Structure Technical Oversight : Committee. The objective of this research was to develop a guide for the analysis of construction loads with and without : traffic live ...

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

PubMed

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-03-22

While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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.…

Day By Day in English: An ESL-SEDAC Daily Living Skills Resource Activities Guide. Final Edition and Resource Activities Packet, Final Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Special Education.

The guide provides daily living experiences built around topics of interest to limited English speaking students in special education programs. Units are organized around eight themes: (1) at school; (2) living at home; (3) community, communication, and travel; (4) clothing and seasons; (5) shopping and food; (6) health, hygiene, and safety; (7)…

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...

Ultrasound-guided transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective, randomized, double-blinded clinical trial.

PubMed

Kıtlık, Arzu; Erdogan, Mehmet Ali; Ozgul, Ulku; Aydogan, Mustafa Said; Ucar, Muharrem; Toprak, Huseyin Ilksen; Colak, Cemil; Durmus, Mahmut

2017-02-01

Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right "J" abdominal incision was used. This prospective, double-blinded, randomized controlled study was conducted with 50 living liver donors, aged 18-65years, who were scheduled to undergo right hepatectomy. Patients who received ultrasonography-guided subcostal TAP block were allocated into Group 1, and patients who did not receive TAP block were allocated into Group 2. The TAP blocks were performed bilaterally at the conclusion of surgery using 1.5mg∗kg -1 bupivacaine diluted with saline to reach a total volume of 40mL. For each patient, morphine consumption, pain scores at rest and movement, sedation scores, nausea, vomiting and the need for antiemetic medication were assessed at 0, 2, 4, 6, 12 and 24h postoperatively by researchers who were blinded to the study groups. Morphine consumption was significantly lower in Group 1 than in Group 2 at the 2nd, 6th and 24th hours (P<0.05). The mean total morphine consumption values after 24h were 40mg and 65mg in Groups 1 and 2, respectively. The TAP block significantly reduced postoperative visual analog scale pain scores both at rest and during movement at 0, 2, 4, 6, and 24h postoperatively (P<0.05). The TAP block reduced 24-h postoperative morphine consumption and contributed to analgesia in living liver donors who underwent upper abdominal wall incisions. Copyright © 2016 Elsevier Inc. All rights reserved.

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…

Structured Transition Protocol for Children with Cystinosis

PubMed Central

Raina, Rupesh; Wang, Joseph; Krishnappa, Vinod

2017-01-01

The transition from pediatric to adult medical services has a greater impact on the care of adolescents or young adults with chronic diseases such as cystinosis. This transition period is a time of psychosocial development and new responsibilities placing these patients at increased risk of non-adherence. This can lead to serious adverse effects such as graft loss and progression of the disease. Our transition protocol will provide patients, families, physicians, and all those involved a structured guide to transitioning cystinosis patients. This structured protocol depends on four areas of competency: Recognition, Insight, Self-reliance, and Establishment of healthy habits (RISE). This protocol has not been tested and therefore challenges not realized. With a focus on medical, social, and educational/vocational aspects, we aim to improve transition for cystinosis patients in all aspects of their lives. PMID:28913329

Development of the Korean Academy of Medical Sciences Guideline for Rating the Impairment in the Brain Injured and Brain Diseased Persons with Motor Dysfunction

PubMed Central

Baik, Jong Sam; Jang, Seong Ho; Park, Dong Sik

2009-01-01

To develop an objective and scientific method to evaluate the brain injured and brain diseased persons with motor dysfunction, American Medical Association's Guides to the Evaluation of Permanent Impairment was used as an exemplar. After the motor dysfunction due to brain injury or brain disease was confirmed, active range of motion and muscle strength of affected extremities were measured. Also, the total function of extremities was evaluated through the assessment of activities of daily living, fine coordination of hand, balance and gait. Then, the total score of manual muscle test and functional assessment of impaired upper and lower extremity were added, respectively. Spasticity of upper and lower extremity was used as minus factors. Patients with movement disorder such as Parkinson's disease were assessed based on the degree of dysfunction in response to medication. We develop a new rating system based on the concept of total score. PMID:19503680

Increasing participation in cancer research: insights from Native Hawaiian women in medically underserved communities.

PubMed

Ka'opua, Lana Sue; Mitschke, Diane; Lono, Joelene

2004-09-01

The cancer burden falls heavily on Native Hawaiian women, and of particular concern are those living in medically underserved communities where participation in potentially helpful clinical studies may be limited. Difficulty in accrual of Native Hawaiian women to a culturally-grounded intervention led researchers to conduct focus groups aimed at exploring attitudes towards research, use of a traditional Hawaiian practice for family discussion, and study promotion. Social marketing theory guided the development of discussion questions and a survey. Through purposive sampling, 30 women from medically underserved communities were recruited. Content analysis was used to identify major discussion themes. Findings indicate that lack of informational access may be a major barrier to participation. Study information disseminated through community channels with targeted outreach to social and religious organizations, promotion through face-to-face contact with researchers, and culturally tailored messages directed to families were preferred. Community oriented strategies based on linkages with organizational networks may increase participation.

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,…

Personal values of family physicians, practice satisfaction, and service to the underserved.

PubMed

Eliason, B C; Guse, C; Gottlieb, M S

2000-03-01

Personal values are defined as "desirable goals varying in importance that serve as guiding principles in people's lives," and have been shown to influence specialty choice and relate to practice satisfaction. We wished to examine further the relationship of personal values to practice satisfaction and also to a physician's willingness to care for the underserved. We also wished to study associations that might exist among personal values, practice satisfaction, and a variety of practice characteristics. We randomly surveyed a stratified probability sample of 1224 practicing family physicians about their personal values (using the Schwartz values questionnaire), practice satisfaction, practice location, breadth of practice, demographics, board certification status, teaching involvement, and the payor mix of the practice. Family physicians rated the benevolence (motivation to help those close to you) value type highest, and the ratings of the benevolence value type were positively associated with practice satisfaction (correlation coefficient = 0.14, P = .002). Those involved in teaching medical trainees were more satisfied than those who were not involved (P = .009). Some value-type ratings were found to be positively associated with caring for the underserved. Those whose practices consisted of more than 40% underserved (underserved defined as Medicare, Medicaid, and indigent populations) rated the tradition (motivation to maintain customs of traditional culture and religion) value type significantly higher (P = .02). Those whose practices consisted of more than 30% indigent care rated the universalism (motivation to enhance and protect the well-being of all people) value type significantly higher (P = .03). Family physicians who viewed benevolence as a guiding principle in their lives reported a higher level of professional satisfaction. Likewise, physicians involved in the teaching of medical trainees were more satisfied with their profession. Family physicians who rate the universalism values highly are more likely to provide care to the indigent.

Live imaging using adaptive optics with fluorescent protein guide-stars

PubMed Central

Tao, Xiaodong; Crest, Justin; Kotadia, Shaila; Azucena, Oscar; Chen, Diana C.; Sullivan, William; Kubby, Joel

2012-01-01

Spatially and temporally dependent optical aberrations induced by the inhomogeneous refractive index of live samples limit the resolution of live dynamic imaging. We introduce an adaptive optical microscope with a direct wavefront sensing method using a Shack-Hartmann wavefront sensor and fluorescent protein guide-stars for live imaging. The results of imaging Drosophila embryos demonstrate its ability to correct aberrations and achieve near diffraction limited images of medial sections of large Drosophila embryos. GFP-polo labeled centrosomes can be observed clearly after correction but cannot be observed before correction. Four dimensional time lapse images are achieved with the correction of dynamic aberrations. These studies also demonstrate that the GFP-tagged centrosome proteins, Polo and Cnn, serve as excellent biological guide-stars for adaptive optics based microscopy. PMID:22772285

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:…

Empathy, justice, and moral behavior

PubMed Central

Decety, Jean; Cowell, Jason M.

2015-01-01

Empathy shapes the landscape of our social lives. It motivates prosocial and caregiving behaviors, plays a role in inhibiting aggression, and facilitates cooperation between members of a similar social group. Thus, empathy is often conceived as a driving motivation of moral behavior and justice, and as such, everyone would think that it should be cultivated. However, the relationships between empathy, morality, and justice are complex. We begin by explaining what the notion of empathy encompasses and then argue how sensitivity to others’ needs has evolved in the context of parental care and group living. Next, we examine the multiple physiological, hormonal, and neural systems supporting empathy and its functions. One troubling but important corollary of this neuro-evolutionary model is that empathy produces social preferences that can conflict with fairness and justice. An understanding of the factors that mold our emotional response and caring motivation for others helps provide organizational principles and ultimately guides decision-making in medical ethics. PMID:26877887

Molecules in Living Systems: A Biochemistry Module. Teacher's Guide.

ERIC Educational Resources Information Center

Martin, David; Sampugna, Joseph; Sandoval, Amado

This teacher's guide provides information and resources for helping to familiarize students with chemistry and its everyday applications around the world using inquiry and investigations. Contents include: (1) "Introducing Molecules in Living Systems"; (2) "Considering Life Processes"; (3) "Understanding the Structure of Biomolecules"; (4)…

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.

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…

Optical coherence tomography guided microinjections in live mouse embryos: high-resolution targeted manipulation for mouse embryonic research.

PubMed

Syed, Saba H; Coughlin, Andrew J; Garcia, Monica D; Wang, Shang; West, Jennifer L; Larin, Kirill V; Larina, Irina V

2015-05-01

The ability to conduct highly localized delivery of contrast agents, viral vectors, therapeutic or pharmacological agents, and signaling molecules or dyes to live mammalian embryos is greatly desired to enable a variety of studies in the field of developmental biology, such as investigating the molecular regulation of cardiovascular morphogenesis. To meet such a demand, we introduce, for the first time, the concept of employing optical coherence tomography (OCT)-guide microinjections in live mouse embryos, which provides precisely targeted manipulation with spatial resolution at the micrometer scale. The feasibility demonstration is performed with experimental studies on cultured live mouse embryos at E8.5 and E9.5. Additionally, we investigate the OCT-guided microinjection of gold–silica nanoshells to the yolk sac vasculature of live cultured mouse embryos at the stage when the heart just starts to beat, as a potential approach for dynamic assessment of cardiovascular form and function before the onset of blood cell circulation. Also, the capability of OCT to quantitatively monitor and measure injection volume is presented. Our results indicate that OCT-guided microinjection could be a useful tool for mouse embryonic research.

Optical coherence tomography guided microinjections in live mouse embryos: high-resolution targeted manipulation for mouse embryonic research

PubMed Central

Syed, Saba H.; Coughlin, Andrew J.; Garcia, Monica D.; Wang, Shang; West, Jennifer L.; Larin, Kirill V.; Larina, Irina V.

2015-01-01

Abstract. The ability to conduct highly localized delivery of contrast agents, viral vectors, therapeutic or pharmacological agents, and signaling molecules or dyes to live mammalian embryos is greatly desired to enable a variety of studies in the field of developmental biology, such as investigating the molecular regulation of cardiovascular morphogenesis. To meet such a demand, we introduce, for the first time, the concept of employing optical coherence tomography (OCT)-guide microinjections in live mouse embryos, which provides precisely targeted manipulation with spatial resolution at the micrometer scale. The feasibility demonstration is performed with experimental studies on cultured live mouse embryos at E8.5 and E9.5. Additionally, we investigate the OCT-guided microinjection of gold–silica nanoshells to the yolk sac vasculature of live cultured mouse embryos at the stage when the heart just starts to beat, as a potential approach for dynamic assessment of cardiovascular form and function before the onset of blood cell circulation. Also, the capability of OCT to quantitatively monitor and measure injection volume is presented. Our results indicate that OCT-guided microinjection could be a useful tool for mouse embryonic research. PMID:25581495

Living Classrooms: Learning Guide for Famous & Historic Trees.

ERIC Educational Resources Information Center

American Forest Foundation, Washington, DC.

This guide provides information to create and care for a Famous and Historic Trees Living Classroom in which students learn American history and culture in the context of environmental change. The booklet contains 10 hands-on activities that emphasize observation, critical thinking, and teamwork. Worksheets and illustrations provide students with…

Living Effectively in the 70's.

ERIC Educational Resources Information Center

Alexis I. DuPont School District, Greenville, DE.

GRADES OR AGES: Unspecified. SUBJECT MATTER: Effective living. ORGANIZATION AND PHYSICAL APPEARANCE: Most of the pages are divided into three columns: concept, some activities, and teacher comments. The guide is offset printed and spiral bound with a soft cover. OBJECTIVES AND ACTIVITIES: The guide is divided into eight units: human growth and…

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…

Global History. A Curriculum Guide. Third Semester. Theme VIII: Economic, Political, and Cultural Changes in the Post-War World Affect Our Lives Today. Teacher Strategies. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

Designed for use in the New York City public secondary schools, this guide was developed to assist the teacher and supervisor in using a three semester, eight theme, global history course. This guide, which covers "Economic, Political, and Cultural Changes in the Post-War World Affect Our Lives Today" is divided into eight sub-themes: (1)…

Ten Principles to Guide Health Reform.

PubMed

Gerald, Joe K

2017-03-01

Americans face inevitable trade-offs between health care affordability, accessibility, and innovation. Although numerous reforms have been proposed, universal principles to guide decision-making are lacking. Solving the challenges that confront us will be difficult, owing to intense partisan divisions and a dysfunctional political process. Nevertheless, we must engage in reasoned debate that respects deeply held differences of opinion regarding our individual and collective obligations to promote healthy living and ensure affordable access to health care. Otherwise, our decisions will be expressed through political processes that reflect the preferences of narrow interests rather than the general public. Our health care system can be made more efficient and equitable by incentivizing consumers and providers to utilize high-value care and avoid low-value care. To accomplish this, we must understand the determinants of consumer and provider behavior and implement policies that encourage, but do not force, optimal decision-making. Although distinguishing between low- and high-value treatments will invariably threaten established interests, we must expand our capacity to make such judgements. Throughout this process, consumers, taxpayers, and policy makers must maintain realistic expectations. Although realigning incentives to promote high-value care will improve efficiency, it is unlikely to control increasing medical expenditures because they are not primarily caused by inefficiency. Rather, rising medical expenditures are driven by medical innovation made possible by increasing incomes and expanding health insurance coverage. Failure to recognize these linkages risks adopting indiscriminate policies that will reduce spending but slow innovation and impair access to needed care.

Efficacy of computer-based video and simulation in ultrasound-guided regional anesthesia training.

PubMed

Woodworth, Glenn E; Chen, Elliza M; Horn, Jean-Louis E; Aziz, Michael F

2014-05-01

To determine the effectiveness of a short educational video and simulation on improvement of ultrasound (US) image acquisition and interpretation skills. Prospective, randomized study. University medical center. 28 anesthesia residents and community anesthesiologists with varied ultrasound experience were randomized to teaching video with interactive simulation or sham video groups. Participants were assessed preintervention and postintervention on their ability to identify the sciatic nerve and other anatomic structures on static US images, as well as their ability to locate the sciatic nerve with US on live models. Pretest written test scores correlated with reported US block experience (Kendall tau rank r = 0.47) and with live US scanning scores (r = 0.64). The teaching video and simulation significantly improved scores on the written examination (P < 0.001); however, they did not significantly improve live US scanning skills. A short educational video with interactive simulation significantly improved knowledge of US anatomy, but failed to improve hands-on performance of US scanning to localize the nerve. Copyright © 2014 Elsevier Inc. All rights reserved.

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…

Assessment of medical students' attitudes on social media use in medicine: a cross-sectional study.

PubMed

Avcı, Kadriye; Çelikden, Sevda Gerek; Eren, Semih; Aydenizöz, Doğukan

2015-02-15

Social media has created a revolution in health services. Information available on the Internet and via social media is now being used as reference guides for sensitive health issues by nonprofessionals, physicians, and medical students. When used by physicians and medical students, social media has the potential to raise issues such as the blurring of the line between professional and private lives, patient relations, and medical ethics. The aim of this cross-sectional study was to evaluate the use of social media and attitudes toward its use in medicine among medical students. Medical students from Afyon Kocatepe University, Faculty of Medicine (Afyonkarahisar, Turkey) were asked to participate in a survey consisting of two sections, the first containing questions assessing the frequency of social media use and the second regarding attitudes toward the use of social media in medicine. Survey responses indicated that 93.4% of medical students used social media and 89.3% used social media for professional purposes. Factor analysis showed that attitudes toward social media are based on five factors: professional usefulness, popularity, ethics, barriers, and innovativeness. A structural equation model revealed the highest positive correlation between usefulness and innovativeness; ethics had a low but positive correlation with other factors. Although social media is being used extensively by medical students, they appear unaware of possible ethical issues. Therefore, social media guidelines should be developed.

Teen Living. 7015. Curriculum Guide.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh. Div. of Vocational and Technical Education Services.

This curriculum guide was developed as a resource for teachers to use in planning and implementing a competency-based instructional program on teenage living at the high school level. It contains materials for a 2-semester consumer home economics course, based on the North Carolina Program of Studies (revised 1992); it is designed to help students…

How to save lives and reduce injuries : a citizen activist guide to effectively fight drunk driving.

DOT National Transportation Integrated Search

1982-08-01

This guide is designed to teach you the basics of exactly how to get drunk drivers off the roads in enough numbers so that there will, in fact, be significantly fewer innocent people killed and injured where you live. And it only takes one motivated ...

Alcohol and Drug Prevention Curriculum Resource Guide Grades 10-12: Science--Biology.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh. Alcohol and Drug Defense Program.

This curriculum resource guide on alcohol and drug prevention provides suggested activities for teachers of grades 10 through 12. Three integrated learning activities for science/biology and healthful living are presented. The science/biology goal is understanding the biology of humans. Healthful living goals include analyzing drug and alcohol use…

Teacher's Guide to Accompany Living Latin: A Contemporary Approach.

ERIC Educational Resources Information Center

Masciantonio, Rudolph

This guide, designed to assist teachers in the classroom use of "Living Latin: A Contemporary Approach", emphasizes procedures to be followed in each chapter of Book One; special procedures for teaching the introduction and first chapter are treated separately. Use of the text as a supplement to Sweet's "Artes Latinae" is discussed. Appendixes…

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…

The Role of Communication During Trauma Activations: Investigating the Need for Team and Leader Communication Training.

PubMed

Raley, Jessica; Meenakshi, Rani; Dent, Daniel; Willis, Ross; Lawson, Karla; Duzinski, Sarah

Fatal errors due to miscommunication among members of trauma teams are 2 to 4 times more likely to occur than in other medical teams, yet most trauma team members do not receive communication effectiveness training. A needs assessment was conducted to examine trauma team members' miscommunication experiences and research scientists' evaluations of live trauma activations. The purpose of this study is to demonstrate that communication training is necessary and highlight specific team communication competencies that trauma teams should learn to improve communication during activations. Data were collected in 2 phases. Phase 1 required participants to complete a series of surveys. Phase 2 included live observations and assessments of pediatric trauma activations using the assessment of pediatric resuscitation team assessments (APRC-TA) and assessment of pediatric resuscitation leader assessments (APRC-LA). Data were collected at a southwestern pediatric hospital. Trauma team members and leaders completed surveys at a meeting and were observed while conducting activations in the trauma bay. Trained research scientists and clinical staff used the APRC-TA and APRC-LA to measure trauma teams' medical performance and communication effectiveness. The sample included 29 healthcare providers who regularly participate in trauma activations. Additionally, 12 live trauma activations were assessed monday to friday from 8am to 5pm. Team members indicated that communication training should focus on offering assistance, delegating duties, accepting feedback, and controlling emotional expressions. Communication scores were not significantly different from medical performance scores. None of the teams were coded as effective medical performance and ineffective team communication and only 1 team was labeled as ineffective leader communication and effective medical performance. Communication training may be necessary for trauma teams and offer a deeper understanding of the communication competencies that should be addressed. The APRC-TA and APRC-LA both include team communication competencies that could be used as a guide to design training for trauma team members and leaders. Researchers should also continue to examine recommendations for improved team and leader communication during activations using in-depth interviews and focus groups. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

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.

DNA-assisted upconversion nanoplatform for imaging-guided synergistic therapy and laser-switchable drug detoxification.

PubMed

Li, Luoyuan; Hao, Panlong; Wei, Peng; Fu, Limin; Ai, Xicheng; Zhang, Jianping; Zhou, Jing

2017-08-01

The side effects of chemotherapy bring significant physical and psychological suffering to patients. To solve this urgent medical problem, Yb 3+ and Er 3+ co-doped NaLuF 4 upconversion nanoparticles (UCNPs) were constructed for upconversion luminescence (UCL)-labeled diagnosis under 980 nm laser irradiation. The UCNPs were then modified layer by layer with polypyrrole and a special programming DNA segment as photothermal conversion agents and controllable drug carriers, respectively. The nanoplatform was successfully used for imaging-guided synergistic therapy (photothermal therapy and chemotherapy) at a safe power density (300 mW cm -2 ), and DNA-assisted detoxification at lower temperature in cancer cells when the laser off. The synergistic therapy of the nanoplatform achieved a higher therapeutic index (∼85%) than chemotherapy only (∼44%) and photothermal therapy only (∼25%) in vitro. In vivo experiments also suggested that the nanoplatform had a higher therapeutic effect and lower side effects. The toxicity study was also evaluated, indicating the nanoplatform is low toxic to living system. This multifunctional upconversion nanoplatform provided an innovative method for imaging-guided photothermal-chemotherapy and laser-switchable drug detoxification. Copyright © 2017 Elsevier Ltd. All rights reserved.

Towards image-guided atrial septal defect repair: an ex vivo analysis

NASA Astrophysics Data System (ADS)

Kwartowitz, David M.; Mefleh, Fuad N.; Baker, George H.

2012-02-01

The use of medical images in the operating room for navigation and planning is well established in many clinical disciplines. In cardiology, the use of fluoroscopy for the placement of catheters within the heart has become the standard of care. While fluoroscopy provides a live video sequence with the current location, it poses risks the patient and clinician through exposure to radiation. Radiation dose is cumulative and thus children are at even greater risk from exposure. To reduce the use of radiation, and improve surgical technique we have begun development of an image-guided navigation system, which can deliver therapeutic devices via catheter. In this work we have demonstrated the intrinsic properties of our imaging system, which have led to the development of a phantom emulating a childs heart with an ASD. Further investigation into the use of this information, in a series of mock clinical experiments, will be performed to design procedures for inserting devices into the heart while minimizing fluoroscopy use.

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.

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,…

Using Complexity Theory to Guide Medical School Evaluations.

PubMed

Jorm, Christine; Roberts, Chris

2018-03-01

Contemporary medical school evaluations are narrow in focus and often do not consider the wider systems implications of the relationship between learning and teaching, research, clinical care, and community engagement. The result is graduates who lack the necessary knowledge and skills for the modern health care system and an educational system that is limited in its ability to learn and change.To address this issue, the authors apply complexity theory to medical school evaluation, using four key factors-nesting, diversity, self-organization, and emergent outcomes. To help medical educators apply this evaluation approach in their own settings, the authors offer two tools-a modified program logic model and sensemaking. In sensemaking, they use the organic metaphor of the medical school as a neuron situated within a complex neural network to enable medical educators to reframe the way they think about program evaluation. The authors then offer practical guidance for applying this model, including describing the example of addressing graduates' engagement in the health care system. The authors consider the input of teachers, the role of culture and curriculum, and the clinical care system in this example.Medical school evaluation is reframed as an improvement science for complex social interventions (medical school is such an intervention) in this model. With complexity theory's focus on emergent outcomes, evaluation takes on a new focus, reimagining medical students as reaching their future potential as change agents, who transform health systems and the lives of patients.

Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

PubMed

Chung, Esther K; Siegel, Benjamin S; Garg, Arvin; Conroy, Kathleen; Gross, Rachel S; Long, Dayna A; Lewis, Gena; Osman, Cynthia J; Jo Messito, Mary; Wade, Roy; Shonna Yin, H; Cox, Joanne; Fierman, Arthur H

2016-05-01

Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources. Copyright © 2016 Mosby, Inc. All rights reserved.

Acceptance and perceived usefulness of robots to assist with activities of daily living and healthcare tasks.

