Science.gov

Sample records for medical evaluation part

  1. Modernizing medical photography, part 1.

    PubMed

    Crompton, Paul

    2004-12-01

    Government, media and public focus on waiting times in the National Health Service in the United Kingdom has forced the organization to look closely at the process by which a patient progresses through an increasingly complex and ever changing system. In an effort to streamline the patient journey or care pathway, modernizers have turned to business and manufacturing for solutions. Whilst medical photographers need to recognize their role in this context, they are also facing major technological modernization through the development of digital photography. Part 1 of this paper looks at the origins of some of the techniques presently being used to modernize the patient journey. Part 2 shows how these tools of modernization 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.

  2. 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.

  3. 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

  4. 78 FR 23940 - Use of International Standard ISO-10993, “Biological Evaluation of Medical Devices Part 1...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... human body in order to determine the potential toxicity resulting from contact of the component... come into direct or indirect contact with the human body in order to determine the potential toxicity... and nonsterile medical devices that come into direct or indirect contact with the human body....

  5. Course Evaluation in Medical Education

    ERIC Educational Resources Information Center

    Kogan, Jennifer R.; Shea, Judy A.

    2007-01-01

    Course evaluation is integral to medical education. We discuss (1) distinctive features of medical education that impact on course evaluation, (2) a framework for course evaluations, (3) details that shape the evaluation process, (4) key measurement issues important to data gathering and interpretation, and (5) opportunities for expanding the…

  6. 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)

  7. 5 CFR 930.108 - Periodic medical evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Periodic medical evaluation. 930.108... Operators § 930.108 Periodic medical evaluation. At least once every 4 years, each agency will ensure that..., the employee may be referred for a medical examination in accordance with the provisions of part...

  8. Evaluating ethics competence in medical education.

    PubMed Central

    Savulescu, J; Crisp, R; Fulford, K W; Hope, T

    1999-01-01

    We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions. PMID:10536759

  9. A guide to clinical trials. Part II: interpreting medical research.

    PubMed

    Highleyman, Liz

    2006-01-01

    Part I of this two-part article, which appeared in the Summer 2005 issue of BETA, provided an overview of the clinical trial process. Part II covers features of clinical trials and interpretation of study results. Clinical trials provide the foundation for evidence-based medicine, or medical decision-making guided by data from formal research. Medical professionals keep up with the latest information by reading peer-reviewed medical journals and attending conferences. Likewise, HIV positive people can keep abreast of the state of the art by following the medical literature and community publications like BETA. Trials offer important information about a therapy's benefits and risks in a population, but they cannot predict how well a given treatment will work for a specific person. Healthcare providers, therefore, must still rely heavily on clinical experience, intuition, and a careful evaluation of the various factors unique to each individual case--the practice of medicine remains an art as well as a science. PMID:16610119

  10. 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.

  11. Content validity--establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1--eliciting concepts for a new PRO instrument.

    PubMed

    Patrick, Donald L; Burke, Laurie B; Gwaltney, Chad J; Leidy, Nancy Kline; Martin, Mona L; Molsen, Elizabeth; Ring, Lena

    2011-12-01

    The importance of content validity in developing patient reported outcomes (PRO) instruments is stressed by both the US Food and Drug Administration and the European Medicines Agency. Content validity is the extent to which an instrument measures the important aspects of concepts that developers or users purport it to assess. A PRO instrument measures the concepts most significant and relevant to a patient's condition and its treatment. For PRO instruments, items and domains as reflected in the scores of an instrument should be important to the target population and comprehensive with respect to patient concerns. Documentation of target population input in item generation, as well as evaluation of patient understanding through cognitive interviewing, can provide the evidence for content validity. Developing content for, and assessing respondent understanding of, newly developed PRO instruments for medical product evaluation will be discussed in this two-part ISPOR PRO Good Research Practices Task Force Report. Topics include the methods for generating items, documenting item development, coding of qualitative data from item generation, cognitive interviewing, and tracking item development through the various stages of research and preparing this tracking for submission to regulatory agencies. Part 1 covers elicitation of key concepts using qualitative focus groups and/or interviews to inform content and structure of a new PRO instrument. Part 2 covers the instrument development process, the assessment of patient understanding of the draft instrument using cognitive interviews and steps for instrument revision. The two parts are meant to be read together. They are intended to offer suggestions for good practices in planning, executing, and documenting qualitative studies that are used to support the content validity of PRO instruments to be used in medical product evaluation.

