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Sample records for medical evaluation part

  1. Preoperative Medical Evaluation: Part 2: Pulmonary, Endocrine, Renal, and Miscellaneous Considerations

    PubMed Central

    Becker, Daniel E

    2009-01-01

    A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to provide sedation or general anesthesia as an adjunct to dental treatment. This article, the second of a 2-part sequence on preoperative assessment, will address pulmonary and other noncardiovascular disorders. PMID:20020794

  2. Types of study in medical research: part 3 of a series on evaluation of scientific publications.

    PubMed

    Röhrig, Bernd; du Prel, Jean-Baptist; Wachtlin, Daniel; Blettner, Maria

    2009-04-01

    The choice of study type is an important aspect of the design of medical studies. The study design and consequent study type are major determinants of a study's scientific quality and clinical value. This article describes the structured classification of studies into two types, primary and secondary, as well as a further subclassification of studies of primary type. This is done on the basis of a selective literature search concerning study types in medical research, in addition to the authors' own experience. Three main areas of medical research can be distinguished by study type: basic (experimental), clinical, and epidemiological research. Furthermore, clinical and epidemiological studies can be further subclassified as either interventional or noninterventional. The study type that can best answer the particular research question at hand must be determined not only on a purely scientific basis, but also in view of the available financial resources, staffing, and practical feasibility (organization, medical prerequisites, number of patients, etc.).

  3. The reading, writing, and arithmetic of the medical literature, part 2: critical evaluation of statistical reporting.

    PubMed

    Mansfield, Lyndon

    2005-10-01

    To offer suggestions to help improve clinicians' understanding of the statistical analyses in the literature and their use of these methods in their own medical writings. Literature searches began at the National Library of Medicine's online database and were traced to primary sources. All referenced information in this article was cited from primary sources. Physicians should be able to determine the variables studied and how they were measured, the comparisons that were made, the difference (with 95% confidence interval) between the groups, the exact P value for the difference, the statistical test used in the analysis, whether the data conformed to the assumptions of the test, whether the study had adequate statistical power, and the clinical importance of the difference. Clinicians should know how to interpret statistical results so that they can use medical science to its full extent in treating patients.

  4. Minimizing medical litigation, Part 1.

    PubMed

    Harold, Tan Keng Boon

    2006-01-01

    The global rise in medical litigation has led to defensive medical practices and rising malpractice insurance premiums. There is a need to review all possible factors influencing litigiousness of the society and to develop strategies to control such factors. Some of the contributory causes of rising litigiousness include higher patients' expectations, poor provider-patient communication, and adversarial legalism of the society. A good combination of system, professional, and legislative strategies may keep medical litigation in check. Part 2 of this article will address the development of a dispute resolution framework.

  5. Modernizing medical photography, part 2.

    PubMed

    Crompton, Paul

    2005-03-01

    Part 1 of this paper explored the origins of process activity mapping, one of the major tools currently being used to modernize patient pathways in the National Health Service in Great Britain. Within medical photography the current notion of modernization is inextricably linked to the development of digital technology. Whilst the core principle of capturing light on a sensitive medium remains as clear and relevant as ever, the mechanisms by which the image is processed and presented to the client have changed profoundly. Part 2 shows how the principles of lean thinking and process activity mapping can be utilized to harness the advantages of digital technology to provide a modern and appropriate medical photography service in a large disparate teaching hospital.

  6. 49 CFR Appendix F to Part 240 - Medical Standards Guidelines

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Medical Standards Guidelines F Appendix F to Part.... F Appendix F to Part 240—Medical Standards Guidelines (1) The purpose of this appendix is to provide... chart, may be further evaluated as determined by the railroad's medical examiner. Ophthalmologic...

  7. Medical Evaluation Before Operation

    PubMed Central

    Elliot, Diane L.; Linz, Douglas H.; Kane, Joseph A.

    1982-01-01

    Surgical outcome can be optimized by anticipation and prevention of medical complications. General considerations that apply to all patients include evaluation for coagulation disorders, prior anesthetic complications and drug history. Evaluation for organ-specific risk factors allows identification of patients at high surgical risk, minimization of risk and anticipation of postoperative complications. Review of the recent literature and a practical guide to therapy is presented for the major medical considerations before surgical procedures: cardiac disease, hypertension, pulmonary disease, endocrine considerations and hepatic disease. Attention to these areas and communication among internists, anesthesiologists and surgeons should provide optimal treatment of surgical patients with medical disease. PMID:7179956

  8. Medical database security evaluation.

    PubMed

    Pangalos, G J

    1993-01-01

    Users of medical information systems need confidence in the security of the system they are using. They also need a method to evaluate and compare its security capabilities. Every system has its own requirements for maintaining confidentiality, integrity and availability. In order to meet these requirements a number of security functions must be specified covering areas such as access control, auditing, error recovery, etc. Appropriate confidence in these functions is also required. The 'trust' in trusted computer systems rests on their ability to prove that their secure mechanisms work as advertised and cannot be disabled or diverted. The general framework and requirements for medical database security and a number of parameters of the evaluation problem are presented and discussed. The problem of database security evaluation is then discussed, and a number of specific proposals are presented, based on a number of existing medical database security systems.

  9. [New Medical Device Evaluation].

    PubMed

    Ikeda, Koji

    2016-01-01

    In this presentation, as a member of the Harmonization by Doing (HBD) project, I discuss the significance of regulatory science in global medical device development and our experience in the international collaboration process for medical devices. In Japan, most innovative medical therapeutic devices were previously developed and exported by foreign-based companies. Due to this device lag, Japanese had minimal opportunities for receiving treatment with innovative medical devices. To address this issue, the Japanese government has actively accepted foreign clinical trial results and promoted global clinical trials in projects such as HBD. HBD is a project with stakeholders from academia, regulatory authorities, and industry in the US and Japan to promote global clinical trials and reduce device lags. When the project started, medical device clinical trials were not actively conducted in Japan at not just hospitals but also at medical device companies. We started to identify issues under the concept of HBD. After 10 years, we have now become key members in global clinical trials and able to obtain approvals without delay. Recently, HBD has started promoting international convergence. Physicians and regulatory authorities play central roles in compiling guidelines for the clinical evaluation of medical device development, which will be a more active field in the near future. The guidelines compiled will be confirmed with members of academia and regulatory authorities in the United Sates.

  10. Evaluation of medical audit.

    PubMed Central

    Robinson, M B

    1994-01-01

    OBJECTIVE--To review current knowledge of the effectiveness of medical audit programmes as a whole and of specific interventions within these programmes, as a means of changing clinical behaviour. CRITERIA FOR INCLUSION AND EXCLUSION OF PUBLISHED REPORTS--Articles listed on Medline from 1985-92 with key words "quality assurance" or "medical audit", and "evaluation" and relevant references from these articles, and from recently published reviews and reports on medical audit, were included. Excluded were simple descriptions of audit activity, replications of previous work, and publication in a language other than English. RESULTS--Evaluation of entire programmes of medical audit is unusual. Most reports concern specific interventions and focus particularly on the scientific and technical aspects of quality. These interventions may be classified by the means through which they attempt to achieve desired changes: patient characteristics; physician characteristics; administrative and organisational structures; and financial incentives. CONCLUSIONS--Knowledge about effective methods of bringing about specific changes in clinical behaviour is rudimentary. Impact is highly dependent on local factors, so generalisation of results to other settings is difficult. More qualitative research is needed to define the local factors which influence results. PMID:7964351

  11. Evaluation of Eligibility Criteria Used to Identify Patients for Medication Therapy Management Services: A Retrospective Cohort Study in a Medicare Advantage Part D Population.

    PubMed

    Lee, Janet S; Yang, Jianing; Stockl, Karen M; Lew, Heidi; Solow, Brian K

    2016-01-01

    General eligibility criteria used by the Centers for Medicare & Medicaid Services (CMS) to identify patients for medication therapy management (MTM) services include having multiple chronic conditions, taking multiple Part D drugs, and being likely to incur annual drug costs that exceed a predetermined threshold. The performance of these criteria in identifying patients in greatest need of MTM services is unknown. Although there are numerous possible versions of MTM identification algorithms that satisfy these criteria, there are limited data that evaluate the performance of MTM services using eligibility thresholds representative of those used by the majority of Part D sponsors. To (a) evaluate the performance of the 2013 CMS MTM eligibility criteria thresholds in identifying Medicare Advantage Prescription Drug (MAPD) plan patients with at least 2 drug therapy problems (DTPs) relative to alternative criteria threshold levels and (b) identify additional patient risk factors significantly associated with the number of DTPs for consideration as potential future MTM eligibility criteria. All patients in the Medicare Advantage Part D population who had pharmacy eligibility as of December 31, 2013, were included in this retrospective cohort study. Study outcomes included 7 different types of DTPs: use of high-risk medications in the elderly, gaps in medication therapy, medication nonadherence, drug-drug interactions, duplicate therapy, drug-disease interactions, and brand-to-generic conversion opportunities. DTPs were identified for each member based on 6 months of most recent pharmacy claims data and 14 months of most recent medical claims data. Risk factors examined in this study included patient demographics and prior health care utilization in the most recent 6 months. Descriptive statistics were used to summarize patient characteristics and to evaluate unadjusted relationships between the average number of DTPs identified per patient and each risk factor. Quartile

  12. Hypertension. Part 2: The Role of Medication.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1990-01-01

    Discusses the differences between exercise alone and exercise with medication (e.g., diuretics, beta blockers, and ACE inhibitors) for treating hypertensive patients. Guidelines are presented for physicians wanting to change the therapeutic regimen or to step down from medical therapy, noting exercise must always be part of the program. (SM)

  13. Hypertension. Part 2: The Role of Medication.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1990-01-01

    Discusses the differences between exercise alone and exercise with medication (e.g., diuretics, beta blockers, and ACE inhibitors) for treating hypertensive patients. Guidelines are presented for physicians wanting to change the therapeutic regimen or to step down from medical therapy, noting exercise must always be part of the program. (SM)

  14. Impact of late-to-refill reminder calls on medication adherence in the Medicare Part D population: evaluation of a randomized controlled study

    PubMed Central

    Taitel, Michael S; Mu, Ying; Gooptu, Angshuman; Lou, Youbei

    2017-01-01

    Objectives This study evaluates a nationwide pharmacy chain’s late-to-refill (LTR) reminder program that entails local pharmacists placing reminder calls to Medicare Part D patients. Methods We conducted a randomized controlled study among 735,218 patients who exhibited nonadherent behavior by not refilling a maintenance medication 3 days from an expected refill date. Patients were randomly assigned to an intervention group who received LTR reminder calls or to a control group. We used Walgreens pharmaceutical claims data from 2015 to estimate the impact of LTR calls on short-term and annual adherence. Results The initial refill rate within the first 14 days of the expected refill date significantly increased in the intervention group by 22.8% (6.09 percentage points) compared to the control group (P<0.001). The proportion of days covered (PDC) in the intervention group increased significantly by 1.5% (0.856 percentage points) relative to the control group (P<0.001) over 365 days. Patients in the intervention group were significantly more adherent (PDC ≥80%) by 3% (0.97 percentage points) compared to the control group (P<0.001). Over a 270-day follow-up period, persistence significantly increased by 2.15 days in the intervention group (P<0.001). Conclusion Results from this study suggest that LTR reminder calls increased adherence for Medicare Part D patients who are late in refilling their medications and therefore have the potential to reduce their risk for hospitalization and health care costs. Additionally, the intervention increased the number of patients with PDC ≥80% by ~3%, positively impacting Medicare Part D plan quality rating. PMID:28280310

  15. Breaking bad news: evaluation study on self-perceived competences and views of medical and nursing students taking part in a collaborative workshop.

    PubMed

    Schildmann, Jan; Härlein, Jürgen; Burchardi, Nicole; Schlögl, Mathias; Vollmann, Jochen

    2006-11-01

    To identify possible effects of an interprofessional breaking bad news course for medical and nursing students on perceived key communication skills and to elicit the views of participants on interprofessional aspects of breaking bad news. Medical and nursing students attending an optional course on breaking bad news received a structured questionnaire on self-perceived communication skills and views on interprofessional aspects at the beginning and end of the course. Forty-seven out of 54 students completed the evaluation questionnaires (response rate=87%). Medical students and nursing students rated their key communication skills after the course as significantly better compared with the beginning of the course. Medical students and nursing students disagreed with the statement that a course format for only one of the professional groups would have been more effective than the interprofessional course concept. Students valued the concept of the interprofessional course positively. The improvement of self-perceived communication skills may be interpreted as a positive effect of the teaching session. Further research is necessary to develop strategies to implement a collaborative approach in breaking bad news in clinical practice.

  16. Evaluating a poetry workshop in medical education.

    PubMed

    Collett, T J; McLachlan, J C

    2006-06-01

    This study aimed at evaluating how doing poetry could affect students' understanding of medical practice and at assessing the effectiveness of the evaluation method used. Qualitative research was carried out on the experiences of medical students participating in a poetry workshop, followed by some quantitative analysis. The study was conducted at Peninsula Medical School and St Ives, Cornwall, UK, with three medical students, a poet and a pathologist as participants. Data were collected by interviews, observation and web access. "Doing poetry" with a professional poet was found to assist communication between doctors and patients as it enhanced skills of observation, heightened awareness of the effect of language and fostered deep reflection. Poetry was also found to offer an outlet for medics and patients. The voluntary workshop attracted three participants; however, it might have had an effect on the wider student community because the poetry website received 493 hits in four months. Qualitative methods worked well as a tool for evaluation. "Doing poetry for poetry's sake" seemed to foster the development of skills related to empathy. The opportunity to do poetry should be made available to medical students as part of a wider arts and humanities programme.

  17. Promoting adherence to psychotropic medication for youth-part 2.

    PubMed

    McGuinness, Teena M; Worley, Julie

    2010-12-01

    Although prescriptions for psychotropic medications for children are at an all-time high, medication adherence rates for children are often low. In Part 1 of this article set, literature regarding adherence to psychotropic medications for children was reviewed. Important issues related to adherence included parental and child attitudes, complex dosing schedules, and barriers to communication between parents and providers. In Part 2, the focus will be on strategies to improve medication adherence, including communication, education, and behavioral strategies. Copyright 2010, SLACK Incorporated.

  18. Strategic planning to reduce medical errors: Part I--diagnosis.

    PubMed

    Waldman, J Deane; Smith, Howard L

    2012-01-01

    Despite extensive dialogue and a continuing stream of proposed medical practice revisions, medical errors and adverse impacts persist. Connectivity of vital elements is often underestimated or not fully understood. This paper analyzes medical errors from a systems dynamics viewpoint (Part I). Our analysis suggests in Part II that the most fruitful strategies for dissolving medical errors include facilitating physician learning, educating patients about appropriate expectations surrounding treatment regimens, and creating "systematic" patient protections rather than depending on (nonexistent) perfect providers.

  19. Principles and practice of medical audit (medical care evaluation).

    PubMed

    Srivastava, M; Sharma, D K

    1992-01-01

    1. Medical audit is a philosophy in the field of medical science which has reached to an advanced stage of practice in Western World, but yet to reach and percolate into Indian medical community. 2. Of late, community is getting increasingly aware of its health rights, gradually community participation in health matters including quantum and quality of case, has started increasing. Thus community leaders have started demanding for quality of medical care and accountability of those, responsible for delivery of medical care at various levels. 3. Medical audit or Evaluation of medical care is an answer to ensure the quality of care. But there are misgivings and distrust about medical audit due to its terminology. 4. There is need to education the medical, nursing and paramedical staff regarding medical audit and its sole purpose of self education and improvement of patient care activity. The present paper spells out fundamentals of medical audit, its scope and limitations.

  20. Privacy, confidentiality, privilege, and the medical record. Part I.

    PubMed

    Hoyt, E M

    1986-08-01

    For thousands of years physicians have recorded clinical observations as private notes to document the clinical course, findings, and treatment of their patients. The medical record was generated exclusively for the physician's use in treating the patient. Physicians and hospitals are now under extraordinary pressure to reveal patient information. During the past 20 years, the role of the medical record has changed and it now has become a multipurpose document. Health care records are the topic of reports, interviews and depositions. Controlled disclosure of the sensitive information contained in the record is essential in today's society yet, when such information is released, various considerations must be carefully evaluated and weighed. From his vantage point as a physician and attorney, the author shares his insight and his concerns about privacy, confidentiality and privilege as related to health records in this two part article.

  1. Medical care evaluation: an old new idea.

    PubMed

    Christoffel, T

    1976-02-01

    The recent implementation of medical care evaluation (medical audit) systems in the nation's hospitals is a phenomenon of major consequence. The systematic measurement of the quality of patient care based on outcome data is becoming a part of the delivery of that care. Sixty years ago Dr. E. A. Codman developed and crusaded for a similar idea that seemed at one point to be on the threshold of widespread acceptance in U. S. hospitals, but for reasons other than lack of conceptual soundness the effort failed. In this article the author reviews the history of this early approach to the evaluation of patient care quality and suggests some lessons this historical episode holds for today's health care professionals.

  2. Asclepius, Caduceus, and Simurgh as medical symbols; part II. Simurgh.

    PubMed

    Nayernouri, Touraj

    2010-05-01

    In part one of this article I reviewed the history of Asclepius and the Caduceus of Hermes as medical symbols and made a tentative suggestion of using the mythical bird Simurgh as an Iranian symbol of medicine. In this, the second part, I shall describe the evolution of the myth of the Simurgh and discuss the medical relevance of this bird in Iranian history.

  3. Writing a scientific paper as part of the medical curriculum.

    PubMed

    Tollan, A; Magnus, J H

    1993-09-01

    The curriculum at the Medical School, University of Tromsø reserves 23 weeks for optional studies, including a period of 12 weeks at the end of the fifth year when the students carry out an independent study and write a short thesis. Of the first 417 doctors (graduation year 1979-89) from Tromsø 84.6% answered a postal questionnaire asking them to evaluate this part of the curriculum. These postgraduates report high levels of satisfaction with and benefit from this part of the curriculum. A total of 26.8% started working on their thesis before the final 12-week period, 32.6% had also published their study, half of these in international journals, and 75.6% found that the skills acquired during the final optional period had been useful in their subsequent work, irrespective of specialty. In conclusion, postgraduates consider their work in preparing a scientific paper as an important and integral part of medical studies.

  4. Early medical registration in Australia. Part 2.

    PubMed

    Dammery, D

    2001-11-01

    The lure of land and gold, the hope for better health and an overcrowded profession in Britain led to an increasing number of doctors migrating to Australia. This migration was even more marked after the goldrush, especially in Victoria. The fifth article in this series looks at the way in which medical practice was controlled by excluding many of those doctors who were from non-British origins.

  5. [Medico-legal opinions in cases for annulment of testament. Part II. Final conclusions of opinions. Quality of medical documentation. Evaluation of witnesses' testimonies].

    PubMed

    Marcinkowski, Jerzy T; Klimberg, Aneta

    2007-01-01

    The percentage of cases, in which devisors were unable to devise properly was high, what was mostly associated with the frequent drawing up of testaments by chronically ill individuals immediately before death. Grounds for pronouncing the devisor lacking in testamentary capacity were observed in 46.6% of cases, while 39.7% of devisors were found to lack free expression of will. Medical records were available in all the cases, including psychiatric records in 20.5% of cases and neurological records in 20.5%. In the majority of instances, the low quality of medical records hindered formulating expert opinions. The fact that in the majority of cases, the testimonies of witnesses were highly divergent indicated that they were either unable to assess the mental state of the devisor or else were themselves interested in the settlement of the case. Frequently, attending physicians from non-psychiatric wards were unable to answer questions on the mental state of the devisor, what resulted from their focusing on the somatic cause of hospitalization and the fact that their contact with the patient was very limited in time. Problems with certification on the basis of medical records were mainly associated with lacking psychiatric or neurological consults performed at the time the testament was drawn up; in some instances, the entire medical records from that period were missing. For this reason, individuals desiring to prepare a last will should be advised to undergo voluntary psychiatric assessment in this period. Medico-legal opinions in testament cases are difficult and time-consuming, but pleading one's case before the court is even more tedious and difficult.

  6. Understanding depression in medical patients. Part I: Diagnostic considerations.

    PubMed

    Wool, M S

    1990-01-01

    Little attention has been devoted to integrating theoretical conceptions of depression when considering patients with medical illness. This is more true of the social work literature than the psychiatric, in which medical formulations and treatment of depression gain primary focus. This paper presents an approach for understanding the phenomenon of depression in medical patients. It incorporates a theoretical perspective on the mechanism of depression relevant to social work intervention. Topics reviewed include diagnostic criteria for depression in the medically ill, organic factors in depression, and psychosocial theory of depression applied to medical patients. A second part of this paper will provide case examples and recommendations for social work intervention.

  7. Positive Medication Changes Resulting from Comprehensive and Noncomprehensive Medication Reviews in a Medicare Part D Population.

    PubMed

    Buhl, Allison; Augustine, Jill; Taylor, Ann M; Martin, Rose; Warholak, Terri L

    2017-03-01

    Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions. Currently, there is limited research comparing the rate of MRPs resolved by CMR and non-CMR interventions. To determine whether CMRs versus non-CMR interventions resulted in more pharmacist-initiated intervention recommendations and positive medication changes. This retrospective, cross-sectional quality improvement project evaluated outcomes for individuals who received interventions following a CMR compared with those who received non-CMR interventions as part of a comprehensive MTM program. For this project, eligible individuals qualified for an MTM program. A positive medication change was defined as the addition of an appropriate medication or the removal of an inappropriate medication within 120 days of a pharmacist recommendation. Differences between the groups were calculated using the Wilcoxon rank sum test. During the 2-year period (2012 and 2013), 788,756 beneficiaries were enrolled in the MTM program and evaluated for potential MRPs. In both years, pharmacists recommended more medication changes per member for those receiving a CMR (0.81 in 2012 and 0.82 in 2013) compared with the non-CMR group (0.68 in 2012 and 0.61 in 2013; P value < 0.001 for both years). However, recommendations made via non-CMR interventions (representing the vast majority of all medication reviews) were more likely to result in a positive medication change (OR = 1.24, 95% CI = 1.21-1.28 for 2012; OR = 1.26, 95% CI = 1.22-1.30 for 2013). These quality

  8. [Medical research in the US Armed Forces. Part 4].

    PubMed

    Agapitov, A A; Aleĭnikov, S I; Bolekhan, V N; Ivchenko, E V; Krassiĭ, A B; Nagibovich, O A; Petrov, S V; Rezvantsev, M V; Soldatov, E A; Shalakhin, R A; Sheppli, E V

    2013-01-01

    The present article is the fourth part of the review dedicated to organization and management of medical research in the US Armed Forces. The first, second and the third parts were published in the previous issues of the journal. Specifically this article is dedicated to organization and management of medical research in the US Navy. It is shown that in the US Navy the fundamental and a part of applied investigations are conducted in the Office of Naval Research while more practical research is carried out at the Naval Medical Research Center. The latter includes the Naval Health Research Center, the Naval Submarine Medical Research Laboratory and seven Naval Medical Research Units which are successively presented. The particular research programs conducted in the above mentioned organizations are discussed.

  9. Astronaut Jack Lousma with part of Inflight Medical Support System

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Astronaut Jack R. Lousma, Skylab 3 pilot, reaches into a medical kit, part of the Inflight Medical Support System (IMSS), during training for the second manned Skylab Earth-orbital mission. This activity took place in the Orbital Workshop (OWS) trainer in the Mission Simulation and Training Facility at JSC.

  10. Evaluating clinical dermatology practice in medical undergraduates.

    PubMed

    Casanova, J M; Sanmartín, V; Martí, R M; Morales, J L; Soler, J; Purroy, F; Pujol, R

    2014-06-01

    The acquisition of competences (the set of knowledge, skills and attitudes required to perform a job to a professional level) is considered a fundamental part of medical training. Dermatology competences should include, in addition to effective clinical interviewing and detailed descriptions of skin lesions, appropriate management (diagnosis, differentiation, and treatment) of common skin disorders and tumors. Such competences can only be acquired during hospital clerkships. As a way of certifying these competences, we propose evaluating the different components as follows: knowledge, via clinical examinations or critical incident discussions; communication and certain instrumental skills, via structured workplace observation and scoring using a set of indicators; and attitudes, via joint evaluation by staff familiar with the student. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  11. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 1: overview, clinical characteristics, and laboratory evaluation.

    PubMed

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Dawn Zhang; Eichenfield, Lawrence F

    2015-10-01

    Acne presenting in adult women is commonly encountered in clinical practice. Many affected women have had acne during their teenaged years, have tried several therapies in the past, and are seeking effective treatment. Others are frustrated by the inexplicable emergence of acne as an adult when they never had it as a teenager. Both groups seek an explanation of why they have acne, are often psychosocially affected by its effects on appearance and self-esteem, and all are wanting effective and safe treatment. Clinicians are encouraged to connect favorably with each patient through careful history and physical examination and to consider underlying causes of androgen excess. Practical approaches to examination and laboratory evaluation are discussed.

  12. University Medical Care Programs: Evaluation.

    ERIC Educational Resources Information Center

    Densen, Paul M.; And Others

    The increasing number of medical centers involved in collaborative and innovative health services in the community is but one reflection of social concerns and pressures for change in the health care system. Medical schools and their affiliated teaching hospitals are trying in various ways to adapt their teaching, research, and service functions…

  13. Chat reference service in medical libraries: part 1--An introduction.

    PubMed

    Dee, Cheryl R

    2003-01-01

    Chat reference services offer the opportunity to provide immediate access to quality information to meet the medical information needs of students, faculty, staff, physicians, nurses, and allied health care professionals. Part 1 of this two-part article on chat reference service in medical libraries is an introduction to the management of chat reference services and to features available for chat reference. The management of chat reference services raises issues of planning, staffing, selecting, and marketing. Planning issues focus on the identification of the users, the users' medical information needs, and the users' information-seeking behavior. Staffing issues relate to the selection of chat hours, the location of the chat service, and participation in collaborative agreements. Selecting chat software weighs the sophistication of the chat features against the related cost. Marketing uses techniques similar to traditional reference services and often begins slowly as chat expertise develops. Part 2 of the article discusses trends in chat reference services in medical libraries.

  14. 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.

  15. Chat reference service in medical libraries: part 2--Trends in medical school libraries.

    PubMed

    Dee, Cheryl R

    2003-01-01

    An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

  16. Using evaluation research to improve medical education.

    PubMed

    Tavakol, Mohsen; Gruppen, Larry D; Torabi, Sima

    2010-09-01

    Evaluation research is a form of applied research that scrutinises how well a particular programme, practice, procedure or policy is operating. Evaluation researchers use both quantitative and qualitative research data to construct a collective picture of the programme under evaluation. Medical educators need to provide information about a particular programme using the methods of evaluation research in order to make a decision on the potential adoption, improvements and refinements of the programme. Improving curricula and pedagogical methods using these methods may enhance health care education. We provide an overview of the methods of evaluation research in the context of medical education. We discuss the application, general methodology, methods of collecting data and analysis for each type of evaluation research. The methods of evaluation research described in this article enable medical educators to gain a comprehensive understanding of evaluation research in the context of medical education. The use of evaluation research findings helps medical educators to make informed decisions regarding a programme and any future actions related to it. © Blackwell Publishing Ltd 2010.

  17. Automated Assessment of Medical Training Evaluation Text

    PubMed Central

    Zhang, Rui; Pakhomov, Serguei; Gladding, Sophia; Aylward, Michael; Borman-Shoap, Emily; Melton, Genevieve B.

    2012-01-01

    Medical post-graduate residency training and medical student training increasingly utilize electronic systems to evaluate trainee performance based on defined training competencies with quantitative and qualitative data, the later of which typically consists of text comments. Medical education is concomitantly becoming a growing area of clinical research. While electronic systems have proliferated in number, little work has been done to help manage and analyze qualitative data from these evaluations. We explored the use of text-mining techniques to assist medical education researchers in sentiment analysis and topic analysis of residency evaluations with a sample of 812 evaluation statements. While comments were predominantly positive, sentiment analysis improved the ability to discriminate statements with 93% accuracy. Similar to other domains, Latent Dirichlet Analysis and Information Gain revealed groups of core subjects and appear to be useful for identifying topics from this data. PMID:23304426

  18. Medical Care Evaluation: An Experience in Continuing Medical Education.

    ERIC Educational Resources Information Center

    Sandlow, L. J.; And Others

    1981-01-01

    The educational contribution of medical care evaluation (MCE) has been portrayed as the identification of physicians' educational needs. A study of 13 MCE committees was undertaken to document the learning that occurs in these committees and to discover the conditions affecting their educational value. (Author/MLW)

  19. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D.

    PubMed

    Bradford, Ashley C; Bradford, W David

    2016-07-01

    Legalization of medical marijuana has been one of the most controversial areas of state policy change over the past twenty years. However, little is known about whether medical marijuana is being used clinically to any significant degree. Using data on all prescriptions filled by Medicare Part D enrollees from 2010 to 2013, we found that the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly, once a medical marijuana law was implemented. National overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws were estimated to be $165.2 million per year in 2013. The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D.

  20. Medication Exposure in Pregnancy Risk Evaluation Program.

    PubMed

    Andrade, Susan E; Davis, Robert L; Cheetham, T Craig; Cooper, William O; Li, De-Kun; Amini, Thushi; Beaton, Sarah J; Dublin, Sascha; Hammad, Tarek A; Pawloski, Pamala A; Raebel, Marsha A; Smith, David H; Staffa, Judy A; Toh, Sengwee; Dashevsky, Inna; Haffenreffer, Katherine; Lane, Kimberly; Platt, Richard; Scott, Pamela E

    2012-10-01

    To describe a program to study medication safety in pregnancy, the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). MEPREP is a multi-site collaborative research program developed to enable the conduct of studies of medication use and outcomes in pregnancy. Collaborators include the U.S. Food and Drug Administration and researchers at the HMO Research Network, Kaiser Permanente Northern and Southern California, and Vanderbilt University. Datasets have been created at each site linking healthcare data for women delivering an infant between January 1, 2001 and December 31, 2008 and infants born to these women. Standardized data files include maternal and infant characteristics, medication use, and medical care at 11 health plans within 9 states; birth certificate data were obtained from the state departments of public health. MEPREP currently involves more than 20 medication safety researchers and includes data for 1,221,156 children delivered to 933,917 mothers. Current studies include evaluations of the prevalence and patterns of use of specific medications and a validation study of data elements in the administrative and birth certificate data files. MEPREP can support multiple studies by providing information on a large, ethnically and geographically diverse population. This partnership combines clinical and research expertise and data resources to enable the evaluation of outcomes associated with medication use during pregnancy.

  1. Medication Exposure in Pregnancy Risk Evaluation Program

    PubMed Central

    Andrade, Susan E.; Davis, Robert L.; Cheetham, T. Craig; Cooper, William O.; Li, De-Kun; Amini, Thushi; Beaton, Sarah J.; Dublin, Sascha; Hammad, Tarek A.; Pawloski, Pamala A.; Raebel, Marsha A.; Smith, David H.; Staffa, Judy A.; Toh, Sengwee; Dashevsky, Inna; Haffenreffer, Katherine; Lane, Kimberly; Platt, Richard; Scott, Pamela E.

    2011-01-01

    To describe a program to study medication safety in pregnancy, the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). MEPREP is a multi-site collaborative research program developed to enable the conduct of studies of medication use and outcomes in pregnancy. Collaborators include the U.S. Food and Drug Administration and researchers at the HMO Research Network, Kaiser Permanente Northern and Southern California, and Vanderbilt University. Datasets have been created at each site linking healthcare data for women delivering an infant between January 1, 2001 and December 31, 2008 and infants born to these women. Standardized data files include maternal and infant characteristics, medication use, and medical care at 11 health plans within 9 states; birth certificate data were obtained from the state departments of public health. MEPREP currently involves more than 20 medication safety researchers and includes data for 1,221,156 children delivered to 933,917 mothers. Current studies include evaluations of the prevalence and patterns of use of specific medications and a validation study of data elements in the administrative and birth certificate data files. MEPREP can support multiple studies by providing information on a large, ethnically and geographically diverse population. This partnership combines clinical and research expertise and data resources to enable the evaluation of outcomes associated with medication use during pregnancy. PMID:22002179

  2. 75 FR 71632 - Revised Medical Criteria for Evaluating Mental Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ... reference to standardized tests in the mental illness sections of the proposed rules and that the change... ADMINISTRATION 20 CFR Parts 404 and 416 RIN 0960-AF69 Revised Medical Criteria for Evaluating Mental Disorders... mental disorders that we receive during this reopened comment period. DATES: To ensure that your comments...

  3. MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS.

    PubMed

    Akpinar, Ilke; Jacobs, Philip; Husereau, Don

    2015-01-01

    Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices. We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective. We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions. Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

  4. [The evaluation of medical research].

    PubMed

    Malacara, J M

    1997-01-01

    The peer review process for manuscripts submitted for publication to scientific journals and for the evaluation of grant research proposals is unsatisfactory in several respects. We examine here some of the problems related with evaluation of scientific merit. Some criteria for rejection are proposed, i.e. a poor preparation of the manuscript, a lack of a distinct hypothesis, a disagreement between hypothesis and methodology, and a deficient methodology. Other important criteria causes of rejection would be lack of originality of the hypothesis, scarce relevance of the work, and inconsistency in the results. Conversely, interesting work are rejected for invalid objections such as "less than optimal design", "lack of experience of the group" and some conceptual objections which are controversial. In order to improve the peer review process, we propose a larger role of editorial committees in final editorial decisions, an improved mechanism for selection of reviewers, and more explicit criteria for causes of rejection for reviewers and authors.

  5. Health care technology assessment: implications for modern medical practice. Part I. Understanding technology adoption and analyses.

    PubMed

    Pierce, Read G; Bozic, Kevin J; Hall, Bruce Lee; Breivis, James

    2007-01-01

    In the modern era of rapidly rising medical costs, health care technology assessment--multidisciplinary evaluation of clinical and economic aspects of technology--has assumed an increasingly important role in health policy and clinical decision-making. This review examines health care technology adoption, its impact on medical and surgical practice, and recent trends in health care technology assessment. Part I discusses the difficult challenges posed by assessment and provides a guide to the methodologies used.

  6. Improvement of Automotive Part Supplier Performance Evaluation

    NASA Astrophysics Data System (ADS)

    Kongmunee, Chalermkwan; Chutima, Parames

    2016-05-01

    This research investigates the problem of the part supplier performance evaluation in a major Japanese automotive plant in Thailand. Its current evaluation scheme is based on experiences and self-opinion of the evaluators. As a result, many poor performance suppliers are still considered as good suppliers and allow to supply parts to the plant without further improvement obligation. To alleviate this problem, the brainstorming session among stakeholders and evaluators are formally conducted. The result of which is the appropriate evaluation criteria and sub-criteria. The analytical hierarchy process is also used to find suitable weights for each criteria and sub-criteria. The results show that a newly developed evaluation method is significantly better than the previous one in segregating between good and poor suppliers.

  7. GP recruitment and medical education: part of the solution?

    PubMed

    Jones, Roger

    2017-08-23

    The current crisis in recruitment to general practice in the U.K. is likely, in part, to be caused by students' and recent graduates' negative perceptions of this career choice, perceptions which may have their roots in their experiences of general practice teaching and the effect of the 'hidden curriculum' in medical schools. There is some evidence that the expansion of the contribution of general practice in medical school curricula has stalled, and may even be shrinking, and of the diminishing visibility of general practice departments. Coupled with negative media and professional perceptions of general practice, the profession faces significant challenges in re-invigorating and re-inventing itself as an attractive career choice for students and recent graduates. General practice teachers and researchers in medical schools have significant opportunities to influence and improve many of these difficulties.

  8. Measurement of Problem Behaviour during Medication Evaluations

    ERIC Educational Resources Information Center

    Zarcone, J. R.; Napolitano, D.; Valdovinos, M.

    2008-01-01

    Background: The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations.…

  9. Research and Evaluation in Medical Education

    ERIC Educational Resources Information Center

    Ferris, Helena A.; Collins, Mary E.

    2015-01-01

    The landscape of medical education is continuously evolving, as are the needs of the learner. The appropriate use of research and evaluation is key when assessing the need for change and instituting one's innovative endeavours. This paper demonstrates how research seeks to generate new knowledge, whereas evaluation uses information acquired from…

  10. Evaluation of Specialized Medication Packaging Combined With Medication Therapy Management

    PubMed Central

    Zillich, Alan J.; Jaynes, Heather A. W.; Snyder, Margie E.; Harrison, Jeff; Hudmon, Karen Suchanek; de Moor, Carl; French, Dustin D.

    2014-01-01

    Background This study evaluates the effect of a program combing specialized medication packaging and telephonic medication therapy management on medication adherence, health care utilization, and costs among Medicaid patients. Research Design A retrospective cohort design compared Medicaid participants who voluntarily enrolled in the program (n = 1007) compared with those who did not (n = 13,614). Main outcome measures were medication adherence at 12 months, hospital admissions and emergency department visits at 6 and 12 months, and total paid claim costs at 6 and 12 months. Multivariate regression models were used to adjust for the effect of age, sex, race, comorbidities, and 12-month preenrollment health care utilization. Results Measures of medication adherence were significantly improved in the program cohort compared with the usual care cohort. At 6 months, adjusted all-cause hospitalization was marginally less in the program cohort compared with the usual care cohort [odds ratio = 0.73, 95% confidence interval (CI), 0.54–1.0, P = 0.05]. No statistically significant differences were observed between the 2 cohorts for any of the other adjusted utilization endpoints at 6 or 12 months. Adjusted total cost at 6 and 12 months were higher in the program cohort (6-month cost ratio = 1.76, 95% CI, 1.65–1.89; 12-month cost ratio = 1.84, 95% CI, 1.72–1.97), primarily because of an increase in prescription costs. Emergency department visits and hospitalization costs did not differ between groups. Conclusions The program improved measures of medication adherence, but the effect on health care utilization and nonpharmacy costs at 6 and 12 months was not different from the usual care group. Reasons for these findings may reflect differences in the delivery of the specialized packaging and the medication therapy management program, health care behaviors in this Medicaid cohort, unadjusted confounding, or time required for the benefit of the intervention to manifest

  11. Evaluating an information system for medical care evaluation studies.

    PubMed

    Holloway, D C; Wiczai, L J; Carlson, E T

    1975-04-01

    The purpose of this study was to evaluate a computerized information system, the Professional Activity Study-Medical Audit Program (PAS-MAP), when used by the medical staff of a hospital to conduct medical care evaluation studies. PAS-MAP was compared to a manual system for collecting data not contained on the face sheets of medical records. The results indicated that, compared to the manual system, PAS-MAP: was less costly if more than 41 per cent of hospitalized patients were included in medical care evaluation studies; was as timely as the manual system for data it could provide but provided fewer clinical data elements than physicians requested; and was less protective against human error. Three decision makers assigned weights indicating the relative importance of these results. The weights were combined in an additive model to arrive at a score for each system. Based on these scores, the manual system was recommended for implementation.

  12. Losartan Potassium: Evaluating the Treated Aviator for Medical Waiver

    DTIC Science & Technology

    2001-06-01

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADPO 11055 TITLE: Losartan Potassium: Evaluating the Treated Aviator for...thru ADP011058 UNCLASSIFIED 145 Losartan Potassium: Evaluating the Treated Aviator for Medical Waiver Jeb S. Pickard, M.D. USAFSAM/FECI 2507 Kennedy... losartan has Furthermore, there is some data suggesting a shown it to be a potential candidate for use in diastolic antihypertensive effect lingering

  13. Medical evaluation for outpatient dental procedures.

    PubMed

    Webb, B W

    1978-05-01

    Family physicians are often consulted to evaluate medically a patient for various dental procedures. The majority of the referrals are for diseases of the cardiovascular system. General guidelines have been established at the University of Maryland Family Health Center for the evaluation of these patients. These guidelines pertain to the use of local anesthetics and prophylaxis for endocarditis, as well as to the evaluation of patients with cardiac disease, hypertension, pulmonary disease, endocrine disease, neurological disease, hepatic disease, pregnancy, and anticoagulant therapy.

  14. Drugs on the Internet, part II: antidepressant medication web sites.

    PubMed

    Morgan, Melissa; Montagne, Michael

    2011-01-01

    Antidepressant medications have been the fastest growing category of use of pharmaceutical products over the past decade. Selected Internet web sites providing information on antidepressant medications were identified and assessed using code of conduct criteria for posting health information on the Internet as developed by the Health on the Internet Foundation. Thirteen representative web sites were evaluated. Degree of compliance with each of the eight criterion varied by site, though all 13 sites met the criterion for legality of content and conduct on their web site. WebMD and FamilyDoctor.org met most of the criteria, while pharmaceutical company sites tended to meet the fewest criteria.

  15. Trends in Medicare Part D Medication Therapy Management Eligibility Criteria

    PubMed Central

    Wang, Junling; Shih, Ya-Chen Tina; Qin, Yolanda; Young, Theo; Thomas, Zachary; Spivey, Christina A.; Solomon, David K.; Chisholm-Burns, Marie

    2015-01-01

    Background To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. Objectives To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. Methods This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008–2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. Results For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. Conclusion The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans. PMID:26380030

  16. Trends in Medicare Part D Medication Therapy Management Eligibility Criteria.

    PubMed

    Wang, Junling; Shih, Ya-Chen Tina; Qin, Yolanda; Young, Theo; Thomas, Zachary; Spivey, Christina A; Solomon, David K; Chisholm-Burns, Marie

    2015-01-01

    To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008-2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans.

  17. Student perceptions of evaluation in undergraduate medical education: A qualitative study from one medical school.

    PubMed

    Schiekirka, Sarah; Reinhardt, Deborah; Heim, Susanne; Fabry, Götz; Pukrop, Tobias; Anders, Sven; Raupach, Tobias

    2012-06-22

    Evaluation is an integral part of medical education. Despite a wide use of various evaluation tools, little is known about student perceptions regarding the purpose and desired consequences of evaluation. Such knowledge is important to facilitate interpretation of evaluation results. The aims of this study were to elicit student views on the purpose of evaluation, indicators of teaching quality, evaluation tools and possible consequences drawn from evaluation data. This qualitative study involved 17 undergraduate medical students in Years 3 and 4 participating in 3 focus group interviews. Content analysis was conducted by two different researchers. Evaluation was viewed as a means to facilitate improvements within medical education. Teaching quality was believed to be dependent on content, process, teacher and student characteristics as well as learning outcome, with an emphasis on the latter. Students preferred online evaluations over paper-and-pencil forms and suggested circulating results among all faculty and students. Students strongly favoured the allocation of rewards and incentives for good teaching to individual teachers. In addition to assessing structural aspects of teaching, evaluation tools need to adequately address learning outcome. The use of reliable and valid evaluation methods is a prerequisite for resource allocation to individual teachers based on evaluation results.

  18. Student perceptions of evaluation in undergraduate medical education: A qualitative study from one medical school

    PubMed Central

    2012-01-01

    Background Evaluation is an integral part of medical education. Despite a wide use of various evaluation tools, little is known about student perceptions regarding the purpose and desired consequences of evaluation. Such knowledge is important to facilitate interpretation of evaluation results. The aims of this study were to elicit student views on the purpose of evaluation, indicators of teaching quality, evaluation tools and possible consequences drawn from evaluation data. Methods This qualitative study involved 17 undergraduate medical students in Years 3 and 4 participating in 3 focus group interviews. Content analysis was conducted by two different researchers. Results Evaluation was viewed as a means to facilitate improvements within medical education. Teaching quality was believed to be dependent on content, process, teacher and student characteristics as well as learning outcome, with an emphasis on the latter. Students preferred online evaluations over paper-and-pencil forms and suggested circulating results among all faculty and students. Students strongly favoured the allocation of rewards and incentives for good teaching to individual teachers. Conclusions In addition to assessing structural aspects of teaching, evaluation tools need to adequately address learning outcome. The use of reliable and valid evaluation methods is a prerequisite for resource allocation to individual teachers based on evaluation results. PMID:22726271

  19. Medications in pregnancy and lactation: part 1. Teratology.

    PubMed

    Buhimschi, Catalin S; Weiner, Carl P

    2009-01-01

    One of the least-developed areas of clinical pharmacology and drug research is the use of medication during pregnancy and lactation. This article is the first in a two-part series designed to familiarize physicians with many aspects of the drugs they commonly prescribe for pregnant and breast-feeding women. Almost every pregnant woman is exposed to some type of medication during pregnancy. Although the majority of pregnant and breast-feeding women consume clinically indicated or over-the-counter drug preparation regularly, only few medications have specifically been tested for safety and efficacy during pregnancy. There is scant information on the effect of common pregnancy complications on drug clearance and efficacy. Often, the safety of a drug for mothers, their fetuses, and nursing infants cannot be determined until it has been widely used. Absent this crucial information, many women are either refused medically important agents or experience potentially harmful delays in receiving drug treatment. Conversely, many drugs deemed "safe" are prescribed despite evidence of possible teratogenicity. Novel research and diagnostic applications evolving from the opportunities presented by the advances in genomics and proteomics are now beginning to affect clinical diagnosis, vaccine development, drug discovery, and unique therapies in a modern diagnostic-therapeutic framework-part of the new scientific field of theranostics. This review critically explores a number of recently raised issues in regard to the use of several classes of medications during gestation and seeks to provide a general and concise resource on drugs commonly used during pregnancy and lactation. It also seeks to make clinicians more aware of the controversies surrounding some drugs in an effort to encourage safer prescribing practices through consultation with a maternal-fetal medicine specialist and through references and Web sites that list up-to-date information.

  20. The economic evaluation of medical devices: challenges ahead.

    PubMed

    Kirisits, Andreas; Redekop, W Ken

    2013-02-01

    The economic evaluation of medical technology has evolved as a key element in supporting health budget allocation decisions. Among suppliers of innovation, the medical device industry is one of the most dynamic fields of medical progress with thousands of new products marketed every year. Accordingly, the broad variety of technologies covered by the umbrella term 'medical devices' have come under increasing scrutiny regarding their cost effectiveness. In the process, a number of device-specific factors have become apparent, each of which can complicate a thorough economic evaluation and limit its informative value. Some of these factors relate to specific characteristics of device functioning. Examples of such factors include the fact that most technologies require, or form part of, a procedure and that many devices have multiple indications or purposes. Others in turn reflect external conditions and are more general in character, such as the regulatory framework that a medical device manufacturer faces prior to market approval and the structure of the medical device industry. Drawing on the available literature, these complicating factors and their practical implications are discussed and used as a basis to elaborate on the emerging challenges for the economic evaluation of medical devices.

  1. Evaluating a Federated Medical Search Engine

    PubMed Central

    Belden, J.; Williams, J.; Richardson, B.; Schuster, K.

    2014-01-01

    Summary Background Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. Objectives To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. Methods This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. Results Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants’ expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. Conclusions The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for

  2. Anniversary paper: evaluation of medical imaging systems.

    PubMed

    Krupinski, Elizabeth A; Jiang, Yulei

    2008-02-01

    Medical imaging used to be primarily within the domain of radiology, but with the advent of virtual pathology slides and telemedicine, imaging technology is expanding in the healthcare enterprise. As new imaging technologies are developed, they must be evaluated to assess the impact and benefit on patient care. The authors review the hierarchical model of the efficacy of diagnostic imaging systems by Fryback and Thornbury [Med. Decis. Making 11, 88-94 (1991)] as a guiding principle for system evaluation. Evaluation of medical imaging systems encompasses everything from the hardware and software used to acquire, store, and transmit images to the presentation of images to the interpreting clinician. Evaluation of medical imaging systems can take many forms, from the purely technical (e.g., patient dose measurement) to the increasingly complex (e.g., determining whether a new imaging method saves lives and benefits society). Evaluation methodologies cover a broad range, from receiver operating characteristic (ROC) techniques that measure diagnostic accuracy to timing studies that measure image-interpretation workflow efficiency. The authors review briefly the history of the development of evaluation methodologies and review ROC methodology as well as other types of evaluation methods. They discuss unique challenges in system evaluation that face the imaging community today and opportunities for future advances.

  3. Deformable part models for object detection in medical images

    PubMed Central

    2014-01-01

    Background Object detection in 3-D medical images is often necessary for constraining a segmentation or registration task. It may be a task in its own right as well, when instances of a structure, e.g. the lymph nodes, are searched. Problems from occlusion, illumination and projection do not arise, making the problem simpler than object detection in photographies. However, objects of interest are often not well contrasted against the background. Influence from noise and other artifacts is much stronger and shape and appearance may vary substantially within a class. Methods Deformable models capture the characteristic shape of an anatomic object and use constrained deformation for hypothesing object boundaries in image regions of low or non-existing contrast. Learning these constraints requires a large sample data base. We show that training may be replaced by readily available user knowledge defining a prototypical deformable part model. If structures have a strong part-relationship, or if they may be found based on spatially related guiding structures, or if the deformation is rather restricted, the supporting data information suffices for solving the detection task. We use a finite element model to represent anatomic variation by elastic deformation. Complex shape variation may be represented by a hierarchical model with simpler part variation. The hierarchy may be represented explicitly as a hierarchy of sub-shapes, or implicitly by a single integrated model. Data support and model deformation of the complete model can be represented by an energy term, serving as quality-of-fit function for object detection. Results The model was applied to detection and segmentation tasks in various medical applications in 2- and 3-D scenes. It has been shown that model fitting and object detection can be carried out efficiently by a combination of a local and global search strategy using models that are parameterized for the different tasks. Conclusions A part-based elastic

  4. Regional Medical Program; Guidelines for Evaluation.

    ERIC Educational Resources Information Center

    Dean, Gary S., And Others

    This set of guidelines was written to provide a systematic explanation of the process of evaluation applied to Regional Medical Programs, as required by Public Law 89-239. Goals of the programs are the improvement of health care of patients suffering from heart disease, cancer, stroke and related diseases and improvement in the practice of health…

  5. Asclepius, Caduceus, and Simurgh as medical symbols, part I.

    PubMed

    Nayernouri, Touraj

    2010-01-01

    This is the first of two articles reviewing the history of medical symbols. In this first article I have briefly reviewed the evolution of the Greek god, Asclepius, (and his Roman counterpart Aesculapius) with the single serpent entwined around a wooden rod as a symbol of western medicine and have alluded to the misplaced adoption of the Caduceus of the Greek god Hermes (and his Roman counterpart Mercury) with its double entwined serpents as an alternative symbol. In the second part of this article (to be published later), I have made a tentative suggestion of why the Simorgh might be adopted as an Eastern or an Asian symbol for medicine.

  6. Medical evaluation and management of urolithiasis.

    PubMed

    Semins, Michelle Jo; Matlaga, Brian R

    2010-02-01

    Nephrolithiasis is a highly prevalent condition with a high recurrence rate that has a large impact on the quality of life of those affected. It also poses a great financial burden on society. There have been great advancements in the surgical treatment of stone disease over the past several decades. The evolution of surgical technique appears to have overshadowed the importance of prevention of stone disease despite evidence showing medical therapies significantly decreasing stone recurrence rates. Herein we review the metabolic evaluation of stone formers with the use of specific blood and urine tests. We complete our discussion with a review of the medical management of stone formers providing both general recommendations as well as reviewing focused therapies for specific metabolic abnormalities and medical conditions.