PubMed

Hall, Amanda K; Backonja, Uba; Painter, Ian; Cakmak, Maya; Sung, Minjung; Lau, Timothy; Thompson, Hilaire J; Demiris, George

2017-11-29

As the number of older adults living with chronic conditions continues to rise, they will require assistance with activities of daily living (ADL) and healthcare tasks to continue living independently in their homes. One proposed solution to assist with the care needs of an aging population and a shrinking healthcare workforce is robotic technology. Using a cross-sectional survey design, we purposively sampled adults (≥18 years old) to assess generational acceptance and perceived usefulness of robots to assist with ADLs, healthcare tasks, and evaluate acceptance of robotic healthcare assistance across different settings. A total of 499 adults (age range [years] 18-98, Mean = 38.7, SD = 22.7) responded to the survey. Significant differences were found among young, middle-aged, and older adults on perceived usefulness of robots for cleaning, escorting them around town, acting as companionship, delivering meals, assessing sadness and calling for help, providing medical advice, taking vital sign assessments, and assisting with personal care (p < 0.05). The majority of younger adults reported that they would like a robot to provide healthcare assistance in the hospital, compared to middle-aged and older adults (p < 0.001). Results of this study can guide the design of robots to assist adults of all ages with useful tasks.

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.

Value of artisanal simulators to train veterinary students in performing invasive ultrasound-guided procedures.

PubMed

Hage, Maria Cristina F N S; Massaferro, Ana Beatriz; Lopes, Érika Rondon; Beraldo, Carolina Mariano; Daniel, Jéssika

2016-03-01

Pericardial effusion can lead to cardiac tamponade, which endangers an animal's life. Ultrasound-guided pericardiocentesis is used to remove abnormal liquid; however, it requires technical expertise. In veterinary medical education, the opportunity to teach this procedure to save lives during emergencies is rare; therefore, simulators are recommended for this practice. The present study aimed to create a model that can be made "at home" at low cost for ultrasound-guided pericardiocentesis training and to gather feedback about this model through questionnaires given to the participants. Eighteen professionals and thirty-six students were introduced to the simulator in pairs. After the simulation training session, participants filled out the questionnaire. Participants considered the model strong in the following areas: visualization of the pericardium, the heart, fluid in the pericardium, and fluid decrease during fictitious pericardiocentesis and its realism. They considered the model weak or moderate in the following areas: visualization of the surrounding tissues, difficulty of pericardial puncture, and visualization of the catheter. The professionals classified the realism of the experimental heart as moderate, whereas the undergraduate students classified it as strong. All participants believed that the experimental model could be useful in preparing for a future real situation. This model fulfills the need for a practical, realistic, and cost-effective model for ultrasound-guided pericardiocentesis training. Copyright © 2016 The American Physiological Society.

Unsung heroes, flying blind - a metasynthesis of parents' experiences of caring for children with special health care needs at home.

PubMed

Nygård, Carina; Clancy, Anne

2018-05-13

To aggregate, synthesize and interpret qualitative research studies of parents' experiences of caring for a child with special health care needs at home. Advances in the field of medical and nursing science have ensured better survival rates for children with chronic illnesses. Many of these children have significant special health care needs. Today parents assume a caregiver role, undertaking tasks previously provided by nurses in hospitals. As the complexity of care delivered by parents continues to develop, synthesized knowledge can provide an evidence base that will support and guide nurses when caring for these families. Metasynthesis. Based upon a systematic search protocol a structured literature search, covering the years 2003-2016 was conducted in five electronic databases. Ten studies were included and appraised using the Critical Appraisal Skills Program assessment tool. A metasummary and a metasynthesis were undertaken guided by the metasynthesis methodology as described by Sandelowski and Barroso (2007). The results were interpreted and integrated under the overarching theme "unsung heroes, flying blind", supported by eight elucidating categories that illustrate aspects of the parents' life world. The enormous burden of care can weaken the parents' will to carry on and result in a decreased ability to provide care. This can have an impact on the parents' health, family functioning and the sick child's potential health outcomes. Nurses are in a unique position to help these families and should be better prepared for the role. Knowledge of how parents of children with special health care needs experience their daily lives can promote trust in nurses and guide them in their efforts to support families with children living with chronic illness. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A Guide to the Study of a Victorian Household.

ERIC Educational Resources Information Center

Hewett, Marie; MacAdam, Barbara

Designed to introduce secondary school students to a variety of historical resources on local, family, and 19th century cultural history, the primary materials presented in this guide provide insight into the lives of one family, the D. H. Osbornes, who lived in Victor, New York, from the 1850's through the first half of this century. Based on a…

Strawberry Square. Thirty-Three Programs in Music Education for Children in Kindergarten and First Grade. Teacher's Guide.

ERIC Educational Resources Information Center

Brown, Sheila; Griffin, Nancy

This teacher's guide accompanies a series of television programs in music education for kindergarten and first-grade children. The story line of the programs centers around the revitalization of a once run down neighborhood called Strawberry Square where people had forgotten how to sing, dance, and live joyful lives. The program builds upon the…

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…

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…

[Living wills under close scrutiny: Medical consultation is indispensable].

PubMed

Schöffner, M; Schmidt, K W; Benzenhöfer, U; Sahm, S

2012-03-01

Since September 2009 the handling of living wills has been regulated by law. Even though a medical consultation is not imperative for the drawing up of a living will, first surveys have shown that medical information about clinical pictures and treatment options lead to an important specification of living wills. For the first time in Germany, a questionnaire has been developed to investigate the impact of medical consultations on the content of living wills. It revealed that nearly all the people surveyed who had already drawn up a living will wished to change the content of their completed will after attending the seminar because the previous version was no longer in accordance with their wishes. In the light of the frequent difficulties in hospitals concerning how to apply a living will to an actual clinical situation, we believe structured medical consultations to be indispensable. © Georg Thieme Verlag KG Stuttgart · New York.

Using Genes to Guide Prescriptions

MedlinePlus

... Science > Using Genes to Guide Prescriptions Inside Life Science View All Articles | Inside Life Science Home Page Using Genes to Guide Prescriptions By ... to Zoloft: Ways Medicines Work This Inside Life Science article also appears on LiveScience . Learn about related ...

Description and Demonstration of Cognitive Behavioral Therapy to Enhance Antiretroviral Therapy Adherence and Treat Depression in HIV-Infected Adults.

PubMed

Newcomb, Michael E; Bedoya, C Andres; Blashill, Aaron J; Lerner, Jonathan A; O'Cleirigh, Conall; Pinkston, Megan M; Safren, Steven A

2015-11-01

There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Furthermore, depression has been found to be associated with nonadherence to antiretroviral therapy (ART), as well as HIV disease progression. Cognitive behavioral therapy (CBT) has repeatedly been found to effectively treat depression in adult populations, and CBT for adherence and depression (CBT-AD) is an effective treatment for improving depressive symptoms and medication adherence in the context of various chronic health conditions, including diabetes and HIV-infection. This paper provides a description of the CBT-AD approach to treat depression and ART adherence in HIV-infected adults, which we have developed and tested in our clinic, and for which detailed therapist and client guides exist. To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment, including Life-Steps for medication adherence, orientation to CBT-AD and psychoeducation, and suggestions for adaptation of core CBT modules for HIV-infected adults. Discussion of video demonstrations highlights differences in patient presentations and course of treatment between HIV-infected adults receiving CBT-AD and HIV-uninfected adults receiving traditional CBT for depression. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.

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

Evaluation of Healthy Living Wellness Program With Minority Underserved Economically Disadvantaged Older Adults.

PubMed

Tallier, Peggy C; Reineke, Patricia R; Frederickson, Keville

2017-04-01

The purpose of this Roy adaptation model-guided study was to test the effectiveness of a student registered nurse intern-led nursing intervention entitled the Healthy Living Wellness Program. A one-group pretest/posttest preexperimental design was used. The intervention was imparted to minority, underserved, economically disadvantaged older adults ( N = 30). Significant findings pre- and postintervention were reported for body mass index, waist circumference, self-reported blood glucose, and weight. The findings supported the effectiveness of the nursing intervention, the Healthy Living Wellness Program, guided by the Roy adaptation model.

Learning by Living: Life-Altering Medical Education through Nursing Home-Based Experiential Learning

ERIC Educational Resources Information Center

Gugliucci, Marilyn R.; Weiner, Audrey

2013-01-01

The University of New England College of Osteopathic Medicine Learning by Living Project (referred to as Learning by Living) was piloted in 2006 as an experiential medical education learning model. Since its inception, medical and other health professions students have been "admitted" into nursing homes to live the life of an older adult nursing…

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…

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…

Imaging and modeling of collagen architecture in living tissue with polarized light transfer (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ramella-Roman, Jessica C.; Stoff, Susan; Chue-Sang, Joseph; Bai, Yuqiang

2016-03-01

The extra-cellular space in connective tissue of animals and humans alike is comprised in large part of collagen. Monitoring of collagen arrangement and cross-linking has been utilized to diagnose a variety of medical conditions and guide surgical intervention. For example, collagen monitoring is useful in the assessment and treatment of cervical cancer, skin cancer, myocardial infarction, and non-arteritic anterior ischemic optic neuropathy. We have developed a suite of tools and models based on polarized light transfer for the assessment of collagen presence, cross-linking, and orientation in living tissue. Here we will present some example of such approach applied to the human cervix. We will illustrate a novel Mueller Matrix (MM) imaging system for the study of cervical tissue; furthermore we will show how our model of polarized light transfer through cervical tissue compares to the experimental findings. Finally we will show validation of the methodology through histological results and Second Harmonic imaging microscopy.

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.

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.

The Live Oak Curriculum: A Guide to Preschool Planning in the Heterogeneous Classroom.

ERIC Educational Resources Information Center

Meyers, Celeste, Ed.

Presented is a curriculum guide for preschool programs serving both handicapped and nonhandicapped children. It is explained that the guide is intended to suggest classroom activities which will strengthen existing skills and encourage development of new skills. The guide presents information on objectives, materials and procedures for the…

English Learners Program Guide. Revised

ERIC Educational Resources Information Center

Oregon Department of Education, 2013

2013-01-01

This guide is designed as a reference for District and School personnel working with English learners (ELs). The content of the guide represents a compilation of information, examples, and resources. This guide is a living document and subject to frequent updates. It is recommended to review the document online rather than printing a hard copy.

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...

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 ...

Chemistry of Living Matter, Energy Capture & Growth, Parts Three & Four of an Integrated Science Sequence, Student Guide, 1971 Edition.

ERIC Educational Resources Information Center

Portland Project Committee, OR.

This student guide is divided into two sections, "Chemistry of Living Matter" and "Energy Capture and Growth," constituting parts three and four of the third year of the Portland Project, a three-year high school integrated science curriculum. The underlying intention of the third year is to study energy and its importance to…

Military Nurses’ Experience in Disaster Response

DTIC Science & Technology

2010-06-23

their lives. A phenomenological approach grounded in the existential phenomenological works of Merleau-Ponty guided the study. Using purposive...Known” versus “Unknown,” “Structured” versus “Chaos,” “Prepared” versus “Making Do,” “Strength” versus “Emotionality,” and “ Existential Growth...responses had on their lives. A phenomenological approach grounded in the existential phenomenological works of Merleau-Ponty guided the study. Using

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.…

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…

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.

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.

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.

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.

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,…

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…

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.

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.

Organ Harvesting and Transplants

ERIC Educational Resources Information Center

Baskette, Kimberly G.; Ritz, John M.

2010-01-01

Humans and animals need healthy organs to live. Due to medical conditions and accidents, some organs fail to function properly. For these reasons, the medical community has experimented and can now perform successful organ transplants, allowing patients to continue to live their lives. Many countries have medical programs where individuals can…

A photo guide to the patterns of discoloration and decay in living northern hardwood trees

Treesearch

Alex L. Shigo; Edwin vH. Larson

1969-01-01

This guide has been prepared to help you estimate the extent and severity of discoloration and decay in northern hardwood trees. Though this certainly is not the last word on the subject, our research in this has progressed to the point where our findings, combined with the findings of others, can be put to practical use. By dissecting living trees and studying the...

Determinants of medication adherence in older people with dementia from the caregivers' perspective.

PubMed

El-Saifi, Najwan; Moyle, Wendy; Jones, Cindy; Alston-Knox, Clair

2018-05-11

ABSTRACTBackground:Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers' perspective, and to identify influencing factors. Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale. Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61-0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77-0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient-provider relationship and less medical problems. Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.

Ethical Tensions in the Pain Management of an End-Stage Cancer Patient with Evidence of Opioid Medication Diversion.

PubMed

Venkat, Arvind; Kim, David

2016-06-01

At the end of life, pain management is commonly a fundamental part of the treatment plan for patients where curative measures are no longer possible. However, the increased recognition of opioid diversion for secondary gain coupled with efforts to treat patients in the home environment towards the end of life creates the potential for ethical dilemmas in the palliative care management of terminal patients in need of continuous pain management. We present the case of an end-stage patient with rectal cancer who required a continuous residential narcotic infusion of fentanyl for pain control due to metastatic disease. His functional status was such that he had poor oral intake and ability to perform other activities of daily living, but was able to live at home with health agency nursing care. The patient presented to this institution with a highly suspect history of having lost his fentanyl infusion in a residential accident and asking for a refill to continue home therapy. The treating physicians had concerns of diversion of the infusion medication by caregivers and were reluctant to continue the therapeutic relationship with the patient. This case exemplifies the tension that can exist between wanting to continue with palliative care management of an end-stage patient and the fear of providers when confronted by evidence of potential diversion of opioid analgesic medications. We elucidate how an ethical framework based on a combination of virtue and narrative/relationship theories with reference to proportionality can guide physicians to a pragmatic resolution of these difficult situations.

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.…

Quality Improvement in Skilled Nursing Facilities for Residents With Alzheimer's Disease.

PubMed

Farlow, Martin R; Borson, Soo; Connor, Stephen R; Grossberg, George T; Mittelman, Mary S

2016-03-01

This report describes a quality improvement continuing medical education activity designed to enhance the recognition and treatment of residents with Alzheimer's disease (AD) or other dementias in skilled-nursing facilities (SNFs). Charts were compared in 6 areas prior to and following (stages A and C) a live, faculty-led workshop (stage B). Four SNFs completed stages A (n = 67 residents) and B, and 3 SNFs completed stage C (n = 52 residents). All charts came from residents with AD or a diagnosis of dementia or dementia-like symptoms. The SNFs had >95% baseline performance in both the frequency of cognitive assessments and documented medication reviews. The percentage of residents who received a quality-of-life assessment and those who had a mental health care plan in place represent areas for improvement. As part of this activity, a toolkit was developed to help guide facilities and clinicians in instituting care improvements for residents with AD/dementia. © The Author(s) 2015.

Image-guided tissue engineering of anatomically shaped implants via MRI and micro-CT using injection molding.

PubMed

Ballyns, Jeffery J; Gleghorn, Jason P; Niebrzydowski, Vicki; Rawlinson, Jeremy J; Potter, Hollis G; Maher, Suzanne A; Wright, Timothy M; Bonassar, Lawrence J

2008-07-01

This study demonstrates for the first time the development of engineered tissues based on anatomic geometries derived from widely used medical imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Computer-aided design and tissue injection molding techniques have demonstrated the ability to generate living implants of complex geometry. Due to its complex geometry, the meniscus of the knee was used as an example of this technique's capabilities. MRI and microcomputed tomography (microCT) were used to design custom-printed molds that enabled the generation of anatomically shaped constructs that retained shape throughout 8 weeks of culture. Engineered constructs showed progressive tissue formation indicated by increases in extracellular matrix content and mechanical properties. The paradigm of interfacing tissue injection molding technology can be applied to other medical imaging techniques that render 3D models of anatomy, demonstrating the potential to apply the current technique to engineering of many tissues and organs.

A call for government accountability to achieve national self-sufficiency in organ donation and transplantation.

PubMed

Delmonico, Francis L; Domínguez-Gil, Beatriz; Matesanz, Rafael; Noel, Luc

2011-10-15

Roughly 100,000 patients worldwide undergo organ transplantation annually, but many other patients remain on waiting lists. Transplantation rates vary substantially across countries. Affluent patients in nations with long waiting lists do not always wait for donations from within their own countries. Commercially driven transplantation, however, does not always ensure proper medical care of recipients or donors, and might lengthen waiting times for resident patients or increase the illegal and unethical purchase of organs from living donors. Governments should systematically address the needs of their countries according to a legal framework. Medical strategies to prevent end-stage organ failure must also be implemented. In view of the Madrid Resolution, the Declaration of Istanbul, and the 63rd World Health Assembly Resolution, a new paradigm of national self-sufficiency is needed. Each country or region should strive to provide a sufficient number of organs from within its own population, guided by WHO ethics principles. Copyright © 2011 Elsevier Ltd. All rights reserved.

Heart Monitoring By Satellite

NASA Technical Reports Server (NTRS)

1978-01-01

The ambulance antenna shown is a specially designed system that allows satellite-relayed two-way communications between a moving emergency vehicle and a hospital emergency room. It is a key component of a demonstration program aimed at showing how emergency medical service can be provided to people in remote rural areas. Satellite communication permits immediate, hospital- guided treatment of heart attacks or other emergencies by ambulance personnel, saving vital time when the scene of the emergency is remote from the hospital. If widely adopted, the system could save tens of thousands of lives annually in the U.S. alone, medical experts say. The problem in conventional communication with rural areas is the fact that radio signals travel in line of sight. They may be blocked by tall buildings, hills and mountains, or even by the curvature of the Earth, so signal range is sharply limited. Microwave relay towers could solve the problem, but a complete network of repeater towers would be extremely expensive. The satellite provides an obstruction-free relay station in space.

A qualitative study examining the perceived barriers and facilitators to medical healthcare services among women with a serious mental illness.

PubMed

Borba, Christina P C; DePadilla, Lara; McCarty, Frances A; von Esenwein, Silke A; Druss, Benjamin G; Sterk, Claire E

2012-03-01

This qualitative study investigates the barriers and facilitators to accessing and utilizing healthcare services among women with a serious mental illness (SMI). A purposive sample of 30 poor, urban, predominantly African-American women with a diagnosis of an SMI was recruited. Interviews were audio-taped and transcribed verbatim. Data analysis was guided by a modified constant comparison approach. The findings highlight a variety of nonmedical factors that serve as both barriers and facilitators to accessing and utilizing medical healthcare services, such as a trusting relationship with a mental health provider and a women's social network. Nonmedical factors and personal circumstances seem to be important factors influencing pathways to healthcare services among women with an SMI. Efforts to better engage and retain women with an SMI into healthcare will need to better acknowledge and incorporate the larger social context of the women's lives. Copyright © 2012 Jacobs Institute of Women

Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS.

PubMed

Cruess, Dean G; Kalichman, Seth C; Amaral, Christine; Swetzes, Connie; Cherry, Chauncey; Kalichman, Moira O

2012-04-01

Psychotropic medications are commonly used for depressive symptoms among people living with HIV/AIDS. We examined the relationships between adherence to psychotropic medications, depressive symptoms, and antiretroviral adherence. We assessed depressive symptoms among 324 people living with HIV/AIDS across a 3-month period (70% men; mean age 45 years; 90% African-American). Psychotropic and antiretroviral adherence was assessed using monthly, unannounced telephone pill counts. Multiple-regression and mediation analyses were utilized to examine associations under investigation. Greater depressive symptoms were associated with lower antiretroviral and psychotropic medication adherence. Greater adherence to psychotropic medications regardless of medication class was positively related to higher antiretroviral adherence. Greater adherence to psychotropic medications also significantly mediated the association between depressive symptoms and antiretroviral adherence. This study demonstrates the benefits of adherence to psychotropic medications on both depressive symptoms and antiretroviral adherence. Future work examining psychotropic medication adherence on disease outcomes in people living with HIV/AIDS is warranted.

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)

Living in Style: A Guide to American Architecture.

ERIC Educational Resources Information Center

Instructor, 1990

1990-01-01

Studying architectural styles is an exciting way to make history come alive and to help students feel a part of their community. This teacher's guide includes several classroom activities, a historical guide to American architectural styles, a list of resources, and a reproducible student worksheet. (IAH)

Math: Objectives Guide. Project CAST.

ERIC Educational Resources Information Center

Charles County Board of Education, La Plata, MD. Office of Special Education.

The guide lists math objectives needed for independent living by secondary special education students. One of a series of Project CAST (Community and School Together) life skills manuals, the guide outlines basic competencies in terms of goal statements, behavioral objectives, and specialized vocabulary for the following areas: money, making…

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.

Development of a Curriculum Guide for Consumer Education in Vocational Home Economics Classes.

ERIC Educational Resources Information Center

Robinson, Nancie Smith

This curriculum guide was developed to improve the present level of living among families in West Virginia. It was intended that vocational home economics teachers combine the objectives of the guide with their own class objectives, or in the absence of consumer education in the curriculum, use the guide for the initiation of a new program or unit…

Forces in Living Things. Study Guide. Unit H2. ZIM-SCI, Zimbabwe Secondary School Science Project. Year 2.

ERIC Educational Resources Information Center

Hosking, Bunty; Zesaguli, Josie

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

Energy for Living. Study Guide. Unit G1. ZIM-SCI, Zimbabwe Secondary School Science Project. Year 2.

ERIC Educational Resources Information Center

Hosking, Bunty

The Zimbabe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide includes activities and…

Living Things and Their Food. Study Guide. Unit G2. ZIM-SCI, Zimbabwe Secondary School Science Project. Year 2.

ERIC Educational Resources Information Center

Hosking, Bunty

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

Energy for Living. Teacher's Guide. Unit G1. ZIM-SCI, Zimbabwe Secondary School Science Project. Year 2.

ERIC Educational Resources Information Center

Hosking, Bunty

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

Spruce Budworms Handbook: shigometry – a reference guide

Treesearch

Alex L. Shigo; Walter C. Shortle

1985-01-01

This guide explains how to test the condition of living trees or wood products by use of the Shigometer and gives instructions for its use. The guide is in three parts: (1) An introduction on operating principles and applications, (2) an example of the procedure, and (3) a photo guide that gives details on the procedure and background information needed to use it....

Teachers Guide to Economic Concepts: Grade 10-12.

ERIC Educational Resources Information Center

McCabe, Milo F.

This grades 10-12 teachers guide is one of five resource guides developed to aid teachers in helping students in South Dakota to achieve a high degree of economic literacy. It is felt that schools must prepare students at all grade levels to develop an understanding of the economy in which they live. This guide was specifically prepared to assist…

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…

Education for Adulthood: A Curriculum for the Mentally Retarded Who Need a Better Understanding of Life's Processes and a Training Guide for Those Who Will Teach the Curriculum.

ERIC Educational Resources Information Center

Greenbaum, Madeline; Noll, Sandra J.

The curriculum guide is intended for those who live and work with mentally retarded adults and for mentally retarded adults attempting to succeed in community living. The first section focuses on training staff and provides guidelines for describing the content and methods employed in the curriculum. Research on such issues as self-concept, sex…

Live with the Disease Like You Used to Before You Knew You Were Infected: A Qualitative Study Among 10-Year Survivors Living with HIV in Haiti.

PubMed

Pierre, Samuel; Riviera, Vanessa; Jean, Circee Phara; Louis, Marie Jude Jean; Reif, Lindsey K; Severe, Patrice; Rouzier, Vanessa; Johnson, Warren D; Pape, Jean W; Fitzgerald, Daniel W; McNairy, Margaret L; Boutin-Foster, Carla

2017-03-01

In 2003, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), a nonprofit organization, began administering antiretroviral therapy (ART) to its patients. This practice transformed HIV from a fatal disease to a more manageable chronic condition. However, relatively few studies focus on the experiences of survivors. This study provided a unique opportunity to interview patients who survived at least 10 years after being treated with ART at GHESKIO. The goal of the study was to elicit from patients their perspectives on what enabled them to survive with AIDS. Grounded Theory, a qualitative research method was used to guide data collection, coding, and analysis. Individual interviews were conducted, audio-taped, transcribed and analyzed in Creole, and translated into English. Data saturation was reached at 25 participants. Of which, 64% were women, the mean age was 49, range of 43-55 years, 24% were married, 44% had not completed elementary school, and 72% had no income, the remaining participants had incomes ranging from $1000 to $5000 annually. Qualitative analysis resulted in 681 codes, which were grouped into six categories: being spiritually grounded, having supportive interactions with providers, caring for children, setting personal goals, persevering and living life as usual, and maintaining strict medication adherence practices. The overarching theory was that having a reason to live despite one's circumstances and living life as usual enabled one to survive. Having a strong spiritual foundation coupled with supportive family and providers motivated participants to live and adhere to their ART. As the number of patients who are living longer with HIV in Haiti increases, results from this study will be important in helping tailor interventions that enhance their overall quality of life.

The Experience of Living with and Using a Dog Guide.

ERIC Educational Resources Information Center

Miner, Rachel Joy-Taub

2001-01-01

A study of eight adults who use dog guides found four themes that described the experience of using a dog guide: increased confidence, increased independence, changed public interactions, and additional responsibilities or inconveniences. Most participants described their dogs as social "ice breakers" that led to increased interaction…

Health Education Curriculum Guide, Grades 1-12.