  12. 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.

  13. Medication use evaluation: pharmacist rubric for performance improvement.

    PubMed

    Fanikos, John; Jenkins, Kathryn L; Piazza, Gregory; Connors, Jean; Goldhaber, Samuel Z

    2014-12-01

    Despite rigorous expert review, medications often fall into routine use with unrecognized and unwanted complications. Use of some medications remains controversial because information to support efficacy is conflicting, scant, or nonexistent. Medication use evaluation (MUE) is a performance improvement tool that can be used when there is uncertainty regarding whether a medication will be beneficial. It is particularly useful when limited evidence is available on how best to choose between two or more medications. MUEs can analyze the process of medication prescribing, preparation, dispensing, administration, and monitoring. MUEs can be part of a structured or mandated multidisciplinary quality management program that focuses on evaluating medication effectiveness and improving patient safety. Successful MUE programs have a structure in place to support completion of rapid-cycle data collection, analysis, and intervention that supports practice change. PMID:25521847

  14. 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.

  15. The economic evaluation of medical devices: challenges.

    PubMed

    Kingkaew, Pritaporn; Teerawattananon, Yot

    2014-05-01

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

  16. Medical evaluation of abused and neglected children.

    PubMed

    Flaherty, E G; Weiss, H

    1990-03-01

    Children who have been abused and neglected may have a variety of medical problems not apparent to a social worker or other nonmedical professional investigating the allegations. A joint project between a state child protective agency and an urban teaching hospital was undertaken to provide for the systematic medical screening of all children brought to the agency before their placement in foster care. These children received a complete medical evaluation with emphasis on documenting the abuse and neglect and also were screened for other medical problems. A total of 5181 children were evaluated. Forty-four percent of these children had some medical problem, including anemia, otitis media, sexually transmitted infections, and lead poisoning. Additional instances of abuse and neglect were identified and documented. This systematic evaluation allows for the optimal identification, documentation, and treatment of abuse, neglect, and other medical problems that may affect a child's outcome and adaptation. PMID:2305740

  17. 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.

  18. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 2: Patient Preparation and Medications).

    PubMed

    Taslakian, Bedros; Sebaaly, Mikhael Georges; Al-Kutoubi, Aghiad

    2016-04-01

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care. Patient care before and after an interventional procedure, identification, and management of early and delayed complications of various procedures are equal in importance to the procedure itself. In this second part, we complete the comprehensive, methodical review of pre-procedural care and patient preparation before vascular and interventional radiology procedures.

  19. 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.

  20. Patient-centered medical homes: standards for approval-part 2: part 2 of 3.

    PubMed

    Stack, Eric; Kier, Karen

    2014-04-01

    Part 1 of this series discussed the key aspects and health care benefits of patient-centered medical homes (PCMHs). Part 2 outlines the approval process employed by the National Committee for Quality Assurance (NCQA) to evaluate, grade, and recognize PCMHs. Primary care practice sites must develop an understanding of the various graded categories to enable them to focus attention on the critical components of a successful PCMH. Overall, the goals of NCQA's recognition standards are to enhance patient access and continuity to health care services, manage patient populations, plan care, provide each patient with support for self-care, track and coordinate patient care, and measure performance of both the clinicians and practice-site as a whole. In short, the standards provide a solid basis for primary care practice sites to evolve into a PCMH model.

  1. 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.

  2. 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.

  3. 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. PMID:26682286

  4. Automated assessment of medical training evaluation text.

    PubMed

    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.

  5. Automated assessment of medical training evaluation text.

    PubMed

    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

  6. 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

  7. Content validity--establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO Good Research Practices Task Force report: part 2--assessing respondent understanding.