  7. Part I--Evaluation of pediatric post-traumatic headaches.

    PubMed

    Pinchefsky, Elana; Dubrovsky, Alexander Sasha; Friedman, Debbie; Shevell, Michael

    2015-03-01

    Brain injury is one of the most common injuries in the pediatric age group, and post-traumatic headache is one of the most common symptoms following mild traumatic brain injury in children. This is an expert opinion-based two-part review on pediatric post-traumatic headaches. Part I will focus on an overview and approach to the evaluation of post-traumatic headache. Part II will focus on the medical management of post-traumatic headache. Relevant articles were reviewed, and an algorithm is proposed. We review the epidemiology, classification, pathophysiology, and clinical approach to evaluating patients with post-traumatic headache. A comprehensive history and physical examination are fundamental to identifying the headache type(s). Identifying the precise headache phenotype is important to help guide treatment. Most of the post-traumatic headaches are migraine or tension type, but occipital neuralgia, cervicogenic headache, and medication overuse headache also occur. Postconcussive signs often resolve within 1 month, and individuals whose signs persist longer may benefit from an interprofessional approach. Rigorous evaluation and diagnosis are vital to treating post-traumatic headaches effectively. A multifaceted approach is needed to address all the possible contributing factors to the headaches and any comorbid conditions that may delay recovery or alter treatment choices. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Antiviral medication in sexually transmitted diseases. Part II: HIV.

    PubMed

    Majewska, Anna; Mlynarczyk-Bonikowska, Beata; Malejczyk, Magdalena; Mlynarczyk, Grazyna; Majewski, Slawomir

    2015-01-01

    This is a second part of a review under a main title Antiviral medication in sexually transmitted diseases. In the part we published in Mini Rev Med Chem. 2013,13(13):1837-45, we have described mechanisms of action and mechanism of resistance to antiviral agents used in genital herpes and genital HPV infection. The Part II review focuses on therapeutic options in HIV infection. In 1987, 6 years after the recognition of AIDS, the FDA approved the first drug against HIV--zidovudine. Since then a lot of antiretroviral drugs are available. The most effective treatment for HIV is highly active antiretroviral therapy--a combination of several antiretroviral medicines that cause a reduction of HIV blood concentration and often results in substantial recovery of impaired immunologic function. At present, there are over 20 drugs licensed and used for the treatment of HIV/AIDS, and these drugs are divided into one of six classes. Investigational agents include GS-7340, the prodrug of tenofovir and BMS-663068--the first in a novel class of drugs that blocks the binding of the HIV gp120 to the CD4 receptor.

  9. Evaluation of online consumer medication information.

    PubMed

    Kim, Karissa Y; Metzger, Anne; Wigle, Patricia R; Choe, Pearl J

    2011-06-01

    Millions of Americans search the Internet for health-related information; however, the readability and comprehensiveness of consumer medication information (CMI) on the Internet has not been widely studied. The purpose of this study was to evaluate the readability and comprehensiveness of online CMI. The readability and comprehensiveness of consumer drug information found on 3 well-known Web sites (Medline Plus, Yahoo Health, and WebMD) was evaluated; in particular, information related to 10 commonly prescribed medications. Readability was assessed using the Simple Measure of Gobbledygook (SMOG) and Fry Readability Graph (FRG) tools; comprehensiveness of information was evaluated using the Keystone action plan criteria. Using SMOG, the mean reading level of each Web site was 13th grade level or higher. Using the FRG, the mean reading level was 10th grade or higher. Out of the 24 points in the Keystone action plan criteria, information found on each of the Web sites was deemed accurate with mean score of 21, 21, and 19 for Medline Plus, Yahoo Health, and WebMD, respectively. For the medications reviewed, CMI found on Web sites was accurate when assessed using the Keystone action plan criteria. The readability levels were higher than the recommended sixth grade level. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Evaluating innovation. Part 2: Development in neurosurgery.

    PubMed

    Schnurman, Zane; Kondziolka, Douglas

    2016-01-01

    OBJECT Patients, practitioners, payers, and regulators are advocating for reform in how medical advances are evaluated. Because surgery does not adhere to a standardized developmental pathway, how the medical community accepts a procedure remains unclear. The authors developed a new model, using publication data and patterns, that quantifies this process. Using this technique, the authors identified common archetypes and influences on neurosurgical progress from idea inception to acceptance. METHODS Seven neurosurgical procedures developed in the past 15-25 years were used as developmental case studies (endovascular coil, deep brain stimulation, vagus nerve stimulation, 1,3-bis(2-chloroethyl)-l-nitrosourea wafer, and 3 radiosurgery procedures), and the literature on each topic was evaluated. A new metric the authors termed "progressive scholarly acceptance" (PSA) was used as an end point for community acceptance. PSA was reached when the number of investigations that refine or improve a procedure eclipsed the total number of reports assessing initial efficacy. Report characteristics, including the number of patients studied, study design, and number of authoring groups from the first report to the point of PSA, were assessed. RESULTS Publication data implicated factors that had an outsized influence on acceptance. First, procedural accessibility to investigators was found to influence the number of reports, number of patients studied, and number of authoring groups contributing. Barriers to accessibility included target disease rarity, regulatory restrictions, and cost. Second, the ease or difficulty in applying a randomized controlled trial had an impact on study design. Based on these 2 factors, 3 developmental archetypes were characterized to generally describe the development of surgery. CONCLUSIONS Common surgical development archetypes can be described based on factors that impact investigative methods, data accumulation, and ultimate acceptance by society

  11. Ethical evaluation of "retainer fee" medical practice.

    PubMed

    Needell, Mervin H; Kenyon, John S

    2005-01-01

    This article examines the reasons that some physicians have recently opted to reduce the size of their practice rosters to allow more time for each patient in exchange for a retainer fee from patients. These physicians also offer supplementary, nonmedical amenities to patients as part of their service. Because physicians have reduced the size of their practice rosters and have increased the price tag for their services, some patients have lost access to their care. We have tried to assess the ethical propriety of such a change in the design of medical practices by weighing plausible, ethically relevant arguments favoring and opposing RFMP. Physicians are ethically obligated first and foremost to promote and protect the health of their patients. RFMP fulfills this duty directly by ensuring prompt and ample professional time for the care of patients. It does so indirectly by allowing time for physicians' continuing education, which in turn should upgrade the quality of care. It also advances the ethical goals of autonomy as it allows patients to choose their own physicians and to spend their money as they please. On the other hand, these ethical positives are offset by the cost of retainer fees that may exclude access of patients to their physicians' care. Even if ethical tradition obligates physicians primarily to patients under their specific care, as professionals and as private citizens, they also have a responsibility to support the health of the entire community. RFMP does little to advance this cause, except that by optimizing the conditions under which their own private patients receive healthcare, they call attention to shortcomings in prevailing public healthcare policies, which by comparison fall short of that standard. An assumption that health is not properly a market commodity, and that all people should receive healthcare on equal terms, would expose RFMP to moral reproof. From an ethical perspective, we find sufficient cause for concern and caution in

  12. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental..., and social evaluations. (a) Before admission to a mental hospital or before authorization for payment... medical findings; (3) Medical history; (4) Mental and physical functional capacity; (5) Prognoses; and...

  13. Immigrant and refugee health: medical evaluation.

    PubMed

    Rew, Karl T; Clarke, S Lindsey; Gossa, Weyinshet; Savin, Daniel

    2014-08-01

    Overseas medical screening by panel physicians for conditions that might jeopardize US public health is required for admission to the United States by immigrant visa or refugee status. According to protocols established by the Centers for Disease Control and Prevention, conditions such as active tuberculosis and substance dependence, when detected, prohibit entry to the United States, whereas close medical follow-up after arrival is required for individuals with other conditions. Refugees and asylees should undergo further medical assessment by a US civil surgeon as soon as possible after arrival. Applicants for legal permanent residence in the United States, whether by immigrant visa or adjustment of status, must receive vaccinations comparable to those recommended for citizens. When immigrants and refugees present to a primary care physician, the vaccination process may not be complete, and documentation of the extent to which it is complete might be lacking. Immigrants and refugees may have a variety of unrecognized or untreated musculoskeletal conditions, mental health conditions, infectious diseases, and chronic conditions. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  14. Evaluation of an online medical teaching forum.

    PubMed

    Ravindran, Rahul; Kashyap, Mavin; Lilis, Lydia; Vivekanantham, Sayinthen; Phoenix, Gokulan

    2014-07-01

    Social media is increasingly being used for teaching and assessment. We describe the design and implementation of a Facebook© teaching forum for medical students, and evaluate its effectiveness. A Facebook© teaching forum was set up in a London Hospital to assist with learning and assessment for undergraduate medical students. An independent online survey was used to collate their experiences. Accessibility to the forum, usefulness in stimulating peer-to-peer discussion and the use of weekly formative assessments were evaluated using a Likert scale. In total, 91 per cent (n=68/75) of students who had Facebook© joined the teaching forum. The majority of students completed the questionnaire (n=39/68, 57%). All students visited the teaching forum group at least once a week. A significant proportion attempted all 10 question sets (n=16/39, 41%). Students felt more comfortable asking questions in the forum than in ward rounds and clinics (n=22/39, 56%). The general consensus was that Facebook© could be used for educational purposes, with just 5 per cent of students (n=2/39) thinking that Facebook© should only be used socially and with 92 per cent believing that the forum helped to achieve the learning objectives of the curriculum (n=36/39). Facebook© provides a safe environment for learning and discussion amongst medical undergraduates undergoing their clinical attachments. Furthermore, through formative assessments set by a medical educator, it provides a useful revision tool for summative assessments and reinforces knowledge learned through conventional teaching methods. © 2014 John Wiley & Sons Ltd.

  15. Towards a metadata registry for evaluating augmented medical interventions.

    PubMed

    Silvent, Anne-Sophie; Moreau-Gaudry, Alexandre; Cinquin, Philippe

    2011-01-01

    Quality evaluation in the field of Augmented Surgery is strategic for public health policies. It implies to be able to effectively perform evaluation of Quality in term of Expected Medical Benefit (EMB). The notion of EMB is complex and not standardized in this field. To define and to evaluate EMB, it is necessary to discover the knowledge on the domain targeted by the device and to structure it. This paper presents first parts of this work. Focused on navigated knee surgery, it led us to obtain two main results: the identification of a new criterion for evaluating EMB obtained thanks to the formalization of a new kind of metadata. These encouraging results seem to offer new perspectives for the evaluation of devices from the field of augmented surgery.

  16. 5 CFR 339.205 - Medical evaluation programs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Medical evaluation programs. 339.205 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...

  17. Evaluation of board performance in Iran's universities of medical sciences.

    PubMed

    Sajadi, Haniye Sadat; Maleki, Mohammadreza; Ravaghi, Hamid; Farzan, Homayoun; Aminlou, Hasan; Hadi, Mohammad

    2014-10-01

    The critical role that the board plays in governance of universities clarifies the necessity of evaluating its performance. This study was aimed to evaluate the performance of the boards of medical universities and provide solutions to enhance its performance. The first phase of present study was a qualitative research in which data were collected through face-to-face semi-structured interviews. Data were analyzed by thematic approach. The second phase was a mixed qualitative and quantitative study, with quantitative part in cross-sectional format and qualitative part in content analysis format. In the quantitative part, data were collected through Ministry of Health and Medical Education (MoHME). In the qualitative part, the content of 2,148 resolutions that were selected by using stratified sampling method were analyzed. Participants believed that the boards had no acceptable performance for a long time.RESULTS also indicated the increasing number of meetings and resolutions of the boards in these 21 years. The boards' resolutions were mostly operational in domain and administrative in nature. The share of specific resolutions was more than the general ones. Given the current pace of change and development and the need to timely respond them, it is recommended to accelerate the slow pace of improvement process of the boards. It appears that more delegation and strengthening the position of the boards are the effective strategies to speed up this process.

  18. Evaluation of hospital medication inventory policies.

    PubMed

    Gebicki, Marek; Mooney, Ed; Chen, Shi-Jie Gary; Mazur, Lukasz M

    2014-09-01

    As supply chain costs constitute a large portion of hospitals' operating expenses and with $27.7 billion spent by the US hospitals on drugs alone in 2009, improving medication inventory management provides a great opportunity to decrease the cost of healthcare. This study investigates different management approaches for a system consisting of one central storage location, the main pharmacy, and multiple dispensing machines located in each department. Each medication has a specific unit cost, availability from suppliers, criticality level, and expiration date. Event-driven simulation is used to evaluate the performance of several inventory policies based on the total cost and patient safety (service level) under various arrangements of the system defined by the number of drugs and departments, and drugs' criticality, availability, and expiration levels. Our results show that policies that incorporate drug characteristics in ordering decisions can address the tradeoff between patient safety and cost. Indeed, this study shows that such policies can result in higher patient safety and lower overall cost when compared to traditional approaches. Additional insights from this study allow for better understanding of the medication inventory system's dynamics and suggest several directions for future research in this topic. Findings of this study can be applied to help hospital pharmacies with managing their inventory.

  19. Flavonoids from barrel medic (Medicago truncatula) aerial parts.

    PubMed

    Kowalska, Iwona; Stochmal, Anna; Kapusta, Ireneusz; Janda, Bogdan; Pizza, Cosimo; Piacente, Sonia; Oleszek, Wieslaw

    2007-04-04

    Twenty-three flavonoids have been identified in the aerial parts of barrel medic, and their structures were established by spectrometric and spectroscopic (ESI-MS/MS and NMR) techniques. Eight of the identified compounds, including apigenin 7-O-beta-D-glucuronopyranosyl-(1-->3)-O-beta-D-glucuronopyranosyl-(1-->2)-O-beta-D-glucuronopyranoside, apigenin 7-O-[2'-O-sinapoyl-beta-D-glucuronopyranosyl-(1-->2)-O-beta-D-glucuronopyranoside], apigenin 7-O-{2-O-feruloyl-[beta-D-glucuronopyranosyl-(1-->3)]-O-beta-D-glucuronopyranosyl-(1-->2)-O-beta-D-glucopyranoside}, chrysoeriol 7-O-[beta-D-glucuronopyranosyl-(1-->2)-O-beta-D-glucuronopyranoside, chrysoeriol 7-O-{2'-O-p-coumaroyl-[beta-D-glucuronopyranosyl-(1-->3)]-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucuronopyranoside}, tricin 7-O-beta-D-glucuronopyranosyl-4'-O-glucopyranoside, tricin 7-O-[2'-O-feruloyl-beta-D-glucuronopyranosyl-(1-->2)-O-beta-D-glucopyranoside], and tricin 7-O-{2'-O-p-coumaroyl-[beta-D-glucuronopyranosyl-(1-->3)]-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucuronopyranoside}, have not been reported before in the plant kingdom. Additionally, the presence of two luteolin, three apigenin, one chrysoeriol, and six tricin glycosides, previously identified in alfalfa (Medicago sativa), was confirmed in M. truncatula. Moreover, besides the above flavones, the aerial parts of this species contained three flavonols including rutin, laricitrin 3,7,5'-triglucoside, and laricitrin 3,5'-diglucoside.

  20. Evaluation of the "medication fall risk score".

    PubMed

    Yazdani, Cyrus; Hall, Scott

    2017-01-01

    Results of a study evaluating the predictive validity of a fall screening tool in hospitalized patients are reported. Administrative claims data from two hospitals were analyzed to determine the discriminatory ability of the "medication fall risk score" (RxFS), a medication review fall-risk screening tool that is designed for use in conjunction with nurse-administered tools such as the Morse Fall Scale (MFS). Through analysis of data on administered medications and documented falls in a population of adults who underwent fall-risk screening at hospital admission over a 15-month period (n = 33,058), the predictive value of admission MFS scores, alone or in combination with retrospectively calculated RxFS-based risk scores, was assessed. Receiver operating characteristic (ROC) curve analysis and net reclassification improvement (NRI) analysis were used to evaluate improvements in risk prediction with the addition of RxFS data to the prediction model. The area under the ROC curve for the predictive model for falls compromising both MFS and RxFS scores was computed as 0.8014, which was greater than the area under the ROC curve associated with use of the MFS alone (0.7823, p = 0.0030). Screening based on MFS scores alone had 81.25% sensitivity and 61.37% specificity. Combined use of RxFS and MFS scores resulted in 82.42% sensitivity and 66.65% specificity (NRI = 0.0587, p = 0.0003). Reclassification of fall risk based on coadministration of the MFS and the RxFS tools resulted in a modest improvement in specificity without compromising sensitivity. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  1. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medical, psychological, and social evaluations. 456...: Intermediate Care Facilities Medical, Psychological, and Social Evaluations and Admission Review § 456.370 Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for...

  2. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medical, psychiatric, and social evaluations. 456... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.170 Medical, psychiatric, and social evaluations. (a) Before admission to a mental hospital or before authorization for payment...

  3. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Medical, psychological, and social evaluations. 456...: Intermediate Care Facilities Medical, Psychological, and Social Evaluations and Admission Review § 456.370 Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for...

  4. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Medical, psychological, and social evaluations. 456...: Intermediate Care Facilities Medical, Psychological, and Social Evaluations and Admission Review § 456.370 Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for...

  5. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Medical, psychological, and social evaluations. 456...: Intermediate Care Facilities Medical, Psychological, and Social Evaluations and Admission Review § 456.370 Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for...

  6. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Medical, psychological, and social evaluations. 456...: Intermediate Care Facilities Medical, Psychological, and Social Evaluations and Admission Review § 456.370 Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization...

  7. 78 FR 19725 - Merchant Mariner Medical Evaluation Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... SECURITY Coast Guard Merchant Mariner Medical Evaluation Program AGENCY: Coast Guard, DHS. ACTION: Notice... mariner medical evaluation program. Section 718 of the Coast Guard Authorization Act of 2012 directed the...'s merchant mariner medical evaluation program and alternatives to the program. Congress specifically...

  8. Boundary overlap for medical image segmentation evaluation

    NASA Astrophysics Data System (ADS)

    Yeghiazaryan, Varduhi; Voiculescu, Irina

    2017-03-01

    All medical image segmentation algorithms need to be validated and compared, and yet no evaluation framework is widely accepted within the imaging community. Collections of segmentation results often need to be compared and ranked by their effectiveness. Evaluation measures which are popular in the literature are based on region overlap or boundary distance. None of these are consistent in the way they rank segmentation results: they tend to be sensitive to one or another type of segmentation error (size, location, shape) but no single measure covers all error types. We introduce a new family of measures, with hybrid characteristics. These measures quantify similarity/difference of segmented regions by considering their overlap around the region boundaries. This family is more sensitive than other measures in the literature to combinations of segmentation error types. We compare measure performance on collections of segmentation results sourced from carefully compiled 2D synthetic data, and also on 3D medical image volumes. We show that our new measure: (1) penalises errors successfully, especially those around region boundaries; (2) gives a low similarity score when existing measures disagree, thus avoiding overly inflated scores; and (3) scores segmentation results over a wider range of values. We consider a representative measure from this family and the effect of its only free parameter on error sensitivity, typical value range, and running time.

  9. [Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

    PubMed

    Godény, Sándor

    2012-02-05

    The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

  10. Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy.

    PubMed

    Murase, Jenny E; Heller, Misha M; Butler, Daniel C

    2014-03-01

    Dermatologists are frequently faced with questions about the safety of commonly prescribed topical and systemic medications during pregnancy and lactation from women of childbearing age who are pregnant, considering pregnancy, or breastfeeding. Safety data, particularly regarding medications that are unique to dermatology, can be difficult to locate and are not consolidated in a single reference guide for clinicians. Parts I and II of this continuing medical education article provide a capsule summary of key points for the most commonly prescribed dermatologic medications to facilitate patient medication risk counseling in pregnancy. A summary table details safety classification data for 3 primary international classification systems: the US Food and Drug Administration, the Swedish Catalogue of Approved Drugs, and the Australian Drug Evaluation Committee. In addition, this table includes an alternative pregnancy classification system developed by a consortium of active members of teratology societies in the US and Europe detailed in Drugs during Pregnancy and Lactation: Treatment Options and Risk Assessment and a safety classification system developed for breastfeeding mothers detailed in Medications and Mother's Milk. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  11. Investigating the faculty evaluation system in Iranian Medical Universities

    PubMed Central

    Kamali, Farahnaz; Yamani, Nikoo; Changiz, Tahereh

    2014-01-01

    Introduction: To achieve a valid evaluation of faculty members, it is necessary to develop an inclusive and dynamic system of evaluation addressing all the activities and responsibilities of faculty members. Among these responsibilities, educational activities comprise an important part which needs to be investigated. This study aimed to investigate the current system of evaluating the faculty members’ educational duties. Methods: In this descriptive cross-sectional study, a checklist for investigating the current evaluation system and was developed confirmed by a focus group. The data for checklist were collected through a researcher-made questionnaire and interview with eight experts of faculty evaluation that worked in different Iranian Medical Universities. For completion of information, the available documents and records were studied. Finally, the current evaluation system of different universities was depicted. Results: The developed checklist had six themes and 123 subthemes. The extracted themes included: Tools, evaluators, processes, appropriateness of faculty field of work with evaluation, feedback status, and university status regarding decisions made based on faculty evaluation results. As for comprehensiveness, all evaluation items except for evaluation and assessment skills and religiosity from personality traits subtheme were fully investigated. The evaluation tools were not enough for different types of education such as clinical education. In six universities, the feedbacks provided were only for making inter/intra department comparison, and no scientific suggestions were included. The results of evaluations were used only for the faculties’ promotions. Discussion: Suitability between evaluation and performance components is a necessity in every evaluation system. The study showed this does not exist in Iranian Universities. For instance, there was no appropriate tool for the evaluation of clinical education. Also, the results of the faculty

  12. Impact of telephone medication therapy management on medication and health-related problems, medication adherence, and Medicare Part D drug costs: a 6-month follow up.

    PubMed

    Moczygemba, Leticia R; Barner, Jamie C; Lawson, Kenneth A; Brown, Carolyn M; Gabrillo, Evelyn R; Godley, Paul; Johnsrud, Michael

    2011-10-01

    The Medicare Modernization Act of 2003 mandated the provision of medication therapy management (MTM) to eligible Part D beneficiaries to improve medication-related outcomes. As MTM programs evolve, evaluation is necessary to help inform MTM best practices. The objective of this study was to determine the impact of pharmacist-provided telephone MTM on: (1) medication and health-related problems (MHRPs); (2) medication adherence; and (3) Part D drug costs. This quasi-experimental study included Part D beneficiaries from a Texas health plan. Andersen's Behavioral Model of Health Services Use served as the study framework. MTM utilization was the health behavior. Age, gender, and race were predisposing factors, and number of medications, chronic diseases, and medication regimen complexity were need factors. Outcomes were pre-to-post changes in: (1) MHRPs; (2) medication adherence, using the medication possession ratio (MPR); and (3) total drug costs. Multiple regression was used to analyze group differences while controlling for predisposing and need factors. At baseline, the intervention (n = 60) and control (n = 60) groups were not statistically different regarding predisposing and need factors, with the exception of gender. The intervention group had significantly (P = 0.009) more men compared with the control group (51.7% vs 28.3%). There were 4.8 (2.7) and 9.2 (2.9) MHRPs identified at baseline and 2.5 (2.0) and 7.9 (3.0) MHRPs remained at the 6-month follow up in the intervention and control groups, respectively. The intervention group (vs control) had significantly more MHRPs resolved (P = 0.0003). There were no significant predictors of change in MPR or total drug costs from baseline to follow up, although total drug costs decreased by $158 in the intervention group compared with a $118 increase in the control group. A telephone MTM program resolved significantly more MHRPs compared with a control group, but there were no significant changes in adherence and

  13. Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations.

    PubMed

    Mubki, Thamer; Rudnicka, Lidia; Olszewska, Malgorzata; Shapiro, Jerry

    2014-09-01

    The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent advances in this field and describes a systematic approach for using the differential diagnostic findings of trichoscopy in alopecia. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Terror Medicine as Part of the Medical School Curriculum

    PubMed Central

    Cole, Leonard A.; Wagner, Katherine; Scott, Sandra; Connell, Nancy D.; Cooper, Arthur; Kennedy, Cheryl Ann; Natal, Brenda; Lamba, Sangeeta

    2014-01-01

    Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ, USA. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training. PMID:25309891

  15. Terror medicine as part of the medical school curriculum.

    PubMed

    Cole, Leonard A; Wagner, Katherine; Scott, Sandra; Connell, Nancy D; Cooper, Arthur; Kennedy, Cheryl Ann; Natal, Brenda; Lamba, Sangeeta

    2014-01-01

    Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ, USA. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training.

  16. Evaluation of Patient Centered Medical Home Practice Transformation Initiatives

    PubMed Central

    Crabtree, Benjamin F.; Chase, Sabrina M.; Wise, Christopher G.; Schiff, Gordon D.; Schmidt, Laura A.; Goyzueta, Jeanette R.; Malouin, Rebecca A.; Payne, Susan M. C.; Quinn, Michael T.; Nutting, Paul A.; Miller, William L.; Jaén, Carlos Roberto

    2011-01-01

    Background The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. Methods Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. Results A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Conclusions Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures. PMID:21079525

  17. Predicting performance on the Medical Council of Canada Qualifying Exam Part II.

    PubMed

    Woloschuk, Wayne; McLaughlin, Kevin; Wright, Bruce

    2013-01-01

    Being able to predict which residents will likely be unsuccessful on high-stakes exams would allow residency programs to provide early intervention. To determine whether measures of clinical performance in clerkship (in-training evaluation reports) and first year of residency (program director ratings) predict pass-fail performance on the Medical Council of Canada Qualifying Exam Part II (MCCQE Part II). Residency program directors assessed the performance of our medical school graduates (Classes 2004-2007) at the end of the 1st postgraduate year. We subsequently collected clerkship in-training evaluation reports for these graduates. Using a neutral third party and unique codes, an anonymous dataset containing clerkship, residency, and MCCQE Part II performance scores was created for our use. Data were analyzed using descriptive statistics, correlations, receiver operating characteristics, and the Youdin index. Regression was also performed to further study the relationship among the variables. Complete data were available for 78.6% of the graduates. Of these participants, 94% passed the licensing exam on their first attempt. Receiver operating characteristics revealed that the area under the curve for clerkship in-training evaluation reports was 0.67 (p<.05) and 0.66 (p<.05) for residency program directors assessments. Corresponding Youdin indices for in-training evaluation reports and residency program director assessments were 0.30 and 0.23, respectively. Although clerkship in-training evaluation reports and residency program director ratings are significant predictors of pass-fail performance on the MCCQE Part II, the effectiveness of each one to predict pass-fail performance was relatively small. Reasons for these findings are discussed.

  18. Evaluation of Medical Education virtual Program: P3 model

    PubMed Central

    REZAEE, RITA; SHOKRPOUR, NASRIN; BOROUMAND, MARYAM

    2016-01-01

    Introduction: In e-learning, people get involved in a process and create the content (product) and make it available for virtual learners. The present study was carried out in order to evaluate the first virtual master program in medical education at Shiraz University of Medical Sciences according to P3 Model. Methods: This is an evaluation research study with post single group design used to determine how effective this program was. All students 60 who participated more than one year in this virtual program and 21 experts including teachers and directors participated in this evaluation project. Based on the P3 e-learning model, an evaluation tool with 5-point Likert rating scale was designed and applied to collect the descriptive data. Results: Students reported storyboard and course design as the most desirable element of learning environment (2.30±0.76), but they declared technical support as the less desirable part (1.17±1.23). Conclusion: Presence of such framework in this regard and using it within the format of appropriate tools for evaluation of e-learning in universities and higher education institutes, which present e-learning curricula in the country, may contribute to implementation of the present and future e-learning curricula efficiently and guarantee its implementation in an appropriate way. PMID:27795971

  19. Is the Medical School a Proper Part of the University?

    ERIC Educational Resources Information Center

    Saxon, David S.

    1976-01-01

    The aloofness of those in the medical schools from general faculty and students and the still narrow education of medical students are considered to be among the causes of the deep problems facing modern medicine. The current state of American medicine is assessed in this regard. (Author/LBH)

  20. Is the Medical School a Proper Part of the University?

    ERIC Educational Resources Information Center

    Saxon, David S.

    1976-01-01

    The aloofness of those in the medical schools from general faculty and students and the still narrow education of medical students are considered to be among the causes of the deep problems facing modern medicine. The current state of American medicine is assessed in this regard. (Author/LBH)

  1. 5 CFR 339.205 - Medical evaluation programs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Medical evaluation programs. 339.205... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives...

  2. 5 CFR 339.205 - Medical evaluation programs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Medical evaluation programs. 339.205... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives...

  3. 5 CFR 339.205 - Medical evaluation programs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Medical evaluation programs. 339.205... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives...

  4. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3) Urinalysis...

  5. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations. 456... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.170 Medical, psychiatric... beneficiary's need for care in the hospital; and appropriate professional personnel must make a...

  6. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Medical, psychiatric, and social evaluations. 456... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.170 Medical, psychiatric... beneficiary's need for care in the hospital; and appropriate professional personnel must make a...

  7. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Medical, psychiatric, and social evaluations. 456... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.170 Medical, psychiatric... beneficiary's need for care in the hospital; and appropriate professional personnel must make a...

  8. 5 CFR 339.205 - Medical evaluation programs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Medical evaluation programs. 339.205... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives...

  9. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    ERIC Educational Resources Information Center

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  10. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    ERIC Educational Resources Information Center

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  11. Part-Time Faculty Evaluation: A Mirage.

    ERIC Educational Resources Information Center

    Andrews, Hans A.

    1987-01-01

    Stresses the importance of faculty evaluation in continuing education and community service programs. Discusses the shortcomings of student evaluations. Identifies key steps in evaluation (i.e., establishing minimum qualifications, providing orientation to teaching, conducting in-class observations and evaluations, and taking follow-up action).…

  12. Part-Time Faculty Evaluation: A Mirage.

    ERIC Educational Resources Information Center

    Andrews, Hans A.

    1987-01-01

    Stresses the importance of faculty evaluation in continuing education and community service programs. Discusses the shortcomings of student evaluations. Identifies key steps in evaluation (i.e., establishing minimum qualifications, providing orientation to teaching, conducting in-class observations and evaluations, and taking follow-up action).…

  13. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456.482 Medical... under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370 must...

  14. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456.482 Medical... under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370 must...

  15. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456.482 Medical... under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370 must...

  16. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456.482 Medical... under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370 must...

  17. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456.482 Medical... under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370 must...

  18. Dermatology - a compulsory part of the UK medical school curriculum?

    PubMed

    Shah, Hemal; Pozo-Garcia, Lucia; Koulouroudias, Marinos

    2015-01-01

    Dermatological conditions form a significant number of consultations seen by general practitioners on a daily basis. There is a lack of training and formal assessment of dermatology during medical school and we propose that there should be a mandatory component in OSCEs for dermatology during medical school to enhance one's diagnostic and clinical reasoning skills which will ultimately lead to better care for the patient and efficacious use of NHS resources.

  19. Medical Education: Barefoot Doctors, Health Care, Health Education, Nursing Education, Pharmacy Education, Part I.

    ERIC Educational Resources Information Center

    Parker, Franklin

    1987-01-01

    This is part I of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1925 to 1983. Most of the references are from the 1970's. (RH)

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

    ERIC Educational Resources Information Center

    Dubowitz, Howard

    1998-01-01

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

  1. Medical evaluations on the KC-135 1990 flight report summary

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.; Guess, Terrell M.; Whiting, Charles W.; Doarn, Charles R.

    1991-01-01

    The medical investigations completed on the KC-135 during FY 1990 in support of the development of the Health Maintenance Facility and Medical Operations are discussed. The experiments are comprised of engineering evaluations of medical hardware and medical procedures. The investigating teams are made up of both medical and engineering personnel responsible for the development of medical hardware and medical operations. The hardware evaluated includes dental equipment, a coagulation analyzer, selected pharmaceutical aerosol devices, a prototype air/fluid separator, a prototype packaging and stowage system for medical supplies, a microliter metering system, and a workstation for minor surgical procedures. The results of these engineering evaluations will be used in the design of fleet hardware as well as to identify hardware specific training requirements.

  2. [Medical evaluation of the climacteric patient].

    PubMed

    Forsbach, G; Lozano, P; Pinto, E; González, O; Calderón, L; Martínez, R; Martínez, G

    1995-10-01

    A pilot program with primary care physicians was established in Clinica Cuauhtémoc y Famosa, focused to evaluate women older than 35 years with climateric symptoms. This program included a survey, a complete gynecological examination with Pap smears, ultrasound pelvic examination and mamography. Also, blood samples were collected for cholesterol, tryglycerides, calcium, phosphorus and alkaline phosphatase. An ECG, bone densitometry of the radius and X-rays of the vertebral column were obtained. This group was formed by 69 women with an age media of 50 years (SD 7.6 years, median 49 years). The survey disclosed that 34/65 women had been hysterectomized, and only 34/64 had received antitetanic immunization in the last 10 years. A preexistent chronic disease occurred in 36/59 women, these were diabetes mellitus, arterial hypertension or degenerative osteoarthritis. Alcohol consumption was recorded in 5/66 women and tabac consumption in 9/66 women, and 32/68 women accepted to be sedentary. Laboratory examinations disclosed hypercholesterolemia in 19/66 women and hypertryglyceridemia in 8/64 women. Osteopenia was detected in 33/60 women. This findings support a systematic plan to provide medical assistance for women in this age, specially if previous epidemiologycal studies have disclosed that coronary disease is the main cause of death for women older than 50 years in this region, that also belongs to the area of highest incidence of diabetes.

  3. Is There a Relationship Between Part D Medication Adherence and Part C Intermediate Outcomes Star Ratings Measures?

    PubMed

    Ta, Jamie T; Erickson, Sara C; Qiu, Wenyi Amanda; Patel, Bimal V

    2016-07-01

    Improvements in the Centers for Medicare & Medicaid Services (CMS) star ratings Part D medication adherence measures may affect performance in Part C intermediate outcome measures for which the Part D targeted medication classes are prescribed. To determine if Part D medication adherence measures are associated with corresponding Part C intermediate outcome measures. This was a cross-sectional analysis using the CMS 2015 star ratings report (based on 2013 benefit year plan data) for Medicare contracts. The measures of interest included the Part D adherence measures for diabetes medications, antihypertensive agents, and statins and the Part C intermediate outcome measures for controlled blood sugar, blood pressure, and cholesterol. All Medicare Advantage Prescription Drug (MAPD) contracts with complete data for all Part C and D measures of interest were included. Contracts with ≥ 25% of total enrollment with MA-only benefit were excluded. Linear and logistic regression models were used to assess the association between 2015 Part D adherence measures and Part C intermediate outcome measures (n = 366). The regression models were adjusted for low-income subsidy (LIS) beneficiary enrollment and log-transformed (natural logarithm) total contract enrollment. Bivariate linear regression models demonstrated moderate positive associations between each of the 2015 Part D adherence scores and related 2015 Part C measures that explained 27%-29% (R(2)) of variance. Including LIS and total contract enrollment in the regression models increased the R2 to 30%-36%. The multivariate logistic regression models showed that each percentage point of improvement in the 2015 Part D adherence measures was associated with a 4.13 to 4.69 greater odds of performing in the top quartile in corresponding 2015 Part C measures. Moderate positive associations were observed between the Part D and Part C scores in the same benefit year. MAPD plans may observe improved Part C intermediate outcome

  4. Medical evaluations on the KC-135 1991 flight report summary

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.

    1993-01-01

    The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.

  5. 23 CFR Appendix E to Part 1240 - Determination of Federal Medical Savings

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Determination of Federal Medical Savings E Appendix E to Part 1240 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION... SEAT BELT USE RATES Pt. 1240, App. E Appendix E to Part 1240—Determination of Federal Medical Savings...

  6. Evaluation of problem-based learning in medical students' education.

    PubMed

    Imanieh, Mohammad Hadi; Dehghani, Seyed Mohsen; Sobhani, Ahmad Reza; Haghighat, Mahmood

    2014-01-01

    In traditional medical education systems much interest is placed on the cramming of basic and clinical facts without considering their applicability in the future professional career. The aim of this study is to evaluate a novice medical training method (problem-based learning) as compared to the contemporary teacher-based medical education or traditional methods. Selection of the study subjects was done through simple sampling and according to the division of medical students introduced from Medical Faculty to the Pediatrics Department with no personal involvement. 120 medical students were assigned to 8 groups of 15 students each. For four months, 4 groups were trained with traditional method and 4 other groups underwent problem-based learning method on selected subject materials. In each method, a pre-course test at the beginning and a post-course test at the end of each course were given to each group. The questionnaire used in this study as the instrument was composed of 39 questions, 37 multiple choice questions and two short answer questions. Three professors of pediatric gastroenterologist took part in the training. Two of these professors were responsible for solving task training method. The third professor used traditional teacher-centered methodology to eliminate any possible bias. Scores obtained from these tests were analyzed using paired t-test and independent t-test. P-values of less than 0.05 were considered as significant. The scores of the students undergoing the traditional method were 14.70±3.03 and 21.20±4.07 in the first and second test, respectively. In problem-based learning, the scores were 15.82±3.29 in the first and 27.52±4.72 in the second test. There was a significant difference between the mean scores of post-course exams of the two groups (p=0.001), while no significant difference was observed between the mean scores of pre-course exams of the groups (p=0.550). It may be concluded that problem-based learning method leads to a

  7. The development and evaluation of a new coding system for medical records.

    PubMed

    Papazissis, Elias

    2014-01-01

    The present study aims to develop a simple, reliable and easy tool enabling clinicians to codify the major part of individualized medical details (patient history and findings of physical examination) quickly and easily in routine medical practice, by entering data to a purpose-built software application, using structure data elements and detailed medical illustrations. We studied medical records of 9,320 patients and we extracted individualized medical details. We recorded the majority of symptoms and the majority of findings of physical examination into the system, which was named IMPACT® (Intelligent Medical Patient Record and Coding Tool). Subsequently the system was evaluated by clinicians, based on the examination of 1206 patients. The evaluation results showed that IMPACT® is an efficient tool, easy to use even under time-pressing conditions. IMPACT® seems to be a promising tool for illustration-guided, structured data entry of medical narrative, in electronic patient records.

  8. Faculty Evaluation of Educational Strategies in Medical Schools.

    ERIC Educational Resources Information Center

    Das, Mandira; And Others

    1994-01-01

    This study sought to evaluate faculty opinion of existing medical curricula in two medical schools in different countries in terms of six educational strategies using the "SPICES continuum." Significant differences between existing educational plans of the two medical schools were identified. (LZ)

  9. Faculty Evaluation of Educational Strategies in Medical Schools.

    ERIC Educational Resources Information Center

    Das, Mandira; And Others

    1994-01-01

    This study sought to evaluate faculty opinion of existing medical curricula in two medical schools in different countries in terms of six educational strategies using the "SPICES continuum." Significant differences between existing educational plans of the two medical schools were identified. (LZ)

  10. Medical Laboratory Science: An International Comparison for Credentials Evaluators.

    ERIC Educational Resources Information Center

    Turner, Solveig M.; Karlsson, Britta

    Information is presented to help medical technology schools abroad evaluate their credentials in comparison to U.S. requirements. After defining the subfields of medical technology, also called medical laboratory science, a summary is provided of the educational requirements, the professional titles, and the certification recognition of medical…

  11. 78 FR 26681 - Medical Criteria for Evaluating Cystic Fibrosis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... ADMINISTRATION RIN 0960-AF58 Medical Criteria for Evaluating Cystic Fibrosis AGENCY: Social Security... additional information regarding this teleconference, please contact Cheryl Williams, Office of Medical... disability benefits. 3. Information we received from medical experts and members of the public. 4. Proposed...

  12. Reform of the Method for Evaluating the Teaching of Medical Linguistics to Medical Students

    ERIC Educational Resources Information Center

    Zhang, Hongkui; Wang, Bo; Zhang, Longlu

    2014-01-01

    Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…

  13. Reform of the Method for Evaluating the Teaching of Medical Linguistics to Medical Students

    ERIC Educational Resources Information Center

    Zhang, Hongkui; Wang, Bo; Zhang, Longlu

    2014-01-01

    Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…

  14. Electromagnetic pulse (EMP), Part I: Effects on field medical equipment

    SciTech Connect

    Vandre, R.H.; Klebers, J.; Tesche, F.M.; Blanchard, J.P. )

    1993-04-01

    The electromagnetic pulse (EMP) from a high-altitude nuclear detonation has the potential to cover an area as large as the continental United States with damaging levels of EMP radiation. In this study, two of seven items of medical equipment were damaged by an EMP simulator. Computer circuit analysis of 17 different items showed that 11 of the 17 items would be damaged by current surges on the power cords, while two would be damaged by current surges on external leads. This research showed that a field commander can expect approximately 65% of his electronic medical equipment to be damaged by a single nuclear detonation as far as 2,200 km away.

  15. Shuttle Orbiter medical system equipment/supplies evaluation

    NASA Technical Reports Server (NTRS)

    Maidlow, Kristin; Schulz, John M.; Lloyd, Charles W.; Breeding, Tiffany

    1991-01-01

    The effectivity was evaluated in zero gravity of several medical equipment and supply items flown in the Shuttle Orbiter Medical System (SOMS). Several procedures listed in Medical Operations Medical Checklist, JSC 1732 were also evaluated. Several items were drawn out of the kits and tested on the KC-135. In two different flights, the following elements were examined: (1) measuring IV flow (drip chamber, one way flow valve, and air/fluid separator); (2) chemstrip protocol for urine analysis in zero-gravity; and (3) tamper resistant seals for injectable medications.

  16. Quantitative Evaluation of Management Courses: Part 1

    ERIC Educational Resources Information Center

    Cunningham, Cyril

    1973-01-01

    The author describes how he developed a method of evaluating and comparing management courses of different types and lengths by applying an ordinal system of relative values using a process of transmutation. (MS)

  17. Medicare Part D benzodiazepine exclusion and use of psychotropic medication by patients with new anxiety disorders.

    PubMed

    Ong, Michael K; Zhang, Lily; Xu, Haiyong; Azocar, Francisca; Ettner, Susan L

    2012-07-01

    The Medicare Modernization Act (MMA) specifically excluded benzodiazepines from Medicare Part D coverage starting in 2006; however, benzodiazepines are an effective, low-cost treatment for anxiety. This study evaluated the effect of the Medicare Part D benzodiazepine coverage exclusion among patients with new anxiety disorders. The authors used a quasi-experimental cohort design to study patients with new anxiety diagnoses from a large national health plan during the first six months of 2005, 2006, and 2007. Logistic and zero-truncated negative-binomial regression models using covered claims for behavioral, medical, and pharmaceutical care linked with eligibility files were used to estimate utilization and costs of psychotropic medication and health care utilization among elderly Medicare Advantage enrollees (N=8,397) subject to the MMA benzodiazepine exclusion and a comparison group of near-elderly (ages 60–64) enrollees (N=1,657) of a managed care plan. Medicare Advantage enrollees diagnosed in 2005 had significantly (p<.05) higher rates of covered claims for benzodiazepines and all psychotropic drugs, lower rates of covered claims for nonbenzodiazepines, and lower expenditures for psychotropic drugs than enrollees diagnosed in 2006 and 2007. There were no significant differences over time in utilization or expenditures related to psychotropic medication among the comparison group. There also were no significant changes over time in outpatient visits for behavioral care by either cohort. Among elderly patients with new anxiety diagnoses, the MMA benzodiazepine exclusion increased use of nonbenzodiazepine psychotropic drugs without substitution of increased behavioral care. Overall, the exclusion was associated with a modest increase in covered claims for psychotropic medication.

  18. Association of potentially inappropriate medication use with patient and prescriber characteristics in Medicare Part D.

    PubMed

    Holmes, Holly M; Luo, Ruili; Kuo, Yong-Fang; Baillargeon, Jacques; Goodwin, James S

    2013-07-01

    The use of potentially inappropriate medications (PIMs) in older people is associated with increased risk of adverse drug events and hospitalization. This study aimed to determine the contribution of primary prescribers to variation in PIM use. This was a retrospective cohort study using 2008 Medicare Part D event files and claims data for a 100% sample of Texas beneficiaries. PIM use was defined as receiving any of 48 medications on the Beers 2003 list of PIMs. Patient characteristics associated with PIM use were determined using a multivariable model. A multilevel model for the odds of PIM use was constructed to evaluate the amount of variation in PIM use at the level of primary care prescriber, controlling for patient characteristics. Of 677,580 patients receiving prescriptions through Part D in 2008, 31.9% received a PIM. Sex, ethnicity, low-income subsidy eligibility, and hospitalization in 2007 were associated with PIM use. The strongest associations with higher PIM use were increasing number of prescribers and increasing number of medications. The odds ratio for PIM use was 1.50 (95%CI 1.47-1.53) for ≥4 prescribers versus only 1 prescriber. In the multilevel model, the adjusted average percent of patients prescribed a PIM ranged from 17.5% for the lowest decile to 28.9% for the highest decile of prescribers. PIM use was prevalent in Part D beneficiaries and varied among individual primary care prescribers. The association of PIM use with increasing numbers of prescribers suggests the need to reduce fragmentation of care to reduce inappropriate prescribing. Copyright © 2013 John Wiley & Sons, Ltd.

  19. Noncognitive Evaluation of Medical Training: A Paracognitive Approach.

    ERIC Educational Resources Information Center

    Raffetto, Allen M.; Zabarenko, Lucy M.

    1979-01-01

    Paracognitive evaluation of medical training recognizes the linkage between training and specific maturational trends. After administering the Paracognitive Evaluation Form to assess medical students' performance in seminars and clinical teaching situations, hierarchical cluster analysis suggested that maturational trends were measured and that…

  20. Evaluating quantitative research designs: Part 1.

    PubMed

    Haughey, B P

    1994-10-01

    This article has provided an overview of the three major types of quantitative designs commonly used in nursing research, as well as some criteria for evaluating the designs of published research. The next column will include additional criteria for critiquing quantitative research designs.

  1. Alternative Learning Programs Evaluation: Part 1 Report.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability Services/Research.

    In North Carolina, Alternative Learning Programs (ALP) is a designation applied to a variety of activities, locations, and student characteristics. This report focuses on descriptive information about the state's ALP efforts, teachers, and the students they serve. Two hundred and fifteen schools and programs met the evaluation criteria as ALPs.…

  2. Observations on medical device design, Part II: Good practice.

    PubMed

    Alexander, K; Clarkson, J; Bishop, D

    1999-10-01

    Current guidance on design is inadequate. This second article in a two-part series presents a framework for good design practice that attempts to improve designers' awareness of manufacturing and validation issues. Seven design tactics, derived from observations of current industry practice and design literature, seek to encourage good practice and achieve safer, more profitable devices.

  3. 78 FR 16614 - Medicare Program; Medicare Hospital Insurance (Part A) and Medicare Supplementary Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... Medicare Program; Medicare Hospital Insurance (Part A) and Medicare Supplementary Medical Insurance (Part B... following the denial of a Part A inpatient hospital claim by a Medicare review contractor on the basis that... Inpatient Billing in Hospitals,'' to propose a permanent policy that would apply on a prospective basis...

  4. Peer Evaluations--A Necessary Part of Evaluating Teaching Effectiveness.

    ERIC Educational Resources Information Center

    Lichty, Richard W.; Peterson, Jerrold M.

    The use of peer evaluation in assessing teaching effectiveness is discussed and two techniques that utilize peer evaluation are explained in this paper. Peer evaluation is viewed as a comprehensive measure of teaching effectiveness and a necessary supplement to student evaluation of teacher performance. It is suggested that this method be carried…

  5. Anatomy in the Third Reich: an outline, part 2. Bodies for anatomy and related medical disciplines.

    PubMed

    Hildebrandt, S

    2009-11-01

    All anatomical departments of German universities used bodies of the executed and other victims of the National Socialist (NS) regime for their work. Many of these victims had been executed in prisons and were members of the German political opposition; others had perished in camps for prisoners of war or forced laborers and concentration camps, and were of various European and other descent. Anatomists generally welcomed the increased influx of "fresh material" for purposes of research and education of the growing numbers of medical students. No anatomist is known to have refused work with the bodies of NS victims. Other medical disciplines also made use of these bodies, among them were racial hygienists and neuropathologists. In the late 19th and early 20th century, the fields of anatomy, physical anthropology, and racial hygiene (eugenics) were closely related in their subject matter. Anatomists were involved in the biological foundation of racial hygiene, most prominently among them Eugen Fischer. The discipline was established as part of the medical curriculum after 1920. Racial hygiene became the scientific justification for NS policies that led to racial discrimination, involuntary sterilization and ultimately mass murder. Anatomists taught racial hygiene throughout the Third Reich and did research in this area. Some were actively involved in NS policies through propaganda and evaluations for the so-called Genetic Health Courts, whereas others became victims of their own science in that they were dismissed for racial reasons.

  6. The program evaluation of services in a primary care clinic: attaining a medical home.

    PubMed

    Kleinsorge, Christy A; Roberts, Michael C; Roy, Kimberlee M; Rapoff, Michael A

    2010-06-01

    A program evaluation of a pediatric primary care training clinic was conducted using the criteria of a "medical home" set forth by the American Academy of Pediatrics (AAP). A total of 107 parents completed questionnaires regarding demographics, satisfaction with care, and questions related to the definition of medical home. Medical providers completed questionnaires regarding demographics, job satisfaction, and community resources. Parents reported acceptable levels of satisfaction with the quality of care provided, and the essential parts of the medical home definition were met. There were several areas that were designated as having room for improvement, including shortening clinic wait times and instructing the medical providers to be more sensitive to cultural differences in beliefs about health and wellness. The concepts of medical home set forth by the AAP are attainable for pediatric primary care clinics, but routine evaluations may be needed to ensure that goals continue to be met.

  7. A plea for a discipline of health and medical evaluation.

    PubMed

    Henderson, M M; Meinert, C L

    1975-03-01

    There is an expanding need for quantitative information to evaluate health and medical care procedures. Existing methods for designing and carrying out evaluation studies need to be improved to provide better techniques for answering questions on efficacy of health and medical procedures, and in providing a more adequate information base on which to set healthy policy. This paper reviews some of the problems in the design and conduct of evaluation research, and makes a plea for creation of a special discipline to support and develop the field of health and medical care evaluation.

  8. Narrowing the gap between medical and mental health evaluation.

    PubMed

    Linn, M W; Linn, S B

    1975-07-01

    Some of the problems facing evaluators of medical care have been dealt with by individuals examining mental health programs. Mental health research has focused more on outcome studies that include a multidimensional approach in evaluation. Techniques have been devised in that field that make the evaluative process patient specific and goal oriented. Borrowing some of these methods to make medical care evaluation include a problem-oriented outcome, which incorporates patient satisfaction, compliance with medical therapy, and relief of symptoms, could lead to more accurate data on the health delivery system.

  9. Evaluation of alarm systems for medical equipment.

    PubMed

    Hyman, W A

    1982-01-01

    The provision of automatic alarm systems on medical equipment is generally designed to supplement the user's ability to monitor a variety of device and patient variables simultaneously. The potential value of such systems in improving the safety and efficacy of medical care is accompanied by the potential for false reliance on or other misuse of the alarm systems. Therefore the alarm provisions become an important aspect of clinical engineering assessment of equipment with respect to selection, user training, hazard analysis, and the provision of effective and appropriate preventive maintenance programs.