ERIC Educational Resources Information Center

Massachusetts State Dept. of Education, Boston. Bureau of Elementary and Secondary Education.

This health education curriculum guide has been developed to assist local school districts develop stronger, more effective, school health programs. The guide is organized into four broad areas of health education: physical health, mental and social health, consumer and environmental health, and safe living. Each of these areas is divided into…

Curriculum Guide in Sex Education for the TMR.

ERIC Educational Resources Information Center

Steward, Kathy L.

Presented is a sex education curriculum guide for teachers of trainable retarded students ages 12 to 21 years. The guide is divided into six units: body parts, gender identification, and restroom signs; living things; reproduction; growth; adolescence, menstruation, and street language; and maturity (including sexual feelings and birth control).…

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.…

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.

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

Infection prevention and control standards in assisted living facilities: are residents' needs being met?

PubMed

Kossover, Rachel A; Chi, Carolyn J; Wise, Matthew E; Tran, Alvin H; Chande, Neha D; Perz, Joseph F

2014-01-01

Assisted living facilities (ALFs) provide housing and care to persons unable to live independently, and who often have increasing medical needs. Disease outbreaks illustrate challenges of maintaining adequate resident protections in these facilities. Describe current state laws on assisted living admissions criteria, medical oversight, medication administration, vaccination requirements, and standards for infection control training. We abstracted laws and regulations governing assisted living facilities for the 50 states using a structured abstraction tool. Selected characteristics were compared according to the time period in which the regulation took effect. Selected state health departments were queried regarding outbreaks identified in assisted living facilities. Of the 50 states, 84% specify health-based admissions criteria to assisted living facilities; 60% require licensed health care professionals to oversee medical care; 88% specifically allow subcontracting with outside entities to provide routine medical services onsite; 64% address medication administration by assisted living facility staff; 54% specify requirements for some form of initial infection control training for all staff; 50% require reporting of disease outbreaks to the health department; 18% specify requirements to offer or require vaccines to staff; 30% specify requirements to offer or require vaccines to residents. Twelve states identified approximately 1600 outbreaks from 2010 to 2013, with influenza or norovirus infections predominating. There is wide variation in how assisted living facilities are regulated in the United States. States may wish to consider regulatory changes that ensure safe health care delivery, and minimize risks of infections, outbreaks of disease, and other forms of harm among assisted living residents. Published by Elsevier Inc.

An Exploratory Study of Spirituality in HIV Infected Adolescents and their Families: FAmily CEntered Advance Care Planning and Medication Adherence

PubMed Central

Lyon, Maureen E.; Garvie, Patricia A.; Kao, Ellin; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J.; McCarter, Robert

2010-01-01

Purpose To explore the impact of spirituality and religious beliefs on FAmily CEntered (FACE) Advance Care Planning and medication adherence in HIV+ adolescents and their surrogate decision-makers. Methods A sample of HIV+ adolescents (n=40) and their surrogates, age 21 or older, (n=40) was randomized to an active Healthy Living Control group or the FACE Advance Care Planning intervention, guided by transactional stress and coping theory. Adolescents’ spirituality was assessed at baseline and 3 months post-intervention, using the FACIT-SP-4-EX, as was the belief that HIV is a punishment from God. Results Control adolescents increased faith and meaning/purpose more so than FACE adolescents (p=0.02). At baseline more behaviorally (16%) vs. perinatally (8%) infected adolescents believed HIV was a punishment from God, but not at 3-months post-intervention. Adolescents endorsing HIV was a punishment scored lower on spirituality (p=.05) and adherence to HAART (p= .04). Surrogates were more spiritual than adolescents (p=<.0001). Conclusion Providing family support in a friendly, facilitated, environment enhanced adolescents’ spirituality. Facilitated family conversations had an especially positive effect on behaviorally infected adolescents’ medication adherence and spiritual beliefs. PMID:21575826

Living Things and Their Food. Teacher's Guide. Unit G2. ZIM-SCI, Zimbabwe Secondary School Science Project. Year 2.

ERIC Educational Resources Information Center

Hosking, Bunty

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

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 ...

[Phenomenology and phenomenological method: their usefulness for nursing knowledge and practice].

PubMed

Vellone, E; Sinapi, N; Rastelli, D

2000-01-01

Phenomenology is a thought movement the main aim of which is to study human fenomena as they are experienced and lived. Key concepts of phenomenology are: the study of lived experience and subjectivity of human beings, the intentionality of consciousness, perception and interpretation. Phenomenological research method has nine steps: definition of the research topic; superficial literature searching; sample selection; gathering of lived experiences; analysis of lived experiences; written synthesis of lived experiences; validation of written synthesis; deep literature searching; writing of the scientific document. Phenomenology and phenomenological method are useful for nursing either to develop knowledge or to guide practice. Qualitative-phenomenological and quantitative-positivistic research are complementary: the first one guides clinicians towards a person-centered approach, the second one allows the manipulation of phenomena which can damage health, worsen illness or decrease the quality of life of people who rely on nursing care.

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…

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…

Nursing Homes

MedlinePlus

... our e-newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed ... guide care in nursing homes. Who lives in nursing homes? Almost half of all people who live ...

Multimodal US-gamma imaging using collaborative robotics for cancer staging biopsies.

PubMed

Esposito, Marco; Busam, Benjamin; Hennersperger, Christoph; Rackerseder, Julia; Navab, Nassir; Frisch, Benjamin

2016-09-01

The staging of female breast cancer requires detailed information about the level of cancer spread through the lymphatic system. Common practice to obtain this information for patients with early-stage cancer is sentinel lymph node (SLN) biopsy, where LNs are radioactively identified for surgical removal and subsequent histological analysis. Punch needle biopsy is a less invasive approach but suffers from the lack of combined anatomical and nuclear information. We present and evaluate a system that introduces live collaborative robotic 2D gamma imaging in addition to live 2D ultrasound to identify SLNs in the surrounding anatomy. The system consists of a robotic arm equipped with both a gamma camera and a stereoscopic tracking system that monitors the position of an ultrasound probe operated by the physician. The arm cooperatively places the gamma camera parallel to the ultrasound imaging plane to provide live multimodal visualization and guidance. We validate the system by evaluating the target registration errors between fused nuclear and US image data in a phantom consisting of two spheres, one of which is filled with radioactivity. Medical experts perform punch biopsies on agar-gelatine phantoms with complex configurations of hot and cold lesions to provide a qualitative and quantitative evaluation of the system. The average point registration error for the overlay is [Formula: see text] mm. The time of the entire procedure was reduced by 36 %, with 80v of the biopsies being successful. The users' feedback was very positive, and the system was deemed to be very intuitive, with handling similar to classic US-guided needle biopsy. We present and evaluate the first medical collaborative robotic imaging system. Feedback from potential users for SLN punch needle biopsy is encouraging. Ongoing work investigates the clinical feasibility with more complex and realistic phantoms.

Caring for overseas liver transplant recipients: Taiwan primary family caregivers' experiences in mainland China.

PubMed

Chen, H M; Shih, F Jong; Chang, C L; Lai, I H; Shih, F J; Hu, R H

2010-12-01

This study explores the motivations of overseas liver transplant recipient (OLTR) families of Taiwanese OLTR who undergo the procedure in mainland China. We report the waiting time to receive the transplant in mainland China as well as the rational and service. This exploratory qualitative method reflects guided face-to-face, semistructured interviews with families members of OLTRs. Data were subjected to content analysis. We interviewed 19 OLTR family members (15 females and 4 males who were between 29 and 71 years of age; mean 55.1 years) regarding 19 patients who had (17 males and 2 females who were between 36 and 71 years of age, mean, 54.6 years). The OLTR underwent transplantation in three cities in mainland China: Tianjin, Shanghai, and Guangzhou. After arrival the average waiting time was 33.1 days. Subjects reported the following reasons to help patients undergo the procedure in mainland China: (1) it is difficult to have the procedure in Taiwan; (2) the desire to extend life; and ((3)) there is no domestic living donor. Seven reasons for serving as OLTR supportive family members were identified: (1) The role and obligation in the marital relationship; (2) a close bloodline relationship; (3) insufficient manpower; (4) an individual's availability; (5) evasion of responsibility by other family members; (6) compensation for inadequate caring efforts earlier in life; and (7) an unwillingness to disturb other relatives' lives. Finally, the following support for the OLTR was reported: providing company during medical treatment/doctor visits, food preparation, massage, daily assistance, medical care, and psychological support. Taiwanese OLTR family members' perspectives throughout the transplant process may provide better understanding of living experiences and concerns during the stages of overseas liver transplantation. Copyright © 2010 Elsevier Inc. All rights reserved.

Roads to Health in Developing Countries: Understanding the Intersection of Culture and Healing.

PubMed

Ibeneme, S; Eni, G; Ezuma, A; Fortwengel, G

2017-01-01

The most important attribute to which all human beings aspire is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled scientists to explore and define several parameters of health by drawing boundaries around factors that are known to influence the attainment of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration. Their definition of health also included a caveat that says, "not merely the absence of sickness." This definition has guided scientists and health care providers in the Western world in the development of health care programs in non-Western societies. However, ethnomedical beliefs about the cause(s) of illness have given rise to alternative theories of health, sickness, and treatment approaches in the developing world. Thus, there is another side to the story. Much of the population in developing countries lives in rural settings where the knowledge of health, sickness, and care has evolved over centuries of practice and experience. The definition of health in these settings tends to orient toward cultural beliefs, traditional practices, and social relationships. Invariably, whereas biomedicine is the dominant medical system in Western societies, traditional medicine-or ethnomedicine-is often the first port of call for patients in developing countries. The 2 medical systems represent, and are influenced by, the cultural environment in which they exist. On one hand, biomedicine is very effective in the treatment of objective, measurable disease conditions. On the other hand, ethnomedicine is effective in the management of illness conditions or the experience of disease states. Nevertheless, an attempt to supplant 1 system of care with another from a different cultural environment could pose enormous challenges in non-Western societies. In general, we, as human beings, are guided in our health care decisions by past experiences, family and friends, social networks, cultural beliefs, customs, tradition, professional knowledge, and intuition. No medical system has been shown to address all of these elements; hence, the need for collaboration, acceptance, and partnership between all systems of care in cultural communities. In developing countries, the roads to health are incomplete without an examination of the intersection of culture and healing. Perhaps mutual exclusiveness rather inclusiveness of these 2 dominant health systems is the greatest obstacle to health in developing countries.

Sea Soup: Discovering the Watery World of Phytoplankton and Zooplankton. Teacher's Guide.

ERIC Educational Resources Information Center

Stevens, Betsy T.

This book is an inquiry- and discovery-based teacher's guide. The interesting and fun activities in this teacher's guide meet the challenge of relating tiny, microscopic organisms to the lives of children. The inquiry-based activities range from designing and making a phytoplankter and collecting phytoplankton to designing an experiment for…

Animals and Us: How We Live Together. Nature. Teacher's Guide.

ERIC Educational Resources Information Center

Barker, Lucia; Brown, Jordan

This curriculum guide was developed for use with public television's Nature series. The materials in the guide are designed to help students actively participate in the study and experience of nature. Students are encouraged to view the programs as naturalists would, observing animals in their environment, noting their behavior, and drawing…

Talking about Freedom: A Teacher's Guide to the First Amendment.

ERIC Educational Resources Information Center

Nemer, Anne, Comp.

Intended to make the First Amendment relevant to young people by addressing issues that speak directly to their lives, this guide assists teachers in using "Talk about Freedom," a series of eight educational print advertisements (ads) for teenagers, in the classroom. The eight print ads presented in the guide address: (1) censorship of…

Student Competencies Guide: Survival Skills for a Changing World.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This guide is designed to help junior and senior high school students acquire basic competencies in daily living. In addition to identifying 13 competencies, the guide explains how students can obtain certification in those skills by members of the community whose jobs require them to be proficient in them. The competencies include transacting…

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.

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.

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…

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…

CRISPR-Cas9 nuclear dynamics and target recognition in living cells

PubMed Central

Ma, Hanhui; Tu, Li-Chun; Zhang, Shaojie; Grunwald, David

2016-01-01

The bacterial CRISPR-Cas9 system has been repurposed for genome engineering, transcription modulation, and chromosome imaging in eukaryotic cells. However, the nuclear dynamics of clustered regularly interspaced short palindromic repeats (CRISPR)–associated protein 9 (Cas9) guide RNAs and target interrogation are not well defined in living cells. Here, we deployed a dual-color CRISPR system to directly measure the stability of both Cas9 and guide RNA. We found that Cas9 is essential for guide RNA stability and that the nuclear Cas9–guide RNA complex levels limit the targeting efficiency. Fluorescence recovery after photobleaching measurements revealed that single mismatches in the guide RNA seed sequence reduce the target residence time from >3 h to as low as <2 min in a nucleotide identity- and position-dependent manner. We further show that the duration of target residence correlates with cleavage activity. These results reveal that CRISPR discriminates between genuine versus mismatched targets for genome editing via radical alterations in residence time. PMID:27551060

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

PubMed Central

Oliveira-Filho, Alfredo D.; Morisky, Donald E.; Costa, Francisco A.; Pacheco, Sara T.; Neves, Sabrina F.; Lyra-Jr, Divaldo P.

2014-01-01

Background Effective interventions to improve medication adherence are usually complex and expensive. Objective To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. Method A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates. Results 61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups. Conclusion The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes. PMID:25590930

What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature.

PubMed

Kaiser, M-L; Schoemaker, M M; Albaret, J-M; Geuze, R H

2014-11-06

This article presents a review of the studies that have analysed the motor skills of ADHD children without medication and the influence of medication on their motor skills. The following two questions guided the study: What is the evidence of impairment of motor skills and aspects of motor control among children with ADHD aged between 6 and 16 years? What are the effects of ADHD medication on motor skills and motor control? The following keywords were introduced in the main databases: attention disorder and/or ADHD, motor skills and/or handwriting, children, medication. Of the 45 articles retrieved, 30 described motor skills of children with ADHD and 15 articles analysed the influence of ADHD medication on motor skills and motor control. More than half of the children with ADHD have difficulties with gross and fine motor skills. The children with ADHD inattentive subtype seem to present more impairment of fine motor skills, slow reaction time, and online motor control during complex tasks. The proportion of children with ADHD who improved their motor skills to the normal range by using medication varied from 28% to 67% between studies. The children who still show motor deficit while on medication might meet the diagnostic criteria of developmental coordination disorder (DCD). It is important to assess motor skills among children with ADHD because of the risk of reduced participation in activities of daily living that require motor coordination and attention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Systematic Review of Palliative Care in the Rural Setting.

PubMed

Bakitas, Marie A; Elk, Ronit; Astin, Meka; Ceronsky, Lyn; Clifford, Kathleen N; Dionne-Odom, J Nicholas; Emanuel, Linda L; Fink, Regina M; Kvale, Elizabeth; Levkoff, Sue; Ritchie, Christine; Smith, Thomas

2015-10-01

Many of the world's population live in rural areas. However, access and dissemination of the advances taking place in the field of palliative care to patients living in rural areas have been limited. We searched 2 large databases of the medical literature and found 248 relevant articles; we also identified another 59 articles through networking and a hand search of reference lists. Of those 307 articles, 39 met the inclusion criteria and were grouped into the following subcategories: intervention (n = 4), needs assessment (n = 2), program planning (n = 3), program evaluation (n = 4), education (n = 7), financial (n = 8), and comprehensive/systematic literature reviews (n = 11). We synthesized the current state of rural palliative care research and practice to identify important gaps for future research. Studies were conducted in the United States, Australia, Canada, Africa, Sweden, and India. Two randomized control trials were identified, both of which used telehealth approaches and had positive survival outcomes. One study demonstrated positive patient quality of life and depression outcomes. Research to guide rural palliative care practice is sparse. Approaches to telehealth, community- academic partnerships, and training rural health care professionals show promise, but more research is needed to determine best practices for providing palliative care to patients living in rural settings.

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.

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.

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.

Probiotics: overview of microbiological and immunological characteristics.

PubMed

Blandino, Giovanna; Fazio, Davide; Di Marco, Roberto

2008-08-01

Over the last few years, probiotics (commercialized as food, dietary supplements of living bacteria or pharmaceuticals) have attracted the interest of scientists as well as consumers. Recent public interest in healthier lifestyles, together with the acceptance by physicians of nonmainstream therapies, has refocused attention on the role of human microbiota in the prevention and therapy of diseases. Modulation of the intestinal microbiota may be achieved by consuming living bacteria or by consuming a combination of probiotics and prebiotics. In addition, we are learning more about the biology of probiotic microorganisms, through sequencing their genomes, and the interactions of probiotics with human cells and with pathogenic bacteria. Results from well-conducted clinical studies help to increase the acceptance of probiotics for the treatment and prevention of selected diseases, both inside and outside the GI tract. Moreover, the use of selected probiotics for particular subject groups may provide more specific health effects. The medical profession is in an ideal position to guide the consumer towards appropriate prophylactic or therapeutic uses of probiotics in health or in specific disease states.

Assisted living nursing practice: medication management: part 2 supervision and monitoring of medication administration by unlicensed assistive personnel.

PubMed

Mitty, Ethel; Flores, Sandi

2007-01-01

More than half the states permit assistance with or administration of medications by unlicensed assistive personnel or med techs. Authorization of this nursing activity (or task) is more likely because of state assisted living regulation than by support and approval of the state Board of Nursing. In many states, the definition of "assistance with" reads exactly like "administration of" thereby raising concern with regard to delegation, accountability, and liability for practice. It is, as well, a hazardous path for the assisted living nurse who must monitor and evaluate the performance of the individual performing this nursing task. This article, the second in a series on medication management, addresses delegation, standards of practice of medication administration, types of medication errors, the components of a performance evaluation tool, and a culture of safety. Maintaining professional standards of assisted living nursing practice courses throughout the suggested recommendations.

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.

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

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.

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

Empirical trials of plant field guides.

PubMed

Hawthorne, W D; Cable, S; Marshall, C A M

2014-06-01

We designed 3 image-based field guides to tropical forest plant species in Ghana, Grenada, and Cameroon and tested them with 1095 local residents and 20 botanists in the United Kingdom. We compared users' identification accuracy with different image formats, including drawings, specimen photos, living plant photos, and paintings. We compared users' accuracy with the guides to their accuracy with only their prior knowledge of the flora. We asked respondents to score each format for usability, beauty, and how much they would pay for it. Prior knowledge of plant names was generally low (<22%). With a few exceptions, identification accuracy did not differ significantly among image formats. In Cameroon, users identifying sterile Cola species achieved 46-56% accuracy across formats; identification was most accurate with living plant photos. Botanists in the United Kingdom accurately identified 82-93% of the same Cameroonian species; identification was most accurate with specimens. In Grenada, users accurately identified 74-82% of plants; drawings yielded significantly less accurate identifications than paintings and photos of living plants. In Ghana, users accurately identified 85% of plants. Digital color photos of living plants ranked high for beauty, usability, and what users would pay. Black and white drawings ranked low. Our results show the potential and limitations of the use of field guides and nonspecialists to identify plants, for example, in conservation applications. We recommend authors of plant field guides use the cheapest or easiest illustration format because image type had limited bearing on accuracy; match the type of illustration to the most likely use of the guide for slight improvements in accuracy; avoid black and white formats unless the audience is experienced at interpreting illustrations or keeping costs low is imperative; discourage false-positive identifications, which were common; and encourage users to ask an expert or use a herbarium for groups that are difficult to identify. © 2014 Society for Conservation Biology.

Solar Economics: A Teacher's Guide.

ERIC Educational Resources Information Center

LaHart, David E., Ed.; Allen, Rodney F., Ed.

Economics and energy are topics of interest to students and teachers alike. They both affect our daily lives, influence how we live and have significant impacts on how our children will live. Since economic education was mandated by the Florida legislature, many attempts have been made to integrate the free enterprise and consumer education…

Handbook, Living Life's Emergencies: A Guide for Home Preparedness.

ERIC Educational Resources Information Center

Lavalla, Patrick

Although not intended as a complete manual, the guide gives families a better chance of surviving and recovering from a major emergency by helping them learn what emergencies and disasters could occur in the area, how to prepare for them, what action to take in emergencies, and how to develop emergency skills. The guide explains what supplies to…

The Trial of Adolf Eichmann, 1961: Educator's Guide. Live from the Past Series.

ERIC Educational Resources Information Center

Sesso, Gloria

This guide provides information on the life and trial of Nazi Gestapo chief Adolf Eichmann. The guide includes suggested activities, discussion questions, suggested readings, a list of key players of the era, a vocabulary list, and a list of components and key events tied to "The New York Times" of the era. (EH)

3-2-1 Contact Teacher's Guide.

ERIC Educational Resources Information Center

Children's Television Workshop, New York, NY.

This guide to the television program 3-2-1 Contact covers 20 theme weeks. The program is designed to bring students into closer contact with the science and technology in their everyday lives. This guide includes: (1) a brief introduction to the contents of each week's shows; (2) a detailed discussion of each week's primary concepts as well as…

Fitness and Hygiene Programming for the Severely Handicapped: A Curriculum-Embedded Assessment Guide. User Manual. Project Transition.

ERIC Educational Resources Information Center

Jansma, Paul

Developed by Project Transition, a 3-year project at Ohio State University, this resource guide deals with physical fitness and personal hygiene training of institutionalized mentally retarded adults, to prepare them for transition into community living environments. Included in the guide are recommended teaching strategies, an assessment system,…

Individualized Study Guide on Apiculture: Student Guide. Curriculum Materials for Agricultural Education.

ERIC Educational Resources Information Center

Housmam, John L.; And Others

The study guide contains introductory level information, principles and management practices which may be applied by a hobbyist or a commercial apiary. The lessons are designed to train students for entry level jobs, to establish students in a beekeeping enterprise, and to emphasize the importance of honey bees in our daily lives and in…

Wetlands & Wildlife: Alaska Wildlife Curriculum Primary Teacher's Guide K-3.

ERIC Educational Resources Information Center

Sigman, Marilyn; And Others

This curriculum guide was designed to give students at the primary level an awareness of Alaska's wetlands and the fish and wildlife that live there. This guide is divided into 13 sections consisting of learning activities covering the following topics: (1) wetland areas in Alaska; (2) water cycles; (3) plants and wildlife found in wetlands; (4)…

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…

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…

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…

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…

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.

Use of standardized patients to teach medical students about living organ donation.

PubMed

Bramstedt, Katrina A; Moolla, Ariff; Rehfield, Patricia L

2012-03-01

Educators routinely use standardized patients to teach medical students a variety of clinical concepts. Standardized patients have also been used to teach students about medical ethics and deceased organ donation. Not reported before, however, is the use of standardized patients to educate medical students about the ethical issues in living organ donation. It seems important to fill this gap because in the United States, roughly 45% of organ donors are living donors, and these patients will visit physicians throughout their lifespan, not just with the occurrence of donation. This article reports an experience teaching concepts in living donation and transplant ethics to second-year osteopathic medicine students using a standardized patient and supplementary instructional materials (eg, film, panel discussion, reading list). Specifically, a transplant ethics module was created that included an actor portraying a living donor candidate who had a number of case variables pertaining to medical and psychosocial matters. Instructional themes included informed consent, altruism, patient selection criteria, organ vending, and post-donation support systems.

Intelligent personal health record: experience and open issues.

PubMed

Luo, Gang; Tang, Chunqiang; Thomas, Selena B

2012-08-01

Web-based personal health records (PHRs) are under massive deployment. To improve PHR's capability and usability, we previously proposed the concept of intelligent PHR (iPHR). By introducing and extending expert system technology and Web search technology into the PHR domain, iPHR can automatically provide users with personalized healthcare information to facilitate their daily activities of living. Our iPHR system currently provides three functions: guided search for disease information, recommendation of home nursing activities, and recommendation of home medical products. This paper discusses our experience with iPHR as well as the open issues, including both enhancements to the existing functions and potential new functions. We outline some preliminary solutions, whereas a main purpose of this paper is to stimulate future research work in the area of consumer health informatics.

Brackish habitat dictates cultivable Actinobacterial diversity from marine sponges

PubMed Central

Chanana, Shaurya; Adnani, Navid; Szachowicz, Emily; Braun, Doug R.; Harper, Mary Kay; Wyche, Thomas P.; Bugni, Tim S.