    PubMed

    Patrick, Donald L; Burke, Laurie B; Gwaltney, Chad J; Leidy, Nancy Kline; Martin, Mona L; Molsen, Elizabeth; Ring, Lena

    2011-12-01

    The importance of content validity in developing patient reported outcomes (PRO) instruments is stressed by both the US Food and Drug Administration and the European Medicines Agency. Content validity is the extent to which an instrument measures the important aspects of concepts developers or users purport it to assess. A PRO instrument measures the concepts most relevant and important to a patient's condition and its treatment. For PRO instruments, items and domains as reflected in the scores of an instrument should be important to the target population and comprehensive with respect to patient concerns. Documentation of target population input in item generation, as well as evaluation of patient understanding through cognitive interviewing, can provide the evidence for content validity. Part 1 of this task force report covers elicitation of key concepts using qualitative focus groups and/or interviews to inform content and structure of a new PRO instrument. Building on qualitative interviews and focus groups used to elicit concepts, cognitive interviews help developers craft items that can be understood by respondents in the target population and can ultimately confirm that the final instrument is appropriate, comprehensive, and understandable in the target population. Part 2 details: 1) the methods for conducting cognitive interviews that address patient understanding of items, instructions, and response options; and 2) the methods for tracking item development through the various stages of research and preparing this tracking for submission to regulatory agencies. The task force report's two parts are meant to be read together. They are intended to offer suggestions for good practice in planning, executing, and documenting qualitative studies that are used to support the content validity of PRO instruments to be used in medical product evaluation.

  8. [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.

  9. Evaluating Medical Residents' Literature-Appraisal Skills.

    ERIC Educational Resources Information Center

    Stern, David T.; And Others

    1995-01-01

    A study of 28 medical residents' skills in evaluating research compared student evaluations of a journal article with 1 developed by means of a Delphi technique utilizing 5 experts. Residents' scores were not significantly associated with residency year or self-assessed critical appraisal skill. The method is proposed as an objective means of…

  10. 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…

  11. 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... proposed rulemaking (NPRM) that we published in the Federal Register on August 19, 2010 (75 FR 51336)....

  12. 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. PMID:27385238

  13. 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

  14. 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

  15. Evaluation of medical waste incinerators in Alexandria.

    PubMed

    Labib, Ossama A; Hussein, Ahmed H; El-Shall, Waffaa I; Zakaria, Adel; Mohamed, Mona G

    2005-01-01

    Medical establishments play important roles in different activities by using of modern technology to serve the humans and the environment through different departments in the establishment and its firms. Medical wastes are considered as a hazardous waste because they contain toxic materials, infectious, or non-infectious wastes and they are considered as a hazard to millions of patients, health care workers, and visitors. Treatment processes for medical wastes comprise autoclaving, microwaving, chemical disinfection, irradiation, plasma system, and incineration. Incineration is a thermal process, which destroys most of the waste including microorganisms. Combustion process must be under controlled conditions to convert wastes containing hazardous materials into mineral residues and gases. Hospital waste incinerators may emit a number of pollutants depending on the waste being incinerated. These pollutants include particulate matter, acid gases, toxic metals, and toxic organic compounds products of incomplete combustion, e.g., dioxins, furans, and carbon monoxide, as well as sulfur oxides and nitrogen oxides. So, there should be a reduction of emissions of most of these pollutants by air pollution control devices. This study was conducted in 51 medical establishments (ME) in Alexandria. To evaluate its incinerators. It was found that only 31.4% of total ME have their own incinerators to treat their medical waste. Also, the incinerators conditions were poor with incomplete combustion. So, the study recommend handling of all medical wastes of ME in Alexandria by the company which is responsible now for management of domestic solid wastes of the city.

  16. Ethnic Disparities in Adherence to Antihypertensive Medications in Medicare Part D Beneficiaries

    PubMed Central

    Holmes, Holly M.; Luo, Ruili; Hanlon, Joseph T.; Elting, Linda S.; Suarez-Almazor, Maria; Goodwin, James S.