  10. Part-Time Faculty Evaluation: A Campus Case Study.

    ERIC Educational Resources Information Center

    Williams, James P.

    For the past 13 years, the Verde Valley Campus of Yavapai College, in Arizona, has used the same system to evaluate part-time faculty in an effort to both maintain quality control and provide feedback to part-time faculty and address their concerns. The system utilizes two instruments to gather evaluative data. The first is used to determine…

  11. Using Complexity Theory to Guide Medical School Evaluations.

    PubMed

    Jorm, Christine; Roberts, Chris

    2017-07-03

    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.

  12. The biostatistical theory versus the harmful dysfunction analysis, part 1: is part-dysfunction a sufficient condition for medical disorder?

    PubMed

    Wakefield, Jerome C

    2014-12-01

    Christopher Boorse's biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield's harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze Boorse's central argument for the sufficiency claim, the "pathologist argument," which takes pathologists' intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion.

  13. Triterpene saponins from barrel medic (Medicago truncatula) aerial parts.

    PubMed

    Kapusta, Ireneusz; Stochmal, Anna; Perrone, Angela; Piacente, Sonia; Pizza, Cosimo; Oleszek, Wieslaw

    2005-03-23

    Triterpene saponins from Medicago truncatula aerial parts have been separated and their structures determined by the extensive use of 1D- and 2D-NMR experiments including 1H-1H (DQF-COSY, 1D-TOCSY) and 1H-13C (HSQC, HMBC) spectroscopy along with ESIMS. Fifteen individual compounds were isolated that included seven medicagenic acid and eight zanhic acid glycosides. Additionally, two soyasapogenol B and soyasapogenol E glycosides were identified by MS/MS and TLC. Four medicagenic acid glycosides (5, 11, 12, 14) and eight zanhic acid glycosides (1-4, 6-9) are reported here for the first time. The common feature of M. truncatula aerial part saponins is the (1-->3) linkage between the two glucose units at C-3 of medicagenic and zanhic acids, which is different from that found in alfalfa (Medicago sativa), where this linkage was always (1-->2). This may suggest differences in glucosyltransferases between these two Medicago species.

  14. A Report on the Feasibility and Design of a Longitudinal Tracking System for Evaluating the Effects of Medical Student Preceptorships on Career Development Processes and Dispositions. Final Report-Part I.

    ERIC Educational Resources Information Center

    Mitchell, Wayne

    The Career Development and Information System (CDIS) is a longitudinal tracking system addressing itself to the distribution of new physicians in underserved areas, and in the field of primary health care as opposed to a specialty. It is comprised of several computerized modules. The Comprehensive Research, Evaluation and Assessment Module (CREAM)…

  15. A Report on the Feasibility and Design of a Longitudinal Tracking System for Evaluating the Effects of Medical Student Preceptorships on Career Development Processes and Dispositions. Final Report-Part I.

    ERIC Educational Resources Information Center

    Mitchell, Wayne

    The Career Development and Information System (CDIS) is a longitudinal tracking system addressing itself to the distribution of new physicians in underserved areas, and in the field of primary health care as opposed to a specialty. It is comprised of several computerized modules. The Comprehensive Research, Evaluation and Assessment Module (CREAM)…

  16. MEDICAL RECORD TECHNOLOGY, A COURSE OF STUDY DESIGNED FOR COOPERATIVE PART-TIME STUDENTS EMPLOYED IN MEDICAL RECORD LIBRARIES.

    ERIC Educational Resources Information Center

    KARNES, JAMES B.

    DESIGNED FOR USE BY ELEVENTH GRADE COOPERATIVE PART-TIME STUDENTS EMPLOYED IN MEDICAL RECORD LIBRARIES, THIS GUIDE MAY ALSO BE USED IN AREA VOCATIONAL OR POST-HIGH SCHOOL SETTINGS. IT WAS DEVELOPED BY A CONSULTANT COMMITTEE, TEACHER EDUCATORS, AND RESEARCH ASSISTANTS AT THE STATE LEVEL AND REVISED AFTER USE IN THE FIELD. THE CONTENT OBJECTIVES ARE…

  17. 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.

  18. Part-time and full-time medical specialists, are there differences in allocation of time?

    PubMed Central

    de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

    2006-01-01

    Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part

  19. Part-time and full-time medical specialists, are there differences in allocation of time?

    PubMed

    de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

    2006-03-03

    An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part-time work is not only a female

  20. Radiofrequency identification and medical devices: the regulatory framework on electromagnetic compatibility. Part I: medical devices.

    PubMed

    Censi, Federica; Mattei, Eugenio; Triventi, Michele; Bartolini, Pietro; Calcagnini, Giovanni

    2012-05-01

    Radiofrequency identification (RFID) technology has acheived significant success and has penetrated into various areas of healthcare. Several RFID-based applications are used in various modalities with the ultimate aim of improving patient care. When a wireless technology is used in a healthcare environment, attention must be paid to the potential risks deriving from its use; one of the most important being electromagnetic interference with medical devices. In this paper, the regulatory framework concerning the electromagnetic compatibility between RFID and medical devices is analyzed to understand whether and how the application of the current standards allows for the effective control of the risks of electromagnetic interference.

  1. Evaluation of information literacy status among medical students at Shiraz University of Medical Sciences.

    PubMed

    Bazrafkan, Leila; Hayat, Ali Asghar; Abbasi, Karim; Bazrafkan, Aghdas; Rohalamini, Azadeh; Fardid, Mozhgan

    2017-01-01

    The information literacy status and the use of information technology among students in the globalization age of course plans are very momentous. This study aimed to evaluate the information literacy status and use of information technology among medical students of Shiraz University of Medical Sciences in 2013. This was a descriptive-analytical study with cross-sectional method. The study population consisted of all medical students (physiopathology, externship and internship) studying at Shiraz University of Medical Sciences. The sample size (n=310) was selected by systematic random sampling. The tool of data gathering was LASSI questionnaire (assigned by America research association) with 48 closed items in five-point LIKERT scale. The questionnaire included two distinct parts of demographic questions and the information literacy skills based on the standards of information literacy capacities for academic education. The content validity was acquired by professors' and experts' comments. The reliability was also calculated by Cronbach'salpha (0.85). Data were analyzed in both descriptive (frequency- mean) and analytical level (t-test, analysis of variance) using SPSS 14 software. 60.3% of the participants were females, and the remaining (29.7%) were males. The mean score of information literacy and its five subgroups among the students weren't at a desirable level. The mean scores of information literacy for educational grades from the highest to lowest belonged to the internship, physiopathology and externship. The results showed that the highest average was related to the effective access ability to information among interns (9.27±3.57) and the lowest one was related to the ability of understanding legal and economical cases related with using information among externs (3.11±1.32).The results of ANOVA showed that there wasn't a significant difference between educational grades and information literacy. Finally, the result of independent t-test did not show a

  2. Evaluation of information literacy status among medical students at Shiraz University of Medical Sciences

    PubMed Central

    BAZRAFKAN, LEILA; HAYAT, ALI ASGHAR; ABBASI, KARIM; BAZRAFKAN, AGHDAS; ROHALAMINI, AZADEH; FARDID, MOZHGAN

    2017-01-01

    Introduction: The information literacy status and the use of information technology among students in the globalization age of course plans are very momentous. This study aimed to evaluate the information literacy status and use of information technology among medical students of Shiraz University of Medical Sciences in 2013. Methods: This was a descriptive-analytical study with cross-sectional method. The study population consisted of all medical students (physiopathology, externship and internship) studying at Shiraz University of Medical Sciences. The sample size (n=310) was selected by systematic random sampling. The tool of data gathering was LASSI questionnaire (assigned by America research association) with 48 closed items in five-point LIKERT scale. The questionnaire included two distinct parts of demographic questions and the information literacy skills based on the standards of information literacy capacities for academic education. The content validity was acquired by professors’ and experts’ comments. The reliability was also calculated by Cronbach’salpha (0.85). Data were analyzed in both descriptive (frequency- mean) and analytical level (t-test, analysis of variance) using SPSS 14 software. Results: 60.3% of the participants were females, and the remaining (29.7%) were males. The mean score of information literacy and its five subgroups among the students weren’t at a desirable level. The mean scores of information literacy for educational grades from the highest to lowest belonged to the internship, physiopathology and externship. The results showed that the highest average was related to the effective access ability to information among interns (9.27±3.57) and the lowest one was related to the ability of understanding legal and economical cases related with using information among externs (3.11±1.32).The results of ANOVA showed that there wasn’t a significant difference between educational grades and information literacy. Finally, the

  3. Service Learning in Medical Education: Project Description and Evaluation

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Hartung, Paul J.

    2007-01-01

    Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…

  4. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3) Urinalysis... weight and vital signs at least once every 24 hours while the inmate is on a hunger strike....

  5. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3) Urinalysis... weight and vital signs at least once every 24 hours while the inmate is on a hunger strike....

  6. The Paucity of Course Work in Medical Care Evaluation

    ERIC Educational Resources Information Center

    Carroll, Jean; Becker, Selwyn

    1975-01-01

    In view of the current emphasis on measurement of the quality of health care services, reflected in regulatory provisions and accreditation requirements, an inquiry was made as to the extent to which medical schools are offering formal training in the techniques of medical care evaluation. (Editor)

  7. Evaluation of a Medical School for Rural Doctors

    ERIC Educational Resources Information Center

    Inoue, Kazuo; Matsumoto, Masatoshi; Sawada, Tsutomu

    2007-01-01

    Context: Jichi Medical School (JMS) is the first and only medical school in Japan that was founded exclusively to graduate/prepare rural doctors. Purpose: To evaluate the long-term effect of JMS on the nationwide distribution of doctors. Methods: Data from the Japanese population census of 1995 and from the Japanese physician census of 1994 were…

  8. Evaluation of a Rural Clinic Rotation for Medical Residents

    ERIC Educational Resources Information Center

    And Others; Crandall, Lee A.

    1978-01-01

    Medical students, nursing students, and residents from the University of Florida College of Medicine live and work for several weeks in a rural county health center, providing a wide range of primary care and emergency medical services. Retrospective evaluations by participants are reported. (LBH)

  9. Medication acquisition by veterans dually eligible for Veterans Affairs and Medicare Part D pharmacy benefits.

    PubMed

    Stroupe, Kevin T; Smith, Bridget M; Bailey, Lauren; Adas, Jamal; Gellad, Walid F; Suda, Katie; Huo, Zhiping; Tully, Sean; Burk, Muriel; Cunningham, Francesca

    2017-02-01

    The patterns of medication acquisition for veterans dually eligible for pharmacy benefits from the Department of Veterans Affairs (VA) and Medicare Part D-reimbursed pharmacies were examined. The characteristics of veterans who used pharmacies reimbursed by (1) VA only, (2) both VA and Part D-reimbursed, and (3) Part D-reimbursed only pharmacies in 2009 were compared and their medication types and sources examined. Pharmacy usage was measured as the number of 30-day medication supplies and the number of different drug classes that veterans received from VA and Part D-reimbursed pharmacies. Chi-square testing and analysis of variance were used to compare unadjusted patient characteristics and healthcare utilization. A total of 145,899 veterans with any VA or Part D-reimbursed pharmacy use were included in the study: 69.6% used VA pharmacies only, 9.9% used VA and Part D-reimbursed pharmacies, and 20.5% used Part D-reimbursed pharmacies only. Veterans who lived in rural areas, were non-Black, had VA medication copayments, or were dual or Medicare-only outpatient users were more likely to be dual or Part D-reimbursed only pharmacy users (p < 0.001). Dual pharmacy users received more 30-day supplies than did the other two pharmacy-use groups (p < 0.001). Nearly one third of VA users received medications from Part D-reimbursed pharmacies, either alone or together with VA pharmacies. Among dual pharmacy users, over half received medications from the same drug class from both VA and Part D-reimbursed pharmacies for which the days' supplies overlapped by more than seven days. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Teaching and evaluation methods of medical ethics in the Saudi public medical colleges: cross-sectional questionnaire study

    PubMed Central

    2013-01-01

    Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing. PMID:24020917

  11. Teaching and evaluation methods of medical ethics in the Saudi public medical colleges: cross-sectional questionnaire study.

    PubMed

    Alkabba, Abdulaziz F; Hussein, Ghaiath M A; Kasule, Omar H; Jarallah, Jamal; Alrukban, Mohamed; Alrashid, Abdulaziz

    2013-09-10

    Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing.

  12. Medical Care Evaluation: An Old New Idea

    ERIC Educational Resources Information Center

    Christoffel, Tom

    1976-01-01

    The systematic measurement of the quality of patient care based on outcome data is becoming a part of the delivery of that care. The author reviews the history of an early approach developed and crusaded by Dr. E. A. Codman 60 years ago and suggests some lessons it holds for today's health care professionals. (Editor/JT)

  13. Accreditation of Veterinary Medical Education: Part II--Influence of the American Veterinary Medical Association

    ERIC Educational Resources Information Center

    Bauer, Elizabeth K.

    1975-01-01

    Traces the development, since its founding in 1863, of the American Veterinary Medical Association (AVMA) influence over the standards of training required in the veterinary profession. Attention is focused on the roles of the U.S. Department of Agriculture, the military, and the land-grant colleges in that development. (JT)

  14. 78 FR 25521 - Revised Medical Criteria for Evaluating Visual Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... From the Federal Register Online via the Government Publishing Office SOCIAL SECURITY ADMINISTRATION Revised Medical Criteria for Evaluating Visual Disorders AGENCY: Social Security Administration. ACTION: Final rules; Correction. SUMMARY: The Social Security Administration published a document in the...

  15. Medical evaluation and treatment of urolithiasis.

    PubMed

    Nicoletta, Julie A; Lande, Marc B

    2006-06-01

    Nephrolithiasis is responsible for 1 in 1000 to 1 in 7600 pediatric hospital admissions annually throughout the United States. Seventy-five percent of children with nephrolithiasis have an identifiable predisposition to stone formation. This article reviews the different causes and disease states associated with nephrolithiasis in the pediatric population. The initial evaluation and the metabolic evaluation of children with nephrolithiasis are reviewed. Treatment modalities for the different stone types are also described.

  16. A basket two-part model to analyze medical expenditure on interdependent multiple sectors.

    PubMed

    Sugawara, Shinya; Wu, Tianyi; Yamanishi, Kenji

    2016-09-01

    This study proposes a novel statistical methodology to analyze expenditure on multiple medical sectors using consumer data. Conventionally, medical expenditure has been analyzed by two-part models, which separately consider purchase decision and amount of expenditure. We extend the traditional two-part models by adding the step of basket analysis for dimension reduction. This new step enables us to analyze complicated interdependence between multiple sectors without an identification problem. As an empirical application for the proposed method, we analyze data of 13 medical sectors from the Medical Expenditure Panel Survey. In comparison with the results of previous studies that analyzed the multiple sector independently, our method provides more detailed implications of the impacts of individual socioeconomic status on the composition of joint purchases from multiple medical sectors; our method has a better prediction performance.

  17. Increasing Medicare part D enrollment in medication therapy management could improve health and lower costs.

    PubMed

    Stuart, Bruce; Loh, F Ellen; Roberto, Pamela; Miller, Laura M

    2013-07-01

    Targeting efforts to improve medication adherence, especially among people with high health needs, can improve health and lower health care spending. To this end, Medicare requires that insurance plans that provide prescription drug (Part D) coverage offer specialized medication therapy management services to optimize medication use for enrollees with high drug costs, multiple chronic diseases, and multiple covered drugs. We analyzed a large random sample of Part D enrollees with diabetes, heart failure, and chronic obstructive pulmonary disease, to see whether poor adherence to recommended drugs was associated with higher Medicare costs. We found that beneficiaries with poor adherence had higher costs, ranging from $49 to $840 per month for patients with diabetes, for example. However, such beneficiaries were not uniformly more likely than others to be eligible for medication therapy management services. Aligning medication therapy management eligibility with a metric such as potentially preventable future costs holds promise for both improving the quality of care and reducing spending.

  18. [Continuity of medical care. Evaluation of a collaborative program between hospital and Primary Care].

    PubMed

    Fernández Moyano, A; García Garmendia, J L; Palmero Palmero, C; García Vargas-Machuca, B; Páez Pinto, J M; Alvarez Alcina, M; Aparicio Santos, R; Benticuaga Martines, M; Delgado de la Cuesta, J; de la Rosa Morales, R; Escorial Moya, C; Espinosa Calleja, R; Fernández Rivera, J; González-Becerra, C; López Herrero, E; Marín Fernández, Y; Mata Martín, A M; Ramos Guerrero, A; Romero Rivero, M J; Sánchez-Dalp, M; Vallejo Maroto, I

    2007-11-01

    The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike.

  19. Medical Education: Barefoot Doctors, Health Care, Health Education, Nursing Education, Pharmacy Education, Part II.

    ERIC Educational Resources Information Center

    Parker, Franklin

    1987-01-01

    This is Part II of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1913 to 1982. Most of the references are from the 1960's and 1970's. (RH)

  20. [A changing medical and economic world: complex diseases and interest in economic evaluation of health technologies].

    PubMed

    Hiligsmann, M; Reginster, J-Y

    2012-01-01

    Medical advances and increasing life expectancy have indirectly contributed to the development of chronic complex diseases. Chronic diseases, which last for a lifetime, are responsible, at least in part, for the increase in health care expenditures which poses new challenges to healthcare systems. Under increasing economic pressure, it has become increasingly important to efficiently allocate scarce healthcare resources. By comparing costs and effects of health interventions, health economic evaluation is a powerful tool to help decision makers to make rational decisions. This article introduces the methods for the economic evaluation of health care programs and discusses the challenges of using economic evaluation in medical decision making.

  1. A social media self-evaluation checklist for medical practitioners.

    PubMed

    Visser, Benjamin J; Huiskes, Florian; Korevaar, Daniel A

    2012-01-01

    Increasing numbers of medical practitioners and medical students are using online social and business-related networking websites such as Facebook, Doc2doc and LinkedIn. These rapidly evolving and growing social media have potential to promote public health by providing powerful instruments for communication and education. However, evidence is emerging from studies, legal cases, and media reports that the use of these new technologies is creating several ethical problems for medical practitioners as well as medical students. Improper online activities may harm not only individual reputations and careers, but also the medical profession as a whole, for example by breach of patient confidentiality, defamation of colleagues and employers, undisclosed conflict of interests that bias the medical practitioner's medical advice, posting of advice/information without an evidence base, and infringement of copyright. We developed a self-evaluation checklist for medical practitioners using social media. The checklist addresses three key elements in the use of social media: personal information and accessibility, connections, and postings. It contains questions specifically formulated to evaluate a medical practitioner's social media profile, to prevent unintended, improper online activities and to promote professional online behaviour.

  2. Medical image database for software and algorithm evaluation

    NASA Astrophysics Data System (ADS)

    dos Santos, Marcelo; Furuie, Sergio S.

    2005-04-01

    This work presents the development of a framework to make available a free, online, multipurpose and multimodality medical image database for software and algorithm evaluation. We have implemented a distributed architecture for medical image database, including authoring, storage, and repository for documents and image processing software. The system aims to offer a complete test bed and a set of resources including software, link to scientific papers, gold standards, reference images and post-processed images, enabling medical image processing community (scientists, physicians, students and industrials) to be more aware of evaluation issues. Our focus of development was on convenience and easy of use of a generic system adaptable to different contexts.

  3. Development of a state medical surge plan, Part II: Components of a medical surge plan.

    PubMed

    Moser, Royce; Connelly, Colleen; Baker, Lloyd; Barton, Richard; Buttrey, Jan; Morris, Stephen; Saffle, Jeffrey; Whitney, Jolene R

    2006-01-01

    In 2003, the Utah State Department of Health received funding from the Health Resources and Services Administration to develop a medical surge plan to increase the number of available hospital beds in the state by 1250 beds, including 125 beds for burn or critical trauma patients. A prior article discussed the planning procedures and process. This article describes the major components of the plan, including analysis of threats, direction and control, activation and system response; communications; and critical issues.

  4. Evaluating the impact of the humanities in medical education.

    PubMed

    Wershof Schwartz, Andrea; Abramson, Jeremy S; Wojnowich, Israel; Accordino, Robert; Ronan, Edward J; Rifkin, Mary R

    2009-08-01

    The inclusion of the humanities in medical education may offer significant potential benefits to individual future physicians and to the medical community as a whole. Debate remains, however, about the definition and precise role of the humanities in medical education, whether at the premedical, medical school, or postgraduate level. Recent trends have revealed an increasing presence of the humanities in medical training. This article reviews the literature on the impact of humanities education on the performance of medical students and residents and the challenges posed by the evaluation of the impact of humanities in medical education. Students who major in the humanities as college students perform just as well, if not better, than their peers with science backgrounds during medical school and in residency on objective measures of achievement such as National Board of Medical Examiners scores and academic grades. Although many humanities electives and courses are offered in premedical and medical school curricula, measuring and quantifying their impact has proven challenging because the courses are diverse in content and goals. Many of the published studies involve self-selected groups of students and seek to measure subjective outcomes which are difficult to measure, such as increases in empathy, professionalism, and self-care. Further research is needed to define the optimal role for humanities education in medical training; in particular, more quantitative studies are needed to examine the impact that it may have on physician performance beyond medical school and residency. Medical educators must consider what potential benefits humanities education can contribute to medical education, how its impact can be measured, and what ultimate outcomes we hope to achieve.

  5. 34 CFR Appendix A to Part 379 - Evaluation Standards

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Evaluation Standards A Appendix A to Part 379 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROJECTS WITH INDUSTRY Pt. 379, App. A Appendix A to Part 379...

  6. 34 CFR Appendix A to Part 379 - Evaluation Standards

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Evaluation Standards A Appendix A to Part 379 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROJECTS WITH INDUSTRY Pt. 379, App. A Appendix A to Part...

  7. 34 CFR Appendix A to Part 379 - Evaluation Standards

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Evaluation Standards A Appendix A to Part 379 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROJECTS WITH INDUSTRY Pt. 379, App. A Appendix A to Part...

  8. 34 CFR Appendix A to Part 379 - Evaluation Standards

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Evaluation Standards A Appendix A to Part 379 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROJECTS WITH INDUSTRY Pt. 379, App. A Appendix A to Part...

  9. 34 CFR Appendix A to Part 379 - Evaluation Standards

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Evaluation Standards A Appendix A to Part 379 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROJECTS WITH INDUSTRY Pt. 379, App. A Appendix A to Part...

  10. Medication adherence and patient outcomes: part 2: interventions and resources to overcome low health literacy.

    PubMed

    Petty, Janet L

    2013-01-01

    This article explores the influence of health literacy on medication adherence. With health literacy skills nearly flat for over a decade and an aging population receiving multiple and complex medication regimens, literacy is becoming a more important factor in nursing assessment and intervention. Concrete tools are provided to help the clinical nurse specialist (CNS) assess literacy and evaluate written resources for patient education and to improve medication adherence.

  11. [Evaluation in medical residency training programs].

    PubMed

    Kolokythas, O; Patzwahl, R; Straka, M; Binkert, C

    2016-01-01

    For resident doctors the acquisition of technical and professional competence is decisive for the successful practice of their activities. Competency and professional development of resident doctors benefit from regular self-reflection and assessment by peers. While often promoted and recommended by national educational authorities, the implementation of a robust evaluation process in the clinical routine is often counteracted by several factors. The aim of the study was to test a self-developed digital evaluation system for the assessment of radiology residents at our institute for practicality and impact with regard to the radiological training. The intranet-based evaluation system was implemented in January 2014, which allowed all Radiology consultants to submit a structured assessment of the Radiology residents according to standardized criteria. It included 7 areas of competency and 31 questions, as well as a self-assessment module, both of which were filled out electronically on a 3-month basis using a 10-point scale and the opportunity to make free text comments. The results of the mandatory self-evaluation by the residents were displayed beside the evaluation by the supervisor. Access to results was restricted and quarterly discussions with the residents were conducted confidentially and individually. The system was considered to be practical to use and stable in its functionality. The centrally conducted anonymous national survey of residents revealed a noticeable improvement of satisfaction with the institute assessment for the criterion "regular feedback"compared to the national average. Since its implementation the system has been further developed and extended and is now available for other institutions.

  12. Fit for purpose? Evaluation of an MSc. in medical physics.

    PubMed

    van der Putten, W J

    2014-05-01

    The National University of Ireland in Galway established a Master in Science (MSc.) program in medical physics in 2002. The course was designed to be 90 ECTS(1) credits and of one calendar year duration. From the outset the MSc. was designed to be part of an overall medical physics training program. MSc. programs are now widely used as part of the training and education of medical physicists. There is however paucity of data on the effectiveness of such courses and the purpose of the study reported here is to provide information on one particular MSc. course in medical physics. This is relevant to medical physicists who are involved in the development and running of medical physics training programs. The study used as methodology the Kirkpatrick levels of professional training. It was conducted through an online survey, both from students who graduated from the course and from students who were in the process of completing the course. The survey proved to be an effective way to determine attributes of modules such as learning outcomes, knowledge imparted, quality of teaching materials and others. The survey proved to be remarkably able to demonstrate interventions in the individual course modules. Although the course was shown to be effective in the imparting of the knowledge required to become a qualified medical physicist several areas for improvement were identified. These are mainly in the areas of increased practical experience and in course delivery. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. The paucity of course work in medical care evaluation.

    PubMed

    Carroll, J; Becker, S

    1975-01-01

    In view of the current emphasis on measurement of the quality of health care services, reflected in regulatory provisions and accreditation requirements, an inquiry was made as to the extent to which medical schools are presently offering formal training in the techniques of medical care evaluation. Of 118 medical schools surveyed, 24 responded with the information that they are actually providing such training. The training reported ranged from a one-hour lecture to five elective courses. The implications of the findings are discussed with reference to the need of physicians to become familiar with the principles and methods of scientific evaluation of medical care. Some of the areas that might be covered in courses on evaluation are discussed, and examples of two current programs are given.

  14. Effective monitoring and evaluation of military humanitarian medical operations.

    PubMed

    Waller, Stephen G; Powell, Clydette; Ward, Jane B; Riley, Kevin

    2011-01-01

    Non-military government agencies and non-governmental organizations (NGOs) have made great strides in the evaluation of humanitarian medical work, and have learned valuable lessons regarding monitoring and evaluation (M&E) that may be equally as valuable to military medical personnel. We reviewed the recent literature by the worldwide humanitarian community regarding the art and science of M&E, with focus toward military applications. The successes and failures of past humanitarian efforts have resulted in prolific analyses. Alliances of NGOs set the standard for humanitarian quality and M&E standards. Military medical personnel can apply some of these standards to military humanitarian M&E in complex and stability operations. The authors believe that the NGO community?s M&E standards should be applied to improve evaluation of U.S. military medical humanitarian operations.

  15. Cost-related Nonadherence by Medication Type among Medicare Part D Beneficiaries with Diabetes

    PubMed Central

    Williams, Jessica; Steers, W. Neil; Ettner, Susan L.; Mangione, Carol M.; Duru, O. Kenrik

    2013-01-01

    Background Despite the rollout of Medicare Part D, cost-related non-adherence (CRN) among older adults remains a problem. Objectives To examine the rate and correlates of self-reported CRN among a population of older persons with diabetes. Research Design Cross-sectional. Subjects 1,264 Part D patients with diabetes, who entered the coverage gap in 2006. Measures Initial administrative medication lists were verified in computer-assisted telephone interviews, in which participants brought their medication bottles to the phone. Medications were classified into cardiometabolic (diabetes, hypertension, cholesterol-lowering), symptom relief, and “other.” Participants were asked if they had any cost-related non-adherence during 2006, and if so to which medication/s. We used the person-medication dyad as the unit of analysis, and tested a multivariate random effects logistic regression model to analyze the correlates of CRN. Results Approximately 16% of participants reported any CRN. CRN was more frequent for cholesterol-lowering medications [Relative risk 1.54, 95%CI 1.01-2.32] compared to medications taken for symptom relief. CRN was reported less frequently with increasing age above 75 years, compared to patients between 65 and 69. In addition, compared to those with incomes >$40,000, CRN risk for those with incomes <$25,000 was markedly higher [RR 3.05, 95%CI 1.99-4.65]. Conclusions In summary, we found high rates of CRN among Medicare beneficiaries with diabetes, particularly those with lower incomes. We observed more frequent CRN for cholesterol-lowering medications as compared to medications for symptom relief. Efforts to ensure medication affordability for this population will be important in boosting adherence to key medications. PMID:23032359

  16. [MEDICAL AND SOCIAL INSPECTION AS A PART OF THE REHABILITATION OF CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS].

    PubMed

    Dudnyk, V M; Popov, V P; Skakyn, Z A; Gumynska, G S; Vinnichuk, L L; Marchuk, O I

    2015-01-01

    Provided evaluation of the medical and social inspection of the dcotrors-consultative commission of Vinnytsya regional childrens hospital in children with juvenile rheumatoid arthritis (JRA). Patients with JRA that got position of the child-invalid are given individual program of the rehabilitation that includes medical, professional, sport and physical, social adaptation that gives ability control recommendations for both--physicians and parents.

  17. Brand Medications and Medicare Part D: How Eye Care Providers' Prescribing Patterns Influence Costs.

    PubMed

    Newman-Casey, Paula Anne; Woodward, Maria A; Niziol, Leslie M; Lee, Paul P; De Lott, Lindsey B

    2017-06-16

    To quantify costs of eye care providers' Medicare Part D prescribing patterns for ophthalmic medications and to estimate the potential savings of generic or therapeutic drug substitutions and price negotiation. Retrospective cross-sectional study. Eye care providers prescribing medications through Medicare Part D in 2013. Medicare Part D 2013 prescriber public use file and summary file were used to calculate medication costs by physician specialty and drug. Savings from generic or therapeutic drug substitutions were estimated for brand drugs. The potential savings from price negotiation was estimated using drug prices negotiated by the United States Veterans Administration (USVA). Total cost of brand and generic medications prescribed by eye care providers. Eye care providers accounted for $2.4 billion in total Medicare part D prescription drug costs and generated the highest percentage of brand name medication claims compared with all other providers. Brand medications accounted for a significantly higher proportion of monthly supplies by volume, and therefore, also by total cost for eye care providers compared with all other providers (38% vs. 23% by volume, P < 0.001; 79% vs. 56% by total cost, P < 0.001). The total cost attributable to eye care providers is driven by glaucoma medications, accounting for $1.2 billion (54% of total cost; 72% of total volume). The second costliest category, dry eye medications, was attributable mostly to a single medication, cyclosporine ophthalmic emulsion (Restasis, Allergan, Irvine, CA), which has no generic alternative, accounting for $371 million (17% of total cost; 4% of total volume). If generic medications were substituted for brand medications when available, $148 million would be saved (7% savings); if generic and therapeutic substitutions were made, $882 million would be saved (42% savings). If Medicare negotiated the prices for ophthalmic medications at USVA rates, $1.09 billion would be saved (53% savings). Eye care

  18. ‘Potentially Driver Impairing’ (PDI) Medication Use in Medically Impaired Adults Referred for Driving Evaluation

    PubMed Central

    Hetland, Amanda J.; Carr, David B.; Wallendorf, Michael J.; Barco, Peggy P.

    2013-01-01

    Background ‘Potentially driver impairing’ (PDI) medications, described in the literature, have been associated with poorer driving performance and increased risk of motor vehicle collision. Objectives The primary aim of this study was to describe frequency of medication use, as well as to determine the association between routine use of PDI medications and performance on driving and cognitive tests. Methods 225 drivers with medical impairment (mean age 68 ± 12.8 years, 62.2% male) were referred to an occupational therapy based driving evaluation clinic and examined in this retrospective cohort study. Medication lists were provided by an informant at the time of evaluation and reviewed to identify PDI drugs, defined by a recent study examining drugs with crash risk. Outcome variables included road testing on the mWURT and cognitive scores on TMT-A, SMT®, CDT, DHI® Useful Field of View, and DHI® Motor Free Visual Perceptual Test, ESS, GDS, and FAQ. Results The frequency of PDI medication use was 68.9% within our sample, with the average subject taking 1.4 PDI drugs. These drivers taking routine PDI medications had a mean Epworth Sleepiness Scale (ESS) score of 7.8, whereas subjects not taking PDI medications had a mean score of 6.0 points, indicative of a higher degree of daytime sleepiness in the PDI medication group (p = 0.007). Total number of routine medications, regardless of PDI designation, also correlated positively with ESS scores (p = 0.023). Conclusions Polypharmacy and the use of PDI medications were common in this sample. Use of these drugs was associated with informant ratings of daytime drowsiness on the ESS, which has been linked to motor vehicle crash risk. We recommend further investigation into the effects of individual drug classes, using larger sample sizes and a high powered study design. PMID:24473491

  19. Evaluation of medication use in Malaysian predialysis patients.

    PubMed

    Salman, Muhammad; Khan, Amer Hayat; Adnan, Azreen Syazril; Syed Sulaiman, Syed Azhar; Shehzadi, Naureen; Asif, Nauman; Hussain, Khalid; Saleem, Fahad; Raza, Muhammed Hussnain; Farooq, Muhammad Shahid

    2017-01-01

    Chronic kidney disease (CKD) patients suffer from multiple comorbidities and complications as a cause or consequence of kidney disease. Information regarding medication- prescribing patterns in predialysis patients is sparse. We conducted a retrospective study to evaluate the medication prescription patterns among predialysis patients. Medical records (both paper based and computerized) of patients at CKD Resource Centre, Hospital Universiti Sains Malaysia, were reviewed. A total of 615 eligible cases were included in the study. The mean number of medications prescribed per patient was 8.22 ± 2.81, and medication use was correlated to the renal function (stage 3a < stage 3b < stage 4 < stage 5; P <0.001). The top three prescribed medication groups were found to be lipid-lowering agents, calcium channel blockers, and antiplatelet agents. Some medication classes such as nonaluminum/noncalcium phosphate binders, erythropoietin-stimulating agents, and renin-angiotensin-aldosterone system blockers, particularly in advanced stage, were found to be underutilized. In conclusion, predialysis patients are prescribed a large number of medications. Our findings highlight the need for assessing the impact of current medication-prescribing patterns on morbidity and mortality rates in Malaysian predialysis population.

  20. Characteristics, satisfaction, and engagement of part-time faculty at U.S. medical schools.

    PubMed

    Pollart, Susan M; Dandar, Valerie; Brubaker, Linda; Chaudron, Linda; Morrison, Leslie A; Fox, Shannon; Mylona, Elza; Bunton, Sarah A

    2015-03-01

    To describe the demographics of part-time faculty at U.S. medical schools and to examine their satisfaction with and perceptions of their workplace. Faculty from 14  Liaison Committee on Medical Education-accredited U.S. medical schools participated in the 2011-2012 Faculty Forward Engagement Survey. The authors calculated descriptive statistics of part-time faculty respondents and used ANOVA and t test analyses to assess significant differences between and among demographic groups. The survey yielded an overall response rate of 62% (9,600/15,490). Of the part-time faculty respondents, most had appointments in clinical departments (634/674; 94%) and were female (415/674; 62%). Just over 80% (384/474) reported a full-time equivalent of 0.5 or higher. The majority of part-time faculty respondents reported satisfaction with their department and medical school as a place to work (372/496 [75%] and 325/492 [66%]); approximately half agreed that their institution had clear expectations for part-time faculty (210/456; 46%) and provided the resources they needed (232/457; 51%). Significant differences existed between part- and full-time faculty respondents regarding perceptions of growth opportunities and compensation and benefits, with part-time faculty respondents feeling less satisfied in these areas. As institutions work to improve the satisfaction of full-time faculty, they should do the same for part-time faculty. Understanding why faculty choose part-time work is important in encouraging the recruitment and retention of the most talented faculty. The findings of this study indicate multiple opportunities to improve the satisfaction and engagement of part-time faculty.

  1. 42 CFR 456.243 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Content of medical care evaluation studies. 456.243... Ur Plan: Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care evaluation study must— (a) Identify and analyze medical or administrative factors related to...

  2. 42 CFR 456.143 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Content of medical care evaluation studies. 456.143...: Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care evaluation study must— (a) Identify and analyze medical or administrative factors related to the hospital's...

  3. Measuring medical students' orientation toward lifelong learning: a psychometric evaluation.

    PubMed

    Wetzel, Angela P; Mazmanian, Paul E; Hojat, Mohammadreza; Kreutzer, Kathleen O; Carrico, Robert J; Carr, Caroline; Veloski, Jon; Rafiq, Azhar

    2010-10-01

    The principle of lifelong learning is pervasive in regulations governing medical education and medical practice; yet, tools to measure lifelong learning are lagging in development. This study evaluates the Jefferson Scale of Physician Lifelong Learning (JeffSPLL) adapted for administration to medical students. The Jefferson Scale of Physician Lifelong Learning-Medical Students (JeffSPLL-MS) was administered to 732 medical students in four classes. Factor analysis and t tests were performed to investigate its construct validity. Maximum likelihood factor analysis identified a three-factor solution explaining 46% of total variance. Mean scores of clinical and preclinical students were compared; clinical students scored significantly higher in orientation toward lifelong learning (P < .001). The JeffSPLL-MS presents findings consistent with key concepts of lifelong learning. Results from use of the JeffSPLL-MS may reliably inform curriculum design and education policy decisions that shape the careers of physicians.

  4. Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor.

    PubMed

    Stuart, Bruce; Hendrick, Franklin B; Shen, Xian; Dai, Mingliang; Tom, Sarah E; Dougherty, J Samantha; Miller, Laura M

    2016-09-01

    Medicare Part D prescription drug plans must offer medication therapy management to beneficiaries with multiple chronic conditions and high drug expenditures. However, plan sponsors have considerable latitude in setting eligibility criteria. Newly available data indicate that enrollment rates in medication therapy management among stand-alone prescription drug plans and Medicare Advantage drug plans averaged only 10 percent in 2012. The enrollment variation across plan sponsors-from less than 0.2 percent to more than 57.0 percent-was associated with the restrictiveness of their eligibility criteria. For example, enrollment was 16.4 percent in plans requiring two chronic conditions versus 9.2 percent in plans requiring three, and 12.7 percent in plans requiring the use of any Part D drug versus 4.4 percent in plans requiring the use of drugs in specific classes. This variation represents inequities in access to medication therapy management across plans and results in missed opportunities for interventions that might improve therapeutic outcomes and reduce spending. The new Part D Enhanced Medication Therapy Management model of the Centers for Medicare and Medicaid Services has the potential to significantly increase the impact of medication therapy management by aligning financial incentives with improvements in medication use and encouraging innovation. Project HOPE—The People-to-People Health Foundation, Inc.

  5. [Evaluation of work conditions for teachers of medical schools].

    PubMed

    Tregubova, E S; Nekhoroshev, A S

    2011-01-01

    Complex sanitary hygienic and sociologic evaluation of high school factors enabled to assign work conditions of medical institute lecturers according to P 2.2.2006 - to 05 for jeopardy and to 2 degree 3 class for hardiness and intensity of work, to define psychosocial risks as main hazards. The authors specified and suggested prophylactic system aimed to increase work efficiency of medical institute lecturers.

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

    PubMed

    Mellado, J M

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

  7. Radiology should be a required part of the medical school curriculum.

    PubMed

    Squire, L F; Novelline, R A

    1985-07-01

    The interests of the future medical community and its patients would be better served if radiology were made a part of the core curriculum in all 4 years in all medical schools so that it would be impossible to obtain an M.D. degree in this country without a thorough grounding in this vital subject. Radiology should no longer be an elective part of the curriculum now that so much of the study and practice of medicine depends on familiarity with imaging studies.

  8. Attitudes of the public to medical care: Part 5-Para-medical services.

    PubMed

    Dixon, C W; Dodge, J S; Emery, G M; Salmond, G C; Spears, G F

    1975-07-09

    A sample of the population of Auckland and Dunedin was asked a series of six questions concerning their attitude to para-medical services as provided by a Plunket nurse; a public health or school nurse; a district nurse; a medico-social worker from a hospital and the ambulance service. Analysis of the replies shows some differences in utilisation of specific services comparing one city to the other. Respondents' opinions on the methods of financing these services show a general vote for preservation of the status quo but with some increased Government support. These are indications that the public is unaware of current methods of financing such services. Public acceptance of the idea of employment of trained nurses and social workers in general practice was high and when the question was made more specific by referring to the respondent's own family doctor the acceptance was much higher. Reasons for non-acceptance do not indicate any major difficulties in the employment of such staff in general practice, at least as far as the patients are concerned.

  9. Medical Malpractice in Dermatology-Part I: Reducing the Risks of a Lawsuit.

    PubMed

    Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

    2016-12-01

    Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs. Herein, we discuss the primary sources of malpractice lawsuits delivered against healthcare practitioners including issues with informed consent, patient noncompliance, medical negligence, and inappropriate documentation, including use of electronic medical records. The overall goal is to effectively avoid these common sources of litigation. The risk management strategies discussed in this paper are relevant to the everyday practitioner and may offer physicians some degree of protection from potential liability.

  10. How Does Emergency Department Crowding Affect Medical Student Test Scores and Clerkship Evaluations?

    PubMed

    Wei, Grant; Arya, Rajiv; Ritz, Z Trevor; He, Albert S; Ohman-Strickland, Pamela A; McCoy, Jonathan V

    2015-11-01

    The effect of emergency department (ED) crowding has been recognized as a concern for more than 20 years; its effect on productivity, medical errors, and patient satisfaction has been studied extensively. Little research has reviewed the effect of ED crowding on medical education. Prior studies that have considered this effect have shown no correlation between ED crowding and resident perception of quality of medical education. To determine whether ED crowding, as measured by the National ED Overcrowding Scale (NEDOCS) score, has a quantifiable effect on medical student objective and subjective experiences during emergency medicine (EM) clerkship rotations. We collected end-of-rotation examinations and medical student evaluations for 21 EM rotation blocks between July 2010 and May 2012, with a total of 211 students. NEDOCS scores were calculated for each corresponding period. Weighted regression analyses examined the correlation between components of the medical student evaluation, student test scores, and the NEDOCS score for each period. When all 21 rotations are included in the analysis, NEDOCS scores showed a negative correlation with medical student tests scores (regression coefficient= -0.16, p=0.04) and three elements of the rotation evaluation (attending teaching, communication, and systems-based practice; p<0.05). We excluded an outlying NEDOCS score from the analysis and obtained similar results. When the data were controlled for effect of month of the year, only student test score remained significantly correlated with NEDOCS score (p=0.011). No part of the medical student rotation evaluation attained significant correlation with the NEDOCS score (p≥0.34 in all cases). ED overcrowding does demonstrate a small but negative association with medical student performance on end-of-rotation examinations. Additional studies are recommended to further evaluate this effect.

  11. A Quantitative Evaluation of Medication Histories and Reconciliation by Discipline

    PubMed Central

    Stewart, Michael R.; Fogg, Sarah M.; Schminke, Brandon C.; Zackula, Rosalee E.; Nester, Tina M.; Eidem, Leslie A.; Rosendale, James C.; Ragan, Robert H.; Bond, Jack A.; Goertzen, Kreg W.

    2014-01-01

    Abstract Background/Objective: Medication reconciliation at transitions of care decreases medication errors, hospitalizations, and adverse drug events. We compared inpatient medication histories and reconciliation across disciplines and evaluated the nature of discrepancies. Methods: We conducted a prospective cohort study of patients admitted from the emergency department at our 760-bed hospital. Eligible patients had their medication histories conducted and reconciled in order by the admitting nurse (RN), certified pharmacy technician (CPhT), and pharmacist (RPh). Discharge medication reconciliation was not altered. Admission and discharge discrepancies were categorized by discipline, error type, and drug class and were assigned a criticality index score. A discrepancy rating system systematically measured discrepancies. Results: Of 175 consented patients, 153 were evaluated. Total admission and discharge discrepancies were 1,461 and 369, respectively. The average number of medications per participant at admission was 8.59 (1,314) with 9.41 (1,374) at discharge. Most discrepancies were committed by RNs: 53.2% (777) at admission and 56.1% (207) at discharge. The majority were omitted or incorrect. RNs had significantly higher admission discrepancy rates per medication (0.59) compared with CPhTs (0.36) and RPhs (0.16) (P < .001). RPhs corrected significantly more discrepancies per participant than RNs (6.39 vs 0.48; P < .001); average criticality index reduction was 79.0%. Estimated prevented adverse drug events (pADEs) cost savings were $589,744. Conclusions: RPhs committed the fewest discrepancies compared with RNs and CPhTs, resulting in more accurate medication histories and reconciliation. RPh involvement also prevented the greatest number of medication errors, contributing to considerable pADE-related cost savings. PMID:25477614

  12. Orientation, Evaluation, and Integration of Part-Time Nursing Faculty.

    PubMed

    Carlson, Joanne S

    2015-07-10

    This study helps to quantify and describe orientation, evaluation, and integration practices pertaining to part-time clinical nursing faculty teaching in prelicensure nursing education programs. A researcher designed Web-based survey was used to collect information from a convenience sample of part-time clinical nursing faculty teaching in prelicensure nursing programs. Survey questions focused on the amount and type of orientation, evaluation, and integration practices. Descriptive statistics were used to analyze results. Respondents reported on average four hours of orientation, with close to half reporting no more than two hours. Evaluative feedback was received much more often from students than from full-time faculty. Most respondents reported receiving some degree of mentoring and that it was easy to get help from full-time faculty. Respondents reported being most informed about student evaluation procedures, grading, and the steps to take when students are not meeting course objectives, and less informed about changes to ongoing curriculum and policy.

  13. Visual servoing in medical robotics: a survey. Part II: tomographic imaging modalities--techniques and applications.

    PubMed

    Azizian, Mahdi; Najmaei, Nima; Khoshnam, Mahta; Patel, Rajni

    2015-03-01

    Intraoperative application of tomographic imaging techniques provides a means of visual servoing for objects beneath the surface of organs. The focus of this survey is on therapeutic and diagnostic medical applications where tomographic imaging is used in visual servoing. To this end, a comprehensive search of the electronic databases was completed for the period 2000-2013. Existing techniques and products are categorized and studied, based on the imaging modality and their medical applications. This part complements Part I of the survey, which covers visual servoing techniques using endoscopic imaging and direct vision. The main challenges in using visual servoing based on tomographic images have been identified. 'Supervised automation of medical robotics' is found to be a major trend in this field and ultrasound is the most commonly used tomographic modality for visual servoing. Copyright © 2014 John Wiley & Sons, Ltd.

  14. AMEE Medical Education Guide No. 23 (Part 2): Curriculum, environment, climate, quality and change in medical education - a unifying perspective.

    PubMed

    Genn, J M

    2001-01-01

    illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Consderations of climate in the medical school along the lines of continuous quality improvement and innovation are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations their quality of health and their longevity may be threatened.

  15. Program evaluation of an Integrated Basic Science Medical Curriculum in Shiraz Medical School, Using CIPP Evaluation Model.

    PubMed

    Rooholamini, Azadeh; Amini, Mitra; Bazrafkan, Leila; Dehghani, Mohammad Reza; Esmaeilzadeh, Zohreh; Nabeiei, Parisa; Rezaee, Rita; Kojuri, Javad

    2017-07-01

    In recent years curriculum reform and integration was done in many medical schools. The integrated curriculum is a popular concept all over the world. In Shiraz medical school, the reform was initiated by stablishing the horizontal basic science integration model and Early Clinical Exposure (ECE) for undergraduate medical education. The purpose of this study was to provide the required data for the program evaluation of this curriculum for undergraduate medical students, using CIPP program evaluation model. This study is an analytic descriptive and triangulation mixed method study which was carried out in Shiraz Medical School in 2012, based on the views of professors of basic sciences courses and first and second year medical students. The study evaluated the quality of the relationship between basic sciences and clinical courses and the method of presenting such courses based on the Context, Input, Process and Product (CIPP) model. The tools for collecting data, both quantitatively and qualitatively, were some questionnaires, content analysis of portfolios, semi- structured interview and brain storming sessions. For quantitative data analysis, SPSS software, version 14, was used. In the context evaluation by modified DREEM questionnaire, 77.75%of the students believed that this educational system encourages them to actively participate in classes. Course schedule and atmosphere of class were reported suitable by 87.81% and 83.86% of students. In input domain that was measured by a researcher made questionnaire, the facilities for education were acceptable except for shortage of cadavers. In process evaluation, the quality of integrated modules presentation and Early Clinical Exposure (ECE) was good from the students' viewpoint. In product evaluation, students' brain storming, students' portfolio and semi-structured interview with faculties were done, showing some positive aspects of integration and some areas that need improvement. The main advantage of assessing

  16. Screening and Evaluation of Medications for Treating Cannabis Use Disorder

    PubMed Central

    Panlilio, Leigh V.; Justinova, Zuzana; Trigo, Jose M.; Le Foll, Bernard

    2016-01-01

    Cannabis use has been increasingly accepted legally and in public opinion. However, cannabis has the potential to produce adverse physical and mental health effects and can result in cannabis use disorder (CUD) in a substantial percentage of both occasional and daily cannabis users. Many people have difficulty discontinuing use. Therefore, it would be beneficial to develop safe and effective medications for treating CUD. To achieve this, methods have been developed for screening and evaluating potential medications using animal models and controlled experimental protocols in human volunteers. In this chapter we describe: 1) animal models available for assessing the effect of potential medications on specific aspects of CUD; 2) the main findings obtained so far with these animal models; 3) the approaches used to assess potential medications in humans in laboratory experiments and clinical trials; and 4) the effectiveness of several potential pharmacotherapies on the particular aspects of CUD modeled in these human studies. PMID:27055612

  17. Economic evaluation of a Ninngen-dokku (medical checkup).

    PubMed

    Shimizu, T; Suzuki, T

    1993-04-01

    An economic evaluation of a medical checkup center (Ninngen-dokku, "human dry dock") was conducted from two perspectives: the cost for cancer checkup, and the cost for medical treatment after a diagnosis was obtained. We studied the cost of diagnosing cancer, compared with the cost required when cancer of an individual organ was detected through mass health testing, and studied the economics of a Ninngen-dokku according to Kawai's method of medical judgment. Assuming that the cost of death is more than the cost of saving the lives of persons who undergo the Ninngen-dokku, the Ninngen-dokku will be affordable. In the group undergoing the Ninngen-dokku compared with the group which did not, the estimated cost of medical treatment was reduced. The Ninngen-dokku carries advantages that cannot be quantified in financial terms; therefore, a multi-layered economic analysis of the Ninngen-dokku was required.

  18. Assessment of the scope and practice of evaluation among medical donation programs.

    PubMed

    Jenny, Alisa M; Li, Meng; Ashbourne, Elizabeth; Aldrink, Myron; Funk, Christine; Stergachis, Andy

    2016-11-04

    Medical donation programs for drugs, other medical products, training and other supportive services can improve access to essential medicines in low- and middle-income countries (LMICs) and provide emergency and disaster relief. The scope and extent to which medical donation programs evaluate their impact on recipients and health systems is not well documented. We conducted a survey of the member organizations of the Partnership for Quality Medical Donations (PQMD), a global alliance of non-profit and corporate organizations, to identify evaluations conducted in conjunction with donation programs. Twenty-five out of the 36 PQMD organizations that were members at the time of the survey participated in the study, for a response rate of 69 %. PQMD members provided information on 34 of their major medical donation programs. Half of the donation programs reported conducting trainings as a part of their donation program. Twenty-six (76 %) programs reported that they conduct routine monitoring of their donation programs. Less than 30 % of donation programs were evaluated for their impact on health. Lack of technical staff and lack of funding were reported as key barriers to conducting impact evaluations. Member organizations of PQMD provide a broad range of medical donations, targeting a wide range of public health issues and events. While some level of monitoring and evaluation was conducted in nearly 80 % of the donation programs, a program's impact was infrequently evaluated. Opportunities exist to develop consistent metrics for medical donation programs, develop a common framework for impact evaluations, and advocate for data collection and analysis plans that collect meaningful metrics.