2017-01-01

Bacterial communities associated with marine invertebrates such as sponges and ascidians have demonstrated potential as sources of bio-medically relevant small molecules. Metagenomic analysis has shown that many of these invertebrates harbor populations of Actinobacteria, many of which are cultivable. While some populations within invertebrates are transmitted vertically, others are obtained from the environment. We hypothesized that cultivable diversity from sponges living in brackish mangrove habitats have associations with Actinobacterial populations that differ from those found in clear tropical waters. In this study, we analyzed the cultivable Actinobacterial populations from sponges found in these two distinct habitats with the aim of understanding the secondary metabolite potential. Importantly, we wanted to broadly evaluate the potential differences among these groups to guide future Actinobacterial collection strategies for the purposes of drug discovery. PMID:28692665

Educator Toolkits on Second Victim Syndrome, Mindfulness and Meditation, and Positive Psychology: The 2017 Resident Wellness Consensus Summit

PubMed Central

Smart, Jon; Zdradzinski, Michael; Roth, Sarah; Gende, Alecia; Conroy, Kylie; Battaglioli, Nicole

2018-01-01

Introduction Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. Methods As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics. Results Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum. Conclusion Residents from across the world collaborated and convened to reach a consensus on high-yield—and potentially high-impact—lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum. PMID:29560061

Educator Toolkits on Second Victim Syndrome, Mindfulness and Meditation, and Positive Psychology: The 2017 Resident Wellness Consensus Summit.

PubMed

Chung, Arlene S; Smart, Jon; Zdradzinski, Michael; Roth, Sarah; Gende, Alecia; Conroy, Kylie; Battaglioli, Nicole

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics. Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum. Residents from across the world collaborated and convened to reach a consensus on high-yield-and potentially high-impact-lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum.

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...

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...

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...

A governor's guide to emergency management. Volume one, Natural disasters

DOT National Transportation Integrated Search

2001-02-27

With lives, infrastructure, and resources at stake, governors must become instant experts in emergency management when their states are affected by natural disaster. The purpose of A Governor's Guide to Emergency Management is to provide governors an...

Educable Mentally Handicapped: Curriculum Guide.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton.

The curriculum guide outlines objectives, strategies, and materials for developing academic, daily living, and vocational skills in educable mentally retarded students. An introductory section explains that the curriculum incorporates a community focus, parental involvement, developmental sequencing, and prescriptive teaching. Guidelines to…

A fully actuated robotic assistant for MRI-guided prostate biopsy and brachytherapy

NASA Astrophysics Data System (ADS)

Li, Gang; Su, Hao; Shang, Weijian; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fischer, Gregory S.

2013-03-01

Intra-operative medical imaging enables incorporation of human experience and intelligence in a controlled, closed-loop fashion. Magnetic resonance imaging (MRI) is an ideal modality for surgical guidance of diagnostic and therapeutic procedures, with its ability to perform high resolution, real-time, high soft tissue contrast imaging without ionizing radiation. However, for most current image-guided approaches only static pre-operative images are accessible for guidance, which are unable to provide updated information during a surgical procedure. The high magnetic field, electrical interference, and limited access of closed-bore MRI render great challenges to developing robotic systems that can perform inside a diagnostic high-field MRI while obtaining interactively updated MR images. To overcome these limitations, we are developing a piezoelectrically actuated robotic assistant for actuated percutaneous prostate interventions under real-time MRI guidance. Utilizing a modular design, the system enables coherent and straight forward workflow for various percutaneous interventions, including prostate biopsy sampling and brachytherapy seed placement, using various needle driver configurations. The unified workflow compromises: 1) system hardware and software initialization, 2) fiducial frame registration, 3) target selection and motion planning, 4) moving to the target and performing the intervention (e.g. taking a biopsy sample) under live imaging, and 5) visualization and verification. Phantom experiments of prostate biopsy and brachytherapy were executed under MRI-guidance to evaluate the feasibility of the workflow. The robot successfully performed fully actuated biopsy sampling and delivery of simulated brachytherapy seeds under live MR imaging, as well as precise delivery of a prostate brachytherapy seed distribution with an RMS accuracy of 0.98mm.

Attitudes toward live and postmortem kidney donation: a survey of Chinese medical students.

PubMed

Ge, Fangmin; Kaczmarczyk, Gabriele; Biller-Andorno, Nikola

2014-12-01

As the gap between supply and demand for donor organs is increasing, we sought to clarify the knowledge and attitudes regarding living-organ donation among Chinese medical students and analyze their incentives and influencing factors. Data were collected from Chinese medical students using a standardized questionnaire. Of 320 surveyed participants, 261 participants (81.6%) said they would consider donating their live kidney organ, and 262 participants (81.9%) were willing to donate posthumously. Although 177 participants (55.7%) confirmed current regulations on posthumous organ donation, only 85 participants (26.7%) could correctly identify the regulations on live organ donation in China. Gender differences were not significantly associated with willingness to donate a kidney, whereas religion and socioeconomic status of the respondents were significantly associated with willingness to donate a live or posthumous kidney. Among well-informed, young, healthy, and economically well-off Chinese male and female medical students, most were willing to be live kidney donors. Religion and socioeconomic status may affect the decision-making process for organ disposition.

Starting and Operating Live Virtual Reference Services: A How-To-Do-It Manual for Librarians. How-To-Do-It Manuals for Librarians, Number 118.

ERIC Educational Resources Information Center

Meola, Marc; Stormont, Sam

This guide discusses the essentials of live virtual reference, preparing for virtual reference, and implementing and incorporating virtual reference. Chapter 1, "Understanding Live Virtual Reference," lays out what virtual reference is and how it compares to other forms of reference. Chapter 2, "Offering Live Virtual Reference," presents ten…

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.

Immediate Outcome of Hypoxic Ischaemic Encephalopathy in Hypoxiate Newborns in Nepal Medical College.

PubMed

Shrestha, S; Shrestha, G S; Sharma, A

2016-05-01

Birth asphyxia is the fifth major cause of under-five child deaths after pneumonia, diarrhoea, neonatal infections and complications of preterm birth. It is one of the important causes of neonatal mortality and morbidity accounting up to 30% of neonatal death in Nepal. It is also an important cause of long-term neurological disability and impairment. The mortality rate due to birth asphyxia is considered a good guide to the quality of perinatal care. This study was conducted to assess the rate of birth asphyxia, risk factors and outcome of the babies who were asphyxiated at birth. A prospective study was conducted during the period of one year from April 2013 to March 2014 in Nepal Medical College. All the term babies born during the period with APGAR score at 5 minutes of < 7 were considered to have birth asphyxia and included in the study. Details of maternal risk factors during pregnancy and labor were analyzed. The newborn babies were assessed for clinical features of hypoxic ischemic encephalopathy (HIE) and its immediate outcome. Out of 2226 live births, 47 (15.9%) newborns had birth asphyxia with the rate of 21.1/1000 live births. The mortality rate due to birth asphyxia was 4.25%. Meconium stained liquor was present in 31(65.96%) cases during delivery and prolonged rupture of membrane in 7(14.89%). Early identification and close monitoring of high-risk mothers with maintaining partograph during labor help to reduce birth asphyxia.

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.

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

Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China.

PubMed

Williams, Ann B; Wang, Honghong; Burgess, Jane; Li, Xianhong; Danvers, Karina

2013-04-01

Adapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. This paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SITE: The intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. The adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. The adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. The primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to details of the original studies that demonstrated efficacy; (4) compare important elements of the original intervention with those of the proposed new population and context to identify primary points for adaptation; (5) explicitly identify sources of tension between intervention fidelity and cultural adaptive needs; (6) document the process of adaptation, pilot the adapted intervention, and evaluate its effectiveness before moving to dissemination and implementation on a large scale. Copyright © 2012 Elsevier Ltd. All rights reserved.

Quality Health Care for People with Developmental Disabilities: A Guide for Parents and Other Caregivers.

ERIC Educational Resources Information Center

Pfaffinger, Kathleen M.; Nelson, Richard P.

Starting with the premise that all people have a right to quality health care, this guide emphasizes that assisting people with developmental disabilities to obtain health care and maintain healthy life styles will enhance the quality of their lives at home and in the community. The guide consists of four sections. A section on obtaining care…

To Keep and Bear Arms: Gun Control and the Second Amendment. Teacher's Guide.

ERIC Educational Resources Information Center

Edwards, Amy N.; Walker, Tim

This teacher's guide is designed to accompany the two-part videotape "To Keep and Bear Arms: Gun Control and the Second Amendment." The videotape and teacher's guide should help students to: (1) understand the history of the Second Amendment; (2) examine how guns and gun control laws affect people's lives; (3) compare and contrast the…

Odyssey Celebrates the Legacy of Mark Twain with "The Prince and the Pauper." Guide for Educators.

ERIC Educational Resources Information Center

KIDSNET, Washington, DC.

This study guide covers the new television version of one of Mark Twain's most popular stories, "The Prince and the Pauper," the classic tale of two boys whose curiosity about each other's lives leads them to switch places and, in the process, learn valuable lessons about outward appearances and true compassion. The guide summarizes the…

Homesteading: The Free Land Idea. An Activity Guide for Teachers Grades 4 through 6.

ERIC Educational Resources Information Center

Lamberson, Wesley; Lange, L. S.; Sutter, Jason; Sutter, Gail

This curriculum/activity guide is designed for use by teachers and other educators who live within trip distance of Homestead National Monument of America in Nebraska. However, some activities in the guide are designed for the classroom, and some are more effective if they are conducted outdoors; but many can be completed at school. The activity…

Guide to Films (16 mm) About Negroes. First Edition.

ERIC Educational Resources Information Center

1970

Over 740 films (16 mm.) concerning the lives, culture, history, and problems of Black people in the United States and in Africa are listed alphabetically by title in this guide. Each entry includes the running time, a synopsis of the film's content, and a source code and tells whether the film is in black-and-white or in color. The guide includes…

Guides in Construction and Manufacturing for Elementary School Industrial Arts. K-2; 3-4; 5-6.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus.

This series of three guides was developed by 25 participants in the institute. One hundred and eight industrial arts lesson plans for grades K-6 are included in these guides for construction and for manufacturing intended to reflect the contemporary industrial and technological society in which young children live. Some typical construction…

The Parents' Guide to the Information Superhighway: Rules and Tools for Families Online.

ERIC Educational Resources Information Center

Lazarus, Wendy; Lipper, Laurie

Computers and online services are becoming a part of children's lives. This guide is designed to introduce parents to the Information Superhighway and to parenting in a world of computers and new forms of media. Prepared by the Children's Partnership, with assistance from the National PTA and the National Urban League, this guide provides tools…

Valerie & Walter's Best Books for Children: A Lively, Opinionated Guide.

ERIC Educational Resources Information Center

Lewis, Valerie V.; Mayes, Walter M.

This comprehensive guide is based on the premise that books and reading are an essential part of every child's development. The guide lists and describes more than 2000 books for children from birth to age 14; from stories that babies can literally chew on, to the best choices for bridging the critical gap between listening and reading, to the…

Healthy Teens: Facing the Challenges of Young Lives. A Practical Guide for Parents, Caregivers, Educators, and Health Professionals. Third Edition.

ERIC Educational Resources Information Center

McCarthy, Alice R.

This monograph is a guide to teen development and the world of 11-18 year olds in contemporary America. It provides practical suggestions to parents and other concerned adults as they guide children through adolescence. The 12 chapters are: (1) "Healthy Bodies, Healthy Minds"; (2) "Teens, Families, and Schools"; (3) "Teens…

Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain.

PubMed

Zander, Viktoria; Eriksson, Henrik; Christensson, Kyllike; Müllersdorf, Maria

2015-09-25

The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients' concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.

Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain

PubMed Central

Zander, Viktoria; Eriksson, Henrik; Christensson, Kyllike; Müllersdorf, Maria

2015-01-01

The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients’ concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration. PMID:26404332

How children and young people construct and negotiate living with medical technology.

PubMed

Kirk, Susan

2010-11-01

Increasing numbers of children need the support of medical technology for their survival and wellbeing, yet little is known about their experiences of living technology-assisted lives. This study aimed to explore how this group of children experience and construct medical technology and its influence on their identity and social relationships. Using a Grounded Theory approach, 28 children/young people aged between 8 and 19 years old and using different types of medical devices were recruited via nursing services in England. Data were collected by in-depth interviews conducted in children's homes. The medical technology occupied an ambivalent position in children's lives being seen as having both an enabling and disabling presence. Children actively engaged in work to incorporate the technology into their lives and bodies by developing strategies to manage their condition, the technology and their identities. This body work appeared to be driven by a desire to 'normalise' their bodies and their lives. Technologies were shaped to integrate them into everyday life and children managed their self-presentation and controlled information about their condition. This work was ongoing, responding to changing social contexts and relationships. For these children the process of 'growing up' involves incorporating disability, illness and technology. This study contributes to knowledge by examining how medical technology is constructed by children whose lives are dependent on it and illuminating the resources and strategies they use to manage their identity and negotiate peer culture interactions and norms. Copyright © 2010 Elsevier Ltd. All rights reserved.

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...

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.

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"…

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…

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.

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

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.

Distress and burnout in young medical researchers before and during the Greek austerity measures: forerunner of a greater crisis?

PubMed

Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Melidoniotis, Evangelos; Mechili, Enkeleint-Aggelos

2018-07-01

Distress and burnout are strongly correlated with austerity and financial recessions. Aim of this study was to assess distress and burnout among young medical researchers (YMR) in Greece before and during the financial crisis. In total 2050 YMR affiliated in all the nursing and medical departments of Greece were enrolled (1025 in Period A: 2008 and 1025 in Period B: 2017). Distress and burnout were measured via DASS-21 and Maslach Burnout Inventory (MBI) questionnaires. Before the crisis, prevalence of distress and burnout among young medical researchers was 24 and 20%, respectively. During the financial crisis distress prevalence increased significantly (56%), while there has also been a tremendous increase in burnout occurrence (60%). Specific sociodemographic characteristics presented significantly increased rate of change (females, singles and divorced/widowers, living with family members, volunteers, smokers and heavy alcohol consumers). Distress and burnout scales were positively correlated (Spearman's r = 0.81; p = 0.01). Depression scores shifted from normal to moderate (rate of change = 13.1%), anxiety levels increased from normal to severe (rate of change = 14.3%) and tension/stress scores elevated from normal to severe (rate of change = 20.2%). It is evident that the current financial crisis and working conditions have a strong impact on health status of young medical researchers in Greece. The observed increased trends and the identified predictors could guide targeted and comprehensive interventions towards tackling distress among the medical researchers not only in Greece but also in other countries suffering from financial crisis.

Pharmacists’ perspectives on promoting medication adherence among patients with HIV

PubMed Central

Kibicho, Jennifer W.; Owczarzak, Jill

2015-01-01

Objectives To provide pharmacists’ perspectives on medication adherence barriers for patients with human immunodeficiency virus (HIV) and to describe pharmacists’ strategies for promoting adherence to antiretroviral medications. Design Multisite, qualitative, descriptive study. Setting Four midwestern U.S. states, from August through October 2009. Participants 19 pharmacists at 10 pharmacies providing services to patients with HIV. Intervention Pharmacists were interviewed using a semistructured interview guide. Main outcome measures Barriers to medication adherence, pharmacist interventions, challenges to promoting adherence. Results Pharmacists reported a range of adherence barriers that were patient specific (e.g., cognitive factors, lack of social support), therapy related (e.g., adverse effects, intolerable medications), and structural level (e.g., strained provider relationships). They used a combination of individually tailored, patient-specific interventions that identified and resolved adherence barriers and actively anticipated and addressed potential adherence barriers. Pharmacist interventions included medication-specific education to enhance patient self-efficacy, follow-up calls to monitor adherence, practical and social support to motivate adherence, and patient referrals to other health care providers. However, the pharmacists faced internal (e.g., lack of time, lack of trained personnel) and external (e.g., insurance policies that disallowed patient enrollment in automatic prescription refill program) challenges. Conclusion Pharmacists in community settings went beyond prescription drug counseling mandated by law to provide additional pharmacy services that were tailored to the needs of patients with HIV. Given that many individuals with HIV are living longer, more research is needed on the effectiveness and cost effectiveness of pharmacists’ interventions in clinical practice, in order to inform insurance reimbursement policies. PMID:22068197

Why shared decision making is not good enough: lessons from patients.

PubMed

Olthuis, Gert; Leget, Carlo; Grypdonck, Mieke

2014-07-01

A closer look at the lived illness experiences of medical professionals themselves shows that shared decision making is in need of a logic of care. This paper underlines that medical decision making inevitably takes place in a messy and uncertain context in which sharing responsibilities may impose a considerable burden on patients. A better understanding of patients' lived experiences enables healthcare professionals to attune to what individual patients deem important in their lives.This will contribute to making medical decisions in a good and caring manner, taking into account the lived experience of being ill.

Curriculum Guides for SSSQ.

ERIC Educational Resources Information Center

McCarron, Lawrence; And Others

The curriculum guide was designed to teach prevocational and independent living skills to students with a wide range of handicapping conditions. The SSSQ (Street Survival Skills Questionnaire) curriculum presents information on objectives, materials, suggested performance criteria, teacher strategies, and specific students activities for the…

Visually Impaired: Curriculum Guide.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton.

The curriculum guide provides guidelines for developing academic and living vocational skills in visually handicapped students from preschool to adolescence. The document, divided into two sections, outlines objectives, teaching strategies, and materials for each skill area. Section 1 covers the following academic skills: communication,…

The lived experience of parenting a child with autism in a rural area: making the invisible, visible.

PubMed

Hoogsteen, Lindsey; Woodgate, Roberta L

2013-01-01

This qualitative study explored the lived experiences of parents parenting a child with autism while living in a rural area. The philosophy of hermeneutic phenomenology was used to guide this inquiry, and interviews of 26 families served as primary data. Thematic statements were isolated using van Manen's (1990) selective highlighting approach. "Making the invisible, visible" emerged as the essence of the parents' experience. Parents shared that although autism was an invisible disability, they in fact made it visible in their constant battles to ensure their child received the best quality of life. The major themes of this essence included a) he's not the Rain Man, b) society's lack of knowledge and understanding, and c) doing it on our own. Findings from this study may be used to guide program development that is concerned with improving the quality of life of families of children with autism living in rural areas.

Scented guide ropes as a method to enhance brown treesnake (Boiga irregularis) trap capture success on Guam

USGS Publications Warehouse

Mason, L.C.; Savidge, J.A.; Rodda, G.H.; Yackel Adams, A.A.

2011-01-01

Current methods for controlling the invasive Brown Treesnake (Boiga irregularis) on Guam include a modified minnow trap with a live mouse lure. We investigated the effects on capture success of augmenting these traps with scented guide ropes leading to trap entrances. Initial screening of scent preferences was based on time spent in scented and unscented arms of a Y-maze. Preferences of large and small snakes were scored for six different prey scents (live and carrion gecko, skink, and mouse). Large snakes spent more time in the maze arm scented with live gecko and carrion gecko, whereas small snakes spent more time in the arm scented with carrion mouse and carrion gecko. After the laboratory study, a pilot trapping session was conducted in the field using three treatments (live mouse-scented ropes, carrion gecko-scented ropes, and carrion mouse-scented ropes) and two controls (traps with unscented guide ropes and those with no ropes attached). Contrary to laboratory results, live mouse-scented ropes were most effective. We conducted a second trapping session using live mouse-scented ropes as well as the two controls used in the pilot study. For snakes of below-average to average condition, the number of captures for traps with live mouse-scented ropes was higher than for traps with no ropes. However, for snakes of above-average condition, there were no differences in capture rates between trap treatments. Overall, treatment effects were weaker than latent individual heterogeneity and the influence of snake body size, with large snakes trapped more readily. ?? 2011 Society for the Study of Amphibians and Reptiles.

Nuclide Guide and International Chart of Nuclides - 2008

NASA Astrophysics Data System (ADS)

Golashvili, T.

2009-08-01

New versions of Nuclide Guide and Chart of the Nuclides were developed as a result of Russian-Chinese collaboration. The Nuclide Guide contains the basic information on more than 3000 radioactive and stable nuclides. The characteristics of isomers with half-lives more than 1 ms are included. For each nuclide spin, parity, mass of nuclide, magnetic moment (if available), mass excess, half-life or abundance, decay modes, branching ratios, emitted particles, energies of most intense gamma-rays and their intensities, decay energies and mean values of radiation energy per decay are given. For stable and natural long-lived nuclides cross-sections of thermal neutron induced activation are indicated. The information presented in the Guide was compiled from 5 sources: 1) ENSDF-2008, 2) atomic mass evaluation-2005 by Audi and Wapstra, 3) interactive data bases at web-sites , , 4) original evaluations of authors, 5) recent publications. The International Chart ot Nuclides was developed on the basis of information presented in Nuclide Guide.

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.

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.

Assessment of a personalized and distributed patient guidance system.

PubMed

Peleg, Mor; Shahar, Yuval; Quaglini, Silvana; Broens, Tom; Budasu, Roxana; Fung, Nick; Fux, Adi; García-Sáez, Gema; Goldstein, Ayelet; González-Ferrer, Arturo; Hermens, Hermie; Hernando, M Elena; Jones, Val; Klebanov, Guy; Klimov, Denis; Knoppel, Daniel; Larburu, Nekane; Marcos, Carlos; Martínez-Sarriegui, Iñaki; Napolitano, Carlo; Pallàs, Àngels; Palomares, Angel; Parimbelli, Enea; Pons, Belén; Rigla, Mercedes; Sacchi, Lucia; Shalom, Erez; Soffer, Pnina; van Schooten, Boris

2017-05-01

The MobiGuide project aimed to establish a ubiquitous, user-friendly, patient-centered mobile decision-support system for patients and for their care providers, based on the continuous application of clinical guidelines and on semantically integrated electronic health records. Patients would be empowered by the system, which would enable them to lead their normal daily lives in their regular environment, while feeling safe, because their health state would be continuously monitored using mobile sensors and self-reporting of symptoms. When conditions occur that require medical attention, patients would be notified as to what they need to do, based on evidence-based guidelines, while their medical team would be informed appropriately, in parallel. We wanted to assess the system's feasibility and potential effects on patients and care providers in two different clinical domains. We describe MobiGuide's architecture, which embodies these objectives. Our novel methodologies include a ubiquitous architecture, encompassing a knowledge elicitation process for parallel coordinated workflows for patients and care providers; the customization of computer-interpretable guidelines (CIGs) by secondary contexts affecting remote management and distributed decision-making; a mechanism for episodic, on demand projection of the relevant portions of CIGs from a centralized, backend decision-support system (DSS), to a local, mobile DSS, which continuously delivers the actual recommendations to the patient; shared decision-making that embodies patient preferences; semantic data integration; and patient and care provider notification services. MobiGuide has been implemented and assessed in a preliminary fashion in two domains: atrial fibrillation (AF), and gestational diabetes Mellitus (GDM). Ten AF patients used the AF MobiGuide system in Italy and 19 GDM patients used the GDM MobiGuide system in Spain. The evaluation of the MobiGuide system focused on patient and care providers' compliance to CIG recommendations and their satisfaction and quality of life. Our evaluation has demonstrated the system's capability for supporting distributed decision-making and its use by patients and clinicians. The results show that compliance of GDM patients to the most important monitoring targets - blood glucose levels (performance of four measurements a day: 0.87±0.11; measurement according to the recommended frequency of every day or twice a week: 0.99±0.03), ketonuria (0.98±0.03), and blood pressure (0.82±0.24) - was high in most GDM patients, while compliance of AF patients to the most important targets was quite high, considering the required ECG measurements (0.65±0.28) and blood-pressure measurements (0.75±1.33). This outcome was viewed by the clinicians as a major potential benefit of the system, and the patients have demonstrated that they are capable of self-monitoring - something that they had not experienced before. In addition, the system caused the clinicians managing the AF patients to change their diagnosis and subsequent treatment for two of the ten AF patients, and caused the clinicians managing the GDM patients to start insulin therapy earlier in two of the 19 patients, based on system's recommendations. Based on the end-of-study questionnaires, the sense of safety that the system has provided to the patients was its greatest asset. Analysis of the patients' quality of life (QoL) questionnaires for the AF patients was inconclusive, because while most patients reported an improvement in their quality of life in the EuroQoL questionnaire, most AF patients reported a deterioration in the AFEQT questionnaire. Feasibility and some of the potential benefits of an evidence-based distributed patient-guidance system were demonstrated in both clinical domains. The potential application of MobiGuide to other medical domains is supported by its standards-based patient health record with multiple electronic medical record linking capabilities, generic data insertion methods, generic medical knowledge representation and application methods, and the ability to communicate with a wide range of sensors. Future larger scale evaluations can assess the impact of such a system on clinical outcomes. MobiGuide's feasibility was demonstrated by a working prototype for the AF and GDM domains, which is usable by patients and clinicians, achieving high compliance to self-measurement recommendations, while enhancing the satisfaction of patients and care providers. Copyright © 2017 Elsevier B.V. All rights reserved.