    2012-01-01

    BACKGROUND Nonadherence to antihypertensive medication is common and leads to adverse health outcomes. The Medicare Part D prescription drug program has decreased cost and increased access to medications, thus potentially improving medication adherence. OBJECTIVES To determine the level of adherence and characteristics of Part D beneficiaries associated with higher levels of antihypertensive medication adherence. DESIGN Retrospective analysis using Medicare claims and Part D event files for 2007. PARTICIPANTS Medicare Part D enrollees with prevalent uncomplicated hypertension who filled at least one antihypertensive prescription in 2006 and two prescriptions in 2007. MEASUREMENTS Medication adherence was defined by an average Medication Possession Ratio (MPR) of 80% or greater. Potential factors associated with adherence evaluated included age, sex, race/ethnicity, socioeconomic factors, comorbidity, medication use, copay, being in the coverage gap, and number of unique prescribers. RESULTS Among 168,522 Medicare Part D enrollees with prevalent uncomplicated hypertension receiving antihypertensive medicines in 2007, overall adherence was 79.5%. In univariate analysis, adherence varied significantly by most patient factors. In multivariable analysis, decreased odds of adherence persisted for blacks (OR 0.53, 95% CI 0.51–0.55), Hispanics (OR 0.58, 95% CI 0.55–0.61) and other non-white races (OR 0.80 95% CI 0.75–0.85) compared to whites. Increased comorbidity and concurrent medication use were also associated with reduced adherence. Adherence was significantly different across several geographic regions. CONCLUSION We identified a number of associations with patient factors and medication adherence to antihypertensive drugs, with significant differences in adherence by ethnicity. Improving adherence could have significant public health implications and could improve outcomes specific to hypertension as well as improved cost and healthcare utilization. PMID

  17. 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

  18. The January effect: medication reinitiation among Medicare Part D beneficiaries.

    PubMed

    Kaplan, Cameron; Zhang, Yuting

    2014-11-01

    The Medicare prescription drug program (Part D) standard benefit includes deductible, initial coverage, coverage gap and catastrophic coverage phases. As beneficiaries enter each phase, their out-of-pocket medication costs change discontinuously. The benefit cycle restarts on 1 January of the next year. Taking advantage of variation in drug coverage, we study how individuals reinitiate discontinued medications in response to the non-linear price schedule. Because some beneficiaries who receive low-income subsidies (LIS) have zero or fixed small copayments throughout the year, we perform a difference-in-difference analysis by using the LIS group as a comparison. We find that individuals delay reinitiating important medications in December and are significantly more likely to reinitiate in January than in other months. Although we find some evidence that reinitiation is lower in the final months of the year, it is mostly driven by those who face higher prices due to the coverage gap. Our study suggests that individuals respond more to the current price of medications and do not anticipate future prices as well as theory would suggest.

  19. Enhancing evaluation in an undergraduate medical education program.

    PubMed

    Gibson, Kathryn A; Boyle, Patrick; Black, Deborah A; Cunningham, Margaret; Grimm, Michael C; McNeil, H Patrick

    2008-08-01

    Approaches to evaluation of medical student teaching programs have historically incorporated a range of methods and have had variable effectiveness. Such approaches are rarely comprehensive, typically evaluating only a component rather than the whole program, and are often episodic rather than continuous. There are growing pressures for significant improvement in academic program evaluation. The authors describe an initiative that arose after a radical reorganization of the undergraduate medical education program at the University of New South Wales in part in response to feedback from the accrediting authority. The aim was to design a comprehensive, multicomponent, program-wide evaluation and improvement system. The framework envisages the quality of the program as comprising four main aspects: curriculum and resources; staff and teaching; student experience; and student and graduate outcomes. Key principles of the adopted approach include the views that both student and staff experiences provide valuable information; that measurement of student and graduate outcomes are needed; that an emphasis on action after evaluation is critical (closing the loop); that the strategies and processes need to be continual rather than episodic; and that evaluation should be used to recognize, report on, and reward excellence in teaching. In addition, an important philosophy adopted was that teachers, course coordinators, and administrators should undertake evaluation and improvement activities as an inherent part of teaching, rather than viewing evaluation as something that is externally managed. Examples of the strategy in action, which provide initial evidence of validation for this approach, are described.