  19. [Evaluation of the theoretical teaching of postgraduate medical students in France].

    PubMed

    Faivre, J-C; Agopiantz, M; Loeb, E; Cassinari, K; Wack, M; Catoire, P; Braun, M; Thilly, N; Coudane, H

    2015-09-01

    In France, medical students regularly complain about the shortcomings of their theoretical training and the necessity of its adaptation to better fit the needs of students. The goal was to evaluate the theoretical teaching practices in postgraduate medical studies by: 1) collecting data from medical students in different medical faculties in France; 2) comparing this data with expected practices when it is possible; 3) and proposing several lines of improvement. A survey of theoretical practices in the 3rd cycle of medical studies was conducted by self-administered questionnaires which were free of charge, anonymous, and administered electronically from July 3 to October 31, 2013 to all medical students in France. National, inter-regional, regional and field internship educational content was absent in respectively 50.5%, 42.8%, 26.0% and 30.2% of cases. Medical students follow complementary training due to insufficient DES and/or DESC 2 training in 43.7% of cases or as part of a professional project in 54.9% of cases. The knowledge sought by medical students concerns the following crosscutting topics: career development (58.9%), practice management (50.7%), medical English (50.4%) and their specialty organization (49.9%). Fifty-four point one percent would like to be evaluated on their theoretical training on an annual basis. The results of this first national survey give insights into the theoretical teaching conditions in postgraduate medical education in France and the aspirations of medical students. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  20. Evaluation of inherent performance of intelligent medical decision support systems: utilising neural networks as an example.

    PubMed

    Smith, A E; Nugent, C D; McClean, S I

    2003-01-01

    Researchers who design intelligent systems for medical decision support, are aware of the need for response to real clinical issues, in particular the need to address the specific ethical problems that the medical domain has in using black boxes. This means such intelligent systems have to be thoroughly evaluated, for acceptability. Attempts at compliance, however, are hampered by lack of guidelines. This paper addresses the issue of inherent performance evaluation, which researchers have addressed in part, but a Medline search, using neural networks as an example of intelligent systems, indicated that only about 12.5% evaluated inherent performance adequately. This paper aims to address this issue by concentrating on the possible evaluation methodology, giving a framework and specific suggestions for each type of classification problem. This should allow the developers of intelligent systems to produce evidence of a sufficiency of output performance evaluation.

  1. Research for medical illustrators. Part 2: Trial design, protocols, results and reporting.

    PubMed

    Young, S; Bellamy, K

    1997-09-01

    Medical illustrators have long been involved in the research projects of other workers, by providing photographic and other visual records. These illustrations may be used for measurement purposes, in which case it is important that medical illustrators understand the requirements for using tested protocols, which ensure that all variables of the recording medium are controlled. Now that there are degree courses in medical illustration an increasing number of medical illustrators in the UK are instigating their own research projects, making it all the more important that they understand the research process. In this second of a two-part article, consideration is given to: the design of experiments and research trials; the production of research protocols; data analysis and interpretation; the writing of the research report or dissertation; and the role of the supervisor or mentor.

  2. The Vanderbilt Professional Nursing Practice Program, part 2: Integrating a professional advancement and performance evaluation system.

    PubMed

    O'Hara, Nancy F; Duvanich, Mary; Foss, Julie; Wells, Nancy

    2003-10-01

    Developing a performance-based advancement system requires evaluation tools that capture essential behaviors and outcomes reflective of key nursing functions. To ensure relevance to clinical practice and enhance buy-in from nursing staff, the behaviors and outcomes were defined by a broad cross-section of nursing staff and administrators. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program under way at Vanderbilt University Medical Center. This second article describes the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the inception of the program. Additionally, the authors present the challenges and lessons we learned in development and implementation of a dynamic evaluation system that supports our career advancement program. The process of advancing within the program will be described in part 3.

  3. Quality evaluation in medical visualization: some issues and a taxonomy of methods

    NASA Astrophysics Data System (ADS)

    Santos, Beatriz S.; Dillenseger, Jean-Louis

    2005-04-01

    Among the several medical imaging stages (acquisition, reconstruction, etc.), visualization is the latest stage on which decision is generally taken. Scientific visualization tools allow to process complex data into a graphical visible and understandable form, the goal being to provide new insight. If the evaluation of procedures is a crucial issue and a main concern in medicine, paradoxically visualization techniques, predominantly in tri-dimensional imaging, have not been the subject of many evaluation studies. This is perhaps due to the fact that the visualization process integrates the Human Visual and Cognitive Systems, which makes evaluation especially difficult. However, as in medical imaging, the question of quality evaluation of a specific visualization remains a main challenge. While a few studies concerning specific cases have already been published, there is still a great need for definition and systemization of evaluation methodologies. The goal of our study is to propose such a framework, which makes it possible to take into account all the parameters taking part in the evaluation of a visualization technique. Concerning the problem of quality evaluation in data visualization in general, and in medical data visualization in particular, three different concepts appear to be fundamental: the type and level of components used to convey to the user the information contained in the data, the type and level at which evaluation can be performed, and the methodologies used to perform such evaluation. We propose a taxonomy involving types of methods that can be used to perform evaluation at different levels.

  4. Evaluation of a breaking bad news course for medical students.

    PubMed

    Cushing, A M; Jones, A

    1995-11-01

    This paper presents the evaluation of a Breaking Bad News course run for three groups of medical students (fourth and fifth year from the London Hospital Medical College and fourth year from St Bartholomew's Hospital Medical College). The course, which is student centred, uses group discussion, videotape presentations and role-play including actors. All teachers, clinicians and human science tutors, had been through a staff training programme on teaching methods. At the end of the course, students' knowledge of important principles in giving bad news had increased, particularly in relation to interpersonal communication; they were more confident in their ability to break bad news well; and the course learning methods were highly rated. The course was just as well received by fourth year as by fifth year students and several said they would like more of this training. The evaluation shows that if reservations about role-play can be overcome then this experiential learning is highly valued by students.

  5. Peer Dynamics Final Evaluation Report. 1979/1980. Part 1.

    ERIC Educational Resources Information Center

    Cooper, Cathy; Walker, Connie

    This is Part I of a final evaluation of a program designed to reduce the incidence of destructive risk-taking behavior (e.g. drug-alcohol abuse, and juvenile delinquency) among school-age youth. Background research indicates that peer group pressure is the single most important factor in dictating the presence or absence of juvenile delinquency…

  6. e-Learning in medical education Guide 32 Part 2: Technology, management and design.

    PubMed

    Masters, Ken; Ellaway, Rachel

    2008-06-01

    With e-learning now part of the medical education mainstream, both educational and practical technical and informatics skills have become an essential part of the medical teacher's portfolio. The Guide is intended to help teachers develop their skills in working in the new online educational environments, and to ensure that they appreciate the wider changes and developments that accompany this 'information revolution'. The Guide is divided into two parts, of which this is the second. The first part introduced the basic concepts of e-learning, e-teaching, and e-assessment, the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. This second part covers topics such as practical knowledge of the forms of technology used in e-learning, the behaviours of teachers and learners in online environments and the design of e-learning content and activities. It also deals with broader concepts of the politics and psychology of e-learning, as well as many of its ethical, legal and economical dimensions, and it ends with a review of emerging forms and directions in e-learning in medical education.

  7. [Part-time medical specialist training; experiences with job-sharing for trainee internists].

    PubMed

    Bevers, K; Nauta, S; Stuyt, P M

    2004-02-14

    Due to various factors such as social changes, an increasing number of couples with two incomes, and a growing proportion of female doctors, there has been a growing demand for part-time work in recent years. This is also true for resident physicians. Objections such as a discontinuity in care and the decline in the quality of education frequently prevent resident physicians from working part-time. Over the past two years, the University Medical Centre Nijmegen, the Netherlands, has experimented with job-sharing on clinical wards for resident physicians in internal medicine. This approach works well in practice, as long as a number of conditions, including the proper transfer of medical information and good communication, are satisfied. Job-sharing is one means of satisfying the growing demand for part-time work among resident physicians and specialists.

  8. Emergency Medical Technician Performance Evaluation. NCHSR Research Report Series.

    ERIC Educational Resources Information Center

    Frazier, William H.; Cannon, Joseph F.

    An evaluation was conducted of the diagnostic accuracy and treatment appropriateness of emergency medical technicians (EMTs) in caring for 4,455 consecutive patients during a four-and-one-half month period. Data on EMT diagnosis and treatment and physician diagnosis were collected, and EMT data validated by observers. There were fifty-eight…

  9. Evaluation of Continuing Medical Education for Chronic Obstructive Pulmonary Diseases.

    ERIC Educational Resources Information Center

    Li Wang, Virginia; And Others

    1979-01-01

    A continuing medical education program is discussed that addresses chronic obstructive pulmonary disease and that links primary care physicians to a source of needed clinical knowledge at a relatively low cost. The educational methods, evaluation design, diagnosis of educational needs, selection of program content and behavioral outcomes are…

  10. Development of a Psychotropic PRN Medication Evaluative Tool

    ERIC Educational Resources Information Center

    Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad

    2013-01-01

    This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all…

  11. Evaluation of Medical Nurse Practitioner Program: Participant Instrument No. 1.

    ERIC Educational Resources Information Center

    Rott, Robert K.

    This instrument was designed to provide a goal-free evaluation of a pilot training program for Medical Nurse Practitioners. With minor modification, the instrument can be applied to programs at several educational levels: secondary, college, adult, and continuing. The instrument uses 5-point Likert-type scales (with positive and negative…

  12. Teaching Evidence-based Medical Care: Description and Evaluation.

    ERIC Educational Resources Information Center

    Grad, Roland; Macaulay, Ann C.; Warner, Michelle

    2001-01-01

    Describes and evaluates a teaching initiative in evidence-based medical care in McGill University's family practice residency program. Discusses results of pre- and post-course self-assessments by students, which indicated significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews,…

  13. Implementation and Evaluation of a Medical Informatics Distance Education Program

    PubMed Central

    Hersh, William R.; Junium, Katherine; Mailhot, Mark; Tidmarsh, Patricia

    2001-01-01

    Objective: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area. Design: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation. Measurements: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions. Results: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students. Conclusion: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented. PMID:11687564

  14. Development of a Psychotropic PRN Medication Evaluative Tool

    ERIC Educational Resources Information Center

    Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad

    2013-01-01

    This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all…

  15. Considered Evaluation of Clinical Placements in a New Medical School

    ERIC Educational Resources Information Center

    Booth, Jerry; Collins, Sarah; Hammond, Anna

    2009-01-01

    This article suggests that quality assessment in the UK has been largely set apart from learning and teaching and reports on a pilot project at the Hull York Medical School which attempted to integrate students' evaluation of their clinical placements into the curriculum. It outlines the operational demands of this integrated method and compares…

  16. Charting the Winds of Change: Evaluating Innovative Medical Curricula.

    ERIC Educational Resources Information Center

    Friedman, Charles P.; And Others

    1990-01-01

    The Josiah Macy Jr. Foundation sponsored a conference to consider designs for evaluation studies and the potential distinctive outcomes of the innovative medical curricula that might be foci of these studies. Differences between graduates of innovative and traditional curricula which might be expected were identified. (Author/MLW)

  17. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland

    PubMed Central

    Nieminen, Pentti; Sipilä, Kirsi; Takkinen, Hanna-Mari; Renko, Marjo; Risteli, Leila

    2007-01-01

    Background Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. Methods A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. Results A high proportion of the theses (69.5%) were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%). Only 61 theses (23.8%) had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. Conclusion The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved. PMID:18053247

  18. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland.

    PubMed

    Nieminen, Pentti; Sipilä, Kirsi; Takkinen, Hanna-Mari; Renko, Marjo; Risteli, Leila

    2007-12-05

    Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. A high proportion of the theses (69.5%) were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%). Only 61 theses (23.8%) had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved.

  19. Evaluating patients' comprehensibility of a standardized medication plan.

    PubMed

    Botermann, Lea; Monzel, Katharina; Krueger, Katrin; Eickhoff, Christiane; Wachter, Angelika; Kloft, Charlotte; Laufs, Ulrich; Schulz, Martin

    2016-10-01

    A standardized medication plan for patients has been developed and recently enacted into German law depicting all medicines taken. It can only increase medication safety if patients use and understand it. We evaluated patients' comprehensibility of the medication plan and analyzed potential variables influencing patients' understanding. The medication plan template v2.0 was first tested in N = 40 patients, and the "Evaluation Tool to test the handling of the Medication Plan" (ET-MP) was developed, rating patients' understanding from 0 to 100 %. The cut-off, distinguishing if patients understand the medication plan, was set at 90 %. The ET-MP was then applied to an amended medication plan questioning N = 40 general internal medicine (GIM) and N = 50 patients with chronic heart failure (CHF). The mean (± standard deviation (SD)) age of the study cohort was 69 ± 13 years, 47 % female. Patients took 8 ± 3 drugs chronically. The CHF patients had a lower level of education compared to the GIM group (p = 0.004). The overall ET-MP score was 82 ± 21 % (GIM 86 ± 19 %, CHF 78 ± 23 %; p = 0.16). Forty-three percent achieved a score >90 %. A moderate correlation was found between the ET-MP score and the level of education (r = 0.45) and age (r = -0.46), respectively (both p < 0.001). Cognitively impaired CHF patients (p = 0.03) and patients with advanced CHF (p = 0.006) achieved a lower ET-MP score. In the CHF cohort, signs of depression or a lower level of self-care behaviour were not associated with a lower ET-MP score. The ET-MP is suitable to explore patients' understanding of a medication plan. Less than 50 % of the patients reached a score above 90 %. Higher age and lower level of education but not the diagnosis of CHF seem to correlate with impaired understanding of the standardized medication plan. In addition to a medication plan, a significant number of patients are in need of further and

  20. Understanding and applying the principles of contemporary medical professionalism: illustration of a suggested approach, part 2.

    PubMed

    Becker, Gary J

    2015-01-01

    In recent years, formal professionalism education, training, and assessment have been introduced to medical schools and accredited residency training programs. Current constructs of medical professionalism characterize it as a multidimensional competency rather than a trait. Medical professionalism is a belief system for organizing and delivering care, in which group members (medical professionals) promise patients and the public that they will self-regulate (ie, ensure that medical professionals live up to standards of competence and ethical values). Physicians who are good professionals have lapses in professionalism. Responses to professional lapses should focus on remediation. Failure of groups of professionals to enforce the standards and values can convey to patients and the public a lack of trustworthiness and thereby undermine the foundation of professionalism, the social contract. The Physician Charter sets forth the 3 fundamental principles and 10 commitments that offer guidance in some of the most challenging situations. One example is illustrated herein and is continued from Part 1 of this two-part series.

  1. Pharmacokinetics and interactions of headache medications, part I: introduction, pharmacokinetics, metabolism and acute treatments.

    PubMed

    Sternieri, Emilio; Coccia, Ciro Pio Rosario; Pinetti, Diego; Ferrari, Anna

    2006-12-01

    Recent progress in the treatment of primary headaches has made available specific, effective and safe medications for these disorders, which are widely spread among the general population. One of the negative consequences of this undoubtedly positive progress is the risk of drug-drug interactions. This review is the first in a two-part series on pharmacokinetic drug-drug interactions of headache medications. Part I addresses acute treatments. Part II focuses on prophylactic treatments. The overall aim of this series is to increase the awareness of physicians, either primary care providers or specialists, regarding this topic. Pharmacokinetic drug-drug interactions of major severity involving acute medications are a minority among those reported in literature. The main drug combinations to avoid are: i) NSAIDs plus drugs with a narrow therapeutic range (i.e., digoxin, methotrexate, etc.); ii) sumatriptan, rizatriptan or zolmitriptan plus monoamine oxidase inhibitors; iii) substrates and inhibitors of CYP2D6 (i.e., chlorpromazine, metoclopramide, etc.) and -3A4 (i.e., ergot derivatives, eletriptan, etc.), as well as other substrates or inhibitors of the same CYP isoenzymes. The risk of having clinically significant pharmacokinetic drug-drug interactions seems to be limited in patients with low frequency headaches, but could be higher in chronic headache sufferers with medication overuse.

  2. Evaluation of the Unified Medical Language System as a Medical Knowledge Source

    PubMed Central

    Bodenreider, Oliver; Burgun, Anita; Botti, Geneviève; Fieschi, Marius; Beux, Pierre Le; Kohler, François

    1998-01-01

    Abstract Objective: The authors evaluated the use of the Unified Medical Language System (UMLS) as a medical knowledge source for the representation of medical procedures in the MAOUSSC system. Design: MAOUSSC, a multiaxial coding system, was used for the representation of 1500 procedures from 15 clinical specialties, using UMLS concepts (augmented by full sources for three new vocabularies being added to the UMLS) and relationships whenever possible. Evaluation criteria for the UMLS included (1) completeness of representation of concepts and of inter-concept relationships, (2) consistency in the categorization of both concepts and inter-concept relationships, and (3) usability, including adaptability of the UMLS to a foreign language (French), its suitability to a geographic region with different medical practices than the USA, and issues relative to the annual update changes in the test vocabularies. Results: During the MAOUSSC trial, the number of missing concepts or relationships identified in the augmented UMLS sources was deemed to be inconsequential relative to overall project goals. “Missing” UMLS inter-concept relationships were identified, although they were small in number. Some inconsistencies in the UMLS were noted, especially in the area of hierarchic relationships. Conclusion: After UMLS was used for five years as a knowledge source for representing 1500 complex medical procedures in MAOUSSC, its value is considered significant. Future editions of the UMLS are expected to improve representation of inter-concept relationships and global consistency. PMID:9452987

  3. The changing role of economic evaluation in valuing medical technologies.

    PubMed

    Rotter, Jason S; Foerster, Douglas; Bridges, John Fp

    2012-12-01

    Economic evaluation is established within health-technology assessment but is challenged by those wanting to use economic evaluation to inform pricing and/or incorporate nontraditional sources of value and the views of diverse stakeholders. The changing role of economic evaluation in (formally or informally) assessing prices/values in four jurisdictions (UK, Australia, Germany and USA) is detailed and the authors propose a taxonomy of factors impacting the value of medical technology spanning clinical utility (effectiveness, safety/tolerability and quality of evidence), consumer demand (consumer preferences, process utility and unmet need), economic incentives (innovation, option value and market competition) and the societal perspective (social justice, social values and national interest). The authors suggest that multicriteria decision analysis methods grounded in hedonic-pricing theory can facilitate the valuing/pricing of medical technologies. The use of such an approach is hindered by a paucity of relevant educational opportunities, vested interests and aversion to placing prices/values on health.

  4. Evaluation of repatriation parameters: does medical history matter?

    PubMed

    Greuters, Sjoerd; Christiaans, Herman M T; Veenings, Bart; Loer, Stephan A; Boer, Christa

    2009-01-01

    Aeromedical repatriation of patients is an expanding service due to the growing number of travelers worldwide. Of these repatriated patients, a small number require specialized transportation due to severe medical complications. We evaluated the medical in-flight records of Dutch patients with severe disease or polytrauma who were repatriated by air from 1998 to 2002 via one of the largest Dutch alarm centers. We questioned how this Dutch population of repatriated patients is demographically distributed and whether this population is a priori at high risk for acute medical complications that need specialized medical attention. Seventy-seven of 115 repatriated patients were 50 years and older, of which most were male (73%). Fifty patients had no significant medical history, whereas the remaining 65 patients suffered from comorbidities such as cardiovascular disease or cancer. In patients aged 18 to 49 years, one third of all patients were repatriated due to traumatic fractures. In the older age category, the main reasons for repatriation were cardiopulmonary incidents. There was an equal distribution in the primary medical reason for repatriation as defined by need for trauma/neurological support and ventilation or circulatory support. Of note, 82% of the 65 patients who traveled with a chronic disease condition were repatriated due to worsening of this particular condition. The present study shows that an aeromedical repatriation service is frequently employed by travelers with a history of chronic disease who develop medical complications. The growing number of repatriated elderly patients and/or patients with preexisting comorbidities requires development of secure pretravel risk assessment and adaptation of the medical service level in foreign countries.

  5. Teaching laboratory medicine to medical students: implementation and evaluation.

    PubMed

    Molinaro, Ross J; Winkler, Anne M; Kraft, Colleen S; Fantz, Corinne R; Stowell, Sean R; Ritchie, James C; Koch, David D; Heron, Sheryl; Liebzeit, Jason; Santen, Sally A; Guarner, Jeannette

    2012-11-01

    Laboratory medicine is an integral component of patient care. Approximately 60% to 70% of medical decisions are based on laboratory results. Physicians in specialties that order the tests are teaching medical students laboratory medicine and test use with minimal input from laboratory scientists who implement and maintain the quality control for those tests. To develop, implement, and evaluate a 1.5-day medical student clinical laboratory experience for fourth-year medical students in their last month of training. The experience was devised and directed by laboratory scientists and included a panel discussion, laboratory tours, case studies that focused on the goals and objectives recently published by the Academy of Clinical Laboratory Physicians and Scientists, and medical-student presentations highlighting salient points of the experience. The same knowledge quiz was administered at the beginning and end of the experience and 84 students took both quizzes. A score of 7 or more was obtained by 16 students (19%) on the initial quiz, whereas 34 (40%) obtained the same score on the final quiz; the improvement was found to be statistically significant (P  =  .002; t  =  3.215), particularly in 3 out of the 10 questions administered. Although the assessment can only measure a small amount of knowledge recently acquired, the improvement observed by fourth-year medical students devoting a short period to learning laboratory medicine principles was encouraging. This medical student clinical laboratory experience format allowed teaching of a select group of laboratory medicine principles in 1.5 days to an entire medical school class.

  6. Pre-Participation Medical Evaluation for Adventure and Wilderness Watersports.

    PubMed

    Nathanson, Andrew T; Young, Justin Mark J; Young, Craig

    2015-12-01

    A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. in this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United states and are generally safe. Drowning, however, is a significant risk, particularly in small, self-propelled craft, and among children. Medical counseling before participation in watersports should include screening for medical conditions which may impair swimming ability, including a history of seizures, heart disease, and lung disease. Physicians should also promote preventive health measures such as use of lifejackets and sun protection, as well as alcohol avoidance. Swim testing tailored to specific activities should be strongly considered for children and those with questionable swimming ability.

  7. Evaluation of a BCMA’s Electronic Medication Administration Record

    PubMed Central

    Staggers, Nancy; Iribarren, Sarah; Guo, Jia-Wen; Weir, Charlene

    2015-01-01

    Barcode medication administration (BCMA) systems can reduce medication errors, but sociotechnical issues are quite common. Although crucial to nurses’ work, few usability evaluations are available for electronic medication administration record screens (eMARs). The purpose of this research was to identify current usability problems in the VA’s eMAR/BCMA system and explore how these might impact nurses’ situation awareness. Three expert evaluators used 10 tasks/elements, heuristic evaluation techniques and explored potential impacts using a situation awareness perspective. The results yielded 99 usability problems categorized into 440 heuristic violations with the largest volume in the category of Match with the Real World. Fifteen usability issues were rated as catastrophic with the Administer/Chart medications task having the most. Situational awareness was impacted at all levels, especially at Level 2, Comprehension. Usability problems point to important areas for improvement because these issues have the potential to impact nurses’ situation awareness, “at a glance” information, nurse productivity and patient safety. PMID:25601936

  8. Evaluation in medical education: A topical review of target parameters, data collection tools and confounding factors

    PubMed Central

    Schiekirka, Sarah; Feufel, Markus A.; Herrmann-Lingen, Christoph; Raupach, Tobias

    2015-01-01

    Background and objective: Evaluation is an integral part of education in German medical schools. According to the quality standards set by the German Society for Evaluation, evaluation tools must provide an accurate and fair appraisal of teaching quality. Thus, data collection tools must be highly reliable and valid. This review summarises the current literature on evaluation of medical education with regard to the possible dimensions of teaching quality, the psychometric properties of survey instruments and potential confounding factors. Methods: We searched Pubmed, PsycINFO and PSYNDEX for literature on evaluation in medical education and included studies published up until June 30, 2011 as well as articles identified in the “grey literature”. Results are presented as a narrative review. Results: We identified four dimensions of teaching quality: structure, process, teacher characteristics, and outcome. Student ratings are predominantly used to address the first three dimensions, and a number of reliable tools are available for this purpose. However, potential confounders of student ratings pose a threat to the validity of these instruments. Outcome is usually operationalised in terms of student performance on examinations, but methodological problems may limit the usability of these data for evaluation purposes. In addition, not all examinations at German medical schools meet current quality standards. Conclusion: The choice of tools for evaluating medical education should be guided by the dimension that is targeted by the evaluation. Likewise, evaluation results can only be interpreted within the context of the construct addressed by the data collection tool that was used as well as its specific confounding factors. PMID:26421003

  9. Depth perception--a major issue in medical AR: evaluation study by twenty surgeons.

    PubMed

    Sielhorst, Tobias; Bichlmeier, Christoph; Heining, Sandro Michael; Navab, Nassir

    2006-01-01

    The idea of in-situ visualization for surgical procedures has been widely discussed in the community. While the tracking technology offers nowadays a sufficient accuracy and visualization devices have been developed that fit seamlessly into the operational workflow [1, 3], one crucial problem remains, which has been discussed already in the first paper on medical augmented reality. Even though the data is presented at the correct place, the physician often perceives the spatial position of the visualization to be closer or further because of virtual/real overlay. This paper describes and evaluates novel visualization techniques that are designed to overcome misleading depth perception of trivially superimposed virtual images on the real view. We have invited 20 surgeons to evaluate seven different visualization techniques using a head mounted display (HMD). The evaluation has been divided into two parts. In the first part, the depth perception of each kind of visualization is evaluated quantitatively. In the second part, the visualizations are evaluated qualitatively in regard to user friendliness and intuitiveness. This evaluation with a relevant number of surgeons using a state-of-the-art system is meant to guide future research and development on medical augmented reality.

  10. Evaluation of an over-the-counter medication program.

    PubMed

    Huntzinger, Paul Evan

    2004-07-01

    Nonprescription medication (i.e., "over-the-counter") programs have historically been popular at many military treatment facilities. These programs were developed to provide a mechanism through which active duty members could obtain certain nonprescription medications without seeing a health care provider. The goal of such programs was to reduce demand on health care provider appointments and operational costs associated with such visits. Coast Guard military treatment facilities are encouraged to provide the service. The purpose of this paper was to evaluate whether the nonprescription medication program offered at the Coast Guard Alameda pharmacy reduced demand on health care provider appointments for self-limiting conditions and reduced costs associated with such visits.

  11. Medical marijuana: the conflict between scientific evidence and political ideology. Part one of two.

    PubMed

    Cohen, Peter J

    2009-01-01

    Whether "medical marijuana" (Cannabis sativa used to treat a wide variety of pathologic states) should be accorded the status of a legitimate pharmaceutical agent has long been a contentious issue. Is it a truly effective drug that is arbitrarily stigmatized by many and criminalized by the federal government? Or is it without any medical utility, its advocates hiding behind a screen of misplaced (or deliberately misleading) compassion for the ill? Should Congress repeal its declaration that smoked marijuana is without "current medical benefit"? Should cannabis be approved for medical use by a vote of the people as already has been done in 13 states? Or should medical marijuana be scientifically evaluated for safety and efficacy as any other new investigational drug? How do the competing--and sometimes antagonistic--roles of science, politics and prejudice affect society's attempts to answer this question? This article examines the legal, political, policy, and ethical problems raised by the recognition of medical marijuana by over one-fourth of our states although its use remains illegal under federal law. Although draconian punishment can be imposed for the "recreational" use of marijuana, I will not address the contentious question of whether to legalize or decriminalize the use of marijuana solely for its psychotropic effects, a fascinating and important area of law and policy that is outside the scope of this paper. Instead, the specific focus of this article will be on the conflict between the development of policies based on evidence obtained through the use of scientific methods and those grounded on ideological and political considerations that have repeatedly entered the longstanding debate regarding the legal status of medical marijuana. I will address a basic question: Should the approval of medical marijuana be governed by the same statute that applies to all other drugs or pharmaceutical agents, the Food, Drug, and Cosmetic Act (FD&C Act), after the

  12. Evaluation of STAT medication ordering process in a community hospital

    PubMed Central

    Walsh., Kim; Schwartz., Barbara

    Background: In most health care facilities, problems related to delays in STAT medication order processing time are of common concern. Objective: The purpose of this study was to evaluate processing time for STAT orders at Kimball Medical Center. Methods: All STAT orders were reviewed to determine processing time; order processing time was also stratified by physician order entry (physician entered (PE) orders vs. non-physician entered (NPE) orders). Collected data included medication ordered, indication, time ordered, time verified by pharmacist, time sent from pharmacy, and time charted as given to the patient. Results: A total of 502 STAT orders were reviewed and 389 orders were included for analysis. Overall, median time was 29 minutes, IQR 16–63; p<0.0001.). The time needed to process NPE orders was significantly less than that needed for PE orders (median 27 vs. 34 minutes; p=0.026). In terms of NPE orders, the median total time required to process STAT orders for medications available in the Automated Dispensing Devices (ADM) was within 30 minutes, while that required to process orders for medications not available in the ADM was significantly greater than 30 minutes. For PE orders, the median total time required to process orders for medications available in the ADM (i.e., not requiring pharmacy involvement) was significantly greater than 30 minutes. [Median time = 34 minutes (p<0.001)]. Conclusion: We conclude that STAT order processing time may be improved by increasing the availability of medications in ADM, and pharmacy involvement in the verification process. PMID:27382418

  13. Evaluation of emissions from medical waste incinerators in Alexandria.

    PubMed

    Zakaria, Adel; Labib, Osama

    2003-01-01

    The emissions from medical waste incinerators might perform a threat to the environment and the Public Health, the aim of the present work is to evaluate the emissions of six medical waste incinerators in six hospitals in Alexandria, Namely; Gamal Abd El-Naser, Sharq El-Madina, Central Blood Bank, Fever, Medical Research Institute, and Al-Mo'asat, ordered serially from 1 to 6. Five air pollutants were sampled and analyzed in the emissions comprising smoke, lead, carbon monoxide, sulphur dioxide and nitrogen oxides. The results of the present study have revealed that all the average values of gases in the six incinerators were within the limits stated in Egyptian environmental law, where as carbonaceous particulate (smoke) averages of the six incinerators have exceeded the maximum allowable limit in the law. On the other hand, lead concentration in emissions were far below the maximum allowable limit in the law. Al-Mo'asat incinerator emissions have been significantly higher in CO, NO2, SO2 and smoke concentration than the other five incinerators P < 0.001, P < 0.0006, P < 0.0001, and P < 0.002 respectively. The main recommendations of the present work are to reassess the limits of emissions in the Egyptian law and to state specific limits for medical wast incinerators and to relocate the medical waste incinerators away from residential areas or to substitute them all by a central incinerator in a proper place out of the city.

  14. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults Part I: Introduction, Review and Evidence-Based Guidelines.

    PubMed

    Anderson, Eric L; Nordstrom, Kimberly; Wilson, Michael P; Peltzer-Jones, Jennifer M; Zun, Leslie; Ng, Anthony; Allen, Michael H

    2017-02-01

    In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I) and then combined this with expert consensus (Part II). In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs.

  15. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults Part I: Introduction, Review and Evidence-Based Guidelines

    PubMed Central

    Anderson, Eric L.; Nordstrom, Kimberly; Wilson, Michael P.; Peltzer-Jones, Jennifer M.; Zun, Leslie; Ng, Anthony; Allen, Michael H.

    2017-01-01

    Introduction In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. Methods The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I) and then combined this with expert consensus (Part II). Results In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Conclusion Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs. PMID:28210358

  16. Assessing implicit gender bias in Medical Student Performance Evaluations.

    PubMed

    Axelson, Rick D; Solow, Catherine M; Ferguson, Kristi J; Cohen, Michael B

    2010-09-01

    For medical schools, the increasing presence of women makes it especially important that potential sources of gender bias be identified and removed from student evaluation methods. Our study looked for patterns of gender bias in adjective data used to inform our Medical Student Performance Evaluations (MSPEs). Multigroup Confirmatory Factor Analysis (CFA) was used to model the latent structure of the adjectives attributed to students (n = 657) and to test for systematic scoring errors by gender. Gender bias was evident in two areas: (a) women were more likely than comparable men to be described as ''compassionate,'' ''sensitive,'' and ''enthusiastic'' and (b) men were more likely than comparable women to be seen as ''quick learners.'' The gender gap in ''quick learner'' attribution grows with increasing student proficiency; men's rate of increase is over twice that of women's. Technical and nontechnical approaches for ameliorating the impact of gender bias on student recommendations are suggested.

  17. 42 CFR 456.143 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Content of medical care evaluation studies. 456.143...: Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care... patient care; (b) Include analysis of at least the following: (1) Admissions; (2) Durations of stay; (3...

  18. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide that... 42 Public Health 4 2011-10-01 2011-10-01 false UR plan requirements for medical care evaluation...

  19. Integrating geriatrics into medical school: student journaling as an innovative strategy for evaluating curriculum.

    PubMed

    Shield, Renée R; Farrell, Timothy W; Nanda, Aman; Campbell, Susan E; Wetle, Terrie

    2012-02-01

    The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer preclerkship and clerkship students between 2007 and 2010. The journals were used to assess the quality of curricular integration of geriatrics didactic and clinical content, to gather information for shaping the evolving curriculum, and to elicit students' responses about their professional development and caring for older adults. Student "journalers" wrote narrative reactions to and evaluations of aging-related content and exposure to older patients in response to written semistructured questions. An interdisciplinary team (including a health services researcher, gerontologist, medical anthropologist, and 2 geriatricians) used qualitative analysis to code the 405 journal entries. The team identified 10 themes within the following domains: (a) evaluation of efforts to integrate geriatrics within the medical school curriculum, (b) recognition and application of geriatrics principles, (c) student attitudes and cultural experiences regarding aging and the care of older patients, and (d) personal and professional development over time. Themes emerging within these domains reflect the effectiveness of geriatrics integration within the new curriculum as well as students' professional development. Journaling provides a novel and effective method for capturing medical students' responses to curricular content in real time, allowing for midcourse corrections and identifying key components of their professional development.

  20. How clinical communication has become a core part of medical education in the UK.

    PubMed

    Brown, Jo

    2008-03-01

    This paper sets out to analyse and interpret the complex events of the last 20 years in order to understand how the teaching and learning of clinical communication has emerged as a core part of the modern undergraduate medical curriculum in most medical schools in the UK. The paper analyses the effects of key political, sociological, historical and policy influences on clinical communication development. Political influences include: the effects of neo-liberalism on society and on the professions in general; the challenging of traditional notions of professionalism in medicine; the creation of an internal market within the National Health Service, and the disempowerment of the medical lobby. Sociological influences include: the effects of a 'marketised' society on medicine and subtle shifts in the doctor-patient relationship because of this; the emergence of globalised information through the Internet, and the influence of increased litigation against doctors. Historical influences include: the effects of a change in emphasis for medical education away from an inflated factual curriculum towards a curriculum that recognises the importance of student attitudes and the teaching and learning of clinical communication skills. Policy influences include the important effects of Tomorrow's Doctors and the Dearing Report on the modern medical curriculum. The paper concludes with a developmental map that charts the complex influences on clinical communication teaching and learning and a brief commentary on the growing body of teachers who deliver and develop the subject today.

  1. [Quality assurance and quality improvement in medical practice. Part 1. Definition and importance of quality in medical practice].

    PubMed

    Godény, Sándor

    2012-01-22

    In Hungary, financing of healthcare has decreased relative to the GDP, while the health status of the population is still ranks among the worst in the European Union. Since healthcare financing is not expected to increase, the number of practicing doctors per capita is continuously decreasing. In the coming years, it is an important question that in this situation what methods can be used to prevent further deterioration of the health status of the Hungarian population, and within this is the role of the quality approach, and different methods of quality management. In the present and the forthcoming two articles those standpoints will be summarized which support the need for the integration of quality assurance in the everyday medical practice. In the first part the importance of quality thinking, quality management, quality assurance, necessity of quality measurement and improvement, furthermore, advantages of the quality systems will be discussed.

  2. Effects of Medicare Part D on Disparity Implications of Medication Therapy Management Eligibility Criteria

    PubMed Central

    Wang, Junling; Qiao, Yanru; Shih, Ya-Chen Tina; Jamison, JoEllen Jarrett; Spivey, Christina A.; Li, Liyuan; Wan, Jim Y.; White-Means, Shelley I.; Dagogo-Jack, Samuel; Cushman, William C.; Chisholm-Burns, Marie

    2014-01-01

    Background Previous studies have shown that there were greater racial and ethnic disparities among individuals who were ineligible for medication therapy management (MTM) services than among MTM-eligible individuals before the implementation of Medicare Part D in 2006. Objective To determine whether the implementation of Medicare Part D in 2006 correlates to changes in racial and ethnic disparities among MTM-ineligible and MTM-eligible beneficiaries. Methods Data from the Medicare Current Beneficiary Survey were analyzed in this retrospective observational analysis. To examine potential racial and ethnic disparities, non-Hispanic whites were compared with non-Hispanic blacks and Hispanics. Three aspects of disparities were analyzed, including health status, health services utilization and costs, and medication utilization patterns. A generalized difference-in-differences analysis was used to examine the changes in difference in disparities between MTM-ineligible and MTM-eligible individuals from 2004–2005 to 2007–2008 relative to changes from 2001–2002 and 2004–2005. Various multivariate regressions were used based on the types of dependent variables. A main analysis and several sensitivity analyses were conducted to represent the ranges of MTM eligibility thresholds used by Medicare Part D plans in 2010. Results The main analysis showed that Part D implementation was not associated with reductions in greater racial and ethnic disparities among MTM-ineligible than MTM-eligible Medicare beneficiaries. The main analysis suggests that after Part D implementation, Medicare MTM eligibility criteria may not consistently improve the existing racial and ethnic disparities in health status, health services utilization and costs, and medication utilization. By contrast, several sensitivity analyses showed that Part D implementation did correlate with a significant reduction in greater racial disparities among the MTM-ineligible group than the MTM-eligible group in

  3. Effects of medicare part d on disparity implications of medication therapy management eligibility criteria.

    PubMed

    Wang, Junling; Qiao, Yanru; Shih, Ya-Chen Tina; Jamison, JoEllen Jarrett; Spivey, Christina A; Li, Liyuan; Wan, Jim Y; White-Means, Shelley I; Dagogo-Jack, Samuel; Cushman, William C; Chisholm-Burns, Marie

    2014-09-01

    Previous studies have shown that there were greater racial and ethnic disparities among individuals who were ineligible for medication therapy management (MTM) services than among MTM-eligible individuals before the implementation of Medicare Part D in 2006. To determine whether the implementation of Medicare Part D in 2006 correlates to changes in racial and ethnic disparities among MTM-ineligible and MTM-eligible beneficiaries. Data from the Medicare Current Beneficiary Survey were analyzed in this retrospective observational analysis. To examine potential racial and ethnic disparities, non-Hispanic whites were compared with non-Hispanic blacks and Hispanics. Three aspects of disparities were analyzed, including health status, health services utilization and costs, and medication utilization patterns. A generalized difference-in-differences analysis was used to examine the changes in difference in disparities between MTM-ineligible and MTM-eligible individuals from 2004-2005 to 2007-2008 relative to changes from 2001-2002 and 2004-2005. Various multivariate regressions were used based on the types of dependent variables. A main analysis and several sensitivity analyses were conducted to represent the ranges of MTM eligibility thresholds used by Medicare Part D plans in 2010. The main analysis showed that Part D implementation was not associated with reductions in greater racial and ethnic disparities among MTM-ineligible than MTM-eligible Medicare beneficiaries. The main analysis suggests that after Part D implementation, Medicare MTM eligibility criteria may not consistently improve the existing racial and ethnic disparities in health status, health services utilization and costs, and medication utilization. By contrast, several sensitivity analyses showed that Part D implementation did correlate with a significant reduction in greater racial disparities among the MTM-ineligible group than the MTM-eligible group in activities of daily living and in instrumental

  4. Evaluating Community Engagement in an Academic Medical Center

    PubMed Central

    Shone, Laura P.; Dozier, Ann M.; Newton, Gail L.; Green, Theresa; Bennett, Nancy M.

    2014-01-01

    From the perspective of academic medical centers (AMCs), community engagement is a collaborative process of working toward mutually defined goals to improve the community’s health, and involves partnerships between AMCs, individuals, and entities representing the surrounding community. AMCs increasingly recognize the importance of community engagement, and recent programs such as Prevention Research Centers and Clinical and Translational Science Awards have highlighted community engagement activities. However, there is no standard or accepted metric for evaluating AMCs’ performance and impact of community engagement activities. In this article, the authors present a framework for evaluating AMCs’ community engagement activities. The framework includes broad goals and specific activities within each goal, wherein goals and activities are evaluated using a health services research framework consisting of structure, process, and outcome criteria. To illustrate how to use this community engagement evaluation framework, the authors present specific community engagement goals and activities of the University of Rochester Medical Center to (1) improve the health of the community served by the AMC; (2) increase the AMC’s capacity for community engagement; and (3) increase generalizable knowledge and practices in community engagement and public health. Using a structure-process-outcomes framework, a multidisciplinary team should regularly evaluate an AMC’s community engagement program with the purpose of measurably improving the performance of the AMC and the health of its surrounding community. PMID:24556768

  5. Forensic evaluation of medical liability cases in general surgery.

    PubMed

    Moreira, H; Magalhães, T; Dinis-Oliveira, Rj; Taveira-Gomes, A

    2014-10-01

    Although medical liability (disciplinary, civil and criminal) is increasingly becoming an issue, few studies exist, particularly from the perspective of forensic science, which demonstrate the extent to which medical malpractice occurs, or when it does, the reasons for it. Our aims were to evaluate the current situation concerning medical liability in general surgery (GS) in Portugal, the reasons for claims, and the forensic evaluations and conclusions, as well as the association between these issues and the judicial outcomes. We analysed the Medico-Legal Council (CML) reports of the National Institute of Legal Medicine and Forensic Sciences of Portugal related to GS during 2001-2010. The judicial outcomes of each case were requested from the Public Prosecutor Office (PPO) and the court. Alleged cases of medical liability in GS represented 11.2% of the total cases analysed by the CML. We estimated that in Portugal, 4:100,000 surgeries are subject to litigation. The majority of complaints were due to the patient's death (75.4%), with laparoscopic cholecystectomy surgeries representing 55.2% of cases. In 76.1% of the cases, the CML believed that there was no violation of legesartis and in 55.2% of cases, no causal nexus was found between the medical practice and the alleged harm. The PPO prosecuted physicians in 6.4% of the cases and resulted in one conviction. Finally, the importance of the CML reports as a relevant technical-scientific tool for judicial decision was evident because these reports significantly (p < 0.05) influenced the prosecutor's decision, whether to prosecute or not.

  6. Attitudes toward statistics in medical postgraduates: measuring, evaluating and monitoring.

    PubMed

    Zhang, Yuhai; Shang, Lei; Wang, Rui; Zhao, Qinbo; Li, Chanjuan; Xu, Yongyong; Su, Haixia

    2012-11-23

    In medical training, statistics is considered a very difficult course to learn and teach. Current studies have found that students' attitudes toward statistics can influence their learning process. Measuring, evaluating and monitoring the changes of students' attitudes toward statistics are important. Few studies have focused on the attitudes of postgraduates, especially medical postgraduates. Our purpose was to understand current attitudes regarding statistics held by medical postgraduates and explore their effects on students' achievement. We also wanted to explore the influencing factors and the sources of these attitudes and monitor their changes after a systematic statistics course. A total of 539 medical postgraduates enrolled in a systematic statistics course completed the pre-form of the Survey of Attitudes Toward Statistics -28 scale, and 83 postgraduates were selected randomly from among them to complete the post-form scale after the course. Most medical postgraduates held positive attitudes toward statistics, but they thought statistics was a very difficult subject. The attitudes mainly came from experiences in a former statistical or mathematical class. Age, level of statistical education, research experience, specialty and mathematics basis may influence postgraduate attitudes toward statistics. There were significant positive correlations between course achievement and attitudes toward statistics. In general, student attitudes showed negative changes after completing a statistics course. The importance of student attitudes toward statistics must be recognized in medical postgraduate training. To make sure all students have a positive learning environment, statistics teachers should measure their students' attitudes and monitor their change of status during a course. Some necessary assistance should be offered for those students who develop negative attitudes.

  7. Attitudes toward statistics in medical postgraduates: measuring, evaluating and monitoring

    PubMed Central

    2012-01-01

    Background In medical training, statistics is considered a very difficult course to learn and teach. Current studies have found that students’ attitudes toward statistics can influence their learning process. Measuring, evaluating and monitoring the changes of students’ attitudes toward statistics are important. Few studies have focused on the attitudes of postgraduates, especially medical postgraduates. Our purpose was to understand current attitudes regarding statistics held by medical postgraduates and explore their effects on students’ achievement. We also wanted to explore the influencing factors and the sources of these attitudes and monitor their changes after a systematic statistics course. Methods A total of 539 medical postgraduates enrolled in a systematic statistics course completed the pre-form of the Survey of Attitudes Toward Statistics −28 scale, and 83 postgraduates were selected randomly from among them to complete the post-form scale after the course. Results Most medical postgraduates held positive attitudes toward statistics, but they thought statistics was a very difficult subject. The attitudes mainly came from experiences in a former statistical or mathematical class. Age, level of statistical education, research experience, specialty and mathematics basis may influence postgraduate attitudes toward statistics. There were significant positive correlations between course achievement and attitudes toward statistics. In general, student attitudes showed negative changes after completing a statistics course. Conclusions The importance of student attitudes toward statistics must be recognized in medical postgraduate training. To make sure all students have a positive learning environment, statistics teachers should measure their students’ attitudes and monitor their change of status during a course. Some necessary assistance should be offered for those students who develop negative attitudes. PMID:23173770

  8. Empowerment evaluation: a collaborative approach to evaluating and transforming a medical school curriculum.

    PubMed

    Fetterman, David M; Deitz, Jennifer; Gesundheit, Neil

    2010-05-01

    Medical schools continually evolve their curricula to keep students abreast of advances in basic, translational, and clinical sciences. To provide feedback to educators, critical evaluation of the effectiveness of these curricular changes is necessary. This article describes a method of curriculum evaluation, called "empowerment evaluation," that is new to medical education. It mirrors the increasingly collaborative culture of medical education and offers tools to enhance the faculty's teaching experience and students' learning environments. Empowerment evaluation provides a method for gathering, analyzing, and sharing data about a program and its outcomes and encourages faculty, students, and support personnel to actively participate in system changes. It assumes that the more closely stakeholders are involved in reflecting on evaluation findings, the more likely they are to take ownership of the results and to guide curricular decision making and reform. The steps of empowerment evaluation include collecting evaluation data, designating a "critical friend" to communicate areas of potential improvement, establishing a culture of evidence, encouraging a cycle of reflection and action, cultivating a community of learners, and developing reflective educational practitioners. This article illustrates how stakeholders used the principles of empowerment evaluation to facilitate yearly cycles of improvement at the Stanford University School of Medicine, which implemented a major curriculum reform in 2003-2004. The use of empowerment evaluation concepts and tools fostered greater institutional self-reflection, led to an evidence-based model of decision making, and expanded opportunities for students, faculty, and support staff to work collaboratively to improve and refine the medical school's curriculum.

  9. Abdominal sonography in the medical evaluation of aviation aspirants.

    PubMed

    Chadha, Davinder S; Sharma, Sanjiv; Sivasankar, Rajeev; Kudva, Naren; Sabhiki, Gurdeep; Behl, Anil

    2010-10-01

    Ultrasonography is increasingly used in elderly individuals for screening of occult malignancy and abdominal aortic aneurysm. Its utility as a screening tool in healthy asymptomatic individuals is not yet established. The current study was undertaken to evaluate the utility of abdominal and pelvic ultrasonographic screening as an adjunct to routine physical examination among young adults undergoing initial medical examination for aviation duties. Abdominal ultrasound findings of 2598 candidates (2339 men, 259 women, mean age 20.3 +/- 1.8 yr) reporting for initial aircrew medical examination between January 2004 and December 2006 at two established medical evaluation centers were analyzed. Of the candidates, 90% (N=2339) screened were for cockpit aircrew duties. Sonographic abnormalities were noted in 6.0% of candidates. These included fatty infiltration of the liver in 2.9%, renal abnormalities in 1.57%, gallstones in 0.34%, and splenomegaly in 0.30%. Of the 259 female candidates, 7 were noted to have pelvic abnormalities which included ovarian cyst in 5, and uterine agenesis and fibroid uterus in 1 each. Of the aircrew who had abnormal findings on the initial ultrasonography, 71% required further testing. Based on the ultrasound findings 10 candidates were declared permanently unfit, 39 candidates were declared temporarily unfit, and the remaining were found fit for aviation duties. Abdominal sonographic screening in young healthy asymptomatic aircrew may be a valuable extension of the initial medical evaluation. It is particularly important in the high-risk subgroup of military aviators for determining long-term career prospects.

  10. Evaluation Study for an ISO 13606 Archetype Based Medical Data Visualization Method.

    PubMed

    Kopanitsa, Georgy

    2015-08-01

    The objective of this evaluation study is to assess a method for standard based medical data visualization. The method allows flexible and customizable visualization for ISO 13606 archetype based medical data. The chosen evaluation concept is based the Guideline for Good Evaluation Practice in Health Informatics (GEP-HI). The stages of the study were identified. Each stage got a detailed description. We also identified the participants and their required qualifications and responsibilities. The evaluation location was described in details. The evaluation metrics were defined. The questionnaires for doctors, patients and experts were developed to fulfill the requirements of the evaluation study. The study was performed in Tomsk, Russia. 30 patients and 5 doctors participated in the study. The overall performance of the users reached the expert level by the end of the study. Patients as well as medical staff stated in their comments that the usability of the system was high, and they preferred it to the previously used paper-based and computer based systems. This was also shown by the high level of satisfaction measured within our study. The visualization approach, integrated into the electronic health record, was well accepted in our pilot setting with high usability scores from patients and doctors alike. The results showed the efficiency for both modeling and visualization part of the system.