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...

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...

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...

Live and non-live pregnancy outcomes among women with depression and anxiety: a population-based study.

PubMed

Ban, Lu; Tata, Laila J; West, Joe; Fiaschi, Linda; Gibson, Jack E

2012-01-01

Women taking antidepressant or anti-anxiety medications during early pregnancy have high risks of non-live pregnancy outcomes, although the contribution of the underlying illnesses to these risks remains unclear. We examined the impacts of antenatal depression and anxiety and of commonly prescribed treatments on the risks of non-live pregnancy outcomes. We identified all pregnancies and their outcome (live birth, perinatal death, miscarriage or termination) among women aged 15-45 years between 1990 and 2009 from a large primary care database in the United Kingdom. Women were grouped according to whether they had no history of depression and anxiety, a diagnosis of such illness prior to pregnancy, illness during pregnancy and illness during pregnancy with use of medication (stratified by medication type). Multinomial logistic regression models were used to compare risks of non-live outcomes among these groups, adjusting for major socio-demographic and lifestyle characteristics. Among 512,574 pregnancies in 331,414 women, those with antenatal drug exposure showed the greatest increased risks for all non-live pregnancy outcomes, relative to those with no history of depression or anxiety, although women with prior (but not currently medicated) illness also showed modest increased risks. Compared with un-medicated antenatal morbidity, there was weak evidence of an excess risk in women taking tricyclic antidepressants, and stronger evidence for other medications. Women with depression or anxiety have higher risks of miscarriage, perinatal death and decisions to terminate a pregnancy if prescribed psychotropic medication during early pregnancy than if not. Although underlying disease severity could also play a role, avoiding or reducing use of these drugs during early pregnancy may be advisable.

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.

[Progress in imaging techniques].

PubMed

Mishima, Kazuaki; Otsuka, Tsukasa

2013-05-01

Today it is common to perform real-time diagnosis and treatment via live broadcast as a method of education and to spread new technology for diagnosis and therapy in medical fields. Live medical broadcasts have developed along with broadcast technology. In the early days, live video feeds were sent from operating rooms to classrooms and lecture halls in universities and hospitals. However, the development of imaging techniques and communication networks enabled live broadcasts that bi-directionally link operating rooms and meeting halls during scientific meetings and live demonstration courses. Live broadcasts therefore became an important method for education and the dissemination of new medical technologies. The development of imaging techniques has contributed to more realistic live broadcasts through such innovative techniques as three-dimensional viewing and higher-definition 4K technology. In the future, live broadcasts will be transmitted on personal computers using regular Internet connections. In addition to the enhancement of image delivery technology, it will also be necessary to examine the entire image delivery environment carefully, including issues of security and privacy of personal information.

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

Special Needs Curriculum Guide.

ERIC Educational Resources Information Center

Idaho State Board of Vocational Education, Boise.

The curriculum guide was designed for Vocational Special Needs Programs in Idaho and concentrates on preparing handicapped and disadvantaged students to succeed in regular vocational programs. The subjects, pre-vocational in nature, include: Living Skills (self concept, life management, community resources, food and nutrition, clothing and…

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 ...

Perceived Strengths and Weaknesses of Highly Realistic Training and Live Tissue Training for Navy Corpsmen

DTIC Science & Technology

2015-04-08

raises about the proper use and care of animals .10–12 For three decades, activists have tried to end the practice of Highly Realistic and Live Tissue...Training 4 using live animals for medical training. Although live tissue training continues to be widely used in the training of military medical...compared. It was concluded that “modern simulation is reaching parity with live animal training models.”14 Similarly, Hall and colleagues found that

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…

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…

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…

Art Image Preschool: Introducing 3-to-5-Year-Old Children to Art and Artists. [Packet] 2: Pets Are Part of Our Lives. Teacher's Guide.

ERIC Educational Resources Information Center

Thompson, Christine

This teacher's guide accompanies a packet of five art reproductions based on pets as a theme. The guide offers suggestions for engaging children's attention and curiosity about art and artists, and encourages exploration of the issues these works present through art activities, discussions, learning centers, field trips, and other experiences…

Girls' Success: Mentoring Guide on Transitioning Girls from School to Work

ERIC Educational Resources Information Center

Barron, Liza; Bertone, Andrea

2011-01-01

Mentoring girls is a challenge. Girls will come to mentors with hard questions and great hope. Sometimes mentors will be able to help make their lives better; other times they will feel that they have not done very much. This guide serves as a road map for mentors. This guide focuses on a very important step in young women's journey toward…

Women's Guide to Overseas Living. Second Edition.

ERIC Educational Resources Information Center

Piet-Pelon, Nancy J.; Hornby, Barbara

This book examines issues critical to women and their families who go abroad to live. In advising how to cope effectively with the problems that arise, the book illuminates the advantages of living overseas and offers practical suggestions and guidelines that help women take advantage of the opportunity to share in another culture. Divided into 13…

42 CFR 482.90 - Condition of participation: Patient and living donor selection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... principles of medical ethics. Transplant centers must: (1) Ensure that a prospective living donor receives a... candidate on its waiting list, the candidate's medical record must contain documentation that the candidate... selected to receive a transplant, the center must document in the patient's medical record the patient...

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

Managing medications for individuals living with a dementia: Evaluating a web-based information resource for informal carers.

PubMed

Horne, Frances; Burns, Pippa; Traynor, Victoria; Gillespie, Robyn; Mullan, Judy; Baker, Amanda; Harrison, Lindsey; Win, Khin Than

2018-05-10

The purpose of the study was to evaluate the usefulness of the "Managing Medicines for People with Dementia" (www.dementiameds.com) website for informal carers. The management of medications for individuals living with a dementia by informal carers is a neglected area of care. We know that informal carers find it difficult accessing reliable and comprehensive information about medications. We also know that the Internet is a contemporary and growing medium through which consumers access health information. This study was unique in that it brought these two elements together through an interdisciplinary study about the usefulness of a new website providing information on medication management. Data collection consisted of focus groups with informal carers of individuals living with a dementia. Data were analysed through content analysis. Four themes were generated from the data to explain the evaluation of the website by informal carers: (1) Suitability of the website; (2) Presentation of the website; (3) Unexpected benefits of the website content; (4) Future enhancements for website. Participants overwhelmingly agreed the content of the website filled a gap in information needs about medication management for individuals living with a dementia. This qualitative evaluation demonstrated the value of the website as a resource for informal carers of individuals living with a dementia. The resource could also be used by community nurses and other healthcare practitioners to help informal carers better manage the medication regimes of individuals living with a dementia. The resource has the potential to reduce complications associated with mismanagement of medications and contribute to new policies for implementing safe medication practices. © 2018 John Wiley & Sons Ltd.

Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7Years).

PubMed

Karlsson, Katarina; Dalheim Englund, Ann-Charlotte; Enskär, Karin; Nyström, Maria; Rydström, Ingela

Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures. This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children. The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs. The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources. The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive. Copyright © 2016 Elsevier Inc. All rights reserved.

As I Am.

ERIC Educational Resources Information Center

Chalufor, Ingrid; And Others

The curriculum presented in this guide focuses on enhancing the mental health of children in Head Start or in other comprehensive early childhood programs. The guide begins with two introductory sections: "Stress and Children," describing stressors in young children's lives, how children manifest stress, and teachers' role in mediating…

Elementary Science Resource Guide.

ERIC Educational Resources Information Center

Texas Education Agency, Austin. Div. of Curriculum Development.

This guide for elementary teachers provides information on getting ideas into action, designing and implementing the right situation, ways in which to evaluate science process activities with students, and seven sample units. The units cover using the senses, magnets, forces, weather forecasting, classification of living things, and the physical…

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.

Using GRADE as a framework to guide research on the sexual and reproductive health and rights (SRHR) of women living with HIV - methodological opportunities and challenges.

PubMed

Siegfried, Nandi; Narasimhan, Manjulaa; Kennedy, Caitlin E; Welbourn, Alice; Yuvraj, Anandi

2017-09-01

In March 2016, WHO reviewed evidence to develop global recommendations on the sexual and reproductive health and rights (SRHR) of women living with HIV. Systematic reviews and a global survey of women living with HIV informed the guideline development decision-making process. New recommendations covered abortion, Caesarean section, safe disclosure, and empowerment and self-efficacy interventions. Identification of key research gaps is part of the WHO guidelines development process, but consistent methods to do so are lacking. Our method aimed to ensure consistency and comprised the systematic application of a framework based on GRADE (Grading of Recommendations, Assessment, Development and Evaluation) to the process. The framework incorporates the strength and quality rating of recommendations and the priorities reported by women in the survey to inform research prioritisation. For each gap, we also articulated: (1) the most appropriate and robust study design to answer the question; (2) alternative pragmatic designs if the ideal design is not feasible; and (3) the methodological challenges facing researchers through identifying potential biases. We found 12 research gaps and identified five appropriate study designs to address the related questions: (1) Cross-sectional surveys; (2) Qualitative interview-driven studies; (3) Registries; (4) Randomised controlled trials; and (5) Medical record audit. Methodological challenges included selection, recruitment, misclassification, measurement and contextual biases, and confounding. In conclusion, a framework based on GRADE can provide a systematic approach to identifying research gaps from a WHO guideline. Incorporation of the priorities of women living with HIV into the framework systematically ensures that women living with HIV can shape future policy decisions affecting their lives. Implementation science and participatory research are appropriate over-arching approaches to enhance uptake of interventions and to ensure inclusion of women living with HIV at all stages of the research process.

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 ...

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.

Design and approach of the Living Organ Video Educated Donors (LOVED) program to promote living kidney donation in African Americans.

PubMed

Sieverdes, John C; Price, Matthew; Ruggiero, Kenneth J; Baliga, Prabhakar K; Chavin, Kenneth D; Brunner-Jackson, Brenda; Patel, Sachin; Treiber, Frank A

2017-10-01

To describe the rationale, methodology, design, and interventional approach of a mobile health education program designed for African Americans with end stage renal disease (ESRD) to increase knowledge and self-efficacy to approach others about their need for a living donor kidney transplant (LDKT). The Living Organ Video Educated Donors (LOVED) program is a theory-guided iterative designed, mixed methods study incorporating three phases: 1) a formative evaluation using focus groups to develop program content and approach; 2) a 2-month proof of concept trial (n=27) to primarily investigate acceptability, tolerability and investigate increases of LDKT knowledge and self-efficacy; and 3) a 6-month, 2-arm, 60-person feasibility randomized control trial (RCT) to primarily investigate increases in LDKT knowledge and self-efficacy, and secondarily, to increase the number of living donor inquiries, medical evaluations, and LDKTs. The 8-week LOVED program includes an interactive web-based app delivered on 10″ tablet computer incorporating weekly interactive video education modules, weekly group video chat sessions with an African American navigator who has had LDKT and other group interactions for support and improve strategies to promote their need for a kidney. Phase 1 and 2 have been completed and the program is currently enrolling for the feasibility RCT. Phase 2 experienced 100% retention rates with 91% adherence completing the video modules and 88% minimum adherence to the video chat sessions. We are in the early stages of an RCT to evaluate the LOVED program; to date, we have found high tolerability reported from Phase 2. Copyright © 2017 Elsevier Inc. All rights reserved.

[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.

Race-Based Medical Mistrust, Medication Beliefs and HIV Treatment Adherence: Test of a Mediation Model in People Living with HIV/AIDS

PubMed Central

Kalichman, Seth C.; Eaton, Lisa; Kalichman, Moira O.; Grebler, Tama; Merely, Cynthia; Welles, Brandi

2016-01-01

Race-based medical mistrust significantly predicts non-adherence to antiretroviral therapy (ART) in people living with HIV. The current study builds on previous research that shows beliefs about medication necessity (i.e., “My medicines protect me from becoming worse”) and concerns (i.e., Having to take my medicines worries me) mediate the association between race-based medical mistrust and medication adherence. Racial and ethnic minority men and women living with HIV and receiving ART (N=178) in a southern US city completed computerized measures of demographic and health characteristics, telephone interviews of race-based medical mistrust and medication beliefs, and unannounced phone-based pill counts for ART adherence. Multiple mediation modeling showed that medical mistrust is related to medication necessity and concerns beliefs and ART adherence. Furthermore, medication necessity beliefs predicted ART adherence. The indirect effect of medical mistrust on adherence through medication necessity beliefs was also significant. Results confirm that medication necessity beliefs, although not concerns beliefs, mediate the association between medical mistrust and ART adherence. Medication necessity beliefs offer a viable target for interventions to improve ART adherence in the context of mistrust that patients may have for medical providers and health care systems. PMID:27392477

Management of plantar fasciitis in the outpatient setting.

PubMed

Lim, Ang Tee; How, Choon How; Tan, Benedict

2016-04-01

Plantar fasciitis is a very common cause of inferior heel pain that can be triggered and aggravated by prolonged standing, walking, running and obesity, among other factors. Treatments are largely noninvasive and efficacious. Supportive treatments, including the plantar fascia-specific stretch, calf stretching, appropriate orthotics and night dorsiflexion splinting, can alleviate plantar fascia pain. While local injections of corticosteroids can help with pain relief, the effects are short-lived and must be weighed against the risk of fat pad atrophy and plantar fascia rupture. Ultrasonography-guided focal extracorporeal shock wave therapy is useful for patients with chronic plantar fasciitis and referrals for this treatment can be made in recalcitrant cases. Activity modification to decrease cyclical repetitive loading of the plantar fascia should be advised during the treatment phase regardless of the chosen treatment modality. Copyright: © Singapore Medical Association.

Needed: Global Collaboration for Comparative Research on Cities and Health.

PubMed

Gusmano, Michael K; Rodwin, Victor G

2016-04-16

Over half of the world's population lives in cities and United Nations (UN) demographers project an increase of 2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of urban health policy and management (HPAM), particularly in the megacities of middle-income and developing nations. We make a case for creating a global database on cities, population health and healthcare systems. The expenses involved in data collection would be difficult to justify without some review of previous work, some agreement on indicators worth measuring, conceptual and methodological considerations to guide the construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address these issues in a manner that we hope will stimulate further discussion and collaboration. © 2016 by Kerman University of Medical Sciences.

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;

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 ...

Where to Turn for Help for Older Persons: A Guide for Action on Behalf of An Older Person.

ERIC Educational Resources Information Center

Administration on Aging (DHHS), Washington, DC.

This guide was written to help persons find help when they are faced with an urgent situation regarding an elderly family member, friend, or neighbor. It provides guidance as to where to find help in the community where the older person lives. The first section of the guide contains the most frequently asked questions in significant areas of life,…

Interior, living room, looking west U.S. Veterans Hospital, Jefferson ...

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

Interior, living room, looking west - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

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…

Skills To Fit Your Life Together.

ERIC Educational Resources Information Center

Draper, Patty; Emmons, Kay; Gregory, Glenda; Lewis, Beverly; Owen, Pat; Rogers, Grenell; Wilson, Cynthia

This document is a fill-in-the-dates calendar that students in a daily living skills or family life education class can use to remind themselves to live a healthy and productive life. Set up with a page of tips on the top with a monthly calendar page below, the guide covers the following topics: (1) living better with less; (2) home safety rules;…

Laws of Life: A Literacy-Based Intervention for Social-Emotional and Character Development and Resilience

ERIC Educational Resources Information Center

Elias, Maurice

2008-01-01

Laws of Life is a literacy-based intervention that allows students to identify and articulate the principles by which they live their lives. In the urban context, such an intervention is vital for reclaiming children's interest in writing and helping them to more intentionally guide their lives and their futures according to positive core values.…

A GUIDE TO ORGANIZATION AND OPERATION OF CLASSES FOR MENTALLY RETARDED MINORS.

ERIC Educational Resources Information Center

ORMOND, LAMAR; AND OTHERS

THE MENTALLY RETARDED PERSON MUST LEARN TO COPE WITH THE FUNDAMENTAL PROBLEMS OF DAILY LIVING FROM THE STANDPOINT OF HIS UNIQUE HANDICAP. SOME OF HIS NEEDS INCLUDE LEARNING TO--MAINTAIN A STATE OF PHYSICAL WELL-BEING, LIVE SAFELY, UNDERSTAND HIMSELF, GET ALONG WITH OTHERS, COMMUNICATE IDEAS, USE LEISURE TIME, EARN A LIVING, BE A HOMEMAKER, ENJOY…

Discover the World of Independent Living: An Independent Living Skills Curriculum and a Guide to the Implementation of the Curriculum. October 1, 1981-December 31, 1984.

ERIC Educational Resources Information Center

Leavitt, Karen J.; Terrell, Glenn J.

This independent living skills curriculum addresses the needs of developmentally handicapped students ages 13-19. Designed to supplement the existing curriculum, nine units focus on the following skill areas: social skills (self-esteem, self-identity, social communication and interaction, goal development, problem solving, developing sexual…

Plant Study Guide.

ERIC Educational Resources Information Center

Brynildson, Inga

Appropriate for secondary school botany instruction, this study guide focuses on the important roles of plants in human lives. Following a rationale for learning the basic skills of a botanist, separate sections discuss the process sunlight undergoes during photosynthesis, the flow of energy in the food chain, alternative plant lifestyles, plant…

Encounter with the Northwest Environment: Natural and Urban.

ERIC Educational Resources Information Center

Angell, Tony; And Others

This environmental education curriculum guide provides a framework for approaching and understanding both the urban and natural environment. The information presented in the guide is designed to meet the following educational objectives: to learn of interrelatedness and interdependencies of living organisms with one another and their physical…

Animals in the Classroom: A Guide for Elementary and Secondary Educators.

ERIC Educational Resources Information Center

Birkholz, Elaine; Theran, Peter

This document features a guide for elementary and secondary school teachers integrating animals into their curriculum and classrooms. Topics discussed include suitable classroom pets, care and housing, integrating the classroom pet into the curriculum, live animal studies, earthworms, dissections, science fairs, and resources. (YDS)

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.

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

PubMed Central

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences. PMID:23633423

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

PubMed

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

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

Living into the imagined body: how the diagnostic image confronts the lived body.

PubMed

Stahl, Devan

2013-06-01

In this paper I will show how the medical image, presented to the patient by the physician, participates in medicine's cold culture of abstraction, objectification and mandated normativity. I begin by giving a brief account of the use of anatomical imaging since the Renaissance to show how images have historically functioned in contrast to how they are currently used in medical practice. Next, I examine how contemporary medical imaging techniques participate in a kind of knowledge production that objectifies the human body. Finally, I elucidate how physicians ought to place the medical image within the context of the lived body so as to create a healing relationship with the patient. In all this I hope to show that the medical image, far from a piece of objective data, testifies to the interplay of particular beliefs, practices and doctrines contemporary medicine holds dear. To best treat her patient, the physician must appreciate the influence of these images and appropriately place them within the context of the patient's lived experience.

A Taxonomy of Community Living Skills.

ERIC Educational Resources Information Center

Dever, Richard B.

1989-01-01

Described is the "Taxonomy of Community Living Skills," a guide for curriculum developers. Experts (n=59) in mental retardation were surveyed to assess the taxonomy's coherence, appropriateness, completeness, etc. Responses to the model's five domains (personal maintenance and development, homemaking and community life, vocational,…

A phenomenological exploration of reflections on lived space by child sexual abusers.

PubMed

Garrett, Linda H

2010-12-01

Child sexual abusers may be better understood by phenomenological exploration of reflections on childhood lived space. Child sexual abusers often suffer from child sexual abuse, physical abuse, and neglect in their childhood lived space. These experiences may be considered a limitation or deformation of the child's lived space, resulting in a distorted self view that contributes to adult behavior. Child sexual abuse is not a new phenomenon; it is a problem that has existed throughout history but has rarely enjoyed the publicity and concern of recent times. Child sexual abusers' reflections on their lived space during childhood were explored by interviewing eight incarcerated child sexual abusers in a US correctional center. Van Manen's descriptive-interpretive theoretical process was used to guide abusers' existential reflections on their childhood lived space. van Manen's phenomenological method is dynamic and was used to organize and analyze data into essential categorical themes, one of which is "failure to root." While the viewpoint is retrospective, participants in this study provided unique perspectives on childhood reflections on lived space. These experiences, as reported by the participants, could be used to assist child victims to cope and to guide nursing practice, education, and future research related to Healthy People 2010's Goal 15 (Healthy People 2010, n.d.).

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.

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

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

Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

PubMed

Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve

2015-09-14

Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners. This research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.

Medical education for equity in health: a participatory action research involving persons living in poverty and healthcare professionals.

PubMed

Hudon, Catherine; Loignon, Christine; Grabovschi, Cristina; Bush, Paula; Lambert, Mireille; Goulet, Émilie; Boyer, Sophie; De Laat, Marianne; Fournier, Nathalie

2016-04-12

Improving the knowledge and competencies of healthcare professionals is crucial to better address the specific needs of persons living in poverty and avoid stigmatization. This study aimed to explore the needs and expectations of persons living in poverty and healthcare professionals in terms of medical training regarding poverty and its effects on health and healthcare. We conducted a participatory action research study using photovoice, a method using photography, together with merging of knowledge and practice, an approach promoting dialogue between different sources of knowledge. Nineteen healthcare professionals and persons from an international community organization against poverty participated in the study. The first phase included 60 meetings and group sessions to identify the perceived barriers between persons living in poverty and healthcare teams. In the second phase, sub-committees deployed action plans in academic teaching units to overcome barriers identified in the first phase. Data were analysed through thematic analysis, using NVivo, in collaboration with five non-academic co-researchers. Four themes in regard to medical training were highlighted: improving medical students' and residents' knowledge on poverty and the living conditions of persons living in poverty; improving their understanding of the reality of those people; improving their relational skills pertaining to communication and interaction with persons living in poverty; improving their awareness and capacity for self-reflection. At the end of the second phase, actions were undertaken such as improving knowledge of the living conditions of persons living in poverty by posting social assistance rates, and tailoring interventions to patients' reality by including sociodemographic information in electronic medical records. Our findings also led to a participatory research project aiming to improve the skills and competency of residents and health professionals in regard to the quality of healthcare provided to persons living in poverty. Medical training and residency programs should aim to improve students' and residents' relational skills, more specifically their communication skills, as well as their awareness and capacity for self-reflection, by helping them to identify and recognize their biases, and limitations.

Protective factors against suicide among young-old Chinese outpatients

PubMed Central

2014-01-01

Background Suicide is common among the elderly worldwide. However, no literature could be found on the beliefs/expectations that protect young-old people from attempting suicide. The purpose of this study was to explore young-old outpatients’ reasons for not killing themselves in Taiwan. Method Data for this qualitative descriptive study were extracted from a large research series. From the 83 elderly outpatients in the original sample, 31 were chosen for this study because they were young-old (65–74 years old) and from two randomly selected medical centers in northern Taiwan. Data on participants’ reasons for not killing themselves in unhappy situations were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Results Analysis of interview data identified six major themes: satisfied with one’s life, suicide cannot resolve problems, fear of humiliating one’s children, religious beliefs, never thought about suicide, and living in harmony with nature. Conclusion These identified protective factors (reasons for living) could be added to suicide-prevention programs for the elderly. Our findings may also serve as a reference for geriatric researchers in western countries with increasing numbers of elderly ethnic minority immigrants. PMID:24739419

'One sip won't do any harm . . .': temptation among women with inflammatory bowel disease/irritable bowel syndrome to engage in negative dietary behaviours, despite the consequences to their health.

PubMed

Schneider, Margaret A; Jamieson, Anne; Fletcher, Paula C

2009-04-01

The purpose of this research was to explore the dietary lived experiences of university-aged women suffering from inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). This paper will address the decision-making process used by these women when contemplating the consumption of dietary temptations, despite the associated negative consequences. This phenomenological study was guided by heuristic inquiry. A purposive sample of eight women, between the ages of 18 and 23 years, who were living with IBD or IBS were recruited via postings and word-of-mouth. The findings indicate that these women occasionally felt compelled to give into dietary temptations, despite the consequences to their health. The decision-making process they used when considering these negative health behaviours involved three personally controlled parameters. These three parameters included: assessing the cost-benefit relationship before engaging in these behaviours; having a physical and/or psychological reliance on medications to treat resulting symptoms; and through controlling the timing and surroundings in which they indulged in these negative dietary behaviours. The practical implications for health-care professionals treating patients with IBD or IBS are discussed.

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…

Making the Most of Continuing Medical Education: Evidence of Transformative Learning During a Course in Evidence-Based Medicine and Decision Making.