  20. Data quality evaluation in medical database watermarking.

    PubMed

    Franco-Contreras, Javier; Coatrieux, Gouenou; Massari, Philippe; Darmoni, Stefan; Cuppens-Boulahia, Nora; Cuppens, Frédéric; Roux, Christian

    2015-01-01

    The use of watermarking in the protection of medical relational databases requires that the introduced distortion does not hinder records interpretation. In this paper, we present the preliminary results of a watermarked data quality evaluation protocol developed so as to analyze the perception the practitioner has of the watermark. These results show that some attributes are more appropriate for watermarking than others and also that incoherent or unlikely records resulting from careless watermarking are easily identified by an expert.

  1. 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.

  2. [The forensic medical evaluation of injuries to the maxillofacial region].

    PubMed

    Yakovenko, L L; Yakovenko, O O; Gonchar, D G

    2016-01-01

    The problem of forensic medical evaluation of injuries to the maxillofacial region remains a serious challenge to the practical activities in forensic medicine and awaits solution. The present article proposes the original classification of the injuries to the maxillofacial region that makes possible their rational structurization. A number of issues and peculiarities of forensic medical diagnostics, expert evaluation of the harm to health and time of infliction of injuries to selected parts of the maxillofacial region are considered in the context of the new classification. Special attention is given to certain aspects of expert evaluation of the injuries to the teeth, periodontum, and oral cavity mucosa as well as to the post-traumatic functional defects of nasal breathing. PMID:27070032

  3. 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.

  4. 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. PMID:20039773

  5. 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

  6. Antiviral medication in sexually transmitted diseases. Part I: HSV, HPV.

    PubMed

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

    2013-11-01

    Sexually transmitted diseases (STD) are one of the most prevalent infectious diseases in the world and important cause of morbidity and mortality. Especially STDs of viral etiology are difficult to cure. In many cases the antiviral therapy can relieve the symptoms but not eliminate the virus. During the past decades, considerable progress has been made in the development of antiviral drugs. One of the oldest antiviral medications is acyclovir (ACV). It is approved to treat initial and recurrent genital herpes and as a suppressive therapy in severe recurrent genital infections as well. Drug resistance to ACV and related drugs is seen among immunocompromised hosts, including human immunodeficiency virus HIV-infected patients. Resistant infections can be managed by second-line drugs - foscarnet or cidofovir- but they are more toxic than ACV. In case of HPV there is not known specific target for the medication and that is why the substances used in human papilloma virus HPV infection therapy are either antimitotics or immunomodulators. The Part I review focuses on mechanisms of actions and mechanisms of resistance to antiviral agents used in a treatment of the genital herpes and genital HPV infection. In Part II we will show the therapeutic options in other sexually transmitted infections: hepatitis B, C and HIV. PMID:24032509

  7. 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...

  8. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 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...

  9. 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. PMID:25128119

  10. 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

  11. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 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)...

  12. 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)...

  13. 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... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

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

    PubMed

    Godény, Sándor

    2012-02-01

    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.

  19. 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.

  20. 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...

  1. Evaluation of the Medication Sketch Artist, a New Method of Determining Unknown Patient Medications

    PubMed Central

    Lowrey, Geoffrey; Lee, Esther; Gerber, Ben

    2003-01-01

    Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians’ and patients’ understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the software’s ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors. PMID:14728203

  2. Evaluation of the medication sketch artist, a new method of determining unknown patient medications.

    PubMed

    Lowrey, Geoffrey; Lee, Esther; Gerber, Ben

    2003-01-01

    Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians' and patients' understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the software's ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors.

  3. 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

  4. 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

  5. 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…

  6. 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.

  7. 42 CFR 456.482 - 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..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370...

  8. 42 CFR 456.482 - 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..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370...

  9. 42 CFR 456.482 - 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..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370...

  10. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Medical, psychiatric, and social evaluations. 456..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a recipient under age 21, the medical, psychiatric, and social evaluations required by §§ 456.170, and 456.370...

  11. 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

  12. 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.

  13. 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.

  14. [Cytotoxicity evaluation of the disposable medical syringe piston].

    PubMed

    He, Huahong; Li, Wei; Wu, Ting

    2010-03-01

    When some testing institutions performed biological evaluation to the disposable medical syringe piston, cytotoxicity was found. According to the biological evaluation testing Selection Guide proposed by Ministry of Health and the Comments of Sample Provider, We performed biological evaluation to one sample by using 5 tests of basic biological evaluation. Cytotoxicity was found, which was probably caused by the residue of the lotion. This research provides reference for objective evaluation of disposable medical syringe piston and safe guarantee of the product.