  11. Nuclear, biological and chemical warfare. Part I: Medical aspects of nuclear warfare.

    PubMed

    Kasthuri, A S; Pradhan, A B; Dham, S K; Bhalla, I P; Paul, J S

    1990-04-01

    Casualties in earlier wars were due much more to diseases than to weapons. Mention has been made in history of the use of biological agents in warfare, to deny the enemy food and water and to cause disease. In the first world war chemical agents were used to cause mass casualties. Nuclear weapons were introduced in the second world war. Several countries are now involved in developing nuclear, biological and chemical weapon systems, for the mass annihilation of human beings, animals and plants, and to destroy the economy of their enemies. Recently, natural calamities and accidents in nuclear, chemical and biological laboratories and industries have caused mass instantaneous deaths in civilian population. The effects of future wars will not be restricted to uniformed persons. It is time that physicians become aware of the destructive potential of these weapons. Awareness, immediate protective measures and first aid will save a large number of persons. This series of articles will outline the medical aspects of nuclear, biological and chemical weapon systems in three parts. Part I will deal with the biological effects of a nuclear explosion. The short and long term effects due to blast, heat and associated radiation are highlighted. In Part II, the role of biological agents which cause commoner or new disease patterns is mentioned. Some of the accidents from biological warfare laboratories are a testimony to its potential deleterious effects. Part III deals with medical aspects of chemical warfare agents, which in view of their mass effects can overwhelm the existing medical resources, both civilian and military.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. An evaluation of ROME Camp: forgotten innovation in medical education.

    PubMed

    Dongre, A R; Deshmukh, P R; Gupta, S S; Garg, B S

    2010-04-01

    Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram, India's first rural medical institute, has been implementing its community-based public health teaching with the aim of building a physician workforce for the rural poor. For the past four decades, the MGIMS has organized and run the Re-orientation of Medical Education (ROME) camp for final year medical undergraduates at one of the rural centres of the department of Community Medicine. The objectives of the present study were to learn students' perceptions of the value and effectiveness of various components of the ROME camp and learn the factors they perceive facilitate and inhibit learning. A mixed-method research design of quantitative (survey) and qualitative (force field analysis) methods was used. The study participants were all 61 of the final year medical undergraduates participating in the ROME camp in 2008. The quantitative data was analyzed using SPSS software package and summative content analysis of the qualitative data was undertaken. Students were generally very positive about all aspects of the camp and its component parts. The greatest consensus (88.9%, on a 0 to 100% scale) was for the contribution to student learning of the visit to the Primary health centre and Sub-centre, as offering direct exposure and interaction with the village-level service providers. There was poorer consensus for students' involvement with the field-based clinics, as this was felt by some not to contribute significantly to their understanding of socio-economic and environmental factors related to cases (78.8%) and their ability to diagnose health problems in resource poor settings (76.5%). The major strength of the camp was felt to be its exposure visits and hands-on experiences in surveys and interaction with village-level health care providers. Students reported poor interactions with teachers in some educational sessions, including the field-based clinics and classes on theories of national health

  13. Health care technology assessment: implications for modern medical practice. Part II. Decision making on technology adoption.

    PubMed

    Pierce, Read G; Bozic, Kevin J; Hall, Bruce Lee; Breivis, James

    2007-02-01

    Health care technology assessment, the multidisciplinary evaluation of clinical and economic aspects of technology, has come to have an increasingly important role in health policy and clinical decision-making. In Part I--Understanding Technology Adoption and Analyses--this review addressed the difficult challenges posed by assessment and provided a guide to the methodologies used. Part II presents the factors that drive the technology choices made by patients, by individual physicians, by provider groups, and by hospital administrators.

  14. An evaluation of training of teachers in medical education in four medical schools of Nepal.

    PubMed

    Baral, Nirmal; Paudel, Bishnu Hari; Das, Binod Kumar Lal; Aryal, Madhukar; Das, Balbhadra Prasad; Jha, Nilambar; Lamsal, Madhab

    2007-09-01

    Effective teaching is a concern of all teachers. Therefore, regular teachers' training is emphasized globally. B. P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university situated in eastern region of Nepal has an established Medical Education unit which attempts to improve teaching-learning skills by training faculty members through organizing regular medical education training programs. The aim of the present study was to assess the effectiveness of 3-day training workshop on "Teaching-learning methodology and Evaluation" held in four different medical colleges of Nepal. The workshop was targeted at middle and entry level of health profession teachers who had not been previously exposed to any teacher's training program. The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching and assessment techniques, were incorporated in the workshop. A team of resource persons from BPKIHS were involved in all the four medical institutions. The collection data had two categories of responses: (1) a questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on usefulness of the workshop. The later category had items with three-point likert scale (very useful, useful and not useful) and responses to open-ended questions/ statements to document participants general views. The response was entered into a spreadsheet and analyzed using SPSS. The result showed that all participants (n = 92) improved their scores after attending the workshop (p < 0.001). Majority of respondents expressed that the teaching-learning methods, media, microteaching and evaluation techniques were useful in teaching-learning. The workshop was perceived as an acceptable way of acquiring

  15. Gains in medication affordability following Medicare Part D are eroding among elderly with multiple chronic conditions

    PubMed Central

    Naci, Huseyin; Soumerai, Stephen B; Ross-Degnan, Dennis; Zhang, Fang; Briesacher, Becky A; Gurwitz, Jerry H; Madden, Jeanne M

    2014-01-01

    Elderly Americans, especially those with multiple chronic conditions, face difficulties paying for prescriptions, resulting in worse adherence and discontinuation of therapy (“cost-related medication nonadherence” or CRN). We investigated whether the gains in medication affordability attributable to Medicare Part D implementation in January 2006 persisted during the six years that followed. Overall, we found continued incremental improvements in medication affordability in the early years of Part D (2007–2009), which then eroded during more recent years (2009–2011). Among elderly beneficiaries with four or more chronic conditions, we observed an increase in the prevalence of CRN from 14.4% in 2009 to 17.0% in 2011, reversing previous downward trends. Similarly, the prevalence of forgoing basic needs in order to purchase medicines among the sickest elderly decreased from 8.7% in 2007 to 6.8% in 2009, then rose to 10.2% in 2011. Our findings highlight the need for targeted policy efforts to alleviate the persistent burden of drug treatment costs in this vulnerable population. PMID:25092846

  16. Medication affordability gains following Medicare Part D are eroding among elderly with multiple chronic conditions.

    PubMed

    Naci, Huseyin; Soumerai, Stephen B; Ross-Degnan, Dennis; Zhang, Fang; Briesacher, Becky A; Gurwitz, Jerry H; Madden, Jeanne M

    2014-08-01

    Elderly Americans, especially those with multiple chronic conditions, face difficulties paying for prescriptions, which results in worse adherence to and discontinuation of therapy, called cost-related medication nonadherence. Medicare Part D, implemented in January 2006, was supposed to address issues of affordability for prescriptions. We investigated whether the gains in medication affordability attributable to Part D persisted during the six years that followed its implementation. Overall, we found continued incremental improvements in medication affordability in the period 2007-09 that eroded during the period 2009-11. Among elderly beneficiaries with four or more chronic conditions, we observed an increase in the prevalence of cost-related nonadherence from 14.4 percent in 2009 to 17.0 percent in 2011, reversing previous downward trends. Similarly, the prevalence among the sickest elderly of forgoing basic needs to purchase medicines decreased from 8.7 percent in 2007 to 6.8 percent in 2009 but rose to 10.2 percent in 2011. Our findings highlight the need for targeted policy efforts to alleviate the persistent burden of drug treatment costs on this vulnerable population. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Touching the private parts: how gender and sexuality norms affect medical students' first pelvic examination.

    PubMed

    Sörensdotter, Renita; Siwe, Karin

    2016-11-01

    Gynaecologists are in a position to challenge norms about gender and sexuality in relation to female genitals. Through their work they have the opportunity to educate patients, which is why teaching medical students to perform examinations in a gender sensitive way is significant. Medical students performing their first pelvic examination often experience the examination as uncomfortable because it is a body part that is connected to sex and to something private. This paper uses medical students' interpretations of performing their first pelvic examination as a means to discuss how cultural norms for gender, sexuality and female genitals affect these examinations. Issues raised include how cultural connotations of female genitals affect the pelvic examination, how female and male students relate differently to examining female genitals and the interpretations they make in relation to themselves. Findings show that the female genitals are perceived as a special body part connected to sexuality and intimacy. Students' gender also affects the interpretations they make during pelvic examinations. Norms of gender, sexuality and female genitals need to be challenged in the teaching and performance of pelvic examination in order to demystify this experience.

  18. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    PubMed

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal.

  19. Virtual scanning--a new system of medical assessment and treatment: Part I. Assessment.

    PubMed

    Ewing, Graham; Ewing, Elena; Hankey, Alex

    2007-03-01

    We summarize fundamental concepts and research supporting Virtual Scanning, a Russian system of health assessment and treatment, which uses computer modeling of brain function to analyze color cognition and so identify and evaluate specific influences from all parts of the nervous system. In Virtual Scanning, quantitative estimates of deviation from predefined measures of good health of all body parts, including organs and organ systems, yield a body scan in virtual reality. Russian evaluations are summarized, with examples of instances in which Virtual Scanning was found to provide early warnings of clinical conditions before conventional tests had detected problems.

  20. Forensic medical evaluations of child maltreatment: a proposed research agenda.

    PubMed

    Dubowitz, Howard; Christian, Cindy W; Hymel, Kent; Kellogg, Nancy D

    2014-11-01

    Physicians play an important role in the forensic evaluation of suspected child abuse and neglect. There has been considerable progress in the medical field, helping distinguish findings related to maltreatment from other conditions or circumstances. Nevertheless, important questions remain. This article covers several of these questions and proposes a research agenda concerning five main topics: sexual abuse, neglect, fractures, abusive head trauma, and physicians work in interdisciplinary settings. The suggestions are hardly inclusive, but offer suggestions the authors think are priorities, and ones that research could reasonably address. By providing some background to gaps in our knowledge, this paper should be of interest to a broader audience than just medical professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Performance evaluation of artificial intelligence classifiers for the medical domain.

    PubMed

    Smith, A E; Nugent, C D; McClean, S I

    2002-01-01

    The application of artificial intelligence systems is still not widespread in the medical field, however there is an increasing necessity for these to handle the surfeit of information available. One drawback to their implementation is the lack of criteria or guidelines for the evaluation of these systems. This is the primary issue in their acceptability to clinicians, who require them for decision support and therefore need evidence that these systems meet the special safety-critical requirements of the domain. This paper shows evidence that the most prevalent form of intelligent system, neural networks, is generally not being evaluated rigorously regarding classification precision. A taxonomy of the types of evaluation tests that can be carried out, to gauge inherent performance of the outputs of intelligent systems has been assembled, and the results of this presented in a clear and concise form, which should be applicable to all intelligent classifiers for medicine.

  2. Evaluation of Perioperative Medication Errors and Adverse Drug Events

    PubMed Central

    Nanji, Karen C.; Patel, Amit; Shaikh, Sofia; Seger, Diane L.; Bates, David W.

    2015-01-01

    Background The purpose of this study is to assess the rates of perioperative medication errors (MEs) and adverse drug events (ADEs) as percentages of medication administrations, evaluate their root causes, and formulate targeted solutions to prevent them. Methods In this prospective observational study, anesthesia-trained study staff (anesthesiologists/nurse anesthetists) observed randomly selected operations at a 1,046 bed tertiary care academic medical center to identify MEs and ADEs over eight months. Retrospective chart abstraction was performed to flag events that were missed by observation. All events subsequently underwent review by two independent reviewers. Primary outcomes were the incidence of MEs and ADEs. Results A total of 277 operations were observed with 3,671 medication administrations of which 193 (5.3%, 95% CI 4.5 to 6.0) involved a ME and/or ADE. Of these, 153 (79.3%) were preventable and 40 (20.7%) were non-preventable. The events included 153 (79.3%) errors and 91 (47.2%) ADEs. While 32 (20.9%) of the errors had little potential for harm, 51 (33.3%) led to an observed ADE and an additional 70 (45.8%) had the potential for patient harm. Of the 153 errors, 99 (64.7%) were serious, 51 (33.3%) were significant and 3 (2.0%) were life-threatening. Conclusions One in twenty perioperative medication administrations included an ME and/or ADE. More than one third of the MEs led to observed ADEs, and the remaining two thirds had the potential for harm. These rates are markedly higher than those reported by retrospective surveys. Specific solutions exist which have the potential to decrease the incidence of perioperative MEs. PMID:26501385

  3. Medication-use evaluation with a Web application.

    PubMed

    Burk, Muriel; Moore, Von; Glassman, Peter; Good, Chester B; Emmendorfer, Thomas; Leadholm, Thomas C; Cunningham, Francesca

    2013-12-15

    A Web-based application for coordinating medication-use evaluation (MUE) initiatives within the Veterans Affairs (VA) health care system is described. The MUE Tracker (MUET) software program was created to improve VA's ability to conduct national medication-related interventions throughout its network of 147 medical centers. MUET initiatives are centrally coordinated by the VA Center for Medication Safety (VAMedSAFE), which monitors the agency's integrated databases for indications of suboptimal prescribing or drug therapy monitoring and adverse treatment outcomes. When a pharmacovigilance signal is detected, VAMedSAFE identifies "trigger groups" of at-risk veterans and uploads patient lists to the secure MUET application, where locally designated personnel (typically pharmacists) can access and use the data to target risk-reduction efforts. Local data on patient-specific interventions are stored in a centralized database and regularly updated to enable tracking and reporting for surveillance and quality-improvement purposes; aggregated data can be further analyzed for provider education and benchmarking. In a three-year pilot project, the MUET program was found effective in promoting improved prescribing of erythropoiesis-stimulating agents (ESAs) and enhanced laboratory monitoring of ESA-treated patients in all specified trigger groups. The MUET initiative has since been expanded to target other high-risk drugs, and efforts are underway to refine the tool for broader utility. The MUET application has enabled the increased standardization of medication safety initiatives across the VA system and may serve as a useful model for the development of pharmacovigilance tools by other large integrated health care systems.

  4. Ginger--chemistry, technology, and quality evaluation: part 1.

    PubMed

    Govindarajan, V S

    1982-01-01

    Ginger is used in more ways than any other spice. This monograph, published in two parts, comprehensively reviews production, trade, processing, chemistry, and evaluation of quality. Botany, world varieties, agronomy, crop improvement and potential are reviewed briefly with emphasis on the yield of functional components. Processing for the market, international trade patterns, and factors influencing them are discussed. Derived products such as ginger powder, syruped ginger, volatile oil, and oleoresin are discussed in greater detail. The increasing world demand for quality products of added value such as the oleoresin and volatile oil show prospects for their production in the growing countries. The chemistry of the components which contribute aroma and pungency that characterize ginger is critically reviewed. The second part deals with evaluation of quality. The physico-chemical parameters prescribed as a measure of quality for ginger and its products in the existing standards can assure only hygienic quality and purity, and possibly the source, when new parameters such as GC-fingerprints are included. The importance of sensorily evaluating flavor quality is emphasized to understand the variation in flavor quality required by the industrial and retail markets. Related areas, such as problems in sensory evaluation of intense flavored substances, objective flavor profile analysis, and correlation of instrumental and sensory data, are discussed and our recent work in this area is summarized. Areas where more research are needed are indicated. Other areas briefly discussed are functional, physiological, and toxicological properties in use of ginger; biosynthetic aspects of the components stimulating flavor; and structure and pungency and chemistry of spices from allied species and genera. A comprehensive bibliography is provided to aid in further study and research.

  5. Ginger-chemistry, technology, and quality evaluation: part 2.

    PubMed

    Govindarajan, V S

    1982-01-01

    Ginger is used in more ways than any other spice. This monograph, published in two parts, comprehensively reviews production, trade, processing, chemistry, and evaluation of quality. Botany, world varieties, agronomy, crop improvement, and potential are reviewed briefly with emphasis on the yield of functional components. Processing for the market, international trade patterns and factors influencing them are discussed. Derived products such as ginger powder, syruped ginger, volatile oil, and oleoresin are discussed in greater detail. The increasing world demand for quality products of added value such as the oleoresin and volatile oil show the prospects for their production in the growing countries. The chemistry of the components which contribute aroma and pungency that characterize ginger is critically reviewed. The second part deals with evaluation of quality. The physicochemical parameters prescribed as a measure of quality for ginger and its products in the existing standards, can assure only hygienic quality and purity, and possibly the source, when new parameters such as GC-finger prints are included. The importance of sensorily evaluating flavor quality is emphasized to understand the variation in flavor quality required by the industrial and retail markets. Related areas, such as problems in sensory evaluation of intense flavored substances, objective flavor profile analysis, correlation of instrumental and sensory data are discussed, and our recent work in this area is summarized. Areas where more research is needed are indicated. Other areas briefly discussed are functional, physiological, and toxicological properties in use of ginger; biosynthetic aspects of components stimulating flavor; structure and pungency and chemistry of spices from allied species and genera. A comprehensive bibliography is provided to aid in further study and research.

  6. Guidelines for School Medication Administration. Part I: Administrative Policies and Procedures. Part II: An Instructional Program for Training School Personnel To Give Medication. Third Edition.

    ERIC Educational Resources Information Center

    Colorado State Board of Nursing, Denver.

    Increasing numbers of students must be given medications at school, with a variety of staff assisting these children. In order to standardized the format for instructing personnel in medication administration procedures, an instructional program was developed for those in schools and out-of-home child care settings who are giving medications that…

  7. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide that... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan requirements for medical care...

  8. Evaluation of Canadian undergraduate ophthalmology medical education at Western University.

    PubMed

    Li, Bo; Curts, Dustin; Iordanous, Yiannis; Proulx, Alain; Sharan, Sapna

    2016-10-01

    To assess and evaluate the current level of ophthalmology knowledge and teaching curriculum in undergraduate year 3 (MS-3) at Western University. The Undergraduate Medical Education Curriculum at Western University has instituted additional ophthalmology lecture series to all MS-3 students. A test on basic ophthalmic knowledge was administered to MS-3 students immediately before and after lecture series to evaluate the level of knowledge at baseline and after ophthalmology didactic teaching. An evaluation survey was also given to MS-3 students to assess students' self-perceived level of competency, exposure, and interests in ophthalmology. A total of 134 students attended the ophthalmology lecture series in the study, and 88.1% of students completed the pretest, post-test, and Ophthalmology Education Survey. The average pretest and post-test scores were 40.7% and 75.6% (p < 0.01), respectively. The average rating from MS-3 students for ophthalmology exposure during medical school education was 2.11 (1 = "very minimal" and 5 = "more than adequate"). The average rating for desire for additional didactic ophthalmology lectures was 4.02 (1 = "strongly disagree" and 5 = "strongly agree"). The average rating for interest in ophthalmology was 2.74 (1 = "very little interest" and 5 = "very strong interest"). The additional ophthalmology lecture series had a positive impact on the level of ophthalmic knowledge among MS-3 students, and a strong desire for more ophthalmology teaching during medical school education was identified, as evidenced by the survey undertaken by students after the lectures. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  9. Virtue ethics - an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics.

    PubMed

    Misselbrook, David

    2015-02-01

    The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.

  10. Introduction to the special section: medical advances in child sexual abuse, part 2.

    PubMed

    Alexander, Randell

    2011-11-01

    This volume is the second of a two-part special issue detailing state of the art practice in medical issues around child sexual abuse. The four articles in this special section discuss topics such as estimating the sexual maturity of a child from computer or photographic images; how several cases of supposed Neisseria gonorrhoeae meningitis actually were a different, but related, organism, thereby removing sexual abuse as a consideration as to etiology; what current laboratory methods are available today to detect specific sexually transmitted infections and what should be used; and how all the evidence in child sexual abuse cases is organized to make clear and accurate statements.

  11. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment.

    PubMed

    Ellaway, Rachel; Masters, Ken

    2008-06-01

    In just a few years, e-learning has become part of the mainstream in medical education. While e-learning means many things to many people, at its heart it is concerned with the educational uses of technology. For the purposes of this guide, we consider the many ways that the information revolution has affected and remediated the practice of healthcare teaching and learning. Deploying new technologies usually introduces tensions, and e-learning is no exception. Some wish to use it merely to perform pre-existing activities more efficiently or faster. Others pursue new ways of thinking and working that the use of such technology affords them. Simultaneously, while education, not technology, is the prime goal (and for healthcare, better patient outcomes), we are also aware that we cannot always predict outcomes. Sometimes, we have to take risks, and 'see what happens.' Serendipity often adds to the excitement of teaching. It certainly adds to the excitement of learning. The use of technology in support of education is not, therefore, a causal or engineered set of practices; rather, it requires creativity and adaptability in response to the specific and changing contexts in which it is used. Medical Education, as with most fields, is grappling with these tensions; the AMEE Guide to e-Learning in Medical Education hopes to help the reader, whether novice or expert, navigate them. This Guide is presented both as an introduction to the novice, and as a resource to more experienced practitioners. It covers a wide range of topics, some in broad outline, and others in more detail. Each section is concluded with a brief 'Take Home Message' which serves as a short summary of the section. The Guide is divided into two parts. The first part introduces the basic concepts of e-learning, e-teaching, and e-assessment, and then focuses on the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. The second part examines technical

  12. Evaluation of board performance in Iran’s universities of medical sciences

    PubMed Central

    Sajadi, Haniye Sadat; Maleki, Mohammadreza; Ravaghi, Hamid; Farzan, Homayoun; Aminlou, Hasan; Hadi, Mohammad

    2014-01-01

    Background: The critical role that the board plays in governance of universities clarifies the necessity of evaluating its performance. This study was aimed to evaluate the performance of the boards of medical universities and provide solutions to enhance its performance. Methods: The first phase of present study was a qualitative research in which data were collected through face-to-face semi-structured interviews. Data were analyzed by thematic approach. The second phase was a mixed qualitative and quantitative study, with quantitative part in cross-sectional format and qualitative part in content analysis format. In the quantitative part, data were collected through Ministry of Health and Medical Education (MoHME). In the qualitative part, the content of 2,148 resolutions that were selected by using stratified sampling method were analyzed. Results: Participants believed that the boards had no acceptable performance for a long time.Results also indicated the increasing number of meetings and resolutions of the boards in these 21 years. The boards’ resolutions were mostly operational in domain and administrative in nature. The share of specific resolutions was more than the general ones. Conclusion: Given the current pace of change and development and the need to timely respond them, it is recommended to accelerate the slow pace of improvement process of the boards. It appears that more delegation and strengthening the position of the boards are the effective strategies to speed up this process. PMID:25337597

  13. Medical care evaluation studies in long-term care facilities.

    PubMed

    Zimmer, J G

    1979-02-01

    This report describes the selection, design, conduct, analysis, and application of medical care evaluation studies in long-term care facilities (skilled nursing homes) in a regional program in the Rochester region of upstate New York. Eight examples are presented to highlight methodologic approaches and problems. They are classified under four general headings: Administration Audits, Diagnosis-specific Studies, Care Modality-specific Studies, and General Outcome Indicators. The implementation of results and recommendations from the studies is discussed and an application of "tracer" methodology for assessing the components of care activities in long-term facilities is described. Problems and challenges in long-term quality care are outlined.

  14. A Guide to Ultrasound of the Shoulder, Part 2: The Diagnostic Evaluation.

    PubMed

    Panero, Alberto J; Hirahara, Alan M

    2016-01-01

    Ultrasound is becoming an increasingly accessible modality for its easy and accurate evaluation of shoulder pathology. In Part 1 of our series (Am J Orthop. 2016;45(3):176-182), we showed how musculoskeletal ultrasound can be properly coded and reimbursed and can be as effective in evaluating the shoulder as magnetic resonance imaging, yet more economical. With more physicians beginning to incorporate this technology into their practice, we describe the physics of ultrasound and our methods for evaluating the shoulder with ultrasound. In the coming year, new certifications are emerging that may be required to perform and bill for these services. Staying abreast with the current guidelines and protocols being introduced by the American Institute of Ultrasound in Medicine and the American Registry for Diagnostic Medical Sonography will be essential.

  15. 76 FR 44086 - Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... AFFAIRS Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity.... 2900-0052.'' SUPPLEMENTARY INFORMATION: Title: Report of Medical Examination for Disability Evaluation... submit the collection of information abstracted below to the Office of Management and Budget (OMB)...

  16. Part 2, Conflict management. How to shape positive relationships in medical practices and hospitals.

    PubMed

    Sotile, W M; Sotile, M O

    1999-01-01

    Managing workplace conflict is one of the most important, stressful, and time-consuming tasks faced by today's physician leaders. In Part 1 of this article series, the authors describe how to assess an organization's interpersonal dynamics. True change comes from interventions that help an organization to become a positive interpersonal culture, one that fosters cooperation and collaboration. Part 2 offers seven steps to solving the disruptive physician problem: (1) provide protection to complainants; (2) listen, empathize, and avoid communication triangles; (3) confront offenders with data, authority, and compassion; (4) if needed, get outside help; (5) offer workplace training and experiences that foster positive relationships; (6) follow-up; and (7) practice what you preach. The self-assessment and intervention guidelines discussed in this series of articles can help physician executive move beyond struggling with episodes of conflict to shaping stress-resilient medical organizations.

  17. A writer's guide to education scholarship: Quantitative methodologies for medical education research (part 1).

    PubMed

    Thoma, Brent; Camorlinga, Paola; Chan, Teresa M; Hall, Andrew Koch; Murnaghan, Aleisha; Sherbino, Jonathan

    2017-04-26

    Quantitative research is one of the many research methods used to help educators advance their understanding of questions in medical education. However, little research has been done on how to succeed in publishing in this area. We conducted a scoping review to identify key recommendations and reporting guidelines for quantitative educational research and scholarship. Medline, ERIC, and Google Scholar were searched for English-language articles published between 2006 and January 2016 using the search terms, "research design," "quantitative," "quantitative methods," and "medical education." A hand search was completed for additional references during the full-text review. Titles/abstracts were reviewed by two authors (BT, PC) and included if they focused on quantitative research in medical education and outlined reporting guidelines, or provided recommendations on conducting quantitative research. One hundred articles were reviewed in parallel with the first 30 used for calibration and the subsequent 70 to calculate Cohen's kappa coefficient. Two reviewers (BT, PC) conducted a full text review and extracted recommendations and reporting guidelines. A simple thematic analysis summarized the extracted recommendations. Sixty-one articles were reviewed in full, and 157 recommendations were extracted. The thematic analysis identified 86 items, 14 categories, and 3 themes. Fourteen quality evaluation tools and reporting guidelines were found. Discussion This paper provides guidance for junior researchers in the form of key quality markers and reporting guidelines. We hope that quantitative researchers in medical education will be informed by the results and that further work will be done to refine the list of recommendations.

  18. Method of evaluating and improving ambulatory medical care.

    PubMed Central

    Payne, B C; Lyons, T F; Neuhaus, E; Kolton, M; Dwarshius, L

    1984-01-01

    The usefulness of an action-research model is demonstrated in the evaluation and improvement of ambulatory medical care in a variety of settings: solo office practice, prepaid capitation multiple-specialty group practice, and medical school hospital-based outpatient clinic practice. Improvements in the process of medical care are found to relate directly to the intensity and duration of planned interventions by the study group and are demonstrated to follow organizational changes in the participating sites--primarily managerial and support services initiated by policy decisions in each study site. Improvement in performance approaching one standard deviation results from the most intense intervention, about one-half standard deviation at the next level of intervention, and virtually no change from a simple feedback of performance measures. On the basis of these findings and other operational and research efforts to improve physician performance, it is unlikely that simple feedback of performance measures will elicit a change in behavior. However, noncoercive methods involving health care providers in problem identification, problem solving, and solution implementation are demonstrated to be effective. PMID:6735736

  19. [Evaluation of medication advertising broadcast on radio stations].

    PubMed

    Batista, Almária Mariz; Carvalho, Maria Cleide Ribeiro Dantas de

    2013-02-01

    The scope of this paper was to evaluate advertising for medication broadcast on radio stations in Natal, State of Rio Grande do Norte, Brazil, from April to September 2008 and from April to September 2010. The advertising was recorded and transcribed in order to conduct legal analysis and content analysis based on the precepts of Laurence Bardin. Both the advertising recorded during the first stage (regulated by RDC 102/00) and the second stage (regulated by RDC 96/08) contained some form of legal violation. Content analysis detected practically the same violations in both stages, namely the lack of information regarding adverse effects of the medication, appeal to consumption, exaggeration of efficiency/effectiveness and abusive exploitation of illness. Despite the inclusion of more modern and restrictive legislation, radio advertising continues to violate the law blatantly, committing abuse and disrespecting the population's entitlement to good health. The study reveals the need for medication advertising to be dealt with in a broader context, in other words to be treated as a public health concern. It must take into consideration the socio-historical scenario in which it evolved, since the legislation alone is insufficient to combat abuse committed to the detriment of public health.

  20. Using Survival Analysis to Evaluate Medical Equipment Battery Life.

    PubMed

    Kuhajda, David

    2016-01-01

    As hospital medical device managers obtain more data, opportunities exist for using the data to improve medical device management, enhance patient safety, and evaluate costs of decisions. As a demonstration of the ability to use data analytics, this article applies survival analysis statistical techniques to assist in making decisions on medical equipment maintenance. The analysis was performed on a large amount of data related to failures of an infusion pump manufacturer's lithium battery and two aftermarket replacement lithium batteries from one hospital facility. The survival analysis resulted in statistical evidence showing that one of the third-party batteries had a lower survival curve than the infusion pump manufacturer's battery. This lower survival curve translates to a shorter expected life before replacement is needed. The data suggested that to limit unexpected failures, replacing batteries at a two-year interval, rather than the current industry recommendation of three years, may be warranted. For less than $5,400 in additional annual cost, the risk of unexpected battery failures can be reduced from an estimated 28% to an estimated 7%.

  1. Evaluating a federated medical search engine: tailoring the methodology and reporting the evaluation outcomes.

    PubMed

    Saparova, D; Belden, J; Williams, J; Richardson, B; Schuster, K

    2014-01-01

    Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants' expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for system improvement.

  2. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations.

    PubMed

    Wilson, Michael P; Nordstrom, Kimberly; Anderson, Eric L; Ng, Anthony T; Zun, Leslie S; Peltzer-Jones, Jennifer M; Allen, Michael H

    2017-06-01

    The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area. The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.

  3. Evaluation of the accuracy of smartphone medical calculation apps.

    PubMed

    Bierbrier, Rachel; Lo, Vivian; Wu, Robert C

    2014-02-03

    Mobile phones with operating systems and capable of running applications (smartphones) are increasingly being used in clinical settings. Medical calculating applications are popular mhealth apps for smartphones. These include, for example, apps that calculate the severity or likelihood of disease-based clinical scoring systems, such as determining the severity of liver disease, the likelihood of having a pulmonary embolism, and risk stratification in acute coronary syndrome. However, the accuracy of these apps has not been assessed. The objective of this study was to evaluate the accuracy of smartphone-based medical calculation apps. A broad search on Google Play, BlackBerry World, and the iTunes App Store was conducted to find medical calculation apps for smartphones. The list of apps was narrowed down based on inclusion and exclusion criteria focusing on functions thought to be relevant by a panel of general internists (number of functions =13). Ten case values were inputted for each function and were compared to manual calculations. For each case, the correct answer was assigned a score of 1. A score for the 10 cases was calculated based on the accuracy of the results for each function on each app. We tested 14 apps and 13 functions for each app if that function was available. We conducted 10 cases for each function for a total of 1240 tests. Most functions tested on the apps were accurate in their results with an overall accuracy of 98.6% (17 errors in 1240 tests). In all, 6 of 14 (43%) apps had 100% accuracy. Although 11 of 13 (85%) functions had perfect accuracy, there were issues with 2 functions: the Child-Pugh scores and Model for End-Stage Liver Disease (MELD) scores on 8 apps. Approximately half of the errors were clinically significant resulting in a significant change in prognosis (8/17, 47%). The results suggest that most medical calculating apps provide accurate and reliable results. The free apps that were 100% accurate and contained the most

  4. Comparing patients who leave the ED prematurely, before vs after medical evaluation: a National Hospital Ambulatory Medical Care Survey analysis.

    PubMed

    Moe, Jessica; Belsky, Justin Brett

    2016-05-01

    Many patients leave the Emergency Department (ED) before beginning or completing medical evaluation. Some of these patients may be at higher medical risk depending on their timing of leaving the ED. To compare patient, hospital, and visit characteristics of patients who leave before completing medical care to patients who leave before ED evaluation. Retrospective cross-sectional analysis of ED visits using the 2009-2011 National Hospital Ambulatory Medical Care Survey. A total of 100962 ED visits were documented in the 2009-2011 National Hospital Ambulatory Medical Care Survey, representing a weighted count of 402211907 total ED visits. 2646 (2.62%) resulted in a disposition of left without completing medical care. Of these visits, 1792 (67.7%) left before being seen by a medical provider versus 854 (32.3%) who left after medical provider evaluation but before a final disposition. Patients who left after being assessed by a medical provider were older, had higher acuity visits, were more likely to have visited an ED without nursing triage, arrived more often by ambulance, and were more likely to have private insurance than to be self-paying or to have other payment arrangements (e.g. worker's compensation or charity/no charge). When comparing all patients who left the ED before completion of care, those who left after versus before medical provider evaluation differed in their patient, hospital, and visit characteristics and may represent a high risk patient group. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Techniques to evaluate the quality of medical images

    NASA Astrophysics Data System (ADS)

    Perez-Diaz, Marlen

    2014-11-01

    There is not a perfect agree in the definition of medical image quality from the physician and physicist point of view. The present conference analyzes the standard techniques used to grade image quality. In the first place, an analysis about how viewing conditions related to environment, monitor used or physician experience determines the subjective evaluation is done. After that, the physics point of view is analyzed including the advantage and disadvantage of the main published methods like: Quality Control Tests, Mathematical metrics, Modulation Transfer Function, Noise Power Spectrum, System Response Curve and Mathematical observers. Each method is exemplified with the results of updated papers. We concluded that the most successful methods up to the present have been those which include simulations of the Human Visual System. They have good correlation between the results of the objective metrics and the subjective evaluation made by the observers.

  6. Lecture Evaluations by Medical Students: Concepts That Correlate With Scores.

    PubMed

    Jen, Aaron; Webb, Emily M; Ahearn, Bren; Naeger, David M

    2016-01-01

    The didactic lecture remains one of the most popular teaching formats in medical education; yet, factors that most influence lecturing success in radiology education are unknown. The purpose of this study is to identify patterns of narrative student feedback that are associated with relatively higher and lower evaluation scores. All student evaluations from our core radiology elective during 1 year were compiled. All evaluation comments were tagged, to identify discrete descriptive concepts. Correlation coefficients were calculated, for each tag with mean evaluation scores. Tags that were the most strongly associated with the highest- versus lowest-rated (> or < 1 SD) lectures were identified. A total of 3,262 comments, on 273 lectures, rated by 77 senior medical students, were analyzed. The mean lecture score was 8.96 ± 0.62. Three tags were significantly positively correlated with lecture score: "interactive"; "fun/engaging"; and "practical/important content" (r = 0.39, r = 0.34, and r = 0.32, respectively; all P < .001). More tags (n = 12) were significantly negatively correlated with score; the three tags with the strongest such correlation were: "not interactive"; "poorly structured or unevenly paced"; and "content too detailed or abundant" (r = -0.44, r = -0.39, and r = -0.36, respectively; all P < .001). Analysis of only the highest- and lowest-rated lectures yielded similar results. Several factors were identified that were strongly associated with lecture score. Among the actionable characteristics, interactive lectures with appropriately targeted content (ie, practical/useful) were the most highly rated. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Evaluation of Relationship Between Childhood Maltreatment and Medication Overuse Headache

    PubMed Central

    ALTINTAŞ, Ebru; KARAKURUM GÖKSEL, Başak; SARITÜRK, Çağla; TAŞKINTUNA, Nilgün

    2015-01-01

    Introduction We aimed to evaluate the prevalence and relationship between childhood maltreatment (CMT) among patients with medication overuse headache (MOH) and to investigate whether CMT is associated with medication overuse in patients having headaches or with headaches that become chronic. Epidemiological studies report a relationship between childhood abuse and headache. There is growing knowledge about the evidence that childhood maltreatment leads to neurobiological sequel. Medication overuse is the most important problem for migraine to become chronic. But in the literature, there was no information about the role of childhood abuse in MOH and for migraine to become chronic. Methods A total of 116 patients with headache, aged from 15 to 65 years, were included in the study. Patients having chronic migraine (CM), MOH and episodic migraine (EM) were selected out of patients presented to the headache outpatient clinic. Types of headache were determined according to the revised International Headache Society (IHS) criteria published in 2004. The Childhood Trauma Questionnaire, Beck Depression Inventory and Beck Anxiety Inventory were performed. Presence of psychiatric co-morbidities was evaluated by a clinician using Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, the Fourth Edition. Results A total of 116 patients with headache were included in the study. Of patients, 64 had MOH, 25 had CM and 27 had EM. The prevalence of CMT, particularly emotional neglect (62%), physical neglect (44%) and emotional abuse (36.2%), was determined higher in all headache groups. There was no statistically significant difference in prevalence of childhood maltreatment between MOH, CM and EM groups. No statistically significant difference was detected between educational status, psychiatric co-morbidities and childhood trauma, except for physical neglect. Conclusion Childhood maltreatment was observed in MOH as in other forms of migraine and

  8. 42 CFR 456.243 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Content of medical care evaluation studies. 456.243... Ur Plan: Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each... the mental hospital's patient care; (b) Include analysis of at least the following: (1) Admissions. (2...

  9. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false UR plan requirements for medical care evaluation...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care evaluation studies. (a) The UR plan must describe the methods that the committee uses to select and...

  10. Review of Economic Submissions to NICE Medical Technologies Evaluation Programme.

    PubMed

    Alshreef, Abualbishr; Jenks, Michelle; Green, William; Dixon, Simon

    2016-12-01

    The economic evaluation of medical devices is increasingly used to inform decision making on adopting new or novel technologies; however, challenges are inevitable due to the unique characteristics of devices. Cost-consequence analyses are recommended and employed by the English National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) to help address these challenges. The aim of this work was to review the critiques raised for previous MTEP submissions and explore if there were common problems across submissions. We reviewed a sample of 12 economic submissions to MTEP representing 50 % of 24 sets of guidance issued to July 2015. For each submission, we reviewed the External Assessment Centre's (EAC) report and the guidance document produced by NICE. We identified the main problems raised by the EAC's assessments and the committee's considerations for each submission, and explored strategies for improvement. We found that the identification and measurement of costs and consequences are the main shortcomings within economic submissions to MTEP. Together, these shortcomings accounted for 42 % of criticisms by the EACs among the reviewed submissions. In certain circumstances problems with these shortcomings may be unavoidable, for example, if there is a limited evidence base for the device being appraised. Nevertheless, strategies can often be adopted to improve submissions, including the use of more appropriate time horizons, whilst cost and resource use information should be taken, where possible, from nationally representative sources.

  11. Cyanoacrylate medical glue application in intervertebral disc annulus defect repair: Mechanical and biocompatible evaluation.

    PubMed

    Kang, Ran; Li, Haisheng; Lysdahl, Helle; Quang Svend Le, Dang; Chen, Menglin; Xie, Lin; Bünger, Cody

    2017-01-01

    In an attempt to find an ideal closure method during annulus defect repair, we evaluate the use of medical glue by mechanical and biocompatible test. Cyanoacrylate medical glue was applied together with a multilayer microfiber/nanofiber polycaprolactone scaffold and suture in annulus repair. Continuous axial loading and fatigue mechanical test was performed. Furthermore, the in vitro response of mesenchymal stem cell (MSC) to the glue was evaluated by cell viability assay. The in vivo response of annulus tissue to the glue and scaffold was also studied in porcine lumbar spine; histological sections were evaluated after 3 months. Cyanoacrylate glue significantly improved the closure effect in the experimental group with failure load 2825.7 ± 941.6 N, compared to 774.1 ± 281.3 N in the control group without glue application (p < 0.01). The experimental group also withstood the fatigue test. No toxic effect was observed by in vitro cell culture and in vivo implantation. On the basis of this initial evaluation, the use of cyanoacrylate medical glue improves closure effect with no toxicity in annulus defect repair. This method of annulus repair merits further effectiveness study in vivo. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 14-20, 2017.

  12. Changes in emotions related to medication used to treat ADHD. Part I: literature review.

    PubMed

    Manos, Michael J; Brams, Matthew; Childress, Ann C; Findling, Robert L; López, Frank A; Jensen, Peter S

    2011-02-01

    To summarize the literature investigating changes in emotional expression (EE) as a function of pharmacotherapy in the treatment of ADHD and to differentiate emotional effects related to ADHD pharmacotherapy from emotional effects related to ADHD as a disorder. English language articles published from January 1, 1988, through August 31, 2008 were identified through a PubMed literature search using the search terms attention, ADHD, hyperactive, hyperkinesis, and ADD cross-referenced with medication terms amphetamine, lisdexamfetamine, methylphenidate , guanfacine, atomoxetine, and clonidine. The search was limited to randomized, controlled trials. Abstracts from all identified articles were selected for further review if they met criteria including (a) presence of a placebo arm, (b) children ≤ 18 years of age, (c) ≥ 20 participants, and (b) study design elements that would allow reviewers to determine whether EE phenomena were specifically attributable to medication effects versus alternative explanations (e.g., time, maturation, baseline comorbidity, selection artifacts, or treatments other than the medication-placebo contrast). Qualifying full-text articles were reviewed for prespecified EE terms. Of 148 articles that met selection criteria, 47 reported varying types of EE. Eight of these included two active treatment arms. Hence, 55 data sets were identified. Patterns of change in EE in studies meeting search criteria are discussed. Data sets that reported accounts of EE by the percentage of patients were compiled and further analyzed for specific medication classes. The changes in EE are further discussed as (a) salutary or detrimental, (b) associated with time of day or circumscribed, and (c) presumed to be caused by pharmacological effects. Definitive methodologies for assessing the presence of changes in EE in clinical trials and guidelines for the evaluation of EE in clinical practice are yet to be established and are needed. Such guidelines could be

  13. [Medical economics evaluation of 5-HT3 receptor antagonist drugs].

    PubMed

    Utsunomiya, Junpei; Hirano, Shigeki; Fukui, Aiko; Funabashi, Kazuaki; Deguchi, Yuko; Yamada, Susumu; Naito, Kazuyuki

    2010-10-01

    At Komaki City Hospital, the drug cost in connection with cancer chemotherapy was re-examined as part of improved management along with the introduction of DPC in July 2008. With due attention to the 5-HT3 receptor antagonists, both the change from injections to oral drugs and the change from brand-name drugs to generic drugs were tried between July 2008 and June 2009. After that, in order to examine the economic impact of these changes, we investigated and analyzed the number of medications, the cost of medicine purchased, and the average drug cost per medication of the 5-HT3 receptor antagonists between April 2008 and September 2009. As a result, the cost of 5-HT3 receptor antagonists purchased decreased greatly, and the impact of the improvement was mainly due to the change to oral drugs, and partially to the change to generic drugs. Therefore, from the viewpoint of hospital economic improvement in DPC, it was thought that the change to oral drugs(5-HT3 receptor antagonists)is given top priority.

  14. A new strategy for stiffness evaluation of sheet metal parts

    NASA Astrophysics Data System (ADS)

    Cai, Q.; Volk, W.; Düster, A.; Rank, E.

    2011-08-01

    In the automotive industry, surfaces of styling models are shaped very often in physical models. For example, in the styling process of a car body important design work is realized by clay models and the resulting geometry information typically comes from optical scans. The scanned data is given in the form of point clouds which is then utilized in the virtual planning process for engineering work, e.g. to evaluate the load-carrying capacity. This is an important measure for the stiffness of the car body panels. In this contribution, the following two issues are discussed: what is the suitable geometric representation of the stiffness of the car body and how it is computed if only discrete point clouds exist. In the first part, the suitable geometric representation is identified by constructing continuous CAD models with different geometric parameters, e.g. Gaussian curvature and mean curvature. The stiffness of models is then computed in LS-DYNA and the influence of different geometric parameters is presented based on the simulation result. In the second part, the point clouds from scanned data, rather than continuous CAD models, are directly utilized to estimate the Gaussian curvature, which is normally derived from continuous surfaces. The discrete Gauss-Bonnet algorithm is applied to estimate the Gaussian curvature of the point clouds and the sensitivity of the algorithm with respect to the mesh quality is analyzed. In this way, the stiffness evaluation process in an early stage can be accelerated since the transformation from discrete data to continuous CAD data is labor-intensive. The discrete Gauss-Bonnet algorithm is finally applied to a sheet metal model of the BMW 3 series.

  15. [Evaluation of using statistical methods in selected national medical journals].

    PubMed

    Sych, Z

    1996-01-01

    The paper covers the performed evaluation of frequency with which the statistical methods were applied in analyzed works having been published in six selected, national medical journals in the years 1988-1992. For analysis the following journals were chosen, namely: Klinika Oczna, Medycyna Pracy, Pediatria Polska, Polski Tygodnik Lekarski, Roczniki Państwowego Zakładu Higieny, Zdrowie Publiczne. Appropriate number of works up to the average in the remaining medical journals was randomly selected from respective volumes of Pol. Tyg. Lek. The studies did not include works wherein the statistical analysis was not implemented, which referred both to national and international publications. That exemption was also extended to review papers, casuistic ones, reviews of books, handbooks, monographies, reports from scientific congresses, as well as papers on historical topics. The number of works was defined in each volume. Next, analysis was performed to establish the mode of finding out a suitable sample in respective studies, differentiating two categories: random and target selections. Attention was also paid to the presence of control sample in the individual works. In the analysis attention was also focussed on the existence of sample characteristics, setting up three categories: complete, partial and lacking. In evaluating the analyzed works an effort was made to present the results of studies in tables and figures (Tab. 1, 3). Analysis was accomplished with regard to the rate of employing statistical methods in analyzed works in relevant volumes of six selected, national medical journals for the years 1988-1992, simultaneously determining the number of works, in which no statistical methods were used. Concurrently the frequency of applying the individual statistical methods was analyzed in the scrutinized works. Prominence was given to fundamental statistical methods in the field of descriptive statistics (measures of position, measures of dispersion) as well as

  16. The 2011 Program Evaluation Standards: a framework for quality in medical education programme evaluations.

    PubMed

    Ruhe, Valerie; Boudreau, J Donald

    2013-10-01

    Based on input from 400 stakeholders over 6 years, the 2011 Program Evaluation Standards represents an in-depth analysis of values, meaning and measurement and their relationships in programme evaluation. Evaluation quality is achieved by balancing five attributes: utility, feasibility, propriety, accuracy and evaluation accountability. These attributes are used to organize 30 standards, 200 strategies and 197 hazards. In response to a call from the authors of the standards, we have used them to guide our meta-evaluation of McGill's undergraduate physicianship programme. Our findings show how the standards illuminate the tensions, dilemmas and hazards inherent in all stages of programme evaluation studies and offer helpful strategies for designing and conducting high-quality evaluation studies. Based on our experience, the third edition needs to be used as a reference document in all stages of evaluations of medical education programmes. © 2012 John Wiley & Sons Ltd.

  17. [Identifying language and communication disorders as part of the medical curriculum].

    PubMed

    Deuster, D; am Zehnhoff-Dinnesen, A; Knief, A; Matulat, P; Bartha-Doering, L; Fiori, A; Schmidt, C-M

    2012-03-01

    Like hearing loss, language and speech disorders can also lead to impaired communication. Speech and language disorders can occur at any age, for example as a specific language impairment, stuttering, dysarthria, and aphasia. Hence, irrespective of their speciality, there is a high probability that physicians will at some point encounter communication-impaired patients, be required to classify their disorder and refer them for appropriate therapy. A new module entitled 'communication disorders' consisting of two teaching units was integrated in the practical course 'ENT--phoniatrics--pedaudiology' for undergraduate clinical students in 2008. The learning objective of the first unit was to identify and classify communication disorders, presented using sound and video data, by means of simple criteria. The module was evaluated on the basis of questionnaires completed by 164 students. On a scale of 1-7, the evaluation showed overall positive results with 6.54 (highest score) for professional competence and 5.32 (lowest score) for discussion. The overall score was 12.28 out of a possible maximum of 15 points. The ability to identify communication impairments is an important medical skill. Since communication disorders are common diseases we suggest that this skill be incorporated in the medical curriculum. Thus we have introduced a module for communication disorders; its evaluation by students shows a high level of satisfaction in each category. After developing specific diagnostic indicators students were able to independently describe and identify communication disorders.

  18. Criteria for evaluating performance of third-year medical students.

    PubMed

    Grim, D R; Miller, M D

    1993-06-01

    Evaluating medical student performance in clinical settings is an aspect of teaching that educators sometimes find difficult. This study was conducted to determine evaluation criteria for clinical performance that were considered important by physician faculty. These criteria were subsequently used in the student evaluation process for a decentralized clerkship in family medicine. In Phase I, physician faculty were surveyed to identify preferred criteria for evaluating student performance through an open-ended format. In Phase II, the identified items were refined. In Phase III, 45 items were presented to the faculty for rating importance on a visual analogue scale. Twenty-nine of 31 physicians responded. Factor analysis identified three factors that accounted for 76.6% of the variance: application of knowledge, relationship with patients, and therapeutics in family medicine. Results of the study suggest that physician faculty have internalized expectations of clinical competence in the discipline of family medicine that address the basic dimensions of cognitive ability, problem-solving skills, and interpersonal relationships.

  19. Medical Literature Evaluation Education at US Schools of Pharmacy.

    PubMed

    O'Sullivan, Teresa A; Phillips, Jennifer; Demaris, Kendra

    2016-02-25

    To determine how medical literature evaluation (MLE) is being taught across the United States and to summarize methods for teaching and assessing MLE. An 18-question survey was administered to faculty members whose primary responsibility was teaching MLE at schools and colleges of pharmacy. Responses were received from 90 (71%) US schools of pharmacy. The most common method of integrating MLE into the curriculum was as a stand-alone course (49%). The most common placement was during the second professional year (43%) or integrated throughout the curriculum (25%). The majority (77%) of schools used a team-based approach. The use of active-learning strategies was common as was the use of multiple methods of evaluation. Responses varied regarding what role the course director played in incorporating MLE into advanced pharmacy practice experiences (APPEs). There is a trend toward incorporating MLE education components throughout the pre-APPE curriculum and placement of literature review/evaluation exercises into therapeutics practice skills laboratories to help students see how this skill integrates into other patient care skills. Several pre-APPE educational standards for MLE education exist, including journal club activities, a team-based approach to teaching and evaluation, and use of active-learning techniques.

  20. Medical Literature Evaluation Education at US Schools of Pharmacy

    PubMed Central

    Phillips, Jennifer; Demaris, Kendra

    2016-01-01

    Objective. To determine how medical literature evaluation (MLE) is being taught across the United States and to summarize methods for teaching and assessing MLE. Methods. An 18-question survey was administered to faculty members whose primary responsibility was teaching MLE at schools and colleges of pharmacy. Results. Responses were received from 90 (71%) US schools of pharmacy. The most common method of integrating MLE into the curriculum was as a stand-alone course (49%). The most common placement was during the second professional year (43%) or integrated throughout the curriculum (25%). The majority (77%) of schools used a team-based approach. The use of active-learning strategies was common as was the use of multiple methods of evaluation. Responses varied regarding what role the course director played in incorporating MLE into advanced pharmacy practice experiences (APPEs). Conclusion. There is a trend toward incorporating MLE education components throughout the pre-APPE curriculum and placement of literature review/evaluation exercises into therapeutics practice skills laboratories to help students see how this skill integrates into other patient care skills. Several pre-APPE educational standards for MLE education exist, including journal club activities, a team-based approach to teaching and evaluation, and use of active-learning techniques. PMID:26941431

  1. 42 CFR 424.24 - Requirements for medical and other health services furnished by providers under Medicare Part B.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for medical and other health services furnished by providers under Medicare Part B. 424.24 Section 424.24 Public Health CENTERS FOR MEDICARE... MEDICARE PAYMENT Certification and Plan Requirements § 424.24 Requirements for medical and other health...