PubMed

Sokol, Randi G; Shaughnessy, Allen F

2018-01-01

Continuing medical information courses have been criticized for not promoting behavior change among their participants. For behavior change to occur, participants often need to consciously reject previous ideas and transform their way of thinking. Transformational learning is a process that cultivates deep emotional responses and can lead to cognitive and behavioral change in learners, potentially facilitating rich learning experiences and expediting knowledge translation. We explored participants' experiences at a 2-day conference designed to support transformative learning as they encounter new concepts within Information Mastery, which challenge their previous frameworks around the topic of medical decision making. Using the lens of transformative learning theory, we asked: how does Information Mastery qualitatively promote perspective transformation and hence behavior change? We used a hermeneutic phenomenologic approach to capture the lived experience of 12 current and nine previous attendees of the "Information Mastery" course through individual interviews, focus groups, and observation. Data were thematically analyzed. Both prevoius and current conference attendees described how the delivery of new concepts about medical decision making evoked strong emotional responses, facilitated personal transformation, and propelled expedited behavior change around epistemological, moral, and information management themes, resulting in a newfound sense of self-efficacy, confidence, and ownership in their ability to make medical decisions. When the topic area holds the potential to foster a qualitative reframing of learners' guiding paradigms and worldviews, attention should be paid to supporting learners' personalized meaning-making process through transformative learning opportunities to promote translation into practice.

Lived experience of epilepsy from the perspective of children in Taiwan.

PubMed

Chen, Hsiu-Jung; Chen, Yueh-Chih; Yang, Hui-Chuan; Chi, Ching-Shiang

2010-05-01

The purpose of this study was to explore the lived experiences of school-aged children with epilepsy in Taiwan. Epilepsy affects many people worldwide, especially school-aged children, but few studies have examined children's viewpoints of their experiences with epilepsy. An exploratory, phenomenological interview design was used. Children (ages 7-12 years) with well-controlled epilepsy and no developmental delay were recruited from a hospital in central Taiwan. Data were collected from 15 children using a semi-structured interview guide. Interviews were tape-recorded with permission from parents and children. Verbatim transcripts were analysed using Colazzi's phenomenological method. Two themes emerged from the analysis. The first theme, 'living with epilepsy', had two subthemes: disease-related experiences and school-related issues. The second theme, 'coping with epilepsy', had two subthemes: developing strategies to manage or reduce seizures and seeking support from family members. Taiwanese children with epilepsy had similar lived experiences as their counterparts in Western culture, e.g. unpleasant somatic symptoms, difficulty learning and troubled peer relationships. Taiwanese children also coped similarly with epilepsy by taking medications to control seizures, but they differed from their Western counterparts in trying to self-manage seizures and seeking support from family members. Public health and school nurses can apply our findings to educate school teachers and parents about epilepsy and encourage activities that allow children with and without epilepsy to interact, thus improving peer relationships and reducing stigmatisation. Children with and without epilepsy would also benefit from an age-appropriate education manual that includes causes of epilepsy, treatment, dealing with seizures and psychological and social adaptation.

A computer-aided audit system for respiratory therapy consult evaluations: description of a method and early results.

PubMed

Kester, Lucy; Stoller, James K

2013-05-01

Use of respiratory therapist (RT)-guided protocols enhances allocation of respiratory care. In the context that optimal protocol use requires a system for auditing respiratory care plans to assure adherence to protocols and expertise of the RTs generating the care plan, a live audit system has been in longstanding use in our Respiratory Therapy Consult Service. Growth in the number of RT positions and the need to audit more frequently has prompted development of a new, computer-aided audit system. The number and results of audits using the old and new systems were compared (for the periods May 30, 2009 through May 30, 2011 and January 1, 2012 through May 30, 2012, respectively). In contrast to the original, live system requiring a patient visit by the auditor, the new system involves completion of a respiratory therapy care plan using patient information in the electronic medical record, both by the RT generating the care plan and the auditor. Completing audits in the new system also uses an electronic respiratory therapy management system. The degrees of concordance between the audited RT's care plans and the "gold standard" care plans using the old and new audit systems were similar. Use of the new system was associated with an almost doubling of the rate of audits (ie, 11 per month vs 6.1 per month). The new, computer-aided audit system increased capacity to audit more RTs performing RT-guided consults while preserving accuracy as an audit tool. Ensuring that RTs adhere to the audit process remains the challenge for the new system, and is the rate-limiting step.

Management and Marketing. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide defines competencies that help students build daily living skills, investigate career options in management and marketing occupations, use technology in these fields effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs. The first section provides a program rationale…

Study Guide for TCT in Health Education.

ERIC Educational Resources Information Center

Wilks, Barbara

This study guide was specifically designed for individuals preparing to take the Georgia Teacher Certification Test (TCT) in health education. The test covers eight subareas: (1) personal health; (2) nutrition; (3) human growth and development; (4) human sexuality and family living; (5) drugs; (6) safety, first aid, and emergency treatment; (7)…

Tourism Studies. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide, focusing on tourism studies, defines competencies that: help students build daily living skills, investigate career options in the design and repair of motor vehicles, use technology in these fields effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs. Section A…

North Dakota Wetlands Discovery Guide. Photocopy Booklet.

ERIC Educational Resources Information Center

Dietz, Nancy J., Ed.; And Others

This booklet contains games and activities that can be photocopied for classroom use. Activities include Wetland Terminology, Putting on the Map, Erosional Forces, Water in...Water out, Who Lives Here?, Wetlands in Disguise, Dichotomous Plant Game, Algae Survey, Conducting an Algal Survey, Water Quality Indicators Guide, Farming Wetlands, Wetlands…

Design Studies. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in design; enhance employability skills, especially in design occupations; and apply and reinforce learning…

Science, Medicine, and Animals: Teacher's Guide

ERIC Educational Resources Information Center

Moran, Lisa C.

2005-01-01

"Science, Medicine, and Animals" explains the role that animals play in biomedical research and the ways in which scientists, governments, and citizens have tried to balance the experimental use of animals with a concern for all living creatures. An accompanying "Teacher's Guide" is available to help teachers of middle and high…

National Audubon Society Specials. Teacher's Guide I.

ERIC Educational Resources Information Center

WETA - TV, Washington, DC.

Since no civilization can survive without a healthy environment, people must learn to live in harmony with their natural ecosystems and build for future generations. This guide describes six award-winning programs on the condor, black-footed ferret, panthers and cheetahs, ducks, farming and wildlife, and the Galapagos Islands. Although each…

Electro-Technologies. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

With this Career and Technologies Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in electro-technologies; enhance employability skills, especially in electro-technologies industries; and…

Enterprise & Innovation. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in enterprise and innovation; enhance employability skills, especially in entrepreneurial pursuits; and apply…

Logistics. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide defines competencies that help students build daily living skills, investigate career options in logistics occupations, use technology in the logistics field effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs. The first section provides a program rationale and…

Long Island Sound Curricular Resource Guide

ERIC Educational Resources Information Center

Payne, Diana, Ed.

2009-01-01

Long Island Sound is an estuary of national significance and provides important economic, recreational, and aesthetic value to the citizens of Connecticut and New York. Investigations have been conducted regarding living marine resources and nutrient loading. However, Long Island Sound is often overlooked as an educational resource. This guide is…

Construction Technologies. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following; develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in construction; enhance employability skills, especially in construction industries; and apply and reinforce…

Values and the Scientific Culture of Behavior Analysis

ERIC Educational Resources Information Center

Ruiz, Maria R.; Roche, Bryan

2007-01-01

As scientists and practitioners, behavior analysts must make frequent decisions that affect many lives. Scientific principles have been our guide as we work to promote effective action across a broad spectrum of cultural practices. Yet scientific principles alone may not be sufficient to guide our decision making in cases with potentially…

The Walking Wellness Teacher's Guide. A Resource Book for Elementary & Middle School Teachers.

ERIC Educational Resources Information Center

Sweetgall, Robert; Neeves, Robert

This teacher's resource guide for implementing a "Walking Wellness" curriculum in grades four through eight offers 16 hands-on workshops. Activities focus on fitness walking, cardiovascular conditioning, nutrition and weight control, walking techniques and posture, stress control, tobacco-free living, and lifestyle planning. The student…

Update: Saudi Arabia.

ERIC Educational Resources Information Center

McGregor, Joy; Nydell, Margaret

A guide for persons planning on living in or relocating to Saudi Arabia for extended periods of time, this book features information on such topics as entry requirements, transportation, money matters, housing, schools, and insurance. The guide's contents include the following sections: (1) an overview; (2) before leaving; (3) on arrival; (4)…

Financial Management. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide defines competencies that help students build daily living skills, investigate career options in financial management, use technology in the financial management field effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs. The first section provides a program rationale…

Minority Images: A Project Guide.

ERIC Educational Resources Information Center

Murphy, Sharon; Estrada, Paula

The reading list and assignments in this study guide are designed to involve high school students in examining the media from a nonwhite perspective. The beginning assignments require students to assemble their own bibliography relating to minority groups in the media, to examine the lives and contributions of specific Chicano, black, and American…

Agriculture. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in agriculture; enhance employability skills, especially in foods; and apply and reinforce learning developed…

Cosmetology Studies. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide defines competencies that help students build daily living skills, investigate career options in cosmetology, use technology in the cosmetology field effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs in the field. The first section provides a program rationale and…

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

PubMed

Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

2014-01-01

To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years. The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Reducing Medical Students' Stigmatization of People with Chronic Mental Illness: A Field Intervention at the "Living Museum" State Hospital Art Studio

ERIC Educational Resources Information Center

Cutler, Janis L.; Harding, Kelli J.; Hutner, Lucy A.; Cortland, Clarissa; Graham, Mark J.

2012-01-01

Objective: The authors designed an intervention to reduce beginning medical students' stigmatization of people with chronic mental illness (CMI). Methods: Pre-clinical medical students visited a state psychiatric facility's "Living Museum," a combination patient art studio/display space, as the intervention. During the visit, students interacted…

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

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.

Nanofiber Nerve Guide for Peripheral Nerve Repair and Regeneration

DTIC Science & Technology

2014-01-01

observing cell migration using live - cell imaging microscopy, and analyzing cell migration with our MATLAB-based programs. Our studies...are then pipetted into the chamber and their path of migration is observed using a live - cell imaging microscope (Fig. 6d). Utilizing this migration

Outdoor Living.

ERIC Educational Resources Information Center

Cotter, Kathy

Course objectives and learning activities are contained in this curriculum guide for a 16-week home economics course which teaches cooking and sewing skills applicable to outdoor living. The course goals include increasing male enrollment in the home economics program, developing students' self-confidence and ability to work in groups, and…

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...

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...

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...

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...

The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts 2: Living Donors, Summary, Guide

PubMed Central

Williams, Robert C.; Opelz, Gerhard; Weil, E. Jennifer; McGarvey, Chelsea J.; Chakkera, Harini A.

2017-01-01

Background Allografts from living donors survive longer than those from deceased donors but the role of HLA mismatching in living kidney donation is still in question. We examined the effect of HLA compatibility on kidney allograft survival from living donors by studying all first adult kidney transplants performed in the United States over 25 years. Methods Using the United Network for Organ Sharing data, we identified first kidney transplants between October 1, 1987, and December 31, 2013. Recipients were classified by their number of HLA mismatches and stratified by donor origin. Cox multivariate regression analyses adjusting for recipient and donor transplant characteristics were performed to determine impact of HLA compatibility on kidney allograft survival for all living donors and for living related and living unrelated subsets. Results There were 66 596 first adult transplants from living donors with 348 960 years of follow-up. We found a linear relationship between HLA mismatch and allograft survival. In adjusted analyses, among all living donors, 1 mismatch conferred a 44% higher risk, whereas 6 mismatches conferred a twofold higher risk of allograft failure. When using 0-mismatched full siblings as a reference, living-donor kidneys reduce the hazard of failure by approximately 34% when compared with deceased donors. Twenty-five years of transplant experience, stratified by donor source, was summarized and presented as a guide for allocation. Conclusions These data reinforce the importance of optimizing HLA matching to further improve survival in first adult kidney allografts in the future, especially in living unrelated donations, when possible. PMID:28573187

The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts 2: Living Donors, Summary, Guide.

PubMed

Williams, Robert C; Opelz, Gerhard; Weil, E Jennifer; McGarvey, Chelsea J; Chakkera, Harini A

2017-05-01

Allografts from living donors survive longer than those from deceased donors but the role of HLA mismatching in living kidney donation is still in question. We examined the effect of HLA compatibility on kidney allograft survival from living donors by studying all first adult kidney transplants performed in the United States over 25 years. Using the United Network for Organ Sharing data, we identified first kidney transplants between October 1, 1987, and December 31, 2013. Recipients were classified by their number of HLA mismatches and stratified by donor origin. Cox multivariate regression analyses adjusting for recipient and donor transplant characteristics were performed to determine impact of HLA compatibility on kidney allograft survival for all living donors and for living related and living unrelated subsets. There were 66 596 first adult transplants from living donors with 348 960 years of follow-up. We found a linear relationship between HLA mismatch and allograft survival. In adjusted analyses, among all living donors, 1 mismatch conferred a 44% higher risk, whereas 6 mismatches conferred a twofold higher risk of allograft failure. When using 0-mismatched full siblings as a reference, living-donor kidneys reduce the hazard of failure by approximately 34% when compared with deceased donors. Twenty-five years of transplant experience, stratified by donor source, was summarized and presented as a guide for allocation. These data reinforce the importance of optimizing HLA matching to further improve survival in first adult kidney allografts in the future, especially in living unrelated donations, when possible.

[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.

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.

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.

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 ...

Interior, central sunporch behind living room, looking northeast U.S. ...

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

Interior, central sunporch behind living room, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

The Economic Domino Effect: A Phenomenological Study Exploring Community College Faculty's Lived Experiences during Financial Hard Times in Higher Education

ERIC Educational Resources Information Center

Taylor, Tridai A.

2014-01-01

This qualitative study explored the lived experiences of eight full-time community college faculty members who taught during the economic crisis of 2008. The study was guided by the central research question, "How do community college faculty members describe their lived experiences regarding the recent economic crisis of 2008 and its impact…

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.

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.

TRIAD IV: Nationwide Survey of Medical Students' Understanding of Living Wills and DNR Orders.

PubMed

Mirarchi, Ferdinando L; Ray, Matthew; Cooney, Timothy

2016-12-01

Living wills are a form of advance directives that help to protect patient autonomy. They are frequently encountered in the conduct of medicine. Because of their impact on care, it is important to understand the adequacy of current medical school training in the preparation of physicians to interpret these directives. Between April and August 2011 of third and fourth year medical students participated in an internet survey involving the interpretation of living wills. The survey presented a standard living will as a "stand-alone," a standard living will with the addition an emergent clinical scenario and then variations of the standard living will that included a code status designation ("DNR," "Full Code," or "Comfort Care"). For each version/ scenario, respondents were asked to assign a code status and choose interventions based on the cases presented. Four hundred twenty-five students from medical schools throughout the country responded. The majority indicated they had received some form of advance directive training and understood the concept of code status and the term "DNR." Based on a stand-alone document, 15% of respondents correctly denoted "full code" as the appropriate code status; adding a clinical scenario yielded negligible improvement. When a code designation was added to the living will, correct code status responses ranged from 68% to 93%, whereas correct treatment decisions ranged from 18% to 78%. Previous training in advance directives had no impact on these results. Our data indicate that the majority of students failed to understand the key elements of a living will; adding a code status designations improved correct responses with the exception of the term DNR. Misunderstanding of advance directives is a nationwide problem and jeopardizes patient safety. Medical School ethics curricula need to be improved to ensure competency with respect to understanding advance directives.

Visible light-sensitive APTES-bound ZnO nanowire toward a potent nanoinjector sensing biomolecules in a living cell

NASA Astrophysics Data System (ADS)

Lee, Jooran; Choi, Sunyoung; Bae, Seon Joo; Yoon, Seok Min; Choi, Joon Sig; Yoon, Minjoong

2013-10-01

Nanoscale cell injection techniques combined with nanoscopic photoluminescence (PL) spectroscopy have been important issues in high-resolution optical biosensing, gene and drug delivery and single-cell endoscopy for medical diagnostics and therapeutics. However, the current nanoinjectors remain limited for optical biosensing and communication at the subwavelength level, requiring an optical probe such as semiconductor quantum dots, separately. Here, we show that waveguided red emission is observed at the tip of a single visible light-sensitive APTES-modified ZnO nanowire (APTES-ZnO NW) and it exhibits great enhancement upon interaction with a complementary sequence-based double stranded (ds) DNA, whereas it is not significantly affected by non-complementary ds DNA. Further, the tip of a single APTES-ZnO NW can be inserted into the subcellular region of living HEK 293 cells without significant toxicity, and it can also detect the enhancement of the tip emission from subcellular regions with high spatial resolution. These results indicate that the single APTES-ZnO NW would be useful as a potent nanoinjector which can guide visible light into intracellular compartments of mammalian cells, and can also detect nanoscopic optical signal changes induced by interaction with the subcellular specific target biomolecules without separate optical probes.Nanoscale cell injection techniques combined with nanoscopic photoluminescence (PL) spectroscopy have been important issues in high-resolution optical biosensing, gene and drug delivery and single-cell endoscopy for medical diagnostics and therapeutics. However, the current nanoinjectors remain limited for optical biosensing and communication at the subwavelength level, requiring an optical probe such as semiconductor quantum dots, separately. Here, we show that waveguided red emission is observed at the tip of a single visible light-sensitive APTES-modified ZnO nanowire (APTES-ZnO NW) and it exhibits great enhancement upon interaction with a complementary sequence-based double stranded (ds) DNA, whereas it is not significantly affected by non-complementary ds DNA. Further, the tip of a single APTES-ZnO NW can be inserted into the subcellular region of living HEK 293 cells without significant toxicity, and it can also detect the enhancement of the tip emission from subcellular regions with high spatial resolution. These results indicate that the single APTES-ZnO NW would be useful as a potent nanoinjector which can guide visible light into intracellular compartments of mammalian cells, and can also detect nanoscopic optical signal changes induced by interaction with the subcellular specific target biomolecules without separate optical probes. Electronic supplementary information (ESI) available: Synthesis of APTES-modified ZnO nanowires, DNA functionalization and spectroscopic measurements with additional fluorescence image ad fluorescence decay times, cell culture, injection of a single nanowire into living cells, subcellular imaging and determination of cytotoxicity. See DOI: 10.1039/c3nr03042c

Living in Japan. Intercultural Exchange Series. Revised.

ERIC Educational Resources Information Center

Hawkinson, Annie

The guide provides a brief introduction to the culture and language of Japan, and is designed for visitors, students, and business travelers. It offers practical information on various aspects of daily living, including: money; banks; food; restaurants; hotels; tipping; postal and telecommunications services; transportation; shopping; health and…

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 ...

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.

Adoption of Canada's Physical Activity Guide and Handbook for Older Adults: impact on functional fitness and energy expenditure.

PubMed

Jiang, Xuesong; Cooper, Juliette; Porter, Michelle M; Ready, A Elizabeth

2004-08-01

This study investigated whether a behaviour change program, based on Canada's Physical Activity Guide and Handbook to Healthy Active Living for Older Adults (Health Canada, 1999a), would elicit greater benefits than adoption of the guide and handbook alone. Fifteen older adults received the guide and accompanying handbook and completed the 8-week behaviour change program (mean age 73.2 +/- 5.2 yrs), while 14 others received only the guide and handbook (mean age 76.8 +/- 10.0 yrs). Functional fitness (lower body strength/endurance, flexibility, agility/dynamic balance) (Rikli and Jones, 1999), and estimated energy expenditure (DiPietro et al., 1993) were measured at baseline and after 8 weeks. Lower body strength/endurance and agility/dynamic balance differed between groups at baseline, p < 0.05. All three functional fitness tests improved in both groups over time, p< 0.05. Estimated energy expended in physical activity increased in both groups over time, p < 0.05; however, there was a significantly greater increase in the behaviour-change group (Group x Time interaction, p < 0.05). Participant response to using the guide and handbook was positive. These results indicate that introduction to Canada's Physical Activity Guide and Handbook to Healthy Active Living for Older Adults leads to benefits, whether or not accompanied by program supports. The group receiving the behaviour change program had a greater increase in energy expenditure, which suggests that such an intervention may ultimately lead to greater health benefits.

Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.

PubMed

Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B

2013-01-01

Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

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).…

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.

Living on the edge of asthma: A grounded theory exploration.

PubMed

Shaw, Michele R; Oneal, Gail

2014-10-01

Most asthma-related emergency department (ED) visits and hospitalizations for asthma are preventable. Our purpose was to develop a grounded theory to guide interventions to reduce unnecessary hospitalizations and ED visits. Grounded theory inquiry guided interviews of 20 participants, including 13 parents and 7 children. Living on the edge of asthma was the emergent theory. Categories included: balancing, losing control, seeking control, and transforming. The theory provides the means for nurses to understand the dynamic process that families undergo in trying to prevent and then deal with and learn from an acute asthma attack requiring hospitalization or an ED visit. © 2014, Wiley Periodicals, Inc.

Energy and Mines. Guide to Standards and Implementation. Career & Technology Studies.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This Alberta curriculum guide defines competencies that help students build daily living skills, investigate career options in energy and mines, use technology in the fields of energy and mining effectively and efficiently, and prepare for entry into the workplace or related postsecondary programs in the field. The first section provides a program…

The Urban Environment. A Teacher's Guide, Grades K-3.

ERIC Educational Resources Information Center

Busch, Phyllis S.

Sixty-three learning activities comprise this curriculum guide to conservation education designed for elementary students. The activities enable the teacher to relate the urban child's immediate environment to the ecological problems which confront our world. Four conceptual schemes are used for each of the four grades, K-3: Living things (plants,…

Guiding Student Inquiry into Eukaryotic Organismal Biology Using the Plasmodial Slime Mold "Physarum Polycephalum"

ERIC Educational Resources Information Center

Weeks, Andrea; Bachman, Beverly; Josway, Sarah; Laemmerzahl, Arndt F.; North, Brittany

2014-01-01

In order to challenge our undergraduate students' enduring misconception that plants, animals, and fungi must be "advanced" and that other eukaryotes traditionally called protists must be "primitive," we have developed a 24-hour take-home guided inquiry and investigation of live Physarum cultures. The experiment replicates…

Using a Combined Approach of Guided Inquiry & Direct Instruction to Explore How Physiology Affects Behavior

ERIC Educational Resources Information Center

Machtinger, Erika T.

2014-01-01

Hands-on activities with live organisms allow students to actively explore scientific investigation. Here, I present activities that combine guided inquiry with direct instruction and relate how nutrition affects the physiology and behavior of the common housefly. These experiments encourage student involvement in the formulation of experimental…

Metrics for Good Measure. Level III. Instructor's Guide.

ERIC Educational Resources Information Center

Cooper, Gloria S.; And Others

This guide and the accompanying student workbook (separate document) comprise the Adult Basic Education Level III (grades 7, 8, and 9) package on the metric system. An introductory section provides background information on adult basic daily living skills, a discussion of the design and use of the student workbook, and information on what the…

Metrics for Good Measure. Level II. Instructor's Guide.

ERIC Educational Resources Information Center

Cooper, Gloria S.; And Others

This guide and the accompanying student workbook (separate document) comprise the Adult Basic Education Level II (grades 4, 5, and 6) package on the metric system. An introductory section provides background information on adult basic daily living skills, a discussion of the design and use of the student workbook, and information on what the…

A Guide to Youth Mentoring: Providing Effective Social Support

ERIC Educational Resources Information Center

Dolan, Pat; Brady, Bernadine

2011-01-01

Youth mentoring can be an effective way of supporting troubled youth, helping them sustain positive mental health, cope with stress, and lead successful lives through adolescence and into adulthood. This book is a comprehensive guide to youth mentoring programmes, illustrating how, if managed well, they can increase the social support available to…

A Living Metaphor of Differentiation: A Meta-Ethnography of Cognitively Guided Instruction in the Elementary Classroom

ERIC Educational Resources Information Center

Baker, Katherine; Harter, Meghan Evelynne

2015-01-01

This meta-ethnography explores qualitative studies around the Cognitively Guided Instruction (CGI) framework of mathematics and illustrates how CGI epitomizes differentiation. The meta-ethnographic process is used to synthesize CGI as differentiation, specifically within the elementary mathematics classroom. Thomas P. Carpenter is credited as one…

PRIMARY LEVEL RESOURCE GUIDE FOR EDUCABLE MENTALLY RETARDED. "WE DO IT THIS WAY" SERIES, VOLUME 1.