  15. 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…

  16. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... medical findings; (3) Medical history; (4) Mental and physical functional capacity; (5) Prognoses; and (6... 42 Public Health 4 2014-10-01 2014-10-01 false Medical, psychiatric, and social evaluations. 456.170 Section 456.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  17. 42 CFR 456.170 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... medical findings; (3) Medical history; (4) Mental and physical functional capacity; (5) Prognoses; and (6... 42 Public Health 4 2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations. 456.170 Section 456.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  18. 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)

  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. Evaluation of problem-based learning in medical students’ education

    PubMed Central

    IMANIEH, MOHAMMAD HADI; DEHGHANI, SEYED MOHSEN; SOBHANI, AHMAD REZA; HAGHIGHAT, MAHMOOD

    2014-01-01

    Introduction: 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. 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. Results: 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). Conclusion: It may be concluded that

  1. 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.

  2. 78 FR 19725 - Merchant Mariner Medical Evaluation Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... public dockets in the January 17, 2008 issue of the Federal Register (73 FR 3316). Background and Purpose... 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...

  3. Student Design and Evaluation of Written Patient Medication Information.

    ERIC Educational Resources Information Center

    Dolinsky, Donna; And Others

    1983-01-01

    A project is described that aims: (1) to give undergraduate pharmacy students an understanding of the complexities of communicating medication information to patients, and (2) to teach skills in the design, analysis, and evaluation of written patient medication information. Materials students developed were evaluated by fellow students (MSE)

  4. Clinicians’ Evaluation of Computer-Assisted Medication Summarization of Electronic Medical Records

    PubMed Central

    Zhu, Xinxin; Cimin, James J.

    2014-01-01

    Each year thousands of patients die of avoidable medication errors. When a patient is admitted to, transferred within, or discharged from a clinical facility, clinicians should review previous medication orders, current orders and future plans for care, and reconcile differences if there are any. If medication reconciliation is not accurate and systematic, medication errors such as omissions, duplications, dosing errors, or drug interactions may occur and cause harm. Computer-assisted medication applications showed promise as an intervention to reduce medication summarization inaccuracies and thus avoidable medication errors. In this study, a computer-assisted medication summarization application, designed to abstract and represent multi-source time-oriented medication data, was introduced to assist clinicians with their medication reconciliation processes. An evaluation study was carried out to assess clinical usefulness and analyze potential impact of such application. Both quantitative and qualitative methods were applied to measure clinicians' performance efficiency and inaccuracy in medication summarization process with and without the intervention of computer-assisted medication application. Clinicians' feedback indicated the feasibility of integrating such a medication summarization tool into clinical practice workflow as a complementary addition to existing electronic health record systems. The result of the study showed potential to improve efficiency and reduce inaccuracy in clinician performance of medication summarization, which could in turn improve care efficiency, quality of care, and patient safety. PMID:24393492

  5. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  6. 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. PMID:10257190

  7. 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...

  8. 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.

  9. 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).…

  10. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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....

  11. 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....

  12. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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....

  13. 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…

  14. 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. 456.170 Section 456.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

  15. The Evaluation of Teaching in Medical Schools. Springer Series on Medical Education, Volume 2.

    ERIC Educational Resources Information Center

    Rippey, Robert M.

    Strengths and weaknesses of systems for evaluating teaching in medical schools are reviewed, and a framework for dealing with issues and critical questions is presented. The model addresses the following areas: goals of the school, the purpose of evaluating teaching, standards that characterize the quality of teaching evaluation measures, measures…

  16. 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...

  17. Medical Evaluation for Exposure Extremes: Cold.

    PubMed

    Fudge, Jessie R; Bennett, Brad L; Simanis, Juris P; Roberts, William O

    2015-09-01

    Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather conditions.

  18. Medical Evaluation for Exposure Extremes: Cold.

    PubMed

    Fudge, Jessie R; Bennett, Brad L; Simanis, Juris P; Roberts, William O

    2015-12-01

    Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather conditions.