  2. A Survey of the Review Programs for the Part 1 Exam of the National Board of Medical Examiners.

    ERIC Educational Resources Information Center

    Litzinger, Marcia J.; Welker, Weston J.

    1979-01-01

    An academic affairs committee submitted a questionnaire to the 116 U. S. medical schools to obtain specific information concerning the existence of National Board of Medical Examiners' part 1 preparatory review programs and the organization and methods of such courses. Only 25 percent of the respondents indicated an organized program of board…

  3. International student exchange and the medical curriculum: evaluation of a medical sciences translational physiology course in Brazil.

    PubMed

    Morris, Mariana; Jones, T David; Rocha, Maria Jose Alves; Fazan, Rubens; Chapleau, Mark W; Salgado, Helio C; Johnson, Alan Kim; Irigoyen, Maria Claudia; Michelini, Lisete C; Goldstein, David L

    2006-09-01

    The objective of the present study was to conduct a short-term international course on translational physiology for medical students from Wright State University and the University of Iowa. The goals were to 1) provide students with an exposure to the academic, cultural, and medical environments in Brazil; 2) promote awareness of the global medical community; and 3) provide an academic course focused on translational physiology. An evaluation of the students was conducted to determine whether such a short-term course might be useful in the medical curriculum. The 2-wk course was held in the summer of 2005 at the University of São Paulo School of Medicine in Ribeirão Preto, Brazil, for 23 American students. The program included presentations of basic and clinical topics, meetings with medical students, and clinical presentations. The program finished with student attendance at a scientific meeting sponsored by the Brazilian Society of Hypertension. Student surveys evaluated issues related to perceived treatment, Brazilian medical school environment, culture and personal attributes, and career aspirations. The international Medical Sciences Translational Physiology course for medical students provided a brief, but intense, experience. It gave students a picture of the medical environment in Brazil and an appreciation for the differences and similarities in cultures. Most students reported that it was a positive experience that would be beneficial to their careers. In conclusion, a short-term international course provides an efficient means for medical students to experience aspects of global medical science.

  4. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    PubMed

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P < .01), but reported similar experiences with routine access and continuity. Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  5. Clinical Performance Evaluations of Third-Year Medical Students and Association With Student and Evaluator Gender.

    PubMed

    Riese, Alison; Rappaport, Leah; Alverson, Brian; Park, Sangshin; Rockney, Randal M

    2017-06-01

    Clinical performance evaluations are major components of medical school clerkship grades. But are they sufficiently objective? This study aimed to determine whether student and evaluator gender is associated with assessment of overall clinical performance. This was a retrospective analysis of 4,272 core clerkship clinical performance evaluations by 829 evaluators of 155 third-year students, within the Alpert Medical School grading database for the 2013-2014 academic year. Overall clinical performance, assessed on a three-point scale (meets expectations, above expectations, exceptional), was extracted from each evaluation, as well as evaluator gender, age, training level, department, student gender and age, and length of observation time. Hierarchical ordinal regression modeling was conducted to account for clustering of evaluations. Female students were more likely to receive a better grade than males (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.13-1.50), and female evaluators awarded lower grades than males (AOR 0.72, 95% CI 0.55-0.93), adjusting for department, observation time, and student and evaluator age. The interaction between student and evaluator gender was significant (P = .03), with female evaluators assigning higher grades to female students, while male evaluators' grading did not differ by student gender. Students who spent a short time with evaluators were also more likely to get a lower grade. A one-year examination of all third-year clerkship clinical performance evaluations at a single institution revealed that male and female evaluators rated male and female students differently, even when accounting for other measured variables.

  6. [Application Status of Evaluation Methodology of Electronic Medical Record: Evaluation of Bibliometric Analysis].

    PubMed

    Lin, Dan; Liu, Jialin; Zhang, Rui; Li, Yong; Huang, Tingting

    2015-04-01

    In order to provide a reference and theoretical guidance of the evaluation of electronic medical record (EMR) and establishment of evaluation system in China, we applied a bibliometric analysis to assess the application of methodologies used at home and abroad, as well as to summarize the advantages and disadvantages of them. We systematically searched international medical databases of Ovid-MEDLINE, EBSCOhost, EI, EMBASE, PubMed, IEEE, and China's medical databases of CBM and CNKI between Jan. 1997 and Dec. 2012. We also reviewed the reference lists of articles for relevant articles. We selected some qualified papers according to the pre-established inclusion and exclusion criteria, and did information extraction and analysis to the papers. Eventually, 1 736 papers were obtained from online database and other 16 articles from manual retrieval. Thirty-five articles met the inclusion and exclusion criteria and were retrieved and assessed. In the evaluation of EMR, US counted for 54.28% in the leading place, and Canada and Japan stood side by side and ranked second with 8.58%, respectively. For the application of evaluation methodology, Information System Success Model, Technology Acceptance Model (TAM), Innovation Diffusion Model and Cost-Benefit Access Model were widely applied with 25%, 20%, 12.5% and 10%, respectively. In this paper, we summarize our study on the application of methodologies of EMR evaluation, which can provide a reference to EMR evaluation in China.

  7. Use of medication technicians in US nursing homes: part of the problem or part of the solution?

    PubMed

    Hughes, Carmel M; Wright, Rollin M; Lapane, Kate L

    2006-06-01

    To determine the relation between organizational characteristics and medication technician (MT) use and quantify the impact of MTs on increasing the likelihood of using medications, employing the example of antiosteoporosis medications. Cross-sectional study. The setting included 6344 Medicare/Medicaid certified nursing homes in 23 states. Residents older than 65 years of age. On-line Survey and Certification of Automated Records (OSCAR) provided facility characteristics information including structural, resource, and staffing levels. The Minimum Data Set (MDS) provided information regarding use of antiosteoporosis medications and resident factors. Adjusted estimates of MT use on antiosteoporosis medication use were derived using logistic regression with generalized estimating equations. MT use varied by state (6.7% in Alaska vs 85% in Kansas). Homes with greater nursing staffing levels per 100 beds (CNA, RN, LPN) were less likely to use MTs, while larger homes, homes using physician extenders, and contracting pharmacy services were more likely to use MTs. Homes with MTs were more likely to have medication error rates of at least 5% (10.1% vs 7.3%) than homes without MTs. After adjustment for resident and facility factors, residents in MT facilities were not more likely to receive antiosteoporosis treatment relative to those in homes without MTs. These data call into question the use of MTs in nursing homes. Use of MTs may lead to more errors, yet not increase use of medications that are labor intensive to administer.

  8. Protocol for the effect evaluation of independent medical evaluation after six months sick leave: a randomized controlled trial of independent medical evaluation versus treatment as usual in Norway.

    PubMed

    Husabo, Elisabeth; Monstad, Karin; Holmås, Tor Helge; Oyeflaten, Irene; Werner, Erik L; Maeland, Silje

    2017-06-14

    It has been discussed whether the relationship between a patient on sick leave and his/her general practitioner (GP) is too close, as this may hinder the GP's objective evaluation of need for sick leave. Independent medical evaluation involves an independent physician consulting the patient. This could lead to new perspectives on sick leave and how to follow-up the patient. The current study is a randomized controlled trial in a Norwegian primary care context, involving an effect evaluation, a cost/benefit analysis, and a qualitative evaluation. Independent medical evaluation will be compared to treatment as usual, i.e., the physicians' and social insurance agencies' current management of long-term sick-listed patients. Individuals aged 18-65 years, sick listed by their GP and on full or partial sick leave for the past 6 months in Hordaland county will be included. Exclusion criteria are pregnancy, cancer, dementia or an ICD-10 diagnosis. A total sample of 3800 will be randomly assigned to either independent medical evaluation or treatment as usual. Official register data will be used to measure the primary outcome; change in sickness benefits at 7, 9 and 12 months. Sick listed in other counties will serve as a second control group, if appropriate under the "common trend" assumption. The Norwegian effect evaluation of independent medical evaluation after 6 months sick leave is a large randomized controlled trial, and the first of its kind, to evaluate this type of intervention as a means of getting people back to work after long-term sickness absence. ClinicalTrials.gov NCT02524392 . Registered June 23, 2015.

  9. Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment.

    PubMed

    Roberts, Wendy E

    2014-04-01

    Periorbital hyperpigmentation (POH) is a common worldwide problem. It is challenging to treat, complex in pathogenesis, and lacking straightforward and repeatable therapeutic options. It may occur in the young and old, however the development of dark circles under the eyes in any age is of great aesthetic concern because it may depict the individual as sad, tired, stressed, and old. While "dark circles" are seen in all skin types, POH is often more commonly seen in skin of color patients worldwide. With a shifting US demographic characterized by growing number of aging patients as well as skin of color patients, we will encounter POH with greater frequency. As forecasted by the US Census, by 2030 1 in 5 Americans will be 65 plus years old and greater than 50% of the population will possess ethnic skin of color. The disparity in the medical community's understanding of POH versus popular demand for treatment is best illustrated when you have only 65 cited articles to date indexed on PubMed line compared to the 150,000,000 results on Google search engine. Most importantly POH may be a final common pathway of dermatitis, allergy, systemic disorders, sleep disturbances, or nutritional deficiences that lends itself to medical, surgical, and cosmeceutical treatments. A complete medical history with ROS and physical examination is encouraged prior to treating the aesthetic component. Sun protection is a cornerstone of therapy. Safety issues are of utmost concern when embarking upon treatments such as chemical peeling, filler injection, and laser therapy as not to worsen the pigmentation. Without intervention, POH usually progresses over time so early intervention and management is encouraged. The objective of this study was to review the current body of knowledge on POH, provide the clinician with a guide to the evaluation and treatment of POH, and to present diverse clinical cases of POH that have responded to different therapies including non-ablative fractional

  10. Evaluation of Internet-based oncologic teaching for medical students.

    PubMed

    Mehta, M P; Sinha, P; Kanwar, K; Inman, A; Albanese, M; Fahl, W

    1998-01-01

    Electronic tools with substantial educational applications are now widely available. In a prospective, randomized study, the value of Web-based educational tools for teaching second-year medical students was evaluated. The 35-hour, image-intensive multifaculty neoplasia course was selected for the experiment, with 103 students assigned to the control group (C) and 61 to the experimental group (E). Representative password-controlled multimedia course modules, accessible via the Internet, were developed. The E cohort was exposed to both classroom and Web-aided materials, whereas the C group had access to the Web modules only after the experiment was concluded (but before the final examination). Pre- and post-exposure questionnaires assessed computer knowledge, familiarity with the Internet, availability of computer access, and the value of Web-based education for both cohorts. Additionally, pre-and post-exposure tests were administered to both cohorts based on educational materials presented in the Web modules. The overall participation rate was 64% (E = 69%; C = 60%). The post-test showed no major performance difference between the two groups. The questionnaires revealed that: less than 1% of the students had not accessed the Internet previously; less than 5% had not used the Internet for medical education before; 34% felt that computer resources on campus were inadequate; and over 75% found Web-based education to be an important additional educational resource. The major negative aspect was the slow pace of data transfer for modem-based home access. Only 1% of students felt that Web-based education could completely replace traditional teaching. The potential for incorporating Web-based education in the medical curriculum is considerable.

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

    PubMed

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

    2017-01-01

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

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

    PubMed Central

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

    2017-01-01

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

  13. 76 FR 34635 - Medical Certification Requirements as Part of the Commercial Driver's License (CDL); Extension of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... qualification requirements must retain a paper copy of the medical examiner's certificate. Interstate motor... are able to post the medical self-certification and medical examiner's certificate data on the... driver record data from a CDL holder's medical self- certification and medical examiner's...

  14. AME survey-003 A1-part 2: the motivation factors of medical doctors in China.

    PubMed

    Wáng, Yì-Xiáng J; Káplár, Zoltán; L, Yáo T

    2015-12-01

    The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals. An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs. The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals. The moral and motivation of medical

  15. Profile of graduates of Israeli medical schools in 1981--2000: educational background, demography and evaluation of medical education programs.

    PubMed

    Bitterman, Noemi; Shalev, Ilana

    2005-05-01

    In light of changes in the medical profession, the different requirements placed on physicians and the evolving needs of the healthcare system, the need arose to examine the medical education curriculum in Israel. This survey, conducted by the Samuel Neaman Institute for Science and Technology, summarizes 20 years of medical education in Israel's four medical schools, as the first stage in mapping the existing state of medical education in Israel and providing a basis for decision-making on future medical education programs. To characterize the academic background of graduates, evaluate their attitudes towards current and alternative medical education programs, and examine subgroups among graduates according to gender, medical school, high school education, etc. The survey included graduates from all four Israeli medical schools who graduated between the years 1981 and 2000 in a sample of 1:3. A questionnaire and stamped return envelope were sent to every third graduate; the questionnaire included open and quantitative questions graded on a scale of 1 to 5. The data were processed for the entire graduate population and further analyzed according to subgroups such as medical schools, gender, high school education, etc. The response rate was 41.3%. The survey provided a demographic profile of graduates over a 20 year period, their previous educational and academic background, additional academic degrees achieved, satisfaction, and suggestions for future medical education programs. The profile of the medical graduates in Israel is mostly homogenous in terms of demographics, with small differences among the four medical schools. In line with recommendations of the graduates, and as an expression of the changing requirements in the healthcare system and the medical profession, the medical schools should consider alternative medical education programs such as a bachelor's degree in life sciences followed by MD studies, or education programs that combine medicine with

  16. Cohort Profile: HAART Observational Medical Evaluation and Research (HOMER) Cohort

    PubMed Central

    Patterson, Sophie; Cescon, Angela; Samji, Hasina; Cui, Zishan; Yip, Benita; Lepik, Katherine J; Moore, David; Lima, Viviane D; Nosyk, Bohdan; Harrigan, P Richard; Montaner, Julio SG; Shannon, Kate; Wood, Evan; Hogg, Robert S

    2015-01-01

    Since 1986, antiretroviral therapy (ART) has been available free of charge to individuals living with HIV in British Columbia (BC), Canada, through the BC Centre of Excellence in HIV/AIDS (BC-CfE) Drug Treatment Program (DTP). The Highly Active Antiretroviral Therapy (HAART) Observational Medical Evaluation and Research (HOMER) cohort was established in 1996 to maintain a prospective record of clinical measurements and medication profiles of a subset of DTP participants initiating HAART in BC. This unique cohort provides a comprehensive data source to investigate mortality, prognostic factors and treatment response among people living with HIV in BC from the inception of HAART. Currently over 5000 individuals are enrolled in the HOMER cohort. Data captured include socio-demographic characteristics (e.g. sex, age, ethnicity, health authority), clinical variables (e.g. CD4 cell count, plasma HIV viral load, AIDS-defining illness, hepatitis C co-infection, mortality) and treatment variables (e.g. HAART regimens, date of treatment initiation, treatment interruptions, adherence data, resistance testing). Research findings from the HOMER cohort have featured in numerous high-impact peer-reviewed journals. The HOMER cohort collaborates with other HIV cohorts on both national and international scales to answer complex HIV-specific research questions, and welcomes input from external investigators regarding potential research proposals or future collaborations. For further information please contact the principal investigator, Dr Robert Hogg (robert_hogg@sfu.ca). PMID:24639444

  17. Cohort Profile: HAART Observational Medical Evaluation and Research (HOMER) cohort.

    PubMed

    Patterson, Sophie; Cescon, Angela; Samji, Hasina; Cui, Zishan; Yip, Benita; Lepik, Katherine J; Moore, David; Lima, Viviane D; Nosyk, Bohdan; Harrigan, P Richard; Montaner, Julio S G; Shannon, Kate; Wood, Evan; Hogg, Robert S

    2015-02-01

    Since 1986, antiretroviral therapy (ART) has been available free of charge to individuals living with HIV in British Columbia (BC), Canada, through the BC Centre of Excellence in HIV/AIDS (BC-CfE) Drug Treatment Program (DTP). The Highly Active Antiretroviral Therapy (HAART) Observational Medical Evaluation and Research (HOMER) cohort was established in 1996 to maintain a prospective record of clinical measurements and medication profiles of a subset of DTP participants initiating HAART in BC. This unique cohort provides a comprehensive data source to investigate mortality, prognostic factors and treatment response among people living with HIV in BC from the inception of HAART. Currently over 5000 individuals are enrolled in the HOMER cohort. Data captured include socio-demographic characteristics (e.g. sex, age, ethnicity, health authority), clinical variables (e.g. CD4 cell count, plasma HIV viral load, AIDS-defining illness, hepatitis C co-infection, mortality) and treatment variables (e.g. HAART regimens, date of treatment initiation, treatment interruptions, adherence data, resistance testing). Research findings from the HOMER cohort have featured in numerous high-impact peer-reviewed journals. The HOMER cohort collaborates with other HIV cohorts on both national and international scales to answer complex HIV-specific research questions, and welcomes input from external investigators regarding potential research proposals or future collaborations. For further information please contact the principal investigator, Dr Robert Hogg (robert_hogg@sfu.ca).

  18. Evaluation of Interprofessional Team Disclosure of a Medical Error to a Simulated Patient

    PubMed Central

    Kern, Donna H.; Shrader, Sarah P.

    2016-01-01

    Objective. To evaluate the impact of an Interprofessional Communication Skills Workshop on pharmacy student confidence and proficiency in disclosing medical errors to patients. Pharmacy student behavior was also compared to that of other health professions’ students on the team. Design. Students from up to four different health professions participated in a simulation as part of an interprofessional team. Teams were evaluated with a validated rubric postsimulation on how well they handled the disclosure of an error to the patient. Individually, each student provided anonymous feedback and self-reflected on their abilities via a Likert-scale evaluation tool. A comparison of pharmacy students who completed the workshop (active group) vs all others who did not (control group) was completed and analyzed. Assessment. The majority of students felt they had adequate training related to communication issues that cause medication errors. However, fewer students believed that they knew how to report such an error to a patient or within a health system. Pharmacy students who completed the workshop were significantly more comfortable explicitly stating the error disclosure to a patient and/or caregiver and were more likely to apologize and respond to questions forthrightly (p<0.05). Conclusions. This data affirms the need to devote more time to training students on communicating with patients about the occurrence of medical errors and how to report these errors. Educators should be encouraged to incorporate such training within interprofessional education curricula. PMID:27899834

  19. Executive skills for medical faculty: a workshop description and evaluation.

    PubMed

    Steinert, Yvonne; Nasmith, Louise; Daigle, Norma

    2003-11-01

    As the healthcare system continues to change, healthcare professionals will need to assume an increasing number of administrative and management responsibilities. The goal of this article is to describe a two-day workshop on Executive Skills for Medical Faculty and the results of an evaluation conducted one year later. This workshop consisted of specific modules on analyzing time-management skills, determining goals and priorities, improving time-management strategies, assessing leadership styles and skills, and conducting effective meetings. The workshop evaluation consisted of an immediate post-workshop questionnaire administered to all of the participants, and semi-structured interviews, conducted on the telephone, with half of the attendees. Both evaluations were designed to assess perceptions of the workshop's usefulness and areas of individual change. Feedback from the participants immediately after the workshop indicated an overall satisfaction with the workshop content and methodology and a desire to try new time-management strategies. Evaluation of the workshop one year later indicated that the majority of the participants had determined their priorities more clearly, altered their time-management strategies, and planned more effective meetings. Less change was noted in the area of leadership styles and skills. Both the immediate and delayed workshop evaluations indicated that the most useful sessions were those devoted to determining goals and priorities, time management and effective meetings. These results suggest that a two-day workshop can improve health care professionals' administrative and management skills in certain areas. A longer workshop and built-in 'follow-up' activities would enhance the potential for change.

  20. [The ideal of establishing an evaluation system about the combination program of Chinese medical pharmacy and western medical pharmacy].

    PubMed

    Yang, Yun-song

    2013-08-01

    The necessity of establishing an evaluation system about the combination program of Chinese medical pharmacy and Western medical pharmacy was addressed in this paper. Besides, its contents were systematically clarified. Besides, existent problems and its future development trend were also explained. The author believed that it was necessary to perform researches on constructing the evaluation system on the basis of patients' needs and physicians' responsibilities. The ultimate goal of this system was to produce an optimal combination program of Chinese medical pharmacy and Western medical pharmacy for a specific disease. This optimal program was the results of comparing and analyzing the therapeutic efficacies of different combination programs. In this program, Chinese medical pharmacy and Western medical pharmacy combined together. On the one hand, it is safe; on the other hand, they do not produce adverse reaction. Their therapeutic effects were synergetic. Chinese medical pharmacy could not only advance the cure effects of Western medical pharmacy, but also supplement the insufficiency of Western medical pharmacy. Of course, the author put forward some assumptions only from the perspective of clinical application in this paper. The evaluation system will become perfect along with further deepening researches of basic sciences.

  1. A usability evaluation of medical software at an expert conference setting.

    PubMed

    Bond, Raymond Robert; Finlay, Dewar D; Nugent, Chris D; Moore, George; Guldenring, Daniel

    2014-01-01

    be very expensive to arrange. A conference-based approach also allows for data to be collected over a few days as opposed to months by avoiding administration duties normally involved in laboratory based approach, e.g. mailing invitation letters as part of a recruitment campaign. Following analysis of the user video recordings, 41 (previously unknown) use errors were identified in the advanced ECG viewer and 29 were identified in the EMS application. All use errors were given a consensus severity rating from two independent usability experts. Out of a rating scale of 4 (where 1=cosmetic and 4=critical), the average severity rating for the ECG viewer was 2.24 (SD=1.09) and the average severity rating for the EMS application was 2.34 (SD=0.97). We were also able to extract task completion rates and times from the video recordings to determine the effectiveness of the software applications. For example, six out of seven tasks were completed by all participants when using both applications. This statistic alone suggests both applications already have a high degree of usability. As well as extracting data from the video recordings, we were also able to extract data from the questionnaires. Using a semantic differential scale (where 1=poor and 5=excellent), delegates highly rated the 'responsiveness', 'usefulness', 'learnability' and the 'look and feel' of both applications. This study has shown the potential user acceptance and user-friendliness of the novel EMS and the ECG viewer applications within the healthcare domain. It has also shown that both medical diagnostic software and medical research software can be evaluated for their usability at an expert conference setting. The primary advantage of a conference-based usability evaluation over a laboratory-based evaluation is the high concentration of experts at one location, which is convenient, less time consuming and less expensive. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Evaluation of RxNorm for Medication Clinical Decision Support.

    PubMed

    Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G

    2014-01-01

    We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS.

  3. Physical evaluation and the prevention of medical emergencies: vital signs.

    PubMed

    Malamed, S F

    1993-01-01

    It was assumed that dentists employ a complete system of physical evaluation for all new patients in their dental practices. Results of a survey of 1,588 dentists demonstrated that the use of a written medical history questionnaire was commonplace; however, recording of blood pressure and heart rate and rhythm on all new patients was quite limited. A greater percentage of dentists monitored blood pressure when there was a history of cardiovascular disease or high blood pressure. Monitoring of the heart rate and rhythm, even in patients with cardiovascular disease or high blood pressure, was severely limited in scope. A significant number of dentists still employ racemic epinephrine impregnated gingival retraction cord, and of these, 40% had observed "epinephrine-reactions."

  4. Evaluation of RxNorm for Medication Clinical Decision Support

    PubMed Central

    Freimuth, Robert R.; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G.

    2014-01-01

    We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360

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

    PubMed

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

    2009-04-01

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

  6. Transforming Medical Assessment: Integrating Uncertainty Into the Evaluation of Clinical Reasoning in Medical Education.

    PubMed

    Cooke, Suzette; Lemay, Jean-Francois

    2017-01-31

    In an age where practicing physicians have access to an overwhelming volume of clinical information and are faced with increasingly complex medical decisions, the ability to execute sound clinical reasoning is essential to optimal patient care. The authors propose two concepts that are philosophically paramount to the future assessment of clinical reasoning in medicine: assessment in the context of "uncertainty" (when, despite all of the information that is available, there is still significant doubt as to the best diagnosis, investigation, or treatment), and acknowledging that it is entirely possible (and reasonable) to have more than "one correct answer." The purpose of this article is to highlight key elements related to these two core concepts and discuss genuine barriers that currently exist on the pathway to creating such assessments. These include acknowledging situations of uncertainty, creating clear frameworks that define progressive levels of clinical reasoning skills, providing validity evidence to increase the defensibility of such assessments, considering the comparative feasibility with other forms of assessment, and developing strategies to evaluate the impact of these assessment methods on future learning and practice. The authors recommend that concerted efforts be directed toward these key areas to help advance the field of clinical reasoning assessment, improve the clinical care decisions made by current and future physicians, and have positive outcomes for patients. It is anticipated that these and subsequent efforts will aid in reaching the goal of making future assessment in medical education more representative of current-day clinical reasoning and decision making.

  7. Evaluation of medication list completeness, safety, and annotations.

    PubMed

    Owen, Michael C; Chang, Nancy M; Chong, David H; Vawdrey, David K

    2011-01-01

    Clinical documents frequently contain a list of a patient's medications. Missing information about the dosage, route, or frequency of a medication impairs clinical communication and may harm patients. We examined 253 medication lists. There were 181 lists (72%) with at least one medication missing a dose, route, or frequency. Missing information was judged to be potentially harmful in 47 of the lists (19% of 253) by three physician reviewers (kappa=0.69). We also observed that many lists contained additional information included as annotations, prompting a secondary thematic analysis of the annotations. Fifty-five of the 253 lists (22%) contained one or more annotations. The most frequent types of annotations were comments about the patient's medical history, the clinician's treatment plan changes, and the patient's adherence to a medication. Future development of electronic medication reconciliation tools to improve medication list completeness should also support annotating the medication list in a flexible manner.

  8. Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002-2008

    PubMed Central

    Semple, Susan J; Roughead, Elizabeth E

    2009-01-01

    Background This paper presents Part 2 of a literature review examining medication safety in the Australian acute care setting. This review was undertaken for the Australian Commission on Safety and Quality in Health Care, updating the 2002 national report on medication safety. Part 2 of the review examined the Australian evidence base for approaches to build safer medication systems in acute care. Methods A literature search was conducted to identify Australian studies and programs published from 2002 to 2008 which examined strategies and activities for improving medication safety in acute care. Results and conclusion Since 2002 there has been significant progress in strategies to improve prescription writing in hospitals with the introduction of a National Inpatient Medication Chart. There are also systems in place to ensure a nationally coordinated approach to the ongoing optimisation of the chart. Progress has been made with Australian research examining the implementation of computerised prescribing systems with clinical decision support. These studies have highlighted barriers and facilitators to the introduction of such systems that can inform wider implementation. However, Australian studies assessing outcomes of this strategy on medication incidents or patient outcomes are still lacking. In studies assessing education for reducing medication errors, academic detailing has been demonstrated to reduce errors in prescriptions for Schedule 8 medicines and a program was shown to be effective in reducing error prone prescribing abbreviations. Published studies continue to support the role of clinical pharmacist services in improving medication safety. Studies on strategies to improve communication between different care settings, such as liaison pharmacist services, have focussed on implementation issues now that funding is available for community-based services. Double checking versus single-checking by nurses and patient self-administration in hospital has been

  9. Risk management in technovigilance: construction and validation of a medical-hospital product evaluation instrument.

    PubMed

    Kuwabara, Cleuza Catsue Takeda; Evora, Yolanda Dora Martinez; de Oliveira, Márcio Mattos Borges

    2010-01-01

    With the continuous incorporation of health technologies, hospital risk management should be implemented to systemize the monitoring of adverse effects, performing actions to control and eliminate their damage. As part of these actions, Technovigilance is active in the procedures of acquisition, use and quality control of health products and equipment. This study aimed to construct and validate an instrument to evaluate medical-hospital products. This is a quantitative, exploratory, longitudinal and methodological development study, based on the Six Sigma quality management model, which has as its principle basis the component stages of the DMAIC Cycle. For data collection and content validation, the Delphi technique was used with professionals from the Brazilian Sentinel Hospital Network. It was concluded that the instrument developed permitted the evaluation of the product, differentiating between the results of the tested brands, in line with the initial study goal of qualifying the evaluations performed.

  10. Evaluation of stereoscopic medical video content on an autostereoscopic display for undergraduate medical education

    NASA Astrophysics Data System (ADS)

    Ilgner, Justus F. R.; Kawai, Takashi; Shibata, Takashi; Yamazoe, Takashi; Westhofen, Martin

    2006-02-01

    Introduction: An increasing number of surgical procedures are performed in a microsurgical and minimally-invasive fashion. However, the performance of surgery, its possibilities and limitations become difficult to teach. Stereoscopic video has evolved from a complex production process and expensive hardware towards rapid editing of video streams with standard and HDTV resolution which can be displayed on portable equipment. This study evaluates the usefulness of stereoscopic video in teaching undergraduate medical students. Material and methods: From an earlier study we chose two clips each of three different microsurgical operations (tympanoplasty type III of the ear, endonasal operation of the paranasal sinuses and laser chordectomy for carcinoma of the larynx). This material was added by 23 clips of a cochlear implantation, which was specifically edited for a portable computer with an autostereoscopic display (PC-RD1-3D, SHARP Corp., Japan). The recording and synchronization of left and right image was performed at the University Hospital Aachen. The footage was edited stereoscopically at the Waseda University by means of our original software for non-linear editing of stereoscopic 3-D movies. Then the material was converted into the streaming 3-D video format. The purpose of the conversion was to present the video clips by a file type that does not depend on a television signal such as PAL or NTSC. 25 4th year medical students who participated in the general ENT course at Aachen University Hospital were asked to estimate depth clues within the six video clips plus cochlear implantation clips. Another 25 4th year students who were shown the material monoscopically on a conventional laptop served as control. Results: All participants noted that the additional depth information helped with understanding the relation of anatomical structures, even though none had hands-on experience with Ear, Nose and Throat operations before or during the course. The monoscopic

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

    PubMed Central

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

    2007-01-01

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

  12. Evaluation and medical management of kidney stones in children.

    PubMed

    Tasian, Gregory E; Copelovitch, Lawrence

    2014-11-01

    We review the current literature on the diagnostic evaluation and dietary and pharmacological management of children with nephrolithiasis. We searched MEDLINE(®), Embase(®) and the Cochrane Library from their inceptions to March 2014 for published articles in English on kidney stones and therapy in children 0 to 18 years old. Based on review of the titles and abstracts, 110 of the 1,014 articles (11%) were potentially relevant to the diagnostic evaluation and medical management of nephrolithiasis in children. We summarized this literature and drew on studies performed in adult populations to augment areas in which no studies of sufficient quality have been performed in children, and to highlight areas in need of research. During the last 25 years the incidence of nephrolithiasis in children has increased by approximately 6% to 10% annually and is now 50 per 100,000 adolescents. Kidney stones that form during childhood have a similar composition to those that form in adulthood. Approximately 75% to 80% of stones are composed of predominantly calcium oxalate, 5% to 10% are predominantly calcium phosphate, 10% to 20% are struvite and 5% are pure uric acid. The recurrence rate of nephrolithiasis in patients with stones that form during childhood is poorly defined. Ultrasound should be used as the initial imaging study to evaluate children with suspected nephrolithiasis, with noncontrast computerized tomography reserved for those in whom ultrasound is nondiagnostic and the suspicion of nephrolithiasis remains high. Current treatment strategies for children with kidney stone disease are based largely on extrapolation of studies performed in adult stone formers and single institution cohort or case series studies of children. Tamsulosin likely increases the spontaneous passage of ureteral stones in children. Increased water intake and reduction of salt consumption should be recommended for all children with a history of kidney stones. Potassium citrate is a

  13. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed. Any...

  14. 78 FR 16679 - Center for Drug Evaluation and Research Medical Policy Council; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research Medical Policy... interested organizations, on medical policy issues that may be considered by the CDER Medical Policy Council (Council) in FDA's Center for Drug Evaluation and Research (CDER). These comments will help the...

  15. Medical podcasting in Iran; pilot, implementation and attitude evaluation.

    PubMed

    Heydarpour, Pouria; Hafezi-Nejad, Nima; Khodabakhsh, Ali; Khosravi, Mohsen; Khoshkis, Shayan; Sadeghian, Majid; Samavat, Bijan; Faturechi, Ali; Pasalar, Parvin; Dehpour, Ahmad Reza

    2013-01-01

    Podcasting has become a popular means of transferring knowledge in higher education through making lecture contents available to students at their convenience. Accessing courses on media players provides students with enhanced learning opportunities. Development of teaching methods able to cope with ever-changing nature of medicine is crucial to train the millennium students. Pharmacology education in Tehran University of Medical Sciences has been based on lectures so far; our aim was to implement a pilot study to evaluate the advantages and disadvantages of offering the course contents as podcasts as well as evaluating whether such program can be feasible in our educational program. 46% of students downloaded the podcast according to our download center. 48% favored usage of both internet and DVD-ROM concurrently. Overall 96% of students perceived that podcasting had a positive impact on their learning in pharmacology course. Our results indicate that most of attendants proposed the positive yields of podcasting despite low usage of it, mainly as a pre-class preparing tool.

  16. Improving emergency department flow through Rapid Medical Evaluation unit

    PubMed Central

    Chartier, Lucas; Josephson, Timothy; Bates, Kathy; Kuipers, Meredith

    2015-01-01

    The Toronto Western Hospital is an academic hospital in Toronto, Canada, with an annual Emergency Department (ED) volume of 64,000 patients. Despite increases in patient volumes of almost six percent per annum over the last decade, there have been no commensurate increases in resources, infrastructure, and staffing. This has led to substantial increase in patient wait times, most specifically for those patients with lower acuity presentations. Despite requiring only minimal care, these patients contribute disproportionately to ED congestion, which can adversely impact resource utilization and quality of care for all patients. We undertook a retrospective evaluation of a quality improvement initiative aimed at improving wait times experienced by patients with lower acuity presentations. A rapid improvement event was organized by frontline workers to rapidly overhaul processes of care, leading to the creation of the Rapid Medical Evaluation (RME) unit – a new pathway of care for patients with lower acuity presentations. The RME unit was designed by re-purposing existing resources and re-assigning one physician and one nurse towards the specific care of these patients. We evaluated the performance of the RME unit through measurement of physician initial assessment (PIA) times and total length of stay (LOS) times for multiple groups of patients assigned to various ED care pathways, during three periods lasting three months each. Weekly measurements of mean and 90th percentile of PIA and LOS times showed special cause variation in all targeted patient groups. Of note, the patients seen in the RME unit saw their median PIA and LOS times decrease from 98min to 70min and from 165min to 130min, respectively, from baseline. Despite ever-growing numbers of patient visits, wait times for all patients with lower acuity presentations remained low, and wait times of patients with higher acuity presentations assigned to other ED care pathways were not adversely affected. By

  17. Improving emergency department flow through Rapid Medical Evaluation unit.

    PubMed

    Chartier, Lucas; Josephson, Timothy; Bates, Kathy; Kuipers, Meredith

    2015-01-01

    The Toronto Western Hospital is an academic hospital in Toronto, Canada, with an annual Emergency Department (ED) volume of 64,000 patients. Despite increases in patient volumes of almost six percent per annum over the last decade, there have been no commensurate increases in resources, infrastructure, and staffing. This has led to substantial increase in patient wait times, most specifically for those patients with lower acuity presentations. Despite requiring only minimal care, these patients contribute disproportionately to ED congestion, which can adversely impact resource utilization and quality of care for all patients. We undertook a retrospective evaluation of a quality improvement initiative aimed at improving wait times experienced by patients with lower acuity presentations. A rapid improvement event was organized by frontline workers to rapidly overhaul processes of care, leading to the creation of the Rapid Medical Evaluation (RME) unit - a new pathway of care for patients with lower acuity presentations. The RME unit was designed by re-purposing existing resources and re-assigning one physician and one nurse towards the specific care of these patients. We evaluated the performance of the RME unit through measurement of physician initial assessment (PIA) times and total length of stay (LOS) times for multiple groups of patients assigned to various ED care pathways, during three periods lasting three months each. Weekly measurements of mean and 90th percentile of PIA and LOS times showed special cause variation in all targeted patient groups. Of note, the patients seen in the RME unit saw their median PIA and LOS times decrease from 98min to 70min and from 165min to 130min, respectively, from baseline. Despite ever-growing numbers of patient visits, wait times for all patients with lower acuity presentations remained low, and wait times of patients with higher acuity presentations assigned to other ED care pathways were not adversely affected. By

  18. Evaluation of 39 medical implants at 7.0 T

    PubMed Central

    Feng, David X; McCauley, Joseph P; Morgan–Curtis, Fea K; Salam, Redoan A; Pennell, David R; Loveless, Mary E

    2015-01-01

    Objective: With increased signal to noise ratios, 7.0-T MRI has the potential to contribute unique information regarding anatomy and pathophysiology of a disease. However, concerns for the safety of subjects with metallic medical implants have hindered advancement in this field. The purpose of the present research was to evaluate the MRI safety for 39 commonly used medical implants at 7.0 T. Methods: Selected metallic implants were tested for magnetic field interactions, radiofrequency-induced heating and artefacts using standardized testing techniques. Results: 5 of the 39 implants tested may be unsafe for subjects undergoing MRI at 7.0 T. Conclusion: Implants were deemed either “MR Conditional” or “MR Unsafe” for the 7.0-T MRI environment. Further research is needed to expand the existing database categorizing implants that are acceptable for patients referred for MRI examinations at 7.0 T. Advances in knowledge: Lack of MRI testing for common metallic medical implants limits the translational potential of 7.0-T MRI. For safety reasons, patients with metallic implants are not allowed to undergo a 7.0-T MRI scan, precluding part of the population that can benefit from the detailed resolution of ultra-high-field MRIs. This investigation provides necessary MRI testing of common medical implants at 7.0 T. PMID:26481696

  19. Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia.

    PubMed

    Ganasegeran, K; Al-Dubai, S A R

    2014-01-01

    The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Cross-sectional survey, in a Malaysian public health hospital. A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.

  20. Evaluating the Effectiveness of Navy Medical Corps Accession Programs

    DTIC Science & Technology

    2012-03-01

    GAO General Accounting Office GME Graduate Medical Education GMO General Medical Officer GPA Grade Point Average xiv HPLRP Health...supersede, or automatically promote, to O-3. At this juncture, a student will begin internship training, followed by a General Medical Officer ( GMO ) or...medical students will not complete a GMO or FS tour, and they will instead continue on through residency and fellowship training. This is commonly

  1. Evaluation of Mobile Authoring and Tutoring in Medical Issues

    ERIC Educational Resources Information Center

    Alepis, Efthymios; Virvou, Maria

    2010-01-01

    Mobile computing facilities may provide many assets to the educational process. Mobile technology provides software access from anywhere and at any time, as well as computer equipment independence. The need for time and place independence is even greater for medical instructors and medical students. Medical instructors are usually doctors that…

  2. Evaluation of an online bioterrorism continuing medical education course.

    PubMed

    Casebeer, Linda; Andolsek, Kathryn; Abdolrasulnia, Maziar; Green, Joseph; Weissman, Norman; Pryor, Erica; Zheng, Shimin; Terndrup, Thomas

    2006-01-01

    Much of the international community has an increased awareness of potential biologic, chemical, and nuclear threats and the need for physicians to rapidly acquire new knowledge and skills in order to protect the public's health. The present study evaluated the educational effectiveness of an online bioterrorism continuing medical education (CME) activity designed to address clinical issues involving suspected bioterrorism and reporting procedures in the United States. This was a retrospective survey of physicians who had completed an online CME activity on bioterrorism compared with a nonparticipant group who had completed at least 1 unrelated online CME course from the same medical school Web site and were matched on similar characteristics. An online survey instrument was developed to assess clinical and systems knowledge and confidence in recognition of illnesses associated with a potential bioterrorism attack. A power calculation indicated that a sample size of 100 (50 in each group) would achieve 90% power to detect a 10% to 15% difference in test scores between the two groups. Compared with nonparticipant physicians, participants correctly diagnosed anthrax (p = .01) and viral exanthem (p = .01), but not smallpox, more frequently than nonparticipants. Participants knew more frequently than nonparticipants who to contact regarding a potential bioterrorism event (p = .03) Participants were more confident than nonparticipants about finding information to guide diagnoses of patients with biologic exposure (p = .01), chemical exposure (p = .02), and radiation exposure (p = .04). An online bioterrorism course shows promise as an educational intervention in preparing physicians to better diagnose emerging rare infections, including those that may be associated with a bioterrorist event, in increasing confidence in diagnosing these infections, and in reporting of such infections for practicing physicians.

  3. Improving the Methods for the Economic Evaluation of Medical Devices.

    PubMed

    Tarricone, Rosanna; Callea, Giuditta; Ogorevc, Marko; Prevolnik Rupel, Valentina

    2017-02-01

    Medical devices (MDs) have distinctive features, such as incremental innovation, dynamic pricing, the learning curve and organisational impact, that need to be considered when they are evaluated. This paper investigates how MDs have been assessed in practice, in order to identify methodological gaps that need to be addressed to improve the decision-making process for their adoption. We used the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist supplemented by some additional categories to assess the quality of reporting and consideration of the distinctive features of MDs. Two case studies were considered: transcatheter aortic valve implantation (TAVI) representing an emerging technology and implantable cardioverter defibrillators (ICDs) representing a mature technology. Economic evaluation studies published as journal articles or within Health Technology Assessment reports were identified through a systematic literature review. A total of 19 studies on TAVI and 41 studies on ICDs were analysed. Learning curve was considered in only 16% of studies on TAVI. Incremental innovation was more frequently mentioned in the studies of ICDs, but its impact was considered in only 34% of the cases. Dynamic pricing was the most recognised feature but was empirically tested in less than half of studies of TAVI and only 32% of studies on ICDs. Finally, organisational impact was considered in only one study of ICDs and in almost all studies on TAVI, but none of them estimated its impact. By their very nature, most of the distinctive features of MDs cannot be fully assessed at market entry. However, their potential impact could be modelled, based on the experience with previous MDs, in order to make a preliminary recommendation. Then, well-designed post-market studies could help in reducing uncertainties and make policymakers more confident to achieve conclusive recommendations. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

  4. Medical Evaluation Board for Mental Health Condition: U.S. Army Officer Medical Evaluation Board Data by Branch and Component.

    PubMed

    Thomas, William A; Doane, Eric L; Gallavan, Robert H; Tavares, Spencer; Jones, Mark C

    2017-09-01

    A retrospective review of Medical Evaluation Board (MEB) data to determine the effect of career field or Army component on the relative risk for mental health (MH) related MEBs among Army Officers, may identify specific populations for enhanced screening before accession, or groups that may require targeted preventive resources during their careers. 4 years' of data available on Army Officers from the Department of the Army's Electronic Disability Evaluation System database, contained specific information on the officers' physical profiles, career fields, and service component. This information was compared with a dataset provided by the Defense Manpower Data Center (DMDC), reporting documented force strength by career field and service component for the corresponding years, allowing for calculation and comparison of MEB and MH-MEB rates between Army components and between career fields. Significant differences in MEB and MH-MEB rates were found between Army components, but database gaps make this assessment uncertain. When comparing MEB and MH-MEB rates between career fields (regardless of service component), 9 career fields had statistically significant higher risk rates of MEB and/or MH-MEB, whereas 13 career fields showed significantly lower rates of MEB and/or MH-MEB. Frequency of Army Officer MEBs and/or MH-MEBs were variable and career field dependent; the underlying causes of these variations warrant further research. The use of the Electronic Disability Evaluation System database for the Integrated Disability Evaluation System process is a rich source of data for in-depth analysis, but the program itself and the procedures for its use need to be improved to obtain more complete information. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  5. Medical shortages and Confederate medicine: a retrospective evaluation.

    PubMed

    Breeden, J O

    1993-09-01

    The Union's decision to treat medicines and medical supplies as contraband of war meant, for the Confederacy, the specter of medical shortages. The Confederate medical department significantly lessened the subsequent suffering through an energetic and resourceful program to supply its physicians' needs. Medicines and medical supplies were purchased abroad and smuggled through the Union blockade, obtained in an illicit trade with the North, captured from the enemy, and manufactured in the Confederacy. The search for home remedies, enthusiastically endorsed by Surgeon General Samuel P. Moore, was one of the most prominent features of the southern program. This paper surveys and analyzes medical shortages and Confederate medicine.

  6. Evaluation of the Coulter STKS five-part differential.

    PubMed

    Cornbleet, P J; Myrick, D; Levy, R

    1993-01-01

    The authors evaluated the Coulter STKS (Coulter Corp., Hialeah, FL) five-part differential in a tertiary-care hospital using samples with a broad range of distributional and morphologic abnormalities. Particular attention was given to the performance of the instrument-generated suspect flags that occur as an aid to identify samples with abnormal leukocytes. A morphologically abnormal, or positive, blood smear was defined by the presence of any blasts, malignant lymphoid cells, grossly dysplastic neutrophils, nucleated red blood cells (nRBC), platelet clumps, or reactive lymphocytes of more than 5%. The presence of any white blood cell-related suspect flag, except for Immature Granulocyte/Bands (i.e., Blasts, Variant Lymph, NRBC, Platelet Clumps, Review Slide, or WBC*R), was considered to be a positive instrument result. The STKS showed excellent quantitative results for the WBC differential compared with the manual differential when these "morphologic abnormalities" were absent in a 400-cell manual differential or low in numbers (< or = 5%). Specificity of these non-immature granulocyte/band suspect flags was good, with a false-positive rate of only 11.7%. Overall sensitivity in 113 samples with morphologic abnormalities was 67.3%. Sensitivity to detection of > or = 1% abnormal WBCs or > or = 1 nRBC/100 WBCs (a subset of 78 samples) was 80.8%. Sensitivity to detection of more than 5% abnormal WBCs or more than 5 nRBC/100 WBCs (a subset of 53 samples) was 84.9%. The primary deficiency was the inability of the STKS to flag samples with lymphoma cells, lymphoid blasts, or more than 5% reactive lymphocytes.

  7. Evaluation of medical research performance – position paper of the Association of the Scientific Medical Societies in Germany (AWMF)

    PubMed Central

    Herrmann-Lingen, Christoph; Brunner, Edgar; Hildenbrand, Sibylle; Loew, Thomas H.; Raupach, Tobias; Spies, Claudia; Treede, Rolf-Detlef; Vahl, Christian-Friedrich; Wenz, Hans-Jürgen

    2014-01-01

    Objective: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists’ careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. Methods: During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here. Results: The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific “impact” rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the

  8. The Value of Upward Evaluation in Libraries--Part II.

    ERIC Educational Resources Information Center

    Perkins, Gay Helen

    1995-01-01

    Examines the value of upward evaluation by reviewing historical outcomes of upward evaluations in industrial psychology/business literature and library literature. Also discusses the utilization of upward evaluation in libraries and focuses on results of the Western Kentucky University Libraries' annual process of supervisor evaluation. Appendixes…

  9. [The history of antitobacco actions in the last 500 years. Part. II. Medical actions].

    PubMed

    Grzybowski, Andrzej

    2006-01-01

    Tobacco was brought to Europe by Christopher Columbus, who discovered it in Cuba in October, 1492. Spread of tobacco consumption was initiated by the French diplomat Jean Nicot de Villemain, who in 1560 recommended it in the form of powdered tobacco leaves to the French Queen Catherine de Medice to combat her migraine headaches, and introduced the term Nicotiana tobaccum. Tobacco consumption greatly rose after the I World War, and after the II World War it became very common, especially among man. In the first half of the 20th century the sale of tobacco products rose by 61%, and cigarettes dominated the market of tobacco products. At the beginning of the 20th century cigarettes constituted only 2% of the total sale of tobacco products, while in the middle of the 20th century--more than 80%. Although the first epidemiological papers indicating that "smoking is connected with the shortening of life span" were published in the first half of the 20th century, not until 1950 did Hill and Doll in Great Britain, and Wynder and Graham in USA in 1951 show a statistically significant correlation between cigarettes smoking and lung cancer occurrence. Many controversies according the use of tobacco accompanied it from the beginning of its presence in Europe. The conflicting opinions according to its influence to health coexisted in the 16th to 19th centuries. In this period, especially in the 19th century dominated moral and religious arguments against tobacco. In the 20th century however, and particularly in its second part, development in medical research was enhanced by civil voluntary actions against advertisement and passive smoking. This lead to the significant limitation of tobacco expansion in Europe, USA and Canada in the end of the 20th century.

  10. [The history of antitobacco actions in the last 500 years. part. 1. Non-medical actions].

    PubMed

    Grzybowski, Andrzej

    2006-01-01

    Tobacco was brought to Europe by Christopher Columbus, who discovered it in Cuba in October, 1492. Spread of tobacco consumption was initiated by the French diplomat Jean Nicot de Villemain, who in 1560 recommended it in the form of powdered tobacco leaves to the French Queen Catherine de Medice to combat her migraine headaches, and introduced the term Nicotiana tobaccum. Tobacco consumption greatly rose after the I World War, and after the II World War it became very common, especially among man. In the first half of the 20th century the sale of tobacco products rose by 61%, and cigarettes dominated the market of tobacco products. At the beginning of the 20th century cigarettes constituted only 2% of the total sale of tobacco products, while in the middle of the 20th century--more than 80%. Although the first epidemiological papers indicating that "smoking is connected with the shortening of life span" were published in the first half of the 20th century, not until 1950 did Hill and Doll in Great Britain, and Wynder and Graham in USA in 1951 show a statistically significant correlation between cigarettes smoking and lung cancer occurrence. Many controversies according the use of tobacco accompanied it from the beginning of its presence in Europe. The conflicting opinions according to its influence to health coexisted in the 16th to 19th centuries. In this period, especially in the 19th century dominated moral and religious arguments against tobacco. In the 20th century however, and particularly in its second part, development in medical research was enhanced by civil voluntary actions against advertisement and passive smoking. This lead to the significant limitation of tobacco expansion in Europe, USA and Canada in the end of the 20th century.

  11. Impact of the closure of a large urban medical center: a qualitative assessment (part I).

    PubMed

    Romero, Diana; Kwan, Amy; Swearingen, Justin; Nestler, Sue; Cohen, Neal

    2012-10-01

    This community health needs assessment-the first part of a mixed-methods project-sought to qualitatively examine the impact of the closure of St. Vincent's Catholic Medical Center, a large not-for-profit hospital in NYC, on individuals who used its services. Key informant interviews with organizational leaders and focus groups with residents were conducted to understand hospital utilization, unmet health care needs, health care utilization and experiences post closure, perceptions of the most significant effect of the closing, and recommendations for improving health care in the community. Most respondents spoke positively of the hospital's accessibility, comprehensive, high-quality services, and its close relationship with the community. Conversely, experiences post-closure were largely negative, including decreased access, interrupted care, and loss of emergency and specialty care. Lack of information concerning medical records reflected a larger problem of poor planning and community outreach. Another issue was widespread anxiety in a community now lacking a hospital. Further, while the hospital's closure might cause inconveniences, these effects were described as more daunting to vulnerable groups. Our findings provide a consistent picture of a hospital highly regarded by residents, patients, and leaders of several health and social services organizations. Regardless of whether it should have been permitted to close (as raised by many respondents), the lack of advance planning and outreach to community members and patients remains a major criticism. Coordinated efforts to provide the community with information about health and social services in the area will respond to a clear need while reducing some of the complexity encountered with utilizing local health care services.