ERIC Educational Resources Information Center

BLESSING, KENNETH R.; AND OTHERS

THIS RESOURCE GUIDE PRESENTS CONTENT AREAS (READING, SPEECH AND LANGUAGE DEVELOPMENT, HANDWRITING AND SPELLING, ARITHMETIC, SCIENCE, HEALTH, SAFETY, SOCIAL STUDIES, SOCIAL LIVING, PHYSICAL EDUCATION, ARTS AND HANDICRAFTS, MUSIC, PRACTICAL ARTS, AND WORK EXPERIENCE PROGRAMS) AS A PART OF UNIT TOPICS. THE SPECIAL UNITS PRESENTED INCLUDE LEARNING TO…

Guide to Careers in World Affairs.

ERIC Educational Resources Information Center

Schisgall, Laura J., Ed.

Designed to help those who are considering a career that enables them to travel or live abroad or to work in an international field, this guide will be especially helpful to college and graduate school students, graduates with advanced degrees, professionals exploring alternative careers, and college-bound high school students, and will also be a…

Nourishing the Learning Spirit: Living Our Way to New Thinking

ERIC Educational Resources Information Center

Battiste, Marie

2010-01-01

Learning, as Aboriginal people have come to know it, is holistic, lifelong, purposeful, experiential, communal, spiritual, and learned within a language and a culture. What guides their learning (beyond family, community, and Elders) is spirit, their own learning spirits who travel with them and guide them along their earth walk, offering them…

Goal Setting Skills for Young Adults.

ERIC Educational Resources Information Center

Youngs, Bettie B.

This guide/workbook was written to help adolescents understand why goals are important, identify their goals, and work toward achieving those goals. Following a brief introduction, the guide is divided into five chapters. Chapter 1 asks readers the question: Who Is in Charge of Your Lives?" Setting goals is presented as the key to shaping the…

Lively Discussions vs. Discussions of Substance: Making the Case for Guided Case Study.

ERIC Educational Resources Information Center

Woloshin/Lerman, Phyllis

1996-01-01

Discusses the history and purpose of the case study method used to stimulate in-class discussion. Advocates the use of the guided case study method to ensure that substantive discussions take place and provides nine steps for using the method. Includes a sample case study worksheet. (11 citations) (BCY)

Human Rights: The Struggle for Freedom, Dignity and Equality. Resource Guide.

ERIC Educational Resources Information Center

Connecticut State Dept. of Education, Hartford.

Every human being deserves the right to live in freedom and dignity. Yet human rights violations dominate the headlines. In addition to becoming sensitive to human pain and suffering, young adults must also begin the lifelong process of creating, recognizing, and exercising options. This resource guide contains suggested questions and projects…

Rural Learning: A Practical Guide to Developing Learning Opportunities in the Countryside.

ERIC Educational Resources Information Center

Payne, John

This guide to rural learning is intended to help those developing learning opportunities in the United Kingdom countryside--teachers, program organizers, project and development workers, and health and housing workers. Section 1 supplies up-to-date facts and figures and useful information about living in the rural context. It highlights issues…

Animals Alive! An Ecological Guide to Animal Activities. Revised Edition.

ERIC Educational Resources Information Center

Holley, Dennis

This guide is designed to help teachers develop an inquiry-oriented program for studying the animal kingdom in which live animals are collected locally, studied, observed, and then released completely unharmed back into their natural habitats. This book addresses such concerns of life science teachers as the environmental soundness of methods and…

Ohio Vocational Consumer/Homemaking Curriculum Guide. Practical Action.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Instructional Materials Lab.

This curriculum guide helps students learn the technical skills of the occupation of homemaking. It also uses the process model of practical reasoning to assist men and women in taking action regarding the perennial problems that face individuals and families living in the world society. The first section provides the philosophy, aim, student…

Housing for the Physically Impaired; A Guide for Planning and Design.

ERIC Educational Resources Information Center

Department of Housing and Urban Development, Washington, DC.

Problems involved in providing homes for independent living for the physically handicapped, health impaired, or older adults are considered. Basic concepts of low rent housing preface a discussion of neighborhoods and site selection, access, ramps, pedestrian walks, parking, landscaping, and lighting. Guides for building design focus on entrances,…

ENCOURAGING COMMUNITY DEVELOPMENT, A TRAINING GUIDE FOR LOCAL WORKERS.

ERIC Educational Resources Information Center

BIDDLE, LOUREIDE J.; BIDDLE, WILLIAM W.

THIS TRAINING GUIDE IS WRITTEN TO MEET THE NEEDS OF UNIVERSITIES AND COLLEGES TO WHICH THE PEACE CORPS, VISTA, CHURCHES, AND OTHER VOLUNTEER-USING AGENCIES TURN FOR HELP IN TRAINING THE NONPROFESSIONAL OR PREPROFESSIONAL LOCAL WORKER IN COMMUNITY DEVELOPMENT. THE LESSONS ARE DIRECTED TO THE "ENCOURAGER" WHO LIVES WITH THE PEOPLE PARTICIPATING IN…

Stationary Engineering Laboratory--2. Teacher's Guide.

ERIC Educational Resources Information Center

Steingress, Frederick M.; Frost, Harold J.

The Stationary Engineering Laboratory Manual 2 Teacher's Guide was designed as an aid to the instructors of vocational-technical high school students who have received instruction in the basics of stationary engineering. The course of study was developed for students who will be operating a live plant and who will be responsible for supplying…

Living in Space. Book II. Levels D, E, F for Grades 4, 5, 6. Operation Liftoff: Elementary School Space Program. A Resource Guide with Activities for Elementary School Teachers.

ERIC Educational Resources Information Center

Andrews, Sheila Briskin; Kirschenbaum, Audrey

This guide contains teacher background information and activities for students which deal with space travel and is designed to encourage elementary school students to take a greater interest in mathematics and science. The activities in this guide are to be used with grades 4 to 6 and cover the topics of food, clothing, health, housing,…

Living in Space. Book 1. Levels A, B, C for Grades 1, 2, 3. Operation Liftoff: Elementary School Space Program. A Resource Guide with Activities for Elementary School Teachers.

ERIC Educational Resources Information Center

Andrews, Sheila Briskin; Kirschenbaum, Audrey

This guide contains teacher background information and activities for students that relate to space travel and is designed to encourage elementary school students to take a greater interest in mathematics and science. The activities in this guide are to be used with grades 1 to 3 and cover the topics of food, clothing, health, housing,…

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…

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…

What Is the True Nitrogenase Reaction? A Guided Approach

ERIC Educational Resources Information Center

Ipata, Piero L.; Pesi, Rossana

2015-01-01

Only diazotrophic bacteria, called "Rizhobia," living as symbionts in the root nodules of leguminous plants and certain free-living prokaryotic cells can fix atmospheric N[subscript 2]. In these microorganisms, nitrogen fixation is carried out by the nitrogenase protein complex. However, the reduction of nitrogen to ammonia has an…

Environmental Science, Grade 9. Experimental Curriculum Bulletin.

ERIC Educational Resources Information Center

Bernstein, Leonard, Ed.

This is the teacher's guide for the required, interdisciplinary, ninth-year environmental science course for the New York City Schools. One hundred twenty lesson plans, divided into nine units, are presented. Areas of study include the living and non-living environment, ecosystems, population, urban ecology, energy and technology, pollution, and…

Why Can't We Talk? : Working Together to Bridge the Communications Gap to Save Lives : A Guide For Public Officials

DOT National Transportation Integrated Search

2003-01-01

The inability of our public safety officials to readily communicate with each other threatens the publics safety and often results in unnecessary loss of lives and property. Recognizing that solutions to this national issue can only be achieved throu...

JULIUS CAESAR. PLUTARCH'S LIVES. AUTOBIOGRAPHY. LITERATURE CURRICULUM IV, STUDENT VERSION.

ERIC Educational Resources Information Center

KITZHABER, ALBERT R.

THIS 10TH-GRADE STUDENT GUIDE POSED SOME QUESTIONS AND CLARIFIED OTHERS ON SHAKESPEARE'S "JULIUS CAESAR," AND PRESENTED SHORT SELECTIONS FROM PLUTARCH'S "LIVES" (ON CAESAR, BRUTUS, AND MARK ANTONY) WITH ACCOMPANYING DISCUSSION QUESTIONS. A UNIT OF AUTOBIOGRAPHICAL READINGS OF EARLY LIFE EXPERIENCES WAS ALSO OUTLINED. BY…

Healthy Children, Healthy Lives: The Wellness Guide for Early Childhood Programs

ERIC Educational Resources Information Center

Bergen, Sharon; Robertson, Rachel

2013-01-01

Early childhood is a critical time in human development. Understanding and supporting children's wellness early on can make the greatest impact on physical, social and emotional, and cognitive health throughout childhood and adulthood. "Healthy Children, Healthy Lives" provides a comprehensive collection of checklists and research ­based…

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 .).

Living Spaces: In the Desert, In the Future, In the Mountains, In the Polar Regions, In Space, On the Water. Living Spaces Series.

ERIC Educational Resources Information Center

Stewart, Gail

Each of the 6 separate books in this classroom series for juveniles introduces students to the variety of living spaces people have adapted in order to survive in a hostile environment. The illustrated guides examine several cultures which have developed and thrived in these environments. (1) "In the Desert" looks at: The San of the…

The case of Samuel Golubchuk and the right to live.

PubMed

Jotkowitz, Alan; Glick, Shimon; Zivotofsky, Ari Z

2010-03-01

Samuel Golubchuk was unwittingly at the center of a medical controversy with important ethical ramifications. Mr. Golubchuk, an 84-year-old patient whose precise neurological level of function was open to debate, was being artificially ventilated and fed by a gastrostomy tube prior to his death. According to all reports he was neither brain dead nor in a vegetative state. The physicians directly responsible for his care had requested that they be allowed to remove the patient from life support against the wishes of the patient's family. Concurrently the Manitoba College of Physicians and Surgeons released a statement which states that the final decision to withdraw life support lies with the physician. In our opinion the statement is ethically problematic for a number of reasons. 1. It is an affront to the guiding principles of Western medical ethics: patient autonomy and human freedom. 2. The position of Samuel Golubchuk's physicians and the new statement lack cultural sensitivity towards other traditions. 3. In modern society there exists an erosion of a basic attitude towards the value of life. 4. The ability of physicians to predict life expectancy in terminally ill patients has been shown repeatedly to be quite limited.

Sounding Narrative Medicine: Studying Students’ Professional Identity Development at Columbia University College of Physicians and Surgeons

PubMed Central

Miller, Eliza; Balmer, Dorene; Hermann, Nellie; Graham, Gillian; Charon, Rita

2014-01-01

Purpose To learn what medical students derive from training in humanities, social sciences, and the arts in a narrative medicine curriculum and to explore narrative medicine’s framework as it relates to students’ professional development. Method On completion of required intensive, half-semester narrative medicine seminars in 2010, 130 second-year medical students at Columbia University College of Physicians and Surgeons participated in focus group discussions of their experiences. Focus group transcriptions were submitted to close iterative reading by a team who performed a grounded-theory-guided content analysis, generating a list of codes into which statements were sorted to develop overarching themes. Provisional interpretations emerged from the close and repeated readings, suggesting a fresh conceptual understanding of how and through what avenues such education achieves its goals in clinical training. Results Students’ comments articulated the known features of narrative medicine—attention, representation, and affiliation—and endorsed all three as being valuable to professional identity development. They spoke of the salience of their work in narrative medicine to medicine and medical education and its dividends of critical thinking, reflection, and pleasure. Critiques constituted a small percentage of the statements in each category. Conclusions Students report that narrative medicine seminars support complex interior, interpersonal, perceptual, and expressive capacities. Students’ lived experiences confirm some expectations of narrative medicine curricular planners while exposing fresh effects of such work to view. PMID:24362390

[Cognitive traps and clinical decisions].

PubMed

Motterlini, Matteo

2017-12-01

We are fallible, we have limited computational capabilities, limited access to information, little memory. Moreover, in everyday life, we feel joy, fear, anger, and other emotions that influence our decisions in a little, "calculated" way. Not everyone, however, is also aware that the mistakes we make are often systematic and therefore, in particular circumstances, are foreseeable. Doctors and patients are constantly called upon to make decisions. They need to identify relevant information (for example, the symptoms or outcome of an examination), formulate a judgment (for example a diagnosis), choose an action course among the various possible ones based on one's own preferences (e.g. medication or surgery), so act. The exact size of the medical error is unknown, but probably huge. In fact, the more we investigate and the more we find. Often these mistakes depend on the cognitive process. Any (rational) decision requires, in particular, an assessment of the possible effects of the action it implements; for example how much pleasure or pain it will cause us. In the medical field, too, the principle of informed consent provides that the patient's preferences and values are to guide clinical choices. Yet, not always the preferences that people express before making an experience match with their preferences after living that experience. Some ingenious experiments suggest (in a seemingly paradoxical way) that before a direct experience, people prefer less pain; after that experience they prefer more, but with a better memory.

A Matter of Perspective: Comparison of the Characteristics of Persons with HIV Infection in the United States from the HIV Outpatient Study, Medical Monitoring Project, and National HIV Surveillance System

PubMed Central

Buchacz, Kate; Frazier, Emma L.; Hall, H. Irene; Hart, Rachel; Huang, Ping; Franklin, Dana; Hu, Xiaohong; Palella, Frank J.; Chmiel, Joan S.; Novak, Richard M.; Wood, Kathy; Yangco, Bienvenido; Armon, Carl; Brooks, John T.; Skarbinski, Jacek

2015-01-01

Comparative analyses of the characteristics of persons living with HIV infection (PLWH) in the United States (US) captured in surveillance and other observational databases are few. To explore potential joint data use to guide HIV treatment and prevention in the US, we examined three CDC-funded data sources in 2012: the HIV Outpatient Study (HOPS), a multisite longitudinal cohort; the Medical Monitoring Project (MMP), a probability sample of PLWH receiving medical care; and the National HIV Surveillance System (NHSS), a surveillance system of all PLWH. Overall, data from 1,697 HOPS, 4,901 MMP, and 865,102 NHSS PLWH were analyzed. Compared with the MMP population, HOPS participants were more likely to be older, non-Hispanic/Latino white, not using injection drugs, insured, diagnosed with HIV before 2009, prescribed antiretroviral therapy, and to have most recent CD4+ T-lymphocyte cell count ≥500 cells/mm3 and most recent viral load test<2 00 copies/mL. The MMP population was demographically similar to all PLWH in NHSS, except it tended to be slightly older, HIV diagnosed more recently, and to have AIDS. Our comparative results provide an essential first step for combined epidemiologic data analyses to inform HIV care and prevention for PLWH in the US. PMID:26793282

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…

Medications for Sexually Transmitted Infections

MedlinePlus

... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...

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.

COPD management: role of symptom assessment in routine clinical practice

PubMed Central

van der Molen, Thys; Miravitlles, Marc; Kocks, Janwillem WH

2013-01-01

Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed. PMID:24143085

Understanding what asthma plans mean: a linguistic analysis of terminology used in published texts.

PubMed

Ring, Nicola; Pinnock, Hilary; Wilson, Caroline; Hoskins, Gaylor; Jepson, Ruth; Wyke, Sally; Sheikh, Aziz

2011-06-01

To identify from the literature what terms are used for 'asthma plans', with what meaning, and in what context(s). Linguistic analysis of a selected body of asthma literature from 1989-2009. A wide range of asthma plan terminology was evident, with terms such as 'action plans', 'self-management plans' and 'treatment plans' being applied inconsistently and synonymously. For individual patients the term 'asthma plan' can describe a clinically-determined list of prescribed medication, an agreed plan to guide self-management of changing symptoms, or a more holistic 'living with asthma' plan. In some contexts the term 'asthma plan' was also used to describe an organisational system of care, which causes further ambiguity. Within the literature, a plethora of terms is used inconsistently and with varied meaning. This is a potential, but previously unrecognised, barrier to asthma plan implementation. A taxonomy of asthma plans and a standardised definitions of terms is required.

Understanding HIV-related stigma among Indonesian nurses

PubMed Central

Waluyo, Agung; Culbert, Gabriel J.; Levy, Judith; Norr, Kathleen

2014-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country’s policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses’ HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses’ stigmatizing attitudes toward PLWH. Four hundred nurses recruited from 4 hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale (NAAS) to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. PMID:24759060

Understanding HIV-related stigma among Indonesian nurses.

PubMed

Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

2015-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Help seeking in a support group for recipients of implantable cardioverter defibrillators and their support persons.

PubMed

Dickerson, S S; Posluszny, M; Kennedy, M C

2000-01-01

To understand shared meanings of help-seeking experiences in support groups of people with implantable cardioverter defibrillator (ICD) and their support persons. ICD support group at an urban medical center. Fifteen individuals with ICD and 9 support persons. Six related themes and 1 constitutive pattern emerged. Themes included hearing and telling stories, help seeking encouraged by triggers, seeking meaningful information, forming a therapeutic friendship through group camaraderie, gaining assistance from the facilitator, and the sharing of a similar view by support persons. The constitutive pattern is coping with the possibility of death. Health care providers may recommend storytelling as the central mechanism of interactions in support groups that assist in coping with daily anxieties of living with an ICD. Nurses would be appropriate facilitators to guide discussion, to provide technical information, and to promote anticipatory guidance in coping with potential firing events.

Pitfalls in lupus.

PubMed

Schneider, M

2016-11-01

"The objective of Pitfall!™ is to guide Harry through a maze of jungle scenes, jumping over or avoiding many deadly dangers… Harry has three lives in each game." If you exchange Harry's adventures with "Life with SLE," patients have to be guided through the jungle having just one life and the deadly dangers are flares, organ manifestations, and, e.g., consequences of immunosuppressive medications, especially glucocorticoids. Monitoring and treatment in line with recommendations and guidelines may be supportive to survive the first 3 to 5 levels in most cases, but for higher levels of the reality game, creativity is needed and life becomes more risky. The aim of this reflection is to identify common pitfalls and to stimulate further research and collaboration in specific areas of the lupus jungle. Topics like "Hidden Power Unit," "Looks similar …," "Rev Meter for SLE," "Flare Prediction," "Level 2: Eminence Based," "Lupus=Lifelong Immunosuppression?!," "Glucocorticoids," "Antimalarials Are Contraindicated," "It Is All About Immunosuppression," "Prediction of Damage," and "Patient Global Assessment (PGA) versus Physician Global Assessment (PhGA)" are addressed. Raised ideas and thoughts are by no means complete or exclusive, but if taken up, they may hopefully lead to another approach in daily care and trials in SLE. Copyright © 2016 Elsevier B.V. All rights reserved.

Design and implementation of a PC-based image-guided surgical system.

PubMed

Stefansic, James D; Bass, W Andrew; Hartmann, Steven L; Beasley, Ryan A; Sinha, Tuhin K; Cash, David M; Herline, Alan J; Galloway, Robert L

2002-11-01

In interactive, image-guided surgery, current physical space position in the operating room is displayed on various sets of medical images used for surgical navigation. We have developed a PC-based surgical guidance system (ORION) which synchronously displays surgical position on up to four image sets and updates them in real time. There are three essential components which must be developed for this system: (1) accurately tracked instruments; (2) accurate registration techniques to map physical space to image space; and (3) methods to display and update the image sets on a computer monitor. For each of these components, we have developed a set of dynamic link libraries in MS Visual C++ 6.0 supporting various hardware tools and software techniques. Surgical instruments are tracked in physical space using an active optical tracking system. Several of the different registration algorithms were developed with a library of robust math kernel functions, and the accuracy of all registration techniques was thoroughly investigated. Our display was developed using the Win32 API for windows management and tomographic visualization, a frame grabber for live video capture, and OpenGL for visualization of surface renderings. We have begun to use this current implementation of our system for several surgical procedures, including open and minimally invasive liver surgery.

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.

[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.

Schizophrenia and the efficacy of qEEG-guided neurofeedback treatment: a clinical case series.

PubMed

Surmeli, Tanju; Ertem, Ayben; Eralp, Emin; Kos, Ismet H

2012-04-01

Schizophrenia is sometimes considered one of the most devastating of mental illnesses because its onset is early in a patient's life and its symptoms can be destructive to the patient, the family, and friends. Schizophrenia affects 1 in 100 people at some point during their lives, and while there is no cure, it is treatable with antipsychotic medications. According to the Clinical Antipsychotic Trials for Interventions Effectiveness (CATIE), about 74% of the patients who have discontinued the first medication prescribed within a year will have a relapse afterward. This shows an enormous need for developing better treatment methods and better ways to manage the disease, since current therapies do not have sufficient impact on negative symptoms, cognitive dysfunction, and compliance to treatment. In this clinical case series, we investigate the efficacy of quantitative electroencephalography (qEEG)-guided neurofeedback (NF) treatment in this population, and whether this method has an effect on concurrent medical treatment and on the patients. Fifty-one participants (25 males and 26 females) ranging from 17 to 54 years of age (mean: 28.82 years and SD: 7.94 years) were included. Signed consent was received from all patients. Most of the participants were previously diagnosed with chronic schizophrenia, and their symptoms did not improve with medication. All 51 patients were evaluated using qEEG, which was recorded at baseline and following treatment. Before recording the qEEG, participants were washed out for up to 7 half-lives of the medication. After Food and Drug Administration (FDA)-approved Nx-Link Neurometric analysis, qEEGs suggested a diagnosis of chronic schizophrenia for all participants. This was consistent with the clinical judgment of the authors. The participants' symptoms were assessed by means of the Positive and Negative Syndrome Scale (PANSS). Besides the PANSS, 33 out of 51 participants were also evaluated by the Minnesota Multiphasic Personality Inventory (MMPI) and the Test of Variables of Attention (TOVA), both at baseline and following treatment. Each participant was prescribed an NF treatment protocol based on the results of their qEEG neurometric analysis. Each session was 60 minutes in duration, with 1 to 2 sessions per day. When 2 sessions were administered during a single day, a 30-minute rest was given between the sessions. Changes in the PANSS, MMPI, and TOVA were analyzed to evaluate the effectiveness of NF treatment. The mean number of sessions completed by the participants was 58.5 sessions within 24 to 91 days. Three dropped out of treatment between 30 and 40 sessions of NF, and one did not show any response. Of the remaining 48 participants 47 showed clinical improvement after NF treatment, based on changes in their PANSS scores. The participants who were able to take the MMPI and the TOVA showed significant improvements in these measures as well. Forty were followed up for more than 22 months, 2 for 1 year, 1 for 9 months, and 3 for between 1 and 3 months after completion of NF. Overall NF was shown to be effective. This study provides the first evidence for positive effects of NF in schizophrenia.

Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.

PubMed

Vidot, Denise C; Lerner, Brenda; Gonzalez, Raul

2017-07-01

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.

Patient Expectations and Perceptions of Goal-setting Strategies for Disease Management in Rheumatoid Arthritis.

PubMed

Strand, Vibeke; Wright, Grace C; Bergman, Martin J; Tambiah, Jeyanesh; Taylor, Peter C

2015-11-01

To identify how patients perceive the broad effect of active rheumatoid arthritis (RA) on their daily lives and indicate how RA disease management could benefit from the inclusion of individual goal-setting strategies. Two multinational surveys were completed by patients with RA. The "Good Days Fast" survey was conducted to explore the effect of disease on the daily lives and relationships of women with RA. The "Getting to Your Destination Faster" survey examined RA patients' treatment expectations and goal-setting practices. Respondents from all countries agreed that RA had a substantial negative effect on many aspects of their lives (work productivity, daily routines, participation in social and leisure activities) and emotional well-being (loss of self-confidence, feelings of detachment, isolation). Daily pain was a paramount issue, and being pain- and fatigue-free was considered the main indicator of a "good day." Setting personal, social, and treatment goals, as well as monitoring disease progress to achieve these, was considered very beneficial by patients with RA, but discussion of treatment goals seldom appeared to be a part of medical appointments. Many patients with RA feel unable to communicate their disease burden and treatment goals, which are critically important to them, to their healthcare provider (HCP). Insights gained from these 2 surveys should help to guide patients and HCP to better focus upon mutually defined goals for continued improvement of management and achievement of optimal care in RA.

Risk Assessment and Management for Medically Complex Potential Living Kidney Donors: A Few Deontological Criteria and Ethical Values

PubMed Central

Petrini, Carlo

2011-01-01

A sound evaluation of every bioethical problem should be predicated on a careful analysis of at least two basic elements: (i) reliable scientific information and (ii) the ethical principles and values at stake. A thorough evaluation of both elements also calls for a careful examination of statements by authoritative institutions. Unfortunately, in the case of medically complex living donors neither element gives clear-cut answers to the ethical problems raised. Likewise, institutionary documents frequently offer only general criteria, which are not very helpful when making practical choices. This paper first introduces a brief overview of scientific information, ethical values, and institutionary documents; the notions of “acceptable risk” and “minimal risk” are then briefly examined, with reference to the problem of medically complex living donors. The so-called precautionary principle and the value of solidarity are then discussed as offering a possible approach to the ethical problem of medically complex living donors. PMID:22174982

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;…

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.