  12. Special Programs in Medical Library Education, 1957-1971: Part IV. Career Characteristics of Two Groups of Medical Librarians *†

    PubMed Central

    Roper, Fred W.

    1974-01-01

    This final report compares career characteristics of former trainees employed in medical libraries in 1971 with those of another group of professional medical librarians who did not enter medical librarianship from special training programs. Career characteristics include career advancement (position level, number of people supervised, salary level), professional utilization (tasks perforṁed), and professional activity (association memberships and offices, number of journals read, continuing education activity). The comparison of characteristics for the two groups showed many similarities. A major difference appeared in the career advancement comparison. For the former trainees, economic advancement seems less dependent on upward movement in line positions. This suggests the possibility of two career tracks available to them. PMID:4462688

  13. Impact of the closure of a large urban medical center: a quantitative assessment (part II).

    PubMed

    Romero, Diana; Kwan, Amy; Nestler, Sue; Cohen, Neal

    2012-10-01

    This community health needs assessment-the second part of a mixed-methods project-sought to quantitatively determine the impact of the closure of St. Vincent's Medical Center, a large not-for-profit hospital in NYC on individuals who used its services. Findings from a community survey disseminated to the broader community affected by the closure of this hospital are described. The questions covered topics including demographics, health status, experiences accessing health care pre- and post-hospital closure, access to medical records, prescriptions, etc. The majority of respondents are from the community immediately surrounding the hospital. Almost 50% report having a physical or mental health condition requiring regular care; roughly 64% had a doctor affiliated with St. Vincent's and 68% currently see the same doctor as before the hospital closed. With regard to service utilization, 74% reported having sought services at St. Vincent's in the past 5 years. Of these, the emergency department was the most commonly used service (75%), followed by specialty tests (32%), inpatient care (30%), and outpatient services (22%). The majority of ratings of services at St. Vincent's were "excellent" or "very good." Conversely, 65% of former St. Vincent's users reported more difficulty obtaining health care post closure. Of the 11% who have tried to access their medical records, 30% have not been able to obtain their records and 42% report their attempt as being "somewhat difficult" or "very difficult." Over 50% report spending more time traveling or traveling further to get to their healthcare provider; and over one third report waiting longer to get an appointment, or to be seen when at an appointment. Bivariate analyses revealed that certain subgroups of respondents had significantly worse negative experiences associated with the closure of the hospital. Specifically, individuals with a health condition were more likely to have visited an ER since St. Vincent's closed, and

  14. Evaluation of an integrated adherence program aimed to increase Medicare Part D star rating measures.

    PubMed

    Leslie, R Scott; Tirado, Breanne; Patel, Bimal V; Rein, Philip J

    2014-12-01

    The Centers for Medicare Medicaid Services (CMS) Plan Quality and Performance Program, or Star Ratings Program, allows Medicare beneficiaries to compare quality of care among available Medicare Advantage prescription drug (MA-PD) plans and stand-alone prescription drug plans (PDPs). Health plans have increased intervention efforts and applied existing care management infrastructure as an approach to improving member medication adherence and subsequent Part D star rating performance. Independent Care Health Plan (iCare), an MA-PD plan; MedImpact Healthcare Systems, Inc. (MedImpact), a pharmacy benefits manager; and US MED, a mail order pharmacy, partnered to engage and enroll iCare's dual-eligible special needs population in an intervention designed to improve patient medication adherence and health plan performance for 3 Part D patient safety outcome measures: Medication Adherence for Oral Diabetes Medications (ODM), Medication Adherence for Hypertension (HTN), and Medication Adherence for Cholesterol (CHOL). To (a) assess the effectiveness of a coordinated member-directed medication adherence intervention and (b) determine the overall impact of the intervention on adherence rates and CMS Part D star rating adherence measures.  Administrative pharmacy claims and health plan eligibility data from MedImpact's databases were used to identify members using 3 target medication classes. Adherence was estimated by the proportion of days covered (PDC) for all members. Those members considered at high risk for nonadherence were prioritized for care management services. Risk factors were based on members' use of more than 1 target medication class, newly started therapy, and suboptimal adherence (PDC  less than  80%) in the most recent 6-month period. Data files listing member adherence rates and contact information were formatted and loaded monthly into iCare's care management system, which triggered an alert for care coordinators to counsel members on the importance

  15. Medical student debt at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part I.

    PubMed

    Gill, D; Palmer, C; Mulder, R; Wilkinson, T

    2001-10-26

    To determine the level and sources of medical student debt at the Christchurch School of Medicine. A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. Included were questions on student demographics, sources and levels of debt, parental financial support, and student perceptions of their debt. The response rate was 88%. International students, whose debt was with an overseas government, and students with mortgages were excluded from the data analysis. The combined total debt for the remaining 165 students was $7775000 with $6290000 (81%) owed to the Government Students Loans scheme. One quarter of 6th year medical students had a debt over $83250, 50% had a debt over $70000, and 75% had a debt over $50000. Student allowances were inaccessible to 64% of 4th and 5th year students and part-time employment during term-time was common. Lack of funds was reported to impair full participation in the medical course. The majority of medical students at the Christchurch School of Medicine accumulate high levels of debt, mainly dtrough the Government Student Loans scheme, during their medical training.

  16. Toward Meaningful Evaluation of Medical Trainees: The Influence of Participants' Perceptions of the Process

    ERIC Educational Resources Information Center

    Watling, Christopher J.; Lingard, Lorelei

    2012-01-01

    An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable…

  17. Comprehensive computerized medical imaging: interim hypothetical economic evaluation

    NASA Astrophysics Data System (ADS)

    Warburton, Rebecca N.; Fisher, Paul D.; Nosil, Josip

    1990-08-01

    The 422-bed Victoria General Hospital (VGH) and Siemens Electric Limited have since 1983 been piloting the implementation of comprehensive computerized medical imaging, including digital acquisition of diagnostic images, in British Columbia. Although full PACS is not yet in place at VGH, experience to date habeen used to project annual cost figures (including capital replacement) for a fully-computerized department. The resulting economic evaluation has been labelled hypothetical to emphasize that some key cost components were estimated rather than observed; this paper presents updated cost figures based on recent revisions to proposed departmental equipment configuration which raised the cost of conventional imaging equipment by 0.3 million* and lowered the cost of computerized imaging equipment by 0.8 million. Compared with conventional diagnostic imaging, computerized imaging appears to raise overall annual costs at VGH by nearly 0.7 million, or 11.6%; this is more favourable than the previous results, which indicated extra annual costs of 1 million (16.9%). Sensitivity analysis still indicates that all reasonable changes in the underlying assumptions result in higher costs for computerized imaging than for conventional imaging. Computerized imaging offers lower radiation exposure to patients, shorter waiting times, and other potential advantages, but as yet the price of obtaining these benefits remains substantial.

  18. Evaluation of pegfilgrastim use at an academic medical center.

    PubMed

    Tang, Kathy; Duffy, Alison; Gilmore, Steven

    2017-01-01

    Purpose Pegfilgrastim is indicated to reduce the risk of febrile neutropenia. As a cost-savings initiative, Pegfilgrastim Process Guidelines were developed and implemented at a large, academic teaching institution to improve appropriate use of pegfilgrastim and to decrease costs of outpatient infusion center administration by deferring doses to home self-administration for eligible patients. Methods A retrospective medical record review was conducted post-implementation of the Pegfilgrastim Process Guideline to evaluate the use of pegfilgrastim and to assess the safety and efficacy of transferring pegfilgrastim orders from outpatient infusion center to home administration for eligible patients. Results Fifty-nine patients were included in the study, with 35 patients receiving pegfilgrastim in the outpatient infusion center, 13 patients self-injecting at home, and 11 patients receiving doses in both settings. The total wholesale cost avoidance for pegfilgrastim orders transferred to self-administration at home during this time period totaled $205,163. The revenue from outpatient prescriptions of pegfilgrastim totaled $291,111.93. The percentage of febrile neutropenia admissions was 11.4%, 0%, and 9.1% in the outpatient infusion, home, and outpatient/home group, respectively. Conclusion Implementation of the Pegfilgrastim Process Guidelines demonstrated decreased total pegfilgrastim orders to be dispensed by the infusion center and a cost avoidance of $205,163 in four months without any perceivable changes in patient outcomes. This represents a significant cost-savings opportunity.

  19. Evaluation of aerosolized medications during parabolic flight maneuvers

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.; Martin, William J.; Gosbee, John

    1991-01-01

    The goal was to visually evaluate the effect gravity has on delivery of medications by the use of various aerosol devices. During parabolic flight the same four aerosols were retested as performed in studio ground tests. It appears that the Cetacaine spray and the Ventolin inhaler function without failure during all test. The pump spray (Nostril) appeared to function normally when the container was full, however it appeared to begin to fail to deliver a full mist with larger droplet size when the container was nearly empty. The simple hand spray bottle appeared to work when the container was full and performed progressively worse as the container was emptied. During Apollo flights, it was reported that standard spray bottles did not work well, however, they did not indicate why. It appears that we would also conclude that standard spray bottles do not function as well in zero gravity by failing to produce a normal mist spray. The standard spray bottle allowed the fluid to come out in a narrow fluid stream when held with the nozzle either level or slightly tilted upward.

  20. Evaluation of Medical Cystine Stone Prevention in an Animal Model

    NASA Astrophysics Data System (ADS)

    Sagi, Sreedhar; Wendt-Nordahl, Gunnar; Alken, Peter; Knoll, Thomas

    2007-04-01

    Medical treatment for cystinuria aims to decrease the concentration of cystine in the urine, increase its solubility and therefore prevent stone formation. Ascorbic acid and captopril have been recommended as alternatives to thiol drugs, though conflicting data undermining their efficacy has been widely reported, too. The aim of this study was to verify the effects of ascorbic acid and captopril on cystine stone formation in the cystinuria mouse model. A total of 28 male homozygous pebbles mice were used for characterizing the mice on normal diet, ascorbic acid and captopril supplemented diets. The baseline physiological parameters of the mice were determined initially. The normal diet was then replaced with the supplemented diet (ascorbic acid/captopril) for the next 48 weeks and various biochemical parameters in urine and plasma were analyzed. All homozygous mice developed urinary cystine stones during the first year of life. No reduction in the urinary cystine concentration was seen with either of the supplemented diets. The stone mass varied widely in the study and a beneficial effect of ascorbic acid in some of the animals was possible though an overall statistical significance was not seen. Conclusions: The cystinuria mouse model provides an ideal tool for evaluation of stone preventive measures in a standardized environment. This study confirms that ascorbic acid and captopril are not effective in cystinuria.

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

    PubMed

    Frasca, Dominic R

    2010-09-01

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

  2. The medical evaluation of the elderly preoperative patient.

    PubMed

    Daly, M P

    1989-06-01

    Improvements in anesthesia and surgical techniques have greatly reduced the perioperative mortality and morbidity of elderly patients. Mortality is more closely correlated with pathology, type of surgery, and duration of anesthesia rather than with age. Particular attention should be directed toward cardiac and pulmonary status, because operative mortality and morbidity is related, for the most part, to cardiovascular and pulmonary complications. Postoperatively, the occurrence of pulmonary emboli and painless myocardial infarctions is more common in this age group. Elderly patients are more often confused postoperatively owing to the residual effect of anesthetics, analgesics, fever, and electrolyte disturbances. The stress of surgery and unfamiliar surroundings are also frequent precipitating causes. Orthostatic blood pressure and pulse readings should be checked before ambulating elderly patients who have been at bed rest for more than 2 to 3 days because of the frequent occurrence of orthostatic hypotension. Pressure sores, incontinence, and aspiration pneumonia may also occur owing to immobility. The elderly patient's functional status and mental status may be enhanced by simple encouragement, early mobilization, and by social interaction. It is not possible to precisely define the risks of proposed procedure, nor can the physician eliminate all risks from a surgical procedure. The risks a particular patient is subjected to depend on the complex interplay of the preoperative medical condition of the patient, the type of surgery proposed, and the skill and expertise of the anesthesiologist and surgeon. We must strive to achieve the goal of bringing our patient to the operating room in the best possible condition in the time available.

  3. Evaluation of life in Skylab from a medical viewpoint

    NASA Technical Reports Server (NTRS)

    Hordinsky, J. R.

    1974-01-01

    The Skylab program established the opportunity for the first time to perform extensive medical experimentation on man in a long-term zero-g environment. This experimentation involved metabolic studies, cardiovascular systems, nutrition and mineral balance, hematology, vestibular function, and many other related investigations. This report presents an overview of the significant results of the medical experiments performed during the program and a summary of the medical observations gathered by the team of life scientists.

  4. Evaluation of the medical student research programme in Norwegian medical schools. A survey of students and supervisors.

    PubMed

    Hunskaar, Steinar; Breivik, Jarle; Siebke, Maje; Tømmerås, Karin; Figenschau, Kristian; Hansen, John-Bjarne

    2009-07-14

    The Medical Student Research Programme is a national education and grant scheme for medical students who wish to carry out research in parallel with their studies. The purpose of the programme is to increase recruitment of people with a standard medical degree to medical research. The Research Programme was established in 2002 and underwent a thorough evaluation during the spring of 2007. The evaluation should investigate if the programme had fulfilled its objectives of increased recruitment to medical research, in addition to the students' and supervisors' satisfaction of the programme, and unwanted differences between the universities. Data was collected from students, supervisors and administrative staff via web-based questionnaires. Information about admission, implementation, results achieved and satisfaction was analysed and compared between the four Norwegian medical schools. In addition, the position of the scheme in relation to the national Quality Reform of Higher Education was analysed. At the end of 2006, the Medical Student Research Programme had recruited 265 medical students to research. These consisted of 214 active students, 35 who had completed their studies and only 17 who had dropped out. Both students and supervisors were generally very satisfied with the scheme, including the curriculum, the results achieved and the administrative service. The majority of students wanted to continue their research towards a PhD and, of those who had completed the Medical Student Research Programme, practically all had published one or several scientific papers. The survey showed only small differences between the four medical schools, despite their choice of somewhat different solutions in terms of administration and organisation. The Medical Student Research Programme satisfies the majority of the demands of the Quality Reform, however as an integrated research programme aimed at a PhD it presupposes access to PhD courses before the completion of medical

  5. Theater Army Medical Management Information System: A MANPRINT evaluation

    DTIC Science & Technology

    1989-06-01

    Management Information System (TAMMIS) and the division level version of the system, TAMMIS-D. TAMMIS/ TAMMIS-D are automated, on-line, interactive, microcomputer systems designed to manage combat medical information but capable of performing peacetime functions as well. The systems were developed to meet the needs of medical commanders by providing timely, accurate, and relevant information on the status of patients, medical units, and medical supplies on the battlefield. The IOT&E was conducted at Fort Lewis, WA in tents erected between two-story barracks

  6. [Evaluation of sanitary-and-epidemiological safety of medical wares].

    PubMed

    Kravchenko, O K

    2008-01-01

    The medical personnel operating currently available medical equipment can be exposed to physical factors. To prevent the adverse consequences of these exposures, medical equipment undergoes sanitary-and-epidemiological examination, resulting in the drawing up of a sanitary-and-epidemiological report. For regulation of this procedure, a management directive has been worked out, which determines an examination procedure, a hygienic classification of medical equipment, allowable values for controlled safety indices during operation, etc. Introduction of the directive makes it possible to upgrade the quality of sanitary-and-epidemiological equipment audit, to improve working conditions, and to keep health in the personnel operating the present-day high-technology equipment.

  7. Medicare program; Medicare Hospital Insurance (Part A) and Medicare Supplementary Medical Insurance (Part B). Notice of CMS ruling.

    PubMed

    2013-03-18

    This notice announces a CMS Ruling that establishes a policy that revises the current policy on Part B billing following the denial of a Part A inpatient hospital claim by a Medicare review contractor on the basis that the inpatient admission was determined not reasonable and necessary. This revised policy is intended as an interim measure until CMS can finalize a policy to address the issues raised by the Administrative Law Judge and Medicare Appeals Council decisions going forward. To that end, elsewhere in this issue of the Federal Register, we published a proposed rule entitled, "Medicare Program; Part B Inpatient Billing in Hospitals,'' to propose a permanent policy that would apply on a prospective basis.

  8. A tool for designing digital test objects for module performance evaluation in medical digital imaging.

    PubMed

    Kocsis, O; Costaridou, L; Efstathopoulos, E P; Lymberopoulos, D; Panayiotakis, G

    1999-01-01

    Currently, medical digital imaging systems are characterized by the introduction of additional modules such as digital display, image compression and image processing, as well as film printing and digitization. These additional modules require performance evaluation to ensure high image quality. A tool for designing computer-generated test objects applicable to performance evaluation of these modules is presented. The test objects can be directly used as digital images in the case of film printing, display, compression and image processing, or indirectly as images on film in the case of digitization. The performance evaluation approach is quality control protocol based. Digital test object design is user-driven according to specifications related to the requirements of the modules being tested. The available quality control parameters include input/output response curve, high contrast resolution, low contrast discrimination, noise, geometric distortion and field uniformity. The tool has been designed and implemented according to an object oriented approach in Visual C++ 5.0, and its user interface is based on the Microsoft Foundation Class Library version 4.2, which provides interface items such as windows, dialog boxes, lists, buttons, etc. The compatibility with DICOM 3.0 part 10 image formats specifications allows the integration of the tool in the existing software framework for medical digital imaging systems. The capability of the tool is demonstrated by direct use of the test objects in case of image processing, and indirect use of the test objects in case of film digitization.

  9. Evaluation of forensic medical history taking from the child in cases of child physical and sexual abuse and neglect.

    PubMed

    Drummond, Rachel; Gall, John A M

    2017-02-01

    Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA(®). With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  10. Consistency in performance evaluation reports and medical records.

    PubMed

    Lu, Mingshan; Ma, Ching-to Albert

    2002-12-01

    In the health care market managed care has become the latest innovation for the delivery of services. For efficient implementation, the managed care organization relies on accurate information. So clinicians are often asked to report on patients before referrals are approved, treatments authorized, or insurance claims processed. What are clinicians responses to solicitation for information by managed care organizations? The existing health literature has already pointed out the importance of provider gaming, sincere reporting, nudging, and dodging the rules. We assess the consistency of clinicians reports on clients across administrative data and clinical records. For about 1,000 alcohol abuse treatment episodes, we compare clinicians reports across two data sets. The first one, the Maine Addiction Treatment System (MATS), was an administrative data set; the state government used it for program performance monitoring and evaluation. The second was a set of medical record abstracts, taken directly from the clinical records of treatment episodes. A clinician s reporting practice exhibits an inconsistency if the information reported in MATS differs from the information reported in the medical record in a statistically significant way. We look for evidence of inconsistencies in five categories: admission alcohol use frequency, discharge alcohol use frequency, termination status, admission employment status, and discharge employment status. Chi-square tests, Kappa statistics, and sensitivity and specificity tests are used for hypothesis testing. Multiple imputation methods are employed to address the problem of missing values in the record abstract data set. For admission and discharge alcohol use frequency measures, we find, respectively, strong and supporting evidence for inconsistencies. We find equally strong evidence for consistency in reports of admission and discharge employment status, and mixed evidence on report consistency on termination status. Patterns of

  11. Evaluation of Patients' Rights Observance According to Patients' Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs' Views.

    PubMed

    Sabzevari, Alireza; Kiani, Mohammad Ali; Saeidi, Masumeh; Jafari, Seyed Ali; Kianifar, Hamidreza; Ahanchian, Hamid; Jarahi, Lida; Zakerian, Mohsen

    2016-10-01

    To supply quality services and healthcare, it is evident that medical ethics and patients' rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients' Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences. This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients' rights, including demographic data and inventory of patients' rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation. Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients' rights was related to the area of respecting patients' privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients' rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients' rights (p>0.05). Although in this study, the observance of patients' rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients' Rights Charter along with training courses, to strengthen medical staff's awareness in this regard.

  12. Evaluation of Patients’ Rights Observance According to Patients’ Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs’ Views

    PubMed Central

    Sabzevari, Alireza; Kiani, Mohammad Ali; Saeidi, Masumeh; Jafari, Seyed Ali; Kianifar, Hamidreza; Ahanchian, Hamid; Jarahi, Lida; Zakerian, Mohsen

    2016-01-01

    Introduction To supply quality services and healthcare, it is evident that medical ethics and patients’ rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients’ Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences. Methods This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients’ rights, including demographic data and inventory of patients’ rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation. Results Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients’ rights was related to the area of respecting patients’ privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients’ rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients’ rights (p>0.05). Conclusion Although in this study, the observance of patients’ rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients’ Rights Charter along with training courses, to strengthen medical staff’s awareness in this regard. PMID:27957310

  13. Medical technology assessment: the use of the analytic hierarchy process as a tool for multidisciplinary evaluation of medical devices.

    PubMed

    Hummel, J M; van Rossum, W; Verkerke, G J; Rakhorst, G

    2000-11-01

    Most types of medical technology assessment are performed only after the technology has been developed. Consequently, they have only minor effects on changes in clinical practice. Our study introduces a new method of constructive medical technology assessment that can change the development and diffusion of a medical device to improve its later clinical effectiveness. The method, based on Saaty's Analytic Hierarchy Process, quantitatively supports discussions between various parties involved in technological development and diffusion. We applied this method in comparing a new blood pump with two competitors based on technical, medical and social requirements. These discussions changed the evaluators' perspectives, reduced diasagreements, and ended in a reliable evaluation of the pump's performance. On the basis of these results, adaptations were derived which improved the design and diffusion of the blood pump. This application shows the adequate potential of our method to steer technological development and diffusion of artificial organs.

  14. Evaluating user perceptions of mobile medication management applications with older adults: a usability study.

    PubMed

    Grindrod, Kelly Anne; Li, Melissa; Gates, Allison

    2014-03-14

    Medication nonadherence has a significant impact on the health and wellbeing of individuals with chronic disease. Several mobile medication management applications are available to help users track, remember, and read about their medication therapy. The objective of this study was to explore the usability and usefulness of existing medication management applications for older adults. We recruited 35 participants aged 50 and over to participate in a 2-hour usability session. The average age ranged from 52-78 years (mean 67 years) and 71% (25/35) of participants were female. Each participant was provided with an iPad loaded with four medication management applications: MyMedRec, DrugHub, Pillboxie, and PocketPharmacist. These applications were evaluated using the 10 item System Usability Scale (SUS) and visual analog scale. An investigator-moderated 30-minute discussion followed, and was recorded. We used a grounded theory (GT) approach to analyze qualitative data. When assessing mobile medication management applications, participants struggled to think of a need for the applications in their own lives. Many were satisfied with their current management system and proposed future use only if cognition and health declined. Most participants felt capable of using the applications after a period of time and training, but were frustrated by their initial experiences with the applications. The early experiences of participants highlighted the benefits of linear navigation and clear wording (eg, "undo" vs "cancel") when designing for older users. While there was no order effect, participants attributed their poor performance to the order in which they tried the applications. They also described being a part of a technology generation that did not encounter the computer until adulthood. Of the four applications, PocketPharmacist was found to be the least usable with a score of 42/100 (P<.0001) though it offered a drug interaction feature that was among the favorite features

  15. Evaluating User Perceptions of Mobile Medication Management Applications With Older Adults: A Usability Study

    PubMed Central

    Gates, Allison

    2014-01-01

    Background Medication nonadherence has a significant impact on the health and wellbeing of individuals with chronic disease. Several mobile medication management applications are available to help users track, remember, and read about their medication therapy. Objective The objective of this study was to explore the usability and usefulness of existing medication management applications for older adults. Methods We recruited 35 participants aged 50 and over to participate in a 2-hour usability session. The average age ranged from 52-78 years (mean 67 years) and 71% (25/35) of participants were female. Each participant was provided with an iPad loaded with four medication management applications: MyMedRec, DrugHub, Pillboxie, and PocketPharmacist. These applications were evaluated using the 10 item System Usability Scale (SUS) and visual analog scale. An investigator-moderated 30-minute discussion followed, and was recorded. We used a grounded theory (GT) approach to analyze qualitative data. Results When assessing mobile medication management applications, participants struggled to think of a need for the applications in their own lives. Many were satisfied with their current management system and proposed future use only if cognition and health declined. Most participants felt capable of using the applications after a period of time and training, but were frustrated by their initial experiences with the applications. The early experiences of participants highlighted the benefits of linear navigation and clear wording (eg, “undo” vs “cancel”) when designing for older users. While there was no order effect, participants attributed their poor performance to the order in which they tried the applications. They also described being a part of a technology generation that did not encounter the computer until adulthood. Of the four applications, PocketPharmacist was found to be the least usable with a score of 42/100 (P<.0001) though it offered a drug interaction

  16. Shared medical appointments for preoperative evaluation of symptomatic macromastia.

    PubMed

    Giladi, Aviram M; Brown, David L; Alderman, Amy K

    2014-12-01

    Shared medical appointments combine individual patient-physician encounters with a group educational segment. This allows for patients' needs to be addressed individually and for patients to benefit from shared learning. Shared medical appointments enhance knowledge, understanding, and management of disease by providing a variety of perspectives and experiences. In addition, physician-patient contact time and clinic efficiency are increased. This study assesses patient satisfaction and provider efficiency with shared medical appointments for symptomatic macromastia. Patients were offered a shared medical appointment or traditional individual appointment. After the appointment, patients completed a satisfaction survey. Provider efficiency was measured by comparing visits per hour. Over 6 months, 26 of 28 shared medical appointment patients and 26 of 29 traditional individual appointment patients completed the survey. Patients reported 89 percent satisfaction with traditional individual appointments and shared medical appointments (p = 0.1), and both groups reported 92 percent satisfaction with thoroughness of care (p = 0.1). Seventy-seven percent of the shared medical appointment group said it was very or extremely likely they would participate in a shared medical appointment in the future. Provider efficiency increased nearly 250 percent, as patients-per-hour averaged 6.4 for shared medical appointments versus 2.67 for traditional individual appointments. Shared medical appointments for macromastia resulted in high patient satisfaction. Results were comparable to those of traditional individual appointments. No patients were dissatisfied, and provider efficiency improved. Shared medical appointments have unique benefits in patient education without compromising thoroughness or patient satisfaction, and offer an alternative delivery model that improves efficiency.

  17. Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy label.

    PubMed

    Shrank, William H; Gleason, Patrick P; Canning, Claire; Walters, Carol; Heaton, Alan H; Jan, Saira; Patrick, Amanda; Brookhart, M Alan; Schneeweiss, Sebastian; Solomon, Daniel H; Avorn, Jerry; Choudhry, Niteesh K

    2009-05-01

    Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding. We evaluated whether the new Target label influenced patient medication adherence. Using claims from two large health plans, we identified patients with one of nine chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies. We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on medication adherence. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively. Our sample included 23,745 Target users and 162,368 matched non-Target pharmacy users. We found no significant change in adherence between new users of medications at Target or other community pharmacies (p = 0.644) after implementing the new label. In prevalent users, we found a 0.0069 percent reduction in level of adherence (95% CI -0.0138-0.0; p < 0.001) and a 0.0007 percent increase in the slope in Target users (the monthly rate of change of adherence) after implementation of the new label (95% CI 0.0001-0.0013; p = 0.001). We found no changes in adherence of chronic medication in new users, and small and likely clinically unimportant changes in prevalent users after implementation of the new label. While adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed.

  18. 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.

  19. 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.

  20. Rural Allied Medical Business Occupations (RAMBO). Final Evaluation Report.

    ERIC Educational Resources Information Center

    Smith, Gloria

    A partnership was formed to address the crisis that rural health care facilities in rural Nebraska face in attracting and hiring trained health care workers. The Rural Allied Medical Business Occupations (RAMBO) project trained economically disadvantaged individuals in high technology medical fields. Five objectives were outlined in the project:…

  1. Evaluation of Learning Style for First Year Medical Students

    ERIC Educational Resources Information Center

    Johnson, Mary

    2009-01-01

    Background: Many studies have documented the correlation of learning style and academic success for medical students. However, few have investigated the intersection of academic preparedness and students' preference for information processing. This study tested the hypothesis that learning style preference differs among medical students grouped by…

  2. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... studies. 456.142 Section 456.142 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care...

  3. Medical Students' Evaluation of Physiology Learning Environments in Two Nigerian Medical Schools

    ERIC Educational Resources Information Center

    Anyaehie, U. S. B.; Nwobodo, E.; Oze, G.; Nwagha, U. I.; Orizu, I.; Okeke, T.; Anyanwu, G. E.

    2011-01-01

    The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional…

  4. Medical Students' Evaluation of Physiology Learning Environments in Two Nigerian Medical Schools

    ERIC Educational Resources Information Center

    Anyaehie, U. S. B.; Nwobodo, E.; Oze, G.; Nwagha, U. I.; Orizu, I.; Okeke, T.; Anyanwu, G. E.

    2011-01-01

    The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional…

  5. [Evaluating photonuclear activation for clearance of decommissioned medical linear accelerators].

    PubMed

    Shida, Koichi; Isobe, Tomonori; Takada, Kenta; Kobayashi, Daisuke; Tadano, Kiichi; Takahashi, Hideki; Seki, Masashi; Yokota, Hiroshi; Sakurai, Hideyuki; Sakae, Takeji

    2011-01-01

    as 40K, 208Tl, 214Pb, 214Bi and 228Ac; the short half-life nuclides can be assigned as 59Fe, 58Co, 185W and 196Au; and the long half-life nuclides can be assigned as 54Mn and 60Co. These results show that photonuclear activation of parts is important in regard to clearance. Currently, there are no regulations that specify criteria for evaluating radioactivation. Such criteria are needed to establish suitable protocols for the clearance of radioactivated materials.

  6. Evaluation of consumer medication information dispensed in retail pharmacies.

    PubMed

    Winterstein, Almut G; Linden, Stephan; Lee, Abigail E; Fernandez, Erica M; Kimberlin, Carole L

    2010-08-09

    United States retail pharmacies are key sources of written consumer medication information (CMI) through leaflets dispensed with prescription drugs. The content and format of this CMI are unregulated. Public Law 104-180 stipulates that by 2006, 95% of prescriptions be accompanied by "useful" CMI. Professional shoppers filled prescriptions for lisinopril and metformin in a national sample of 365 pharmacies. Dispensed CMI was evaluated according to explicit criteria (77 for lisinopril and 78 for metformin) adapted from Food and Drug Administration guidelines. Six percent of pharmacies did not provide any written CMI. A mean (SD) of 60.2% (20.7%) and 57.7% (20.1%) of the criteria for useful CMI were met for lisinopril and metformin prescriptions, respectively. Shortcomings concerned especially "directions about use" with means of 53.4% (95% confidence interval [CI], 51.4%-56.5%) and 45.6% (43.7%-47.6%), and "comprehensibility/legibility," with means of 43.8% (42.6%-44.9%) and 42.6% (41.1%-43.7%) for lisinopril and metformin, respectively. The CMI leaflets ranged from 33 to 2482 words, with more than 1000-word differences among those meeting higher than 80% of the content criteria, suggesting large variations in conciseness. Chain pharmacies had better adherence to content criteria than did independent stores, with mean differences of 22.1% (95% CI, 15.8%-28.4%) for lisinopril and 21.1% (95% CI, 14.9%-27.3%) for metformin. Although distribution through pharmacies seems effective, the content, format, reading level, and excessive length of CMI are disconcerting. Private sector initiatives to provide useful CMI have failed. Research is needed on effective information selection and presentation in terms of effects on comprehension, retention, and appropriate patient actions to derive optimal drug benefit.

  7. Guidelines for clinical engineering programs--Part I: guidelines for electrical isolation; Part II: performance evaluation of clinical engineering programs.

    PubMed

    Ridgway, M

    1980-01-01

    This series presents guidelines for: electrically isolated inputs and outputs; measuring the performance of hospital biomedical engineering programs; evaluating the risk of electric shock in hospitals; and for isolated power in anesthetizing locations. In Part I, specific recommendations are given for the use of insulated approach, battery-powered monitors in surgery, and for isolation requirements for devices connected to cardiac leads. In Part II, checklists are provided for the self-evaluation of an in-house, biomedical engineering staff. Parts III and IV, in future issues of this Journal, will include discussion of the theoretical electrical hazard potential in reference to the use of isolated power systems. The question of whether isolated power should be required in all anesthetizing locations will be discussed in Part IV.

  8. [Consultation skills training is necessary in medical education. Evaluation by student questionnaire and focus group interviews].

    PubMed

    Löfdahl, Therese; Nilsson, Erika; Haffling, Ann-Christin; Håkansson, Anders

    At Lund University Medical School communication skills are taught during both the preclinical and clinical part of the medical programme. As part of the training during the 5th year the students are required to videotape at least one patient consultation at a local primary health care centre. The students then meet in groups of 6-7 participants and a group leader to watch the recorded consultations and discuss them. To evaluate the quality of the consultation skills training and to identify potential weaknesses, we used both a quantitative and a qualitative method. A written questionnaire was distributed to all students and three focus group interviews, two with students and one with group leaders, were performed. The focus groups consisted of 5-6 participants each. The students were overall pleased with the training, and the majority thought that their consultation skills had improved. More commitment from the tutors at the health care centres was needed in order for the students to successfully record a complete consultation. Nearly all students found that the participants cooperated well in the groups, and that the group leader helped to create a positive atmosphere and gave constructive advice.

  9. Command and Control Related Computer Technology. Part I. Packet Radio. Part 2. Speech Compression and Evaluation

    DTIC Science & Technology

    1977-09-01

    demonstrated the new information process , station control process, and measurement process. Part of the demonstration consisted of running the software at SRI...to INFO, the information process , it was discovered that INFO was not quite compatible with the TIU SPP implementation. INFO expected the packet it

  10. A Multicenter Evaluation of Off-Label Medication Use and Associated Adverse Drug Reactions in Adult Medical ICUs.

    PubMed

    Smithburger, Pamela L; Buckley, Mitchell S; Culver, Mark A; Sokol, Sarah; Lat, Ishaq; Handler, Steven M; Kirisci, Levent; Kane-Gill, Sandra L

    2015-08-01

    Prior research indicates that off-label use is common in the ICU; however, the safety of off-label use has not been assessed. The study objective was to determine the prevalence of adverse drug reactions associated with off-label use and evaluate off-label use as a risk factor for the development of adverse drug reactions in an adult ICU population. Multicenter, observational study : Medical ICUs at three academic medical centers. Adult patients (age ≥ 18 yr old) receiving medication therapy. All administered medications were evaluated for Food and Drug Administration-approved or off-label use. Patients were assessed daily for the development of an adverse drug reaction through active surveillance. Three adverse drug reaction assessment instruments were used to determine the probability of an adverse drug reaction resulting from drug therapy. Severity and harm of the adverse drug reaction were also assessed. Cox proportional hazard regression was used to identify a set of covariates that influenced the rate of adverse drug reactions. Overall, 1,654 patient-days (327 patients) and 16,391 medications were evaluated, with 43% of medications being used off-label. One hundred and sixteen adverse drug reactions were categorized dichotomously (Food and Drug Administration or off-label), with 56% and 44% being associated with Food and Drug Administration-approved and off-label use, respectively. The number of adverse drug reactions for medications administered and the number of harmful and severe adverse drug reactions did not differ for medications used for Food and Drug Administration-approved or off-label use (0.74% vs 0.67%; p = 0.336; 33 vs 31 events, p = 0.567; 24 vs 24 events, p = 0.276). Age, sex, number of high-risk medications, number of off-label medications, and severity of illness score were included in the Cox proportional hazard regression. It was found that the rate of adverse drug reactions increases by 8% for every one additional off-label medication

  11. A Multicenter Evaluation of Off-Label Medication Use and Associated Adverse Drug Reactions in Adult Medical Intensive Care Units

    PubMed Central

    Smithburger, Pamela L.; Buckley, Mitchell S.; Culver, Mark A.; Sokol, Sarah; Lat, Ishaq; Handler, Steven M.; Kirisci, Levent; Kane-Gill, Sandra L.

    2016-01-01

    Objective Prior research indicates off-label use is common in the intensive care unit (ICU); however the safety of off-label use has not been assessed. The study objective was to determine the incidence of adverse drug reactions (ADRs) associated with off-label use and evaluate off-label use as a risk factor for the development of ADRs in an adult ICU population. Setting Medical ICUs at three academic medical centers Patients Adult patients (age ≥ 18 years old) receiving medication therapy Interventions All administered medications were evaluated for Food and Drug Administration (FDA) approved or off-label use. Patients were assessed daily for the development of an ADR through active surveillance. Three ADR assessment instruments were used to determine the probability of an ADR resulting from drug therapy. Severity and harm of the ADR were also assessed. Cox proportional hazard regression was used to identify a set of covariates that influenced the rate of ADRs. Measurements and Main Results Overall, 1654 patient days (327 patients) and 16,391 medications were evaluated, with 43% of medications being used off-label. One hundred and sixteen ADRs were categorized dichotomously (FDA or off-label), with 56% and 44% being associated with FDA approved and off-label use, respectively. The number of ADRs for medications administered and number of harmful and severe ADRs did not differ for medications used for FDA approved or off-label use (0.74% vs 0.67%, p = 0.336; 33 vs. 31 events, p=0.567; 24 vs. 24 events, p = 0.276). Age, sex, number of high-risk medications, number of off-label medications, and severity of illness score were included in the Cox proportional hazard regression. It was found that the rate of ADRs increases by 8% for every one additional off-label medication (HR = 1.08; 95 % CI: 1.018–1.154). Conclusion While ADRs do not occur more frequently with off-label use, ADR risk increases with each additional off-label medication used. PMID:25855897

  12. FRONTLINE: teaching affect recognition to medical students: evaluation and reflections.

    PubMed

    Forrest, David V

    2011-01-01

    Techniques developed for teaching more empathic affect recognition and reflection to medical students during their introduction to psychiatric interviewing begin with a concrete grounding in facial muscular movements and facial affect recognition, and proceed to the use of countertransferential affective experience to aid in ascertaining personality types. Observations about the temper of today's medical students by psychoanalysts may be of help in avoiding increasing their already substantial characterological resistance to affective learning and empathy that has recently been reported in the medical education literature.

  13. Research in Medical School: A Survey Evaluating Why Medical Students Take Research Years

    PubMed Central

    Taleghani, Noushafarin

    2016-01-01

    Introduction: In recent years, an increasing number of medical students have taken time off during medical school in order to conduct research. Schools and students have invested millions of dollars and thousands of person-years on research projects, but little is known as to why students choose to take this time off. We aim to characterize why students take research years during medical school. Methods: The authors distributed an online survey about research in medical school to students at five medical schools that have highly regarded research programs. Results: 328 students responded to the survey. The most common reasons students take years off for research are: “increase competitiveness for residency application” (32%), “time to pursue other opportunities” (24%), and “academic interest” (23%). Students who would still take a research year even if they were already assured a position in a residency program of their choice were at 65%, while 35% would not take a research year. Responses varied based on whether students intended to go into a competitive specialty. Discussion: Medical students take research years for multiple reasons, although they frequently are not motivated by an interest in the research itself. Many student projects consume a substantial amount of time and money despite having little educational value. Medical schools, residency programs, and policymakers should rethink incentives to increase value and help students better pursue their academic interests. PMID:27672532

  14. Evaluating mastery of biostatistics for medical researchers: need for a new assessment tool.

    PubMed

    Enders, Felicity

    2011-12-01

    Research training has enabled academic clinicians to contribute significantly to the body of medical research literature. Biostatistics represents a critical methodological skill for such researchers, as statistical methods are increasingly a necessary part of medical research. However, there is no validated knowledge and skills assessment for graduate level biostatistics for academic medical researchers. In this paper, I review graduate level statistical competencies and existing instruments intended to assess physicians' ability to read the medical literature and for undergraduate statistics for their alignment with core competencies necessary for successful use of statistics. This analysis shows a need for a new instrument to assess biostatistical competencies for medical researchers. © 2011 Wiley Periodicals, Inc.

  15. Ultrasound pallet part evaluator/grader and cant scanner

    Treesearch

    Mohammed F. Kabir; Philip A. Araman; Daniel L. Schmoldt; Mark E. Schafer

    2002-01-01

    Sorting and grading of wooden pallet parts are key factors for manufacturing quality and durable pallets. The feasibility of ultrasonic scanning for defect detection and classification has been examined in this report. Defects, such as sound and unsound knots, decay, bark pockets, wane, and holes were scanned on both red oak (Quercus rubra, L.) and yellow-poplar (...

  16. Application of Ultrasound Nondestructive Evaluation to Grading Pallet Parts

    Treesearch

    Daniel L. Schmoldt; John C. Duke; Michael Morrone; Chris M. Jennings

    1994-01-01

    Building high quality pallets makes pallets easier to repair and increases their longevity. To obtain the high quality parts necessary to build durable pallets requires grading and sorting by an automated inspection system. Ultrasonic sensing was selected for this application because (1) it is relatively inexpensive, (2) it can penetrate and characterize internal...

  17. The reading, writing, and arithmetic of the medical literature, part 3: critical appraisal of primary research.

    PubMed

    Mansfield, Lyndon

    2006-01-01

    To offer suggestions that will help clinicians improve their scrutiny of the medical literature and apply these suggestions to their own medical writings. Literature searches began at the National Library of Medicine's online database and were traced to primary sources. Studies were selected for their ability to provide historical background, discuss the aspects of study design and statistical analysis, and explore important facets of reading and writing medical manuscripts. Physician readers will become more proficient in their skills as both users and creators of the medical literature. Reading and interpretation of the medical literature requires a set of skills that can be learned. Similarly, good medical writing skills can be developed. Achieving these skills will enhance the clinician's practice of medicine.

  18. Evaluating the Evaluators: Implementation of a Multi-Source Evaluation Program for Graduate Medical Education Program Directors.

    PubMed

    Goldhamer, Mary Ellen J; Baker, Keith; Cohen, Amy P; Weinstein, Debra F

    2016-10-01

    Multi-source evaluation has demonstrated value for trainees, but is not generally provided to residency or fellowship program directors (PDs). To develop, implement, and evaluate a PD multi-source evaluation process. Tools were developed for PD evaluation by trainees, department chairs, and graduate medical education (GME) leadership. Evaluation questions were based on PD responsibilities, including Accreditation Council for Graduate Medical Education (ACGME) requirements. A follow-up survey assessed the process. Evaluation completion rates were as follows: trainees in academic year 2012-2013, 53% (958 of 1824), and in academic year 2013-2014, 42% (800 of 1898); GME directors in 2013-2014, 100% (95 of 95); and chairs/chiefs in 2013-2014, 92% (109 of 118). Results of a follow-up survey of PDs (66%, 59 of 90) and chairs (74%, 48 of 65) supports the evaluations' value, with 45% of responding PDs (25 of 56) and 50% of responding chairs (21 of 42) characterizing them as "extremely" or "quite" useful. Most indicated this was the first written evaluation they had received (PDs 78%, 46 of 59) or provided (chairs 69%, 33 of 48) regarding the PD role. More than 60% of PD (30 of 49) and chair respondents (24 of 40) indicated trainee feedback was "extremely" or "quite" useful, and nearly 50% of PDs (29 of 59) and 21% of chairs (10 of 48) planned changes based on the results. Trainee response rates improved in 2014-2015 (52%, 971 of 1872) and 2015-2016 (69%, 1276 of 1837). In our institution, multi-source evaluation of PDs was sustained over 4 years with acceptable and improving evaluation completion rates. The process and assessment tools are potentially transferrable to other institutions.

  19. How are we doing? Evaluation as part of sexuality education.

    PubMed

    Brick, P

    1997-01-01

    In 1986, Planned Parenthood of Greater Northern New Jersey (PPGNNJ) began to evaluate its sex education programs. First PPGNNJ staff evaluated a 1-day, 40-minute lesson designed to help high school students 1) identify risk behavior for unplanned pregnancy, 2) estimate risk, and 3) review basic contraceptive methods. This project showed that a single lesson could substantially increase knowledge about contraception and comfort with the idea of condoms and family planning (FP) clinic use. A second PPGNNJ evaluation project revealed that adding a motivational video to the lesson increased the feeling of comfort expressed about use of an FP clinic and that PPGNNJ staff were more effective than regular teachers in promoting change in attitudes about FP services, but teachers were more effective in promoting longterm knowledge of risk. Evaluation of five popular AIDS prevention videos revealed that all of the videos significantly increased HIV/AIDS knowledge and motivation to seek protection. However, the videos made many viewers feel helpless about their ability to protect themselves and unwilling to support an AIDS home in their neighborhood. PPGNNJ's staff also designed the "Human Sexuality Questionnaire" to determine the impact of a five-session sex education program delivered to high-risk youth. This tool is now used in program evaluation nationwide. Evaluation of two date rape prevention strategies (a single-lesson, interactive date-rape scenario and a video) revealed a significant impact on females and none on males. Testing of a 1994 video and discussion session designed to improve adolescent attitudes towards use of an FP clinic also had positive results. While these evaluation methodologies were not problem-free, evaluation forced PPGNNJ staff to define objectives and lessons, enter a new collaboration with schools, and use results to continually evaluate work.

  20. A brief review of Croatian medical history until the 19 century--Part 1.

    PubMed

    Belicza, B

    1992-01-01

    The purpose of this study is to remind the contemporary readers of the role and contribution of Croatian medical heritage in the development of medicine in Europe and the World, as well as of the development of medical concepts and medical practice on the territory of what is Croatia today. Selected examples are presented of the famous events and notable persons from the ancient time until the middle of the 19th century.

  1. Evaluation of medical student attitudes toward alcoholics anonymous.

    PubMed

    Fazzio, Lydia; Galanter, Marc; Dermatis, Helen; Levounis, Petros

    2003-09-01

    This is a two-phase study on attitudes of medical students toward Alcoholics Anonymous. The first phase compares views of addiction faculty to third-year medical students on the importance of spirituality in addiction treatment. We administered a questionnaire to assess attitudes toward spiritual, biological, and psychosocial approaches to addiction treatment. The faculty viewed spirituality as relatively more important in addiction treatment than did the students. The second phase was designed to assess whether medical student attitudes toward spiritually based treatments changed over the course of a psychiatry clerkship. At the beginning of the clerkship, students rated a spiritually oriented approach as important in addiction treatment as a biological approach, whereas, at the end of the clerkship, they rated the biological approach as more important. It may be important to educate medical students about the spiritual dimensions of recovery so they can integrate this into their treatment of addiction.

  2. Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies, Part 1.

    PubMed

    Tucci, Veronica Theresa; Moukaddam, Nidal; Alam, Al; Rachal, James

    2017-09-01

    Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Instructions included? Make safety training part of medical device procurement process.

    PubMed

    Keller, James P

    2010-04-01

    Before hospitals embrace new technologies, it's important that medical personnel agree on how best to use them. Likewise, hospitals must provide the support to operate these sophisticated devices safely. With this in mind, it's wise for hospitals to include medical device training in the procurement process. Moreover, purchasing professionals can play a key role in helping to increase the amount of user training for medical devices and systems. What steps should you take to help ensure that new medical devices are implemented safely? Here are some tips.

  4. [A sociological evaluation of medical care measures in craniocerebral trauma].

    PubMed

    Babenko, A I; Orekhova, G G

    2003-01-01

    According to a questionnaire of 830 patients and 153 neurologists, both a timely asking for medical care and a timely treatment at specialized neurology hospitals are the key factor that cuts the rate of complications in craniocerebral trauma. Finally, a differential approach to treatment schemes with due respect to a trauma severity, availability of rehabilitation centers and application of new medical technologies, e.g. cranio-sacral therapy, are equally important.

  5. Skill analysis part 2: evaluating a practice skill.

    PubMed

    Price, Bob

    This is the second of three articles exploring skill analysis, assisting readers to evaluate a practice skill of their choice. Sometimes evaluations are made against external reference points, the competencies of the registered nurse or a job description for a post eagerly sought after; sometimes they are made with reference to aspirations--an ideal of the skill in use that the nurse and colleagues admire. Nurses may be understandably anxious about the evaluation of practice skills, as they work in a performance-orientated world where they are judged on whether their practice is competent, safe, ethical, cost effective and efficient. Nonetheless, understanding the strengths and weaknesses of a chosen practice skill is central to practice development. If the skill is to be affirmed, improved or adjusted, it is necessary to evaluate the skill in use.

  6. [Rehabilitation, social medical evaluation and counselling in HIV-infected patients].

    PubMed

    Kolenda, K-D; Hoffmann, C

    2006-04-01

    An inpatient rehabilitation programme for HIV-infected patients is described. Since the early nineties some 1,200 patients with HIV infection have been treated in our internal and orthopaedic rehabilitation clinic. Beside internal and orthopaedic diagnostics, supporting compliance with antiretroviral therapy, motivating the patients for regular moderate exercises and specific nutritional counselling are major issues of the programme. From the psychological point of view, the patients are offered to aquire relaxation and stress coping techniques, to take part in non-smoking courses and to use individual psychological counselling in case of depression or panic. In addition, all HIV-infected patients are offered individual advice on their disease and necessary changes in lifestyle. Finally, the programme includes social medical evaluation and counselling. As the majority of the patients are still working or are of working age, evaluating the capacity for work and potential introduction of occupational rehabilitation measures are prominent. Almost 70 percent of the HIV-infected patients who had been treated in our clinic over the last few years were fully capable of returning to their previous occupation. Our experiences demonstrate that statements such as rehabilitation of AIDS patients being useless because of its missing prospects of success, are not up-to-date any longer. Since introduction of combination antiretroviral therapy many patients with HIV infection are able to return to their previous occupation if they receive the necessary medical und psychosocial support.

  7. Medical students' evaluation of physiology learning environments in two Nigerian medical schools.

    PubMed

    Anyaehie, U S B; Nwobodo, E; Oze, G; Nwagha, U I; Orizu, I; Okeke, T; Anyanwu, G E

    2011-06-01

    The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional didactic lectures thus predominate, and learning is further constrained by funding gaps, poor infrastructure, and increasing class sizes. We reviewed medical students' perceptions of their exposed learning environment to determine preferences, shortcomings, and prescriptions for improvements. The results confirm declining interest in didactic lectures and practical sessions with preferences for peer-tutored discussion classes, which were considered more interactive and interesting. This study recommends more emphasis on student-centered learning with alternatives to passive lecture formats and repetitive cookbook practical sessions. The institutionalization of student feedback processes in Nigerian medical schools is also highly recommended.

  8. Increasing the Educational Value of Medical Care Evaluation: A Model Program.

    ERIC Educational Resources Information Center

    Bashook, P. G.; And Others

    1982-01-01

    A model medical care evaluation (MCE) program was implemented at the Michael Reese Hospital and Medical Center. The program was evaluated by quantitative and qualitative observational techniques, questionnaires, and interviews, and by comparing committees for which the implementation was highly successful with those less successful. (Author/MLW)

  9. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... studies. 456.142 Section 456.142 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan must describe the methods that the committee uses to select and...

  10. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... studies. 456.142 Section 456.142 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan must describe the methods that the committee uses to select and...

  11. The Role of the Medical Provider in the Evaluation of Sexually Abused Children and Adolescents

    ERIC Educational Resources Information Center

    Newton, Alice Whittier; Vandeven, Andrea Marie

    2010-01-01

    It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…

  12. Evaluation of Information Literacy Skill Development in First Year Medical Students

    ERIC Educational Resources Information Center

    Carr, Sandra; Iredell, Helena; Newton-Smith, Carol; Clark, Catherine

    2011-01-01

    Medical practitioners need the skills to find relevant information and evaluate its authenticity, validity, and reliability. The learning of information literacy has been embedded in the University of Western Australia (UWA) medical course since 2000. The purpose of this study was to evaluate the effectiveness of the enhanced information literacy…

  13. The Role of the Medical Provider in the Evaluation of Sexually Abused Children and Adolescents

    ERIC Educational Resources Information Center

    Newton, Alice Whittier; Vandeven, Andrea Marie

    2010-01-01

    It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…

  14. 76 FR 59407 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... HUMAN SERVICES Food and Drug Administration Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information on Non-Standardized Allergenic Extracts in the...

  15. [What medical students want - evaluation of medical recruitment ads by future physicians].

    PubMed

    Renkawitz, T; Schuster, T; Benditz, A; Craiovan, B; Grifka, J; Lechler, P

    2013-10-01

    Three-quarters of all hospitals in Germany are now struggling to fill open positions for doctors. The medical job ad is a vital tool for human resources marketing and an important image factor. The present study examines the importance of information and offers in medical recruitment ads on application decisions by medical students. A total of 184 future physicians from clinical semesters participated voluntarily in an anonymous cross-sectional survey. Using a standardised questionnaire, the importance of 49 -individual items extracted from medical recruitment ads were rated with the help of a 4-point Likert Scale. Finally, the study participants prioritised their reasons for an application as a physician. Primary influence on the application decision on medical recruitment ads by medical students had offers/information in relation to education and training aspects and work-life balance. Payment rates for physicians and work load played an important role for the application motivation. Additional earnings for, e. g., emergency calls, providing of medical expertise and assistance with housing, relocation and reimbursement of interview expenses were less crucial. In prioritising key reasons for selecting a prospective employer "regular working hours," an "individual training concept" and an "attractive work-life balance" scored the highest priority. The "opportunity for scientific work" was assigned only a small significance. High importance for the application decision by future physicians on medical recruitment ads is placed on jobs with an opportunity for personal development and aspects that contribute to work-life balance. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Part D and Dual-Eligibles with Mental Illness: Problems Accessing Medications and Use of Intensive Mental Health Services

    PubMed Central

    Huskamp, Haiden A.; West, Joyce C.; Rae, Donald S.; Rubio-Stipec, Maritza; Regier, Darrel A.; Frank, Richard G.

    2009-01-01

    Objective This study examined the occurrence of medication access problems and use of intensive mental health services after the transition from Medicaid drug coverage to Part D for dual-eligibles. Methods Psychiatrists randomly selected from American Medical Association’s Physicians Masterfile reported on experiences in the first twelve months of 2006 of one systematically-selected dual-eligible patient (n=908). Propensity score matching was used to compare use of psychiatric emergency room and inpatient care for individuals who experienced a problem accessing a psychiatric medication after Part D and those who did not. Results Approximately 44% of dual-eligible patients were reported to experience a problem accessing medications. The likelihood of having an emergency room visit was significantly higher for those who experienced a problem compared to those who did not (mean OR=1.75, mean p-value=0.003). There was no difference in number of emergency room visits conditional on emergency room use or in hospitalization use. Conclusions Many dual-eligible patients experienced difficulty accessing psychiatric medications after Part D’s implementation. Patients who experienced difficulties were significantly more likely to use psychiatric emergency room care than patients who did not experience difficulties. While not definitive evidence of a cost offset onto non-drug health care benefits of the switch to Part D for dual-eligibles, these findings raise concerns about potential offsets and possible negative impacts on quality of care. Additional study is needed to understand the full effects of Part D on outcomes and functioning as well as treatment costs for dual-eligibles. PMID:19723730

  17. A student authored online medical education textbook: editing patterns and content evaluation of a medical student wiki.

    PubMed

    Thompson, C L; Schulz, Wade L; Terrence, Adam

    2011-01-01

    The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki's management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases.

  18. A Student Authored Online Medical Education Textbook: Editing Patterns and Content Evaluation of a Medical Student Wiki

    PubMed Central

    Thompson, CL; Schulz1, Wade L.; Terrence, Adam

    2011-01-01

    The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki’s management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases. PMID:22195202

  19. Evaluating the Impact of Sample Medication on Subsequent Patient Adherence.

    PubMed

    Pringle, Janice L; Aldridge, Arnie; Kearney, Shannon M; Grasso, Kim; Radack, John; Hogue, Susan; Manolis, Chronis

    2016-11-01

    Medication nonadherence is problematic throughout health care practice. Patient nonadherence is a result of several factors, such as financial issues, confusion about the medication, or concerns about possible side effects. Efforts to improve adherence have been implemented, but new strategies are needed to ensure that patients fill their medication prescriptions and adhere to their prescribed use. To investigate whether providing patients with a free 30-day supply of medication at the point of care via a dispensing kiosk-a secure, computerized cabinet placed in the prescriber's office-that provides sample medication and educational materials had a measurable impact on adherence and health care cost. The study sample consisted of patients drawn from the electronic health records of a large health care provider who were prescribed medications to treat diabetes, hypertension, and dyslipidemia. The comparison groups included a treatment group of patients who each received a 30-day generic sample of medication and a control group of patients who did not receive a sample. The study outcome was primary medication non-adherence (PMN), defined as whether a patient filled a prescription within 90, 180, or 365 days of prescribing. Only patients receiving a prescription for the first time were considered; patients on a medication before receipt of the sample were dropped. Postprescription medication adherence (PPMA), measured as proportion of days covered (PDC) and proportion of days covered ≥ 80% (PDC80), was also examined. Propensity score methods and multivariate regression models were used to examine the outcomes and group differences. Costs to the patient before and after the prescription were also analyzed. Key informant interviews were conducted with physicians, and qualitative analyses were performed. Patients who received a 30-day generic medication sample had a higher probability of filling a first prescription within 90 days (72.2% for treatment patients vs. 37

  20. Radiofrequency identification and medical devices: the regulatory framework on electromagnetic compatibility. Part II: active implantable medical devices.

    PubMed

    Mattei, Eugenio; Censi, Federica; Triventi, Michele; Bartolini, Pietro; Calcagnini, Giovanni

    2012-05-01

    The number and the types of electromagnetic emitters to which patients with active implantable medical devices (AIMD) are exposed to in their daily activities have proliferated over the last decade. Radiofrequency identification (RFID) is an example of wireless technology applied in many fields. The interaction between RFID emitters and AIMD is an important issue for patients, industry and regulators, because of the risks associated with such interactions. The different AIMDs refer to different standards that address the electromagnetic immunity issue in different ways. Indeed, different test setups, immunity levels and rationales are used to guarantee that AIMDs are immune to electromagnetic nonionizing radiation. In this article, the regulatory framework concerning electromagnetic compatibility between RFID systems and AIMDs is analyzed to understand whether and how the application of the current AIMD standards allows for the effective control of the possible risks associated with RFID technology.

  1. Efficacy of a checklist as part of a physical medicine and rehabilitation clerkship to teach medical students musculoskeletal physical examination skills: a prospective study.

    PubMed

    Altschuler, Eric L; Cruz, Eduardo; Salim, Sara Z; Jani, Jay B; Stitik, Todd P; Foye, Patrick M; DeLisa, Joel A

    2014-01-01

    The aim of this study was to evaluate the efficacy of a checklist as part of a physical medicine clerkship to teach medical students physical examination maneuvers. This is a prospective study performed on fourth year medical students enrolled in a 2-wk mandatory clerkship of the Department of Physical Medicine and Rehabilitation. At the start and end of the rotation, the participating students were tested by performing 20 physical examination maneuvers on an investigator who was both the standardized patient and the evaluator. At the end of the rotation, the students also completed a survey. Data were analyzed using the Bernoulli trial model, with the percentage of students who performed the maneuver correctly on the pretest as the a priori probability. A full Bonferroni correction was applied. The authors enrolled 141 of the 176 fourth year medical students; 121 completed testing. At prerotation, approximately 35% of the physical examination maneuvers were performed correctly; at postrotation, 82%. For 19 of 20 maneuvers, the improvement was statistically significant at P < 0.01. The survey results indicated that the students felt that they had limited exposure to musculoskeletal examination skills at prerotation, that this rotation helped them achieve competency in performing the maneuvers, and that this would improve their future patient care irrespective of field of choice. Considering the high prevalence of musculoskeletal disorders and the anticipated rise in the future, the authors strongly recommend teaching musculoskeletal physical examination maneuvers in medical school, which can be accomplished via a mandatory physical medicine and rehabilitation rotation. The authors conclude that checklists as part of this rotation can effectively help in teaching physical examination skills to medical students.

  2. Digital Management of a Hysteroscopy Surgery Using Parts of the SNOMED Medical Model

    PubMed Central

    Kollias, Anastasios; Paschopoulos, Minas; Evangelou, Angelos; Poulos, Marios

    2012-01-01

    This work describes a hysteroscopy surgery management application that was designed based on the medical information standard SNOMED. We describe how the application fulfils the needs of this procedure and the way in which existing handwritten medical information is effectively transmitted to the application’s database. PMID:22848338

  3. How Does This Happen? Part I: Mechanisms of Adverse Drug Reactions Associated with Psychotropic Medications

    PubMed Central

    Elbe, Dean; Savage, Robert

    2010-01-01

    Objective: To review the background and mechanisms behind how certain psychotropic medications cause adverse drug reactions. Methods: A literature review pertaining to several interesting and unusual adverse drug reactions attributed to selected psychotropic medications was conducted. These include: 1) QTc interval prolongation secondary to ziprasidone, pimozide, and other antipsychotic agents. 2) Nephrogenic diabetes insipidus and hypernatremia secondary to lithium. 3) Hypothyroidism secondary to lithium. 4) Erectile dysfunction secondary to selective serotonin and serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs). Results: Biochemical mechanisms of how certain psychotropic medications cause adverse drug reactions were reviewed. Specific interventions and monitoring recommendations to prevent or reduce the impact of these adverse reactions are discussed briefly. Conclusion: Knowledge of risk factors and mechanisms of adverse drug reactions with psychotropic medications can help to guide medication prescribing, monitoring and interventions to prevent or mitigate these reactions. PMID:20119566

  4. Do students' and authors' genders affect evaluations? A linguistic analysis of Medical Student Performance Evaluations.

    PubMed

    Isaac, Carol; Chertoff, Jocelyn; Lee, Barbara; Carnes, Molly

    2011-01-01

    Recent guidelines for the Medical Student Performance Evaluation (MSPE) have standardized the "dean's letter." The authors examined MSPEs for linguistic differences according to student or author gender. This 2009 study analyzed 297 MSPEs for 227 male and 70 female medical students applying to a diagnostic radiology residency program. Text analysis software identified word counts, categories, frequencies, and contexts; factor analysis detected patterns of word categories in student-author gender pairings. Analyses showed a main effect for student gender (P=.046) and a group difference for the author-student gender combinations (P=.048). Female authors of male student MSPEs used the fewest "positive emotion" words (P=.006). MSPEs by male authors were shorter than those by females (P=.014). MSPEs for students ranked in the National Resident Matching Program contained more "standout" (P=.002) and "positive emotion" (P=.001) words. There were no differences in the author-gender pairs in the proportion of students ranked, although predominant word categories differed by author and student gender. Factor analysis revealed differences among the author-student groups in patterns of correlations among word categories. MSPEs differed slightly but significantly by student and author gender. These differences may derive from societal norms for male and female behaviors and the subsequent linguistic interpretation of these behaviors, which itself may be colored by the observer's gender. Although the differences in MSPEs did not seem to influence students' rankings, this work underscores the need for awareness of the complex effects of gender in evaluating students and guiding their specialty choices.

  5. Pain medication management processes used by oncology outpatients and family caregivers part I: health systems contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. The aim was to describe day-to-day pain medication management from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management by patients and family caregivers in the context of multiple complex health systems. We qualitatively analyzed audio-recorded intervention sessions that included extensive dialogue between patients, family caregivers, and nurses about pain medication management during the 10-week intervention. The health systems context for pain medication management included multiple complex systems for clinical care, reimbursement, and regulation of analgesic prescriptions. Pain medication management processes particularly relevant to this context were getting prescriptions and obtaining medications. Responsibilities that fell primarily to patients and family caregivers included facilitating communication and coordination among multiple clinicians, overcoming barriers to access, and serving as a final safety checkpoint. Significant effort was required of patients and family caregivers to insure safe and effective pain medication management. Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and health-care reform initiatives. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  6. Evaluation of a combat medic skills validation test.

    PubMed

    Hemman, Eileen Ann; Gillingham, David; Allison, Nancy; Adams, Richard

    2007-08-01

    The purpose of this study was to describe validity and reliability of a skills-based test (the Semi-Annual Combat Medic Skills-Validation Test) used by the Army to determine combat medic competency. An instrumentation design was used in which a panel of experts completed a content validity index on all skills. Simulation testing was used to determine criterion validity, intrarater, interrater, and test-retest reliability. Findings revealed that needle chest decompression, Combitube insertion, and automatic external defibrillator were the only skills with low validity (content validity index < or = 0.75). Splinting was recommended as an addition to the skill test. The validity criterion of a modified postcourse Emergency Medical Technician-Basic examination score was significantly related to the Semi-Annual Combat Medic Skills-Validation Test scores (r = 0.409, p = 0.006, two tailed). There was high intra- and interrater agreement on performance steps and skills. Higher subject scores were seen on the medical skills than on the trauma skills. When retested, there was significant improvement (t = 3.268, df = 7, p < 0.014, two tailed).

  7. Age 60 Study, Part 4: Experimental Evaluation of Pilot Performance

    DTIC Science & Technology

    1994-10-01

    and aging. Computerized cognitive test batteries, COGSREEN and WOMBAT , were selected as the domain-independent measures. Flitescript and whole task...were assessed. COGSCREEN total composite scores were significantly correlated with evaluator ratings on emergency/abnormal maneuvers. Neither WOMBAT ...B-3 WOMBAT Questionnaire .......................................... B-4 Sim ulator Post-flight Questionnaire

  8. Alternative Learning Programs Evaluation: Part 2 Report. Outcomes.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability Services/Research.

    In 1996, North Carolina began a 5-year evaluation of Alternative Learning Programs (ALPs). This report describes selected outcomes for students who participated in ALPs during 1995-96. These outcomes include performance on North Carolina End-of-Grade tests (elementary school) and performance on the End-of-Course(EOC) tests (high school) for…

  9. An Evaluation of Crisis Hotline Outcomes. Part 2: Suicidal Callers

    ERIC Educational Resources Information Center

    Gould, Madelyn S.; Kalafat, John; HarrisMunfakh, Jimmie Lou; Kleinman, Marjorie

    2007-01-01

    In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed…

  10. Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

    PubMed

    Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

    2015-01-01

    Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities

  11. Evaluation of a clinical medical librarian program at the Yale Medical Library.

    PubMed

    Greenberg, B; Battison, S; Kolisch, M; Leredu, M

    1978-07-01

    A clinical medical librarian (CML) program in a large university-based teaching hospital setting is viewed by the majority of clinicians as education-oriented, with slightly fewer clinicians viewing it as patient care oriented. The CML service has been utilized for research purposes only when it is clear that case-relevant information can evolve into research intended to have "clinical" impact. This study reports the results of a questionnaire circulated among clinicians receiving CML support by a large medical school library. Results indicate that (1) the CML effected a change in information-seeking behavior by the clinicians--they obtained information that would not have been available to them if the CML had not been present in patient-management conferences; (2) relevancy of information provided by the CML was judged by the clinicians to be very high; (3) the accuracy of the CML's search, coupled with the rapidity of delivery, was found to be highly satisfactory; (4) acceptance of the CML within the patient care setting was acknowledged by the majority of clinicians, who contact the CML in-hospital and overwhelmingly prefer to do so; and (5) there was no statistically significant variation in the manner in which different medical specialties use the services of a CML. These findings justify implementation of a clinical medical librarian program, on a modified basis, as an additional service to already existing reference services offered by a large medical school library.

  12. Evaluation of oral medication delivery devices provided by community pharmacies.

    PubMed

    Honey, Brooke L; Condren, Michelle; Phillips, Christina; Votruba, Allyson

    2013-05-01

    Oral liquids remain common medication dosage forms used for patients who have difficulty swallowing. However, liquids require a delivery device and thus have been linked to medication administration errors. This study identified medication delivery devices available at pharmacies. Delivery devices were obtained from area pharmacies and analyzed for units of measurement, abbreviations, and largest/smallest measurable volume. A total of 58 devices were collected from 22 pharmacies. All devices were marked with mL, and 79% were additionally marked in teaspoons. The 5-mL syringe was the only device dispensed at 14% of locations. Other devices included the dosing spoon, dropper, and cup. The largest measurable volume was 30 mL, whereas the smallest was 0.01 mL, with significant variability among devices. A more consistent approach in prescribing units of measurement is needed. Prescribing in milliliters is an optimal choice because of the accessibility of measuring devices containing this measurement.

  13. Evaluating an interprofessional disease state and medication management review model.

    PubMed

    Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

    2014-03-01

    There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

  14. Evaluation of displays for medical x-ray applications using observer performance

    NASA Astrophysics Data System (ADS)

    Sund, Patrik; Hakansson, Markus; Lindskog, Lars; Tylen, Ulf; Kheddache, Susanne; Mansson, Lars G.

    2002-04-01

    A physical and clinical evaluation of four different display systems intended for the presentation of medical x-ray images was performed. State-of-the-art b/w display devices were studied as well as a low-cost color display. The systems tested were: a) CRT 21' b/w 1K, b) CRT 21' b/w, 2K, c) CRT 21' color, 1K, d) LCD 20.8' b/w, 1.5K. All displays were, as far as possible, adjusted to conform to DICOM 3.0 part 14. The physical evaluation included quantities such as resolution, flickering and uniformity. The clinical evaluation was performed by 15 radiologists using visual grading analysis of one phantom chest image and 12 clinical images of the chest and small bones. One subtle pathological structure and one anatomical structure were rated. The CRT b/w 1K display was used as the reference display system. All displays were evaluated at two different luminance levels (160 and 320 cd/m2) and viewed under two different ambient light conditions (10 and 40 lux). The LCD 1.5K display was rated best and the color CRT display was rated worst for both luminance levels. The result for the color CRT display - unable to produce more than 120 cd/m2 - at the high ambient light setting was very poor.

  15. [Evaluation of the efficiency of preventive medical examinations of railway transport workers].

    PubMed

    Pankova, V B; Golysheva, G V; Khvastunov, R M; Makarov, A A

    2006-01-01

    The paper reflects the priority role of preliminary and periodic medical examinations in the system of measures implemented by therapeutic-and-prophylactic institutions of the Ministry of Railway of Russia. It gives a comprehensive assessment of the medical, social, and economic aspects of the efficiency of preventive medical examinations. Emphasis is laid on the necessity of elaborating methods to evaluate the economic efficiency of medical measures under the conditions of market economy. At the same time, light is shed on the difficulties available when a full-scale, within the whole industry, economic evaluation of periodic medical examinations is made. The role of a cost-effect analysis is shown as the most flexible existing principle in the evaluation of the efficiency of medical preventive measures.

  16. The medical department in military operations other than war. Part I. Planning for deployment.

    PubMed

    Baker, M S; Ryals, P A

    1999-08-01

    Many military deployments are "military operations other than war" (MOOTW), a spectrum of assignments less than all-out combat. The corresponding medical support requirement differs from conventional military medical combat support and also from customary civilian medical practice. Hence, medical planners will use different doctrine and planning tools than are used in civilian facilities or on field training exercises when tasked for MOOTW activities. The deployment team must be self-sufficient, plan for very large numbers of affected individuals, and arrange for food, water, shelter, sanitation, power, light, security, transportation, communications, and team health care in advance of arrival. Careful and well-thought-out advance liaison with numerous interested parties is required to ensure mission success. The medical department on these missions may represent the lead element, and other warfare specialists and line and staff officers may support the medical mission by providing security, communications, transportation, and logistics. The medical team may find that it represents the foreign policy "point of the spear" during MOOTW deployments.

  17. Promoting medical humanism: design and evaluation of an online curriculum.

    PubMed

    Wiecha, John M; Markuns, Jeffrey F

    2008-10-01

    To provide patient-centered care, physicians must be well trained in the concepts and methods of humanistic practice. Educational efforts to promote humanism may help to overcome the counter-training of the hidden medical school curriculum, responsible for a decline in empathy and idealism over the course of medical training. The online component of the clerkship in family medicine at Boston University introduced activities founded on reflection, self-awareness, collaborative learning, and applied practice to successfully promote student confidence in three key areas of humanistic practice.

  18. Pain medication management processes used by oncology outpatients and family caregivers part II: home and lifestyle contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  19. Medical school graduates' retrospective evaluation of a clinical medical librarian program.

    PubMed Central

    Byrd, G D; Arnold, L

    1979-01-01

    This paper reports on the results of a survey of sixty-six graduates of the University of Missouri-Kansas City (UMKC) School of Medicine conducted in the spring of 1977. The graduates were questioned about their present library use behavior and their restrospective perceptions of the clinical medical librarian (CML) services which they received as medical students at UMKC. The results show that these young physicians, after regular association with other, more tradional medical library services, hold very positive impressions of the CML program. The graduates also typically credit the CML'S with helping them to learn to use library resources effectively. These retrospective perceptions of the CML match the short-term benefits reported in other studies of similar programs. PMID:476318

  20. Medical school graduates' retrospective evaluation of a clinical medical librarian program.

    PubMed

    Byrd, G D; Arnold, L

    1979-07-01

    This paper reports on the results of a survey of sixty-six graduates of the University of Missouri-Kansas City (UMKC) School of Medicine conducted in the spring of 1977. The graduates were questioned about their present library use behavior and their restrospective perceptions of the clinical medical librarian (CML) services which they received as medical students at UMKC. The results show that these young physicians, after regular association with other, more tradional medical library services, hold very positive impressions of the CML program. The graduates also typically credit the CML'S with helping them to learn to use library resources effectively. These retrospective perceptions of the CML match the short-term benefits reported in other studies of similar programs.

  1. Evaluation of an educational program on deciphering heterogeneity for medical coverage decisions.

    PubMed

    Warholak, Terri L; Hilgaertner, Jianhua W; Dean, Joni L; Taylor, Ann M; Hines, Lisa E; Hurwitz, Jason; Brown, Mary; Malone, Daniel C

    2014-06-01

    It is increasingly important for decision makers, such as medical and pharmacy managers (or pharmacy therapeutics committee members and staff), to understand the variation and diversity in treatment response as decisions shift from an individual patient perspective to optimizing care for populations of patients. To assess the effectiveness of an instructional program on heterogeneity designed for medical and pharmacy managers. A live educational program was offered to members of the Academy of Managed Care Pharmacy at the fall 2012 educational meeting and also to medical directors and managers attending a national payer roundtable meeting in October 2012. Participants completed a retrospective pretest-posttest assessment of their knowledge, attitudes, and self-efficacy immediately following the program. Participants were offered the opportunity to participate in a follow-up assessment 6 months later. Willing participants for the follow-up assessment were contacted via e-mail and telephone. Rasch rating scale models were used to compare pre- and postscores measuring participants' knowledge about and attitude towards heterogeneity. A total of 49 individuals completed the retrospective pretest-posttest assessment and agreed to be a part of the program evaluation. Fifty percent (n = 25) of participants had heard of the phrase "heterogeneity of treatment effect," and 36 (72%) were familiar with the phrase "individualized treatment effect" prior to the live program. Participants reported a significant improvement in knowledge of heterogeneity (P  less than  0.01) and attitudes about heterogeneity (P  less than  0.01) immediately after attending the program. At the time of the educational program, participants had either never considered heterogeneity (26%) or reported not knowing (28%) whether their organizations considered it when determining basic coverage. Participants were more likely to report "sometimes" considering heterogeneity for determining

  2. 10 CFR Part 35: changes to the NRC rule governing the medical use of radioisotopes and implications for radiologic practice.

    PubMed

    Foens, Cassandra S; Fairobent, Lynne A; Guiberteau, Milton J

    2006-02-01

    In the spring of 2005, the US Nuclear Regulatory Commission completed its revision of Title 10, Part 35, of the Code of Federal Regulations, its regulatory framework for the medical use of radioisotopes. Because of the complexity of the regulation and the lengthy period over which the revisions were accomplished, many radiologists remain uninformed regarding changes in the rule. This article highlights some of the more important of these changes as they relate to the practice of radiology, radiation oncology, nuclear medicine, and medical physics.

  3. Peroxy bleaches Part 1. Background and techniques for hazard evaluation.

    PubMed

    Carson, P A; Fairclough, C S; Mauduit, C; Colsell, M

    2006-08-25

    Fabric laundering is now a sophisticated chemical process involving a variety of operations including bleaching. The chemistry of peroxy bleaches is described including the use of novel organic compounds to provide effective bleaching at the lower temperatures of modern wash cycles. The instability of peroxy compounds is illustrated using cameo case histories to relate theory and practice. Techniques available for determining their thermochemistry are summarised. A model is provided for hazard and risk assessment of development projects in general (particularly those involving new molecules, processes or formulations) from ideas phase through exploratory laboratory investigations to pilot plant scale-up and eventual manufacture and commercial exploitation. This paper is a prelude to Part 2, which describes the determination of thermodynamic and kinetic properties of peroxy bleaches and discusses the implication of the results in terms of precautions for their safe storage and incorporation into detergent formulations during processing.

  4. Evaluation of a Program to Teach Medical Students about Alcoholism.

    ERIC Educational Resources Information Center

    Siegal, Harvey A.; And Others

    1986-01-01

    The Week-end Intervention Program (WIP) used by Wright State University School of Medicine, which assesses the alcohol problems of those convicted of offenses such as drunk driving and then assists in finding treatment, is described. The impact of the program in educating medical students about alcoholism is discussed. (MLW)

  5. Evaluating the Systematic Validity of a Medical Subspecialty Examination

    ERIC Educational Resources Information Center

    Raddatz, Mikaela M.; Royal, Kenneth D.; Pennington, Jessica

    2012-01-01

    The purpose of this study is to determine if the construct of a medical subspecialty examination, as defined by the hierarchy of item difficulties, is stable across physicians who completed a fellowship and recertifiers as compared to non-fellows. Three comparisons of groups are made: 1) Practice pathway board candidates compared to members of all…

  6. STARPAHC space-oriented medical evaluation. [telemedicine system

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Development of the STARPAHC telemedicine system is documented. Using STARPAHC assessment results and monitoring experience, on board and ground based flight medical system monitoring requirements and operational procedures were developed for use with the Space Transportation System during OFT and mature operation phases of the shuttle.

  7. Actuarial considerations of medical malpractice evaluations in M&As.

    PubMed

    Frese, Richard C

    2014-11-01

    To best project an actuarial estimate for medical malpractice exposure for a merger and acquisition, a organization's leaders should consider the following factors, among others: How to support an unbiased actuarial estimation. Experience of the actuary. The full picture of the organization's malpractice coverage. The potential for future loss development. Frequency and severity trends.

  8. Evaluation of a Lecture Recording System in a Medical Curriculum

    ERIC Educational Resources Information Center

    Bacro, Thierry R. H.; Gebregziabher, Mulugeta; Fitzharris, Timothy P.

    2010-01-01

    Recently, the Medical University of South Carolina adopted a lecture recording system (LRS). A retrospective study of LRS was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). The number of accesses and…

  9. Evaluation of a Lecture Recording System in a Medical Curriculum

    ERIC Educational Resources Information Center

    Bacro, Thierry R. H.; Gebregziabher, Mulugeta; Fitzharris, Timothy P.

    2010-01-01

    Recently, the Medical University of South Carolina adopted a lecture recording system (LRS). A retrospective study of LRS was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). The number of accesses and…

  10. A Course in Diagnostic Test Evaluation for Senior Medical Students.

    ERIC Educational Resources Information Center

    Goldenberg, Kim; And Others

    1989-01-01

    A group of medical students at Wright State University School of Medicine developed and participated in a one-month elective on selecting and interpreting diagnostic tests. Tests and diseases were reviewed, recorded and published by the students as a reference manual for their later use during clinical rotations. (MLW)

  11. Evaluation of a Program to Teach Medical Students about Alcoholism.

    ERIC Educational Resources Information Center

    Siegal, Harvey A.; And Others

    1986-01-01

    The Week-end Intervention Program (WIP) used by Wright State University School of Medicine, which assesses the alcohol problems of those convicted of offenses such as drunk driving and then assists in finding treatment, is described. The impact of the program in educating medical students about alcoholism is discussed. (MLW)

  12. Evaluation of medication reconcilliation in a Trauma Unit.

    PubMed

    Pascual, O; Real, J M; Uriarte, M; Larrodé, I; Alonso, Y M; Abad, M R

    2015-01-01

    The aim of this study was to assess the rate of discrepancies in medication reconciliation on admission patients in a trauma unit, and identifying potential risk factors associated with these discrepancies. A cross-sectional, observational study was carried out to identify reconciliation errors in a tertiary hospital during the period from May 1 to July 16 of 2012. Medication history of the patient was compared with home medication data collected on admission, to identify reconciliation errors. These were classified according to the type and severity of the discrepancies. Statistical analysis by logistic regression was performed, using the presence of discrepancies as dependent variable. The study included 164 patients, and reconciliation errors were found in 48.8%, of which 14.4% were considered highly relevant. Around two-thirds (66.7%) of the patients admitted to the emergency department showed unjustified discrepancies compared to 44.8% in scheduled patients. In total, 153 reconciliation errors were identified, being omitted drug the most frequent type of discrepancie (72%). The risk of discrepancies increases by 33% for each drug added to the usual home treatment. This study demonstrates the lack of quality in home medication recording in patients admitted to the trauma unit. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  13. Assessing the Quality of Medical Information Technology Economic Evaluations: Room for Improvement

    PubMed Central

    Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R.; Lobach, David F.

    2006-01-01

    Medical information systems are being recognized for their ability to improve patient outcomes. While standards for the economic evaluation of medical technologies were instituted in the mid-1990s, little is known about their application in medical information technology studies. In a review of medical information technology evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased; however, investigators routinely omitted key cost or effectiveness elements in their designs, resulting in publications with incomplete, and potentially biased, economic findings. Of the studies that made economic claims, 23% did not report any economic data, 40% failed to include any effectiveness measures, and more than 50% used a case study or pre- post- test design. Thus, during a time when health economic study methods in general have experienced significant development, there is little evidence of similar progress in medical information technology economic evaluations. PMID:17238338

  14. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    PubMed

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  15. Currently available medical engineering degrees in the UK. Part 1: Undergraduate degrees.

    PubMed

    Joyce, T

    2009-05-01

    This paper reviews mechanical-engineering-based medical engineering degrees which are currently provided at undergraduate level in the UK. At present there are 14 undergraduate degree programmes in medical engineering, offered by the University of Bath, University of Birmingham, University of Bradford, Cardiff University, University of Hull, Imperial College London, University of Leeds, University of Nottingham, University of Oxford, Queen Mary University of London, University of Sheffield, University of Southampton, University of Surrey, and Swansea University. All these undergraduate courses are delivered on a full-time basis, both 3 year BEng and 4 year MEng degrees. Half of the 14 degree courses share a core first 2 years with a mechanical engineering stream. The other seven programmes include medical engineering modules earlier in their degrees. Within the courses, a very wide range of medical-engineering-related modules are offered, although more common modules include biomaterials, biomechanics, and anatomy and physiology.

  16. Principles and practice of hyperbaric medicine: a medical practitioner's primer, part I.

    PubMed

    Perdrizet, George A

    2014-01-01

    The purpose of this monograph is to narrow the knowledge gap between current medical practice and hyperbaric oxygen therapy. Graduate medical education has not kept pace with the expanding science and practice of hyperbaric medicine. The number of hyperbaric chambers in the state of Connecticut has increased by >400% during the past five years. A brief overview of the science and practice of hyperbaric oxygen therapy is presented, with additional resources identified where more in-depth coverage can be found. The reader will find the basics of hyperbaric medical practice reviewed and be able to recognize diagnoses that are appropriate for referral to a hyperbaric medical center. The intended audience is practitioners who have had no formal exposure to hyperbaric medicine or chronic wound care.

  17. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 3: oral therapies.

    PubMed

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Lawrence F

    2015-12-01

    Parts 1 and 2 of this 3-part series provided an overview of the epidemiology, visible patterns, and important considerations for clinical and laboratory evaluation of acne vulgaris (AV) in adult women and reviewed the role of proper skin care and topical therapies in this patient population. In Part 3, oral therapies including combination oral contraceptives, spironolactone, antibiotics, and isotretinoin are discussed along with important considerations that clinicians should keep in mind when selecting oral agents for management of AV in adult women.

  18. Teaching children about health, part II: the effect of an academic-community partnership on medical students' communication skills.

    PubMed

    Olm-Shipman, Casey; Reed, Virginia; Christian, Jernstedt G

    2003-11-01

    Partners in Health Education (PHE) is a Dartmouth Medical School elective that pairs first- and second-year medical students with local elementary school classroom teachers to provide health messages to students. The primary aim of the programme is to help medical students improve their communication skills through teaching children about health. Secondary aims are to teach children about health and the prevention of injury and disease and to support community teachers in their health promotion efforts. This report contains the results of the assessment of the programme's impact on the medical students. Sixteen first- and second-year medical students comprised the participants for the study. Students were assessed during their first and fourth teaching experiences using a variety of evaluation measures, including student surveys of expectations and perceptions; ratings of performance in the classroom by students, teachers, and classroom observers; coded videotapes of classroom teaching sessions; and performance on a measure of physician-patient communication skills. Over the course of the teaching experience, medical students' teaching and communication skills increased on a number of measures. Programmes such as PHE can provide true service-learning experiences in which all participants benefit. Medical students can learn how to communicate about health, a set of skills they will need to become effective physicians. School children can learn about health, so they are empowered to take charge of their health and to make healthy choices.

  19. Medical Care Quality Evaluation Using the Fleet Marine Force Medical Information System

    DTIC Science & Technology

    1983-12-08

    ALIEGIESZ penicillin G-6-PD deficient MEDICjALmisTORY: Appendectomy, age 14. infectious hepatitis, age 19. malaria, age 21; positive ppd, age 25: angina ... pectoris . age 32; hypertension, age 32. peptic ulcer, age 32 PRESENT MEDICATIONS! Hydrochlorothiazide, 50 mg. once a day, propran- olol. 60 mg, once a day

  20. Economic Evaluation in Medical Information Technology: Why the Numbers Don’t Add Up

    PubMed Central

    Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R.; Lobach, David F.

    2006-01-01

    Standards for the economic evaluation of medical technologies were instituted in the mid-1990s, yet little is known about their application in medical information technology studies. In a review of evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased. However, investigators routinely omitted key cost or effectiveness elements in their designs, resulting in publications with incomplete, and potentially biased, economic findings. PMID:17238533

  1. Gallium-doped germanium, evaluation of photoconductors, part 1

    NASA Technical Reports Server (NTRS)

    Moore, W. J.

    1979-01-01

    Gallium-doped germanium far infrared detectors were evaluated at low temperatures and low background simulating the space environment. Signal and noise characteristics were determined for detector temperatures in the 2K to 4K range. Optimum performance occurs at about 2.5K for all devices tested. The minimum average NEP in the 40-130 micron region was found to be approximately 4 x 10 to the minus 17th power watt Hz(-1/2) at a frequency of 1 Hz.

  2. A bibliometric analysis of evaluative medical education studies: characteristics and indexing accuracy.

    PubMed

    Sampson, Margaret; Horsley, Tanya; Doja, Asif

    2013-03-01

    To determine the characteristics of medical education studies published in general and internal medicine (GIM) and medical education journals, and to analyze the accuracy of their indexing. The authors identified the five GIM and five medical education journals that published the most articles indexed in MEDLINE as medical education during January 2001 to January 2010. They searched Ovid MEDLINE for evaluative medical education studies published in these journals during this period and classified them as quantitative or qualitative studies according to MEDLINE indexing. They also examined themes and learner levels targeted. Using a random sample of records, they assessed the accuracy of study-type indexing. Of 4,418 records retrieved, 3,853 (87.2%) were from medical education journals and 565 (12.3%) were from GIM journals. Qualitative studies and program evaluations were more prevalent within medical education journals, whereas GIM journals published a higher proportion of clinical trials and systematic reviews (χ=74.28, df=3, P<.001). Medical education journals had a concentration of studies targeting medical students, whereas GIM journals had a concentration targeting residents; themes were similar. The authors confirmed that 170 (56.7%) of the 300 sampled articles were correctly classified in MEDLINE as evaluative studies. The majority of the identified evaluative studies were published in medical education journals, confirming the integrity of medical education as a specialty. Findings concerning the study types published in medical education versus GIM journals are important for medical education researchers who seek to publish outside the field's specialty journals.

  3. Dynamic evaluation of CMAQ part I: Separating the effects of ...

    EPA Pesticide Factsheets

    A dynamic evaluation of the Community Multiscale Air Quality (CMAQ) modeling system version 5.0.1 was conducted to evaluate the model's ability to predict changes in ozone levels between 2002 and 2005, a time period characterized by emission reductions associated with the EPA's Nitrogen Oxides State Implementation Plan as well as significant reductions in mobile source emissions. Model results for the summers of 2002 and 2005 were compared to simulations from a previous version of CMAQ to assess the impact of model updates on predicted pollutant response. Changes to the model treatment of emissions, meteorology and chemistry had substantial impacts on the simulated ozone concentrations. While the median bias for high summertime ozone decreased in both years compared to previous simulations, the observed decrease in ozone from 2002 to 2005 in the eastern US continued to be underestimated by the model. Additional “cross” simulations were used to decompose the model predicted change in ozone into the change due to emissions, the change due to meteorology and any remaining change not explained individually by these two components. The decomposition showed that the emission controls led to a decrease in modeled high summertime ozone close to twice as large as the decrease attributable to changes in meteorology alone. Quantifying the impact of retrospective emission controls by removing the impacts of meteorology during the control period can be a valuable approac

  4. Radioactive tracers facilitate stimulation job evaluation. Part 1

    SciTech Connect

    Fisher, K.; Walker, R.; Dunleavy, R.; Woodroof, B.; Crabb, H.

    1995-02-01

    Logging tools can now quantify multiple isotopes, including the volume of individual isotopes present and their radial position away from the well bore. In conjunction with those improvements, tracers have been developed that eliminate wash off effects of conventional tracers. By precisely locating the presence and concentration of traced proppant at the well bore, better evaluations can be made of vertical and radial proppant distribution near the well bore and fracture aperture width. A comprehensive study of 98 wells with 136 fracture stages in four different basins has been completed. Each stage was traced and logged. Spectral gamma ray logs were compared with conventional openhole logs, sonic stress logs where available, and cased hole logs such as cement bond and production logs. This data was then compared on a well-by-well basis with the fracture design program, post treatment stimulation reports and production history. Several trends were identified while building this massive stimulation evaluation database. Problems that potentially could be solved using tracer technology are: fracture height greater than design; unstimulated perforation sets within a stage; understimulated pay intervals.

  5. Personality type and clinical evaluations in an obstetrics/gynecology medical student clerkship.

    PubMed

    Davis, Katrina R; Banken, Joseph A

    2005-11-01

    The purpose of this study was to determine whether the Myers-Briggs type inventory extraversion is associated with clinical evaluation ratings that students earn during their (obstetrics/gynecology) junior medical student clerkship. The Myers-Briggs type inventory was administered to medical students during their obstetrics/gynec clerkship. Bivariate correlations between clinical evaluations, National Board of Medical Examiners subject scores, and data from the Myers-Briggs type inventory extraversion scale were analyzed. Pearson product-moment correlation between clinical and National Board of Medical Examiners subject scores was not significant (r = .25; P = .05). The National Board of Medical Examiners did not show significant correlations with the Myers-Briggs type inventory extraversion data. The clinical evaluations showed a significant correlation (r = .35; P = .005) with Myers-Briggs type inventory extraversion. Results show that Myers-Briggs type inventory extraversion is correlated positively with clinical evaluations. The National Board of Medical Examiners subject examination and clinical evaluations were not correlated significantly. Findings question whether clinical evaluation data should be included in the obstetrics/gynecology medical student evaluation process.

  6. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities.

    PubMed

    Hasan, Syed Shahzad; Thiruchelvam, Kaeshaelya; Kow, Chia Siang; Ghori, Muhammad Usman; Babar, Zaheer-Ud-Din

    2017-10-01

    Medication reviews is a widely accepted approach known to have a substantial impact on patients' pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities.

  7. Evaluation of Methods for Multidisciplinary Design Optimization (MDO). Part 2

    NASA Technical Reports Server (NTRS)

    Kodiyalam, Srinivas; Yuan, Charles; Sobieski, Jaroslaw (Technical Monitor)

    2000-01-01

    A new MDO method, BLISS, and two different variants of the method, BLISS/RS and BLISS/S, have been implemented using iSIGHT's scripting language and evaluated in this report on multidisciplinary problems. All of these methods are based on decomposing a modular system optimization system into several subtasks optimization, that may be executed concurrently, and the system optimization that coordinates the subtasks optimization. The BLISS method and its variants are well suited for exploiting the concurrent processing capabilities in a multiprocessor machine. Several steps, including the local sensitivity analysis, local optimization, response surfaces construction and updates are all ideally suited for concurrent processing. Needless to mention, such algorithms that can effectively exploit the concurrent processing capabilities of the compute servers will be a key requirement for solving large-scale industrial design problems, such as the automotive vehicle problem detailed in Section 3.4.

  8. Evaluation of engine coolant recycling processes: Part 2

    SciTech Connect

    Bradley, W.H.

    1999-08-01

    Engine coolant recycling continues to provide solutions to both economic and environmental challenges often faced with the disposal of used engine coolant. General Motors` Service Technology Group (STG), in a continuing effort to validate the general practice of recycling engine coolants, has conducted an in-depth study on the capabilities of recycled coolants. Various recycling processes ranging from complex forms of fractional distillation to simple filtration were evaluated in this study to best represent the current state of coolant recycling technology. This study incorporates both lab and (limited) fleet testing to determine the performance capabilities of the recycled coolants tested. While the results suggest the need for additional studies in this area, they reveal the true capabilities of all types of engine coolant recycling technologies.

  9. An evaluation of crisis hotline outcomes. Part 2: Suicidal callers.

    PubMed

    Gould, Madelyn S; Kalafat, John; Harrismunfakh, Jimmie Lou; Kleinman, Marjorie

    2007-06-01

    In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in the follow-up assessment. Several key findings emerged. Seriously suicidal individuals reached out to telephone crisis services. Significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks. A caller's intent to die at the end of the call was the most potent predictor of subsequent suicidality. The need to heighten outreach strategies and improve referrals is highlighted.

  10. RIPE integrity primitives, part 2 (RACE Integrity Primitives Evaluation)

    NASA Astrophysics Data System (ADS)

    Denboer, B.; Boly, J. P.; Bosselaers, A.; Brandt, J.; Chaum, D.; Damgaard, I.; Dichtl, M.; Fumy, W.; Vanderham, M.; Jansen, C. J. A.

    1993-04-01

    A manual intended for those seeking to secure information systems by applying modern cryptography is presented. It represents the successful attainment of goals by RIPE (RACE (Research and development of Advanced Communications technology in Europe) Integrity Primitives Evaluation). The recommended portfolio of integrity primitives, which is the main product of the project, forms the heart of the manual. By integrity, is meant the kinds of security that can be achieved through cryptography, apart from keeping messages secret. Thus included are ways to ensure that stored or communicated data is not illicitly modified, that parties exchanging messages are actually present, and that 'signed' electronic messages can be recognized as authentic by anyone. Of particular concern to the project were the high speed requirements of broadband communication. The project also aimed for completeness in its recommendations. As a result, the portfolio contains primitives, that is building blocks, that can meet most of today's perceived needs for integrity.

  11. RIPE integrity primitives, part 1 (RACE Integrity Primitives Evaluation)

    NASA Astrophysics Data System (ADS)

    Denboer, B.; Boly, J. P.; Bosselaers, A.; Brandt, J.; Chaum, D.; Damgaard, I.; Dichtl, M.; Fumy, W.; Vanderham, M.; Jansen, C. J. A.

    1993-04-01

    A manual intended for those seeking to secure information systems by applying modern cryptography is presented. It represents the successful attainment of goals by RIPE (RACE (Research and development of Advanced Communication technology in Europe) Integrity Primitives Evaluation). The recommended portfolio of integrity primitives, which is the main product of the project, forms the heart of the manual. By integrity, is meant the kinds of security that can be achieved through cryptography, apart from keeping messages secret. Thus included are ways to ensure that stored or communicated data is not illicitly modified, that parties exchanging messages are actually present, and that 'signed' electronic messages can be recognized as authentic by anyone. Of particular concern to the project were the high speed requirements of broadband communication. The project also aimed for completeness in its recommendations. As a result, the portfolio contains primitives, that is building blocks, that can meet most of today's perceived needs for integrity.

  12. Battlefield Medical Research Development Training and Evaluation Priorities

    DTIC Science & Technology

    2012-12-20

    DEFENSE HEAL TH BOARD DEFENSE HEAL TH HEADQUARTERS 7700 ARLINGTON BOULEVARD, SUITE 5101 FALLS CHURCH, VA 22042-5101 DEC 2 0 2012 FOR: JONATHAN...combat fatalities. He noted that: 1) Approximately 25 percent of combat fatalities occurred in casualties with potentially survivable injuries; 2 ...accept the list provided by the Subcommittee as a Board recommended list of top priorities. 2 SUBJECT: Battlefield Medical Research, Development

  13. An Expert System Advisor for Medical Evaluation Boards

    DTIC Science & Technology

    1991-12-01

    Rule conclusion BECAUSE "In Accordance With The VA Schedule For Rating Disabilities" RULE N3 !Mandatory rule label IF Problem= Sacroiliac Joint ...Condition OR REFERRAL=MedicalBoard_Slip !Condition AND PROBLEM=Spine_Scapulae.. Sacroiliac !Condition THEN ACTION=Refer-toMEB !Rule conclusion BECAUSE "In...Rules Block RULE N1 !Mandatory rule label IF Problem= Joints !Condition THEN Decision=Narrative !Rule conclusion BECAUSE "In

  14. Evaluation of medical career-counseling resources across Canada.

    PubMed

    Harris, June A; McKay, Donald W

    2012-01-01

    North American medical school accreditation requires career counseling. The Memorial University of Newfoundland (MUN) MedCAREERS program was implemented in 2000 before published evidence of efficacy of Canadian medical school career-counseling programs existed. Data were gathered initially through the Canadian Residency Matching Service Post-Match Survey in 2003 and subsequently through the Canadian Graduation Questionnaire from 2006 to 2008. The overall response rate was 61%. Perceived benefits and efficacy of the MUN MedCAREERS Web site and several career-counseling resources were determined along with participation rates encompassing a 6-year period. Most career-counseling resources were perceived as helpful, regardless of participation rate. Our goal was to provide information on an array of career-counseling resources so that Canadian medical schools can avail of appropriate resources and select activities to help students make informed decisions about their specialty choice. Planners of career-counseling activities may wish to consider elements that students find most helpful.

  15. Towards uniformity in English for medical purposes: evaluation and design.

    PubMed

    Antić, Zorica

    2009-01-01

    A thorough analysis of students' needs will enable teachers to build up a profile of a typical learner. The objective of this study was to determine the current and target English language skill level and use the findings as guidelines in designing a uniform course. The investigation was carried out at the Congress of Biomedical Science Students of Serbia held in Lepenski Vir in 2009. The investigation was conducted using a questionnaire and included 277 medical students of all study years and from all university centres of Serbia. The obtained results do not vary significantly among universities. The students marked writing and translation as their weakest skills and pointed out that their greatest problem areas were also vocabulary and grammar. On one hand, writing was ranked high among the skills which needed improvement but on the other hand, it was believed to be the least important in medical career. Speaking and listening were shown to be the most important for medical students. In designing the course, teachers need to be able to use approaches and methods flexibly and creatively in order to bring about positive results. Since course design is a dynamic process, teachers have the responsibility of negotiating a plan of work with the learners.

  16. Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education

    PubMed Central

    Thayer, Erin K.; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C.; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A.

    2016-01-01

    Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data. PMID:27443407

  17. Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education.

    PubMed

    Thayer, Erin K; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A

    2016-01-01

    Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data.

  18. Do Students’ and Authors’ Genders Affect Evaluations? A Linguistic Analysis of Medical Student Performance Evaluations

    PubMed Central

    Isaac, Carol; Chertoff, Jocelyn; Lee, Barbara; Carnes, Molly

    2012-01-01

    Purpose Recent guidelines for the Medical Student Performance Evaluation (MSPE) have standardized the “dean’s letter.” The authors examined MSPEs for linguistic differences according to student or author gender. Method This 2009 study analyzed 297 MSPEs for 227 male and 70 female medical students applying to a diagnostic radiology residency program. Text analysis software identified word counts, categories, frequencies, and contexts; factor analysis detected patterns of word categories in student–author gender pairings. Results Analyses showed a main effect for student gender (P=.046) and a group difference for the author–student gender combinations (P=.048). Female authors of male student MSPEs used the fewest “positive emotion” words (P=.006). MSPEs by male authors were shorter than those by females (P=.014). MSPEs for students ranked in the National Resident Matching Program contained more “standout” (P=.002) and “positive emotion” (P=.001) words. There were no differences in the author–gender pairs in the proportion of students ranked, although predominant word categories differed by author and student gender. Factor analysis revealed differences among the author–student groups in patterns of correlations among word categories. Conclusions MSPEs differed slightly but significantly by student and author gender. These differences may derive from societal norms for male and female behaviors and the subsequent linguistic interpretation of these behaviors, which itself may be colored by the observer’s gender. Although the differences in MSPEs did not seem to influence students’ rankings, this work underscores the need for awareness of the complex effects of gender in evaluating students and guiding their specialty choices. PMID:21099389

  19. [Study on situations of review and pre-evaluation for medical device product specification in China].

    PubMed

    Li, Baolin

    2013-07-01

    This paper researched on course of registration and administrative licensing for medical device product specification, analyzed the existing demands of review and pre-evaluation, discussed about how to improve and manage pre-evaluation results for testing laboratory and manufacturer in China, based on "Provision of Medical Device Product Specification Standardization", "Provision on Medical Device Registration" and relative documents of States Food & Drug Administration. It suggested that set up and maintain a professional team of review and approval staff, further strengthen standardization of medical device specification, arming at current situations of non-compatibility between documents and inconformity of performance in different provinces. It paid attention to control the quality of medical device to ensure the core of safety and effectiveness for using medical device.

  20. AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education-a unifying perspective.

    PubMed

    Genn, J. M.

    2001-07-01

    learning organization evolving and changing in the illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Considerations of climate in the medical school, along the lines of continuous quality improvement and innovation, are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations, their quality of health and their longevity may be threatened.