Medication use in people with late stage Parkinson's disease and parkinsonism living at home and in institutional care in north-east England: A balance of symptoms and side-effects?

PubMed

Hand, Annette; Gray, William K; Oates, Lloyd L; Woolford, Megan; Todd, Anna; Bale, Elizabeth; Jones, Catherine; Wood, Brian H; Walker, Richard W

2016-11-01

People with Parkinson's disease (PD) and parkinsonism living in care homes (residential or nursing care) in the UK represent around 10-15% of all people with PD and 3-5% of all care home residents. There are few previous data on medication use in those living in care homes with PD. In this study we aimed to compare medication use in a representative cohort of people with PD living in care homes in north-east England with those living in their own homes. All people with late stage (Hoehn and Yahr III-V) idiopathic PD, PD dementia, or atypical parkinsonian syndromes under the care of the Northumbria Healthcare NHS Foundation Trust PD service on 1st January 2015 were identified. Demographic, disease characteristics and medication use data were collected from an audit of medical notes of all those identified. We identified 377 people who met the inclusion criteria, 91 (24.1%) of whom were living in a care home. Disease stage, age and age at disease onset were all significantly higher and levodopa equivalent dose significantly lower in those living in care homes, although disease duration and levodopa dose were not. Greater age, lower levodopa equivalent dose and higher disease stage were independently associated with being in a care home. Although people in care homes had more advanced disease, they were on a significantly lower levodopa equivalent dose. This is likely to be due to the requirement to balance symptom management with drug side-effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

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…

The Role of the Occupational and Physical Therapist in Assistive Technology. Tech Use Guide: Using Computer Technology.

ERIC Educational Resources Information Center

Reed, Penny; Bowser, Gayl

This guide defines assistive technology as specialized hardware and software equipment used by students with disabilities to increase their ability to participate in tasks of learning and daily living and function as independently as possible. Types of assistive technology are listed, and information resources about assistive technology are noted.…

Curriculum Guide: Social Science. Primary.

ERIC Educational Resources Information Center

Boston Public Schools, MA.

The purpose of this curriculum is to guide the child in decision-making in the areas of citizenship and human relations, to develop an understanding of his immediate environment and the larger environment of the world in which he lives, to help the child to adapt to our changing society and its changing demands. We hope to accomplish these goals…

Knife River Indian Villages National Historic Site: Teacher's Guide.

ERIC Educational Resources Information Center

National Park Service (Dept. of Interior), Washington, DC. National Register of Historic Places.

This guide provides history and social studies teachers, at all grade levels, with information and activities about the American Indians of the Northern Plains who lived in the area of the Knife River where it enters the Missouri River. Located in what is now North Dakota, this area is the Knife River Indian Villages National Historic Site. The…

Managing Individual and Family Resources. Learning Guide 7. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Managing Home and Work Responsibilities. Learning Guide 9. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Strengthening Parenting Skills: School Age. Learning Guide 2. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Get Wild about Reading! A Guide for Kindergarten Teachers from "Between the Lions."

ERIC Educational Resources Information Center

Cerier, Laura

"Between the Lions" is a Public Broadcasting System program promoting literacy for children 4 through 7 years combining state-of-the-art puppetry, animation, live action, and music to achieve its mission of helping young children learn to read. This guide is designed to help kindergarten teachers integrate "Between the Lions"…

A Guide to the Study of Childhood 1820-1920.

ERIC Educational Resources Information Center

Hewett, Marie

Designed to introduce junior and senior high school students to a variety of historical resources on local, family, and 19th century cultural history, the primary materials presented in this guide provide insight into methods of child rearing and children's lives between 1820 and 1920. Based on a major exhibition and the collections of the Strong…

The Whole World Guide to Language Learning.

ERIC Educational Resources Information Center

Marshall, Terry

An in situ or "on location" approach to language learning is presented for people going abroad for an extended period of time. The approach features two components: (1) the use of a mentor (native speaker who lives in the community and serves as a guide); and (2) the "daily learning cycle" of planning, practicing, communicating face-to-face, and…

Socratic Knowledge, Christian Love, Confucian Virtue and Buddhist Emptiness: Guiding Principles for Education

ERIC Educational Resources Information Center

Clarken, Rodney

2010-01-01

Socrates' view of knowledge, Jesus' conception of love, Confucius' idea of virtue and Buddha's path of emptiness provide valuable insights and guiding principles to help us achieve a well-rounded education. Each of these individuals caused a transformation in the individual and collective lives of their followers and their respective societies…

Assessing Toxic Risk. Teacher's Guide [and] Student Edition. Cornell Scientific Inquiry Series.

ERIC Educational Resources Information Center

Trautmann, Nancy M.; Carlsen, William S.; Krasny, Marianne E.; Cunningham, Christine M.

The teacher's guide of "Assessing Toxic Risk" aims to help students conduct scientific research on relevant environmental topics. Using the research protocols in this book, students learn to carry out experiments known as bioassays. In this way, the toxicity of substances is evaluated by measuring its effect on living things. The text is…

Making Consumer Choices. Learning Guide 6. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

A Student's Guide to Japanese American Genealogy. Oryx American Family Tree Series.

ERIC Educational Resources Information Center

Yamaguchi, Yoji

This book provides a guide to the study of genealogy, or family history, through the use of historical documents, artifacts, and private records. Intended mainly for students who wish to trace their family roots, the book can be used by anyone interested in the lives of Japanese Americans throughout the years. Often called the "model…

Natural Resources and Career Awareness: A Teacher's Guide for Grades K-6.

ERIC Educational Resources Information Center

Ward, George C.

The materials in this teacher's guide have three general divisions that are based on a sequential progression from kindergarten through grade six. Section A (kindergarten through two) explores the world of the child and divides this world into identifiable study groups. Section B (third and fourth grades) deals with the needs of living things and…

Trees: Dead or Alive. 4-H Leader's Guide 147-L-22.

ERIC Educational Resources Information Center

Krasny, Marianne E.

This illustrated leader's guide to exploring trees and forests provides activities which emphasize careful observation of trees and the living things associated with them for youths age 9 and older. Introductory information for leaders explains the uses for trees and the role of trees in the ecosystem. It also gives suggestions for leaders to…

Alcohol and Drug Prevention Curriculum Resource Guide Grades 10-12: Social Studies--United States History.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh. Alcohol and Drug Defense Program.

This curriculum resource guide on alcohol and drug prevention provides suggested activities for teachers of grades 10 through 12. Three integrated learning activities for United States history and healthful living are presented. The history goals are understanding that the years since 1945 have been years of great changes, and learning to organize…

Law and the Family: A High School Curriculum Guide.

ERIC Educational Resources Information Center

Khanlian, John F., Ed.; And Others

This curriculum guide is designed to assist high school classroom teachers in developing and implementing a program on family law. The major objective of the document is to help students understand how profoundly the law is associated with their private lives. The document is presented in four chapters. Key areas in this frequently ignored area of…

Composing as the Curriculum: A Guide for Instruction in Written Composition, Grades K-12.

ERIC Educational Resources Information Center

Blake, Robert W.; Tuttle, Frederick B., Jr.

The Albion (New York) school district provides this guide to written composition instruction in its kindergarten through grade 12 curriculum because of the importance and necessity of writing, not only as a school activity but also as a lifelong intellectual, self-actualizing, and daily-living activity. Following a brief overview that summarizes…

Guided Viewing of Film with Gifted Students: Resources for Educators and Counselors

ERIC Educational Resources Information Center

Hebert, Thomas P.; Hammond, Daniel R.

2006-01-01

Using movies to guide gifted students toward self-understanding provides them with numerous benefits. Movies have the potential to enrich and influence the lives of gifted students in constructive ways. A good movie, for example, can become a meaningful metaphor that explains the essence of a young person's dilemma. When an appropriate movie is…

Community Tree Planting Guide

Treesearch

Katie Himanga; Douglas Jones; Jean Miller; Janette Monear; Gail Steinman; Katherine Widin

2001-01-01

Tree Trust has been helping people plant trees in their communities since 1976. Our goal is to educate people about the importance of trees in their community and guide them through the process of successful tree-planting projects. Franklin Delano Roosevelt once said ?to exist as a nation, to prosper as a state, and to live as a people, we must have trees?....

Living Traditions--A Teacher's Guide: Teaching Local History Using State and National Learning Standards.

ERIC Educational Resources Information Center

Skelding, Mark; Kemple, Martin; Kiefer, Joseph

This guide is designed to take teachers through a step-by-step process for developing an integrated, standards-based curriculum that focuses on the stories, history, folkways, and agrarian traditions of the local community. Such a place-based curriculum helps students to become culturally literate, makes learning relevant and engaging, draws on…

Strengthening Parenting Skills: Teenagers. Learning Guide 3. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Preventing Teen Pregnancy. Learning Guide 4. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Healthy Water, Healthy Habits, Healthy People Educators Guide

ERIC Educational Resources Information Center

Project WET Foundation, 2008

2008-01-01

Clean water, proper sanitation and good hygiene form a solid foundation for a student's health education. This activities guide is designed to enable teachers to take an active role in making a real difference in the lives of children and their families. Its 40 pages are filled with engaging ways to impart an understanding about how common…

Core IV Materials for Rural Agriculture Programs. Units A-G.

ERIC Educational Resources Information Center

Courson, Roger; And Others

This curriculum guide, the first part of a core curriculum for a rural agriculture program, consists of materials for use in presenting the first seven units of a nine-unit course for high school vocational agriculture students living in rural areas. Addressed in the individual units of the guide are the following topics: educational and…

A Guide to the Film "BULLY": Fostering Empathy and Action in Schools. A Facing History and Ourselves Guide

ERIC Educational Resources Information Center

Sigward, Daniel

2013-01-01

The film "BULLY" follows five stories of children and families who are affected deeply by bullying within the course of a school year. With intimate glimpses into homes, classrooms, cafeterias, and principals' offices, the film offers insight into the lives of bullied, ridiculed children. Historically, seemingly small instances of…

Balancing Work and Family. Learning Guide 5. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

Interventional cardiology live case presentations: regulatory considerations.

PubMed

Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

2010-10-01

Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. © 2010 Wiley-Liss, Inc.

Interventional cardiology live case presentations regulatory considerations.

PubMed

Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

2010-10-01

Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. Copyright © 2010. Published by Elsevier Inc.

New Technology Provides Urgent Medical Information and Protects Privacy: Providing Important Information in Medical Situations for the Developmentally Disabled

ERIC Educational Resources Information Center

Seelig, Richard

2006-01-01

Fernando Viesca has a 24-year-old son who suffers from Angelman Syndrome, a little known chromosomal disorder that has left him with significant functional deficiencies. When Nando lived at home, his father took care of him full time, thus alleviating any worries about medical care. However, now that Nando lives in a group home, his father is no…

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.

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…

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…

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.

Image quality assessment for teledermatology: from consumer devices to a dedicated medical device

NASA Astrophysics Data System (ADS)

Amouroux, Marine; Le Cunff, Sébastien; Haudrechy, Alexandre; Blondel, Walter

2017-03-01

Aging population as well as growing incidence of type 2 diabetes induce a growing incidence of chronic skin disorders. In the meantime, chronic shortage of dermatologists leaves some areas underserved. Remote triage and assistance to homecare nurses (known as "teledermatology") appear to be promising solutions to provide dermatological valuation in a decent time to patients wherever they live. Nowadays, teledermatology is often based on consumer devices (digital tablets, smartphones, webcams) whose photobiological and electrical safety levels do not match with medical devices' levels. The American Telemedicine Association (ATA) has published recommendations on quality standards for teledermatology. This "quick guide" does not address the issue of image quality which is critical in domestic environments where lighting is rarely reproducible. Standardized approaches of image quality would allow clinical trial comparison, calibration, manufacturing quality control and quality insurance during clinical use. Therefore, we defined several critical metrics using calibration charts (color and resolution charts) in order to assess image quality such as resolution, lighting uniformity, color repeatability and discrimination of key couples of colors. Using such metrics, we compared quality of images produced by several medical devices (handheld and video-dermoscopes) as well as by consumer devices (digital tablet and cameras) widely spread among dermatologists practice. Since diagnosis accuracy may be impaired by "low quality-images", this study highlights that, from an optical point of view, teledermatology should only be performed using medical devices. Furthermore, a dedicated medical device should probably be developed for the time follow-up of skin lesions often managed in teledermatology such as chronic wounds that require i) noncontact imaging of ii) large areas of skin surfaces, both criteria that cannot be matched using dermoscopes.

Mechanism of Genome Interrogation: How CRISPR RNA-Guided Cas9 Proteins Locate Specific Targets on DNA.

PubMed

Shvets, Alexey A; Kolomeisky, Anatoly B

2017-10-03

The ability to precisely edit and modify a genome opens endless opportunities to investigate fundamental properties of living systems as well as to advance various medical techniques and bioengineering applications. This possibility is now close to reality due to a recent discovery of the adaptive bacterial immune system, which is based on clustered regularly interspaced short palindromic repeats (CRISPR)-associated proteins (Cas) that utilize RNA to find and cut the double-stranded DNA molecules at specific locations. Here we develop a quantitative theoretical approach to analyze the mechanism of target search on DNA by CRISPR RNA-guided Cas9 proteins, which is followed by a selective cleavage of nucleic acids. It is based on a discrete-state stochastic model that takes into account the most relevant physical-chemical processes in the system. Using a method of first-passage processes, a full dynamic description of the target search is presented. It is found that the location of specific sites on DNA by CRISPR Cas9 proteins is governed by binding first to protospacer adjacent motif sequences on DNA, which is followed by reversible transitions into DNA interrogation states. In addition, the search dynamics is strongly influenced by the off-target cutting. Our theoretical calculations allow us to explain the experimental observations and to give experimentally testable predictions. Thus, the presented theoretical model clarifies some molecular aspects of the genome interrogation by CRISPR RNA-guided Cas9 proteins. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

An inexpensive, easily constructed, reusable task trainer for simulating ultrasound-guided pericardiocentesis.

PubMed

Zerth, Herb; Harwood, Robert; Tommaso, Laura; Girzadas, Daniel V

2012-12-01

Pericardiocentesis is a low-frequency, high-risk procedure integral to the practice of emergency medicine. Ultrasound-guided pericardiocentesis is the preferred technique for providing this critical intervention. Traditionally, emergency physicians learned pericardiocentesis in real time, at the bedside, on critically ill patients. Medical education is moving toward simulation for training and assessment of procedures such as pericardiocentesis because it allows learners to practice time-sensitive skills without risk to patient or learner. The retail market for models for pericardiocentesis practice is limited and expensive. We have developed an ultrasound-guided pericardiocentesis task trainer that allows the physician to insert a needle under ultrasound guidance, pierce the "pericardial sac" and aspirate "blood." Our model can be simply constructed in a home kitchen, and the overall preparation time is 1 h. Our model costs $20.00 (US, 2008). Materials needed for the construction include 16 ounces of plain gelatin, one large balloon, one golf ball, food coloring, non-stick cooking spray, one wooden cooking skewer, surgical iodine solution, and a 4-quart sized plastic food storage container. Refrigeration and a heat source for cooking are also required. Once prepared, the model is usable for 2 weeks at room temperature and may be preserved an additional week if refrigerated. When the model shows signs of wear, it can be easily remade, by simply recycling the existing materials. The self-made model was well liked by training staff due to accessibility of a simulation model, and by learners of the technique as they felt more at ease performing pericardiocentesis on a live patient. Copyright © 2012 Elsevier Inc. All rights reserved.

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

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.

The Lived Experience of Teachers and Administrators in Persistently Low Achieving Schools

ERIC Educational Resources Information Center

Bickenheuser, Charles William

2013-01-01

In 2010 Washington State's persistently lowest performing public schools were identified and published by the superintendent of public instruction. However, no research has described the lived experiences of teachers and administrators who work in those schools. Guided by the combined frameworks of Van Manen and Moustakas, this qualitative study…

Making It Better: Activities for Children Living in a Stressful World.

ERIC Educational Resources Information Center

Oehlberg, Barbara

Recognizing the need to empower children experiencing difficulties in their everyday lives, this book presents activities for healing and recovery designed for classroom or small group use with children ages 3 to 10 years. The activities are intended to guide children into self-directed understanding and processing of experiences and memories,…

Developmental Plan Handbook for Community Skills Training (TACL, Training Adults for Community Living).

ERIC Educational Resources Information Center

Roth, Martin R.; Hermus, Gary P.

Based on behavioral principles, the handbook is designed as both an assessment tool and curriculum guide for training community living skills to mentally retarded and developmentally disabled individuals. Behavioral Programing Scales are provided to record baseline data, where the client receives no assistance. These scales cover all program…

Christianity and Resilience as Experienced by Caregivers of Dementia Patients

ERIC Educational Resources Information Center

Lackey, Steven L.

2014-01-01

The purpose of this study was to examine the role and relationship of the practice of Christian beliefs and resilience in the context of dementia patient caregivers' lives. The guiding question was "What is the relational nature of the practice of Christian beliefs and resilience in the lived experiences of caregivers of dementia…

Incoming Population: Where Will the People Live? Coping with Growth.

ERIC Educational Resources Information Center

Siegler, Theodore R.

The guide describes an assessment procedure that can be used by sparsely populated communities located near a potential development to help predict where the incoming population will choose to live and shop. First, a numerical model, the "gravity model," is presented which utilizes community size and the distance from the community to…

Why Can't We Talk? : Working Together to Bridge the Communications Gap to Save Lives : A Guide For Public Officials. Supplemental Resources

DOT National Transportation Integrated Search

2003-01-01

The inability of our public safety officials to readily communicate with each other threatens the publics safety and often results in unnecessary loss of lives and property. Recognizing that solutions to this national issue can only be achieved throu...

Sources of Strength: Women and Culture. A Teacher's Guide.

ERIC Educational Resources Information Center

Hunter, Lisa K.; And Others

The document presents teaching methods, content, and learning activities for units in multicultural women's studies for secondary students. The major objective is to help students answer the question, "How much control can a person exercise over her/his own life?" Students learn about the ways women have lived their lives and perceived…

Considering a Voice of the Body for Adult Transformative Learning Theory

ERIC Educational Resources Information Center

Boleyn, Elizabeth C.

2013-01-01

Unknowingly, much of the population of the Western World are thinking machines who live and learn isolated from somatic experiences. They distrust their bodies in the learning process and are stuck living out unquestioned realities of embodied socioculturalism and rationalism which guide decision making, learning and ways of being. Considering a…

Perspectives on Transportation. [Student's Guide.] Preparing for Tomorrow's World.

ERIC Educational Resources Information Center

Iozzi, Louis A.; And Others

In this module students (grades 7-9) examine some of the many issues related to transportation and consider how different problems impact upon their lives and the lives of others. Student material consists of readings, dilemmas, and activities. These are presented in four sections focusing on land transportation, water transportation, air…

Facing the World. An Independent Living/Pre-Employment Curriculum for Refugee Youths.

ERIC Educational Resources Information Center

Bateman, Mary Jo; And Others

This document, a curriculum guide focusing on both independent living skills and job readiness skills, is based on the experience of the Bilingual Vocational Education program in Virginia. The lessons are sequenced to increase in difficulty as students acquire more English skills, but individual units do not necessarily require competencies…

Guide to New Resources

ERIC Educational Resources Information Center

He, Ming Fang; Sapp, Jeff; Botelho, Maria Jose; Nunez, Isabel; Scott-Simmons, Wynnetta; Johnson, Lincoln

2013-01-01

The theme of this column is African American Women's Memories of Racial Oppression and Segregation in the U.S. South and Its Relevance to Multicultural Education. The focus of the review is on Anne Valk and Leslie Brown's "Living with Jim Crow: African American Women and Memories of the Segregated South" (2010). In "Living with Jim…

Family Living and Parenthood. Performance Objectives and Criterion-Referenced Test Items.

ERIC Educational Resources Information Center

Missouri Univ., Columbia. Instructional Materials Lab.

This guide was developed to assist home economics teachers in implementing the Missouri Vocational Instructional Management System into the home economics curriculum at the local level through a family living and parenthood semester course. The course contains a minimum of two performance objectives for each competency developed and validated by…

Beyond the Billboard: The Facebook-Based Application, Donor, and Its Guided Approach to Facilitating Living Organ Donation.

PubMed

Bramstedt, K A; Cameron, A M

2017-02-01

Living donor solicitation can raise ethical concerns, regardless of the medium used: newspaper, television, pulpit, billboard or Internet. Moving the search for a living donor into the social media realm introduces the risk of unguided and coercive patient narratives as well as decoupling or even total absence of information that could aid the consent process. The Facebook application (app) for living donors, called Donor (restricted to patient use), aims to address these concerns in several ways: (i) by directing the patient's initial appeal to friends and family; (ii) by guiding the patient's narrative; and (iii) by providing a library of clinical, ethical and regulatory information that informs the consent process. In this paper, we explored these features and contrasted them with billboard solicitation activities and current independent social media efforts. We concluded that the proactive ethical design of the Donor app is a permissible way to help satisfy the shortfall of deceased donor livers and kidneys. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

[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.

The Lived Experience of Patients Receiving Hemodialysis Treatment for End-Stage Renal Disease: A Qualitative Study.

PubMed

Chiaranai, Chantira

2016-06-01

End-stage renal disease (ESRD), the last stage of chronic kidney disease, is the point at which the kidneys are no longer able to support the body's needs. Thus, ESRD significantly impacts the day-to-day life of patients. To improve bodily functions and prolong life, patients with ESRD require renal replacement therapy in the form of either hemodialysis (HD) or kidney transplantation. Research has documented the impact of ESRD and HD on quality of life. There is a lack of qualitative studies that describe how ESRD sufferers in Thailand cope with daily life. This study aimed to better understand the daily life experiences of Thai patients with ESRD who are on HD. This study used a phenomenological approach and a semistructured interview guide. Thai men and women with ESRD and on HD were purposively recruited from an HD unit at one hospital in Thailand between February and May 2013. Inclusion criteria included (a) currently being treated for HD, (b) ability to communicate in Thai, and (c) age of over 18 years. Participants were asked to describe their problems, feelings, thoughts, and attitudes as well as how they experienced their lives. Data saturation was reached after the completion of 26 interviews. The data were analyzed using thematic analysis. The following themes emerged from the data: (a) facing life's limitations, (b) living with uncertainty, and (c) dependence on medical technology. The authors hope that the findings increase the understanding of healthcare providers about the lived experience of Thai patients with ESRD on HD. Greater understanding is critical in helping healthcare providers identify the changes in practice that will be necessary to better care for and integrate the best holistic practices into standardized care for this population.

TTaPP: Together Take a Pause and Ponder: A Critical Thinking Tool for Exploring the Public/Private Lives of Patients.

PubMed

Kuhnel, Leslie

2018-01-01

The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse. This type of online searching for patient information is known as patient-targeted googling or PTG. This article provides an overview of the emergence of PTG, identifies the potential benefits and possible pitfalls of engaging in PTG, and explores current ethical frameworks that guide decisions about PTG. The article describes the development of a critical thinking tool developed by the Behavioral Health Ethics Committee at CHI Health, that can serve as a best-practice model for other hospitals and health systems. Called TTaPP (Together Take a Pause and Ponder), this tool is designed to help healthcare professionals across settings practice collaborative critical thinking skills as they consider the ethical questions of whether or not to engage in PTG. Finally, this article suggests areas for further study, including ways to prompt collaboration and appropriate documentation by maximizing electronic medical records systems, exploring the effectiveness of the TTaPP tool as a way to promote a culture of collaborative critical thinking practices, and the attitudes of patients and the public regarding PTG. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.

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.

Our Children, Our Hope: Voices of African American Mothers Living with HIV and Rearing Uninfected Children.

PubMed

Muze, Ruth; Onsomu, Elijah O

2017-01-01

Parenting school-aged children while living with HIV has been associated with significant consequences for African American mothers. This article presents and discusses the results of a qualitative study that examined the parenting experiences of HIV-infected African American mothers rearing young children. A sample of 8 inner-city, African American mothers of uninfected preschool-aged children were interviewed individually. Interview guide questions explored day-to-day childcare activities from the mothers' perspective. Five themes emerged: role of mothering, doing it all, less time for self, fear, and hope. Findings can be used to guide the development of programs to support HIV-infected mothers rearing young children.