  19. 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.

  20. 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. PMID:23099596

  1. [Growth check-ups as part of preventive medical examinations].

    PubMed

    Butenandt, O

    1982-09-01

    Failure to thrive as well as increased growth velocity may have different causes. Specific diagnostic evaluation has to be performed as soon as a delineation of the growth rate is observed. Examples are hypopituitarism, hypothyroidism, celiac disease in depressed growth or congenital adrenal hypoplasia or pubertas praecox in enhanced growth. PMID:7129318

  2. ‘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

  3. 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.

  4. 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.

  5. 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)…

  6. 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.

  7. 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....04 to evaluate claims involving cystic fibrosis in adults and children under titles II and XVI of the... information on the disability program. 2. Information for individuals with cystic fibrosis who apply...

  8. Evaluation of the Arizona Medical Student Exchange Program.

    PubMed

    Navin, T R; Nichols, A W

    1977-10-01

    In this article the authors describe and present an evaluation of the Arizona Medical Student Exchange Program of the Western Interstate Commission for Higher Education. The program is designed to help defray the cost that an Arizona student faces in attending an out-of-state medical school by paying, in the student's behalf, the difference between the resident and nonresident tuition at the out-of-state school. Furthermore, the accepting medical school is paid an additional sum as an inducement to accepts more Arizona students in the future. The program's goal is to increase the number of graduating physicians who will return to practice in Arizona, especially in areas of medical need. While the program apparently has been successful in increasing the number of Arizona students studying medicine and the number of physicians returning to the state--both to metropolitan areas and to areas of medical need--these increases have not kept pace with Arizona's growing population. PMID:903947

  9. A model for selecting assessment methods for evaluating medical students in African medical schools.

    PubMed

    Walubo, Andrew; Burch, Vanessa; Parmar, Paresh; Raidoo, Deshandra; Cassimjee, Mariam; Onia, Rudy; Ofei, Francis

    2003-09-01

    Introduction of more effective and standardized assessment methods for testing students' performance in Africa's medical institutions has been hampered by severe financial and personnel shortages. Nevertheless, some African institutions have recognized the problem and are now revising their medical curricula, and, therefore, their assessment methods. These institutions, and those yet to come, need guidance on selecting assessment methods so as to adopt models that can be sustained locally. The authors provide a model for selecting assessment methods for testing medical students' performance in African medical institutions. The model systematically evaluates factors that influence implementation of an assessment method. Six commonly used methods (the essay examinations, short-answer questions, multiple-choice questions, patient-based clinical examination, problem-based oral examination [POE], and objective structured clinical examination) are evaluated by scoring and weighting against performance, cost, suitability, and safety factors. In the model, the highest score identifies the most appropriate method. Selection of an assessment method is illustrated using two institutional models, one depicting an ideal situation in which the objective structured clinical examination was preferred, and a second depicting the typical African scenario in which the essay and short-answer-question examinations were best. The POE method received the highest score and could be recommended as the most appropriate for Africa's medical institutions, but POE assessments require changing the medical curricula to a problem-based learning approach. The authors' model is easy to understand and promotes change in the medical curriculum and method of student assessment.

  10. Revised Medical Criteria for Evaluating Respiratory System Disorders. Final rule.

    PubMed

    2016-06-01

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate claims involving respiratory disorders in adults and children under titles II and XVI of the Social Security Act (Act). The revisions reflect our program experience and advances in medical knowledge since we last comprehensively revised this body system in 1993, as well as comments we received from medical experts and the public. PMID:27295734

  11. Revised Medical Criteria for Evaluating Respiratory System Disorders. Final rule.

    PubMed

    2016-06-01

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate claims involving respiratory disorders in adults and children under titles II and XVI of the Social Security Act (Act). The revisions reflect our program experience and advances in medical knowledge since we last comprehensively revised this body system in 1993, as well as comments we received from medical experts and the public.

  12. External Examinations for Internal Evaluation: The National Board Part I Test as a Case

    ERIC Educational Resources Information Center

    Wile, Marcia Z.

    1978-01-01

    The appropriateness of the Part I examination of the National Board of Medical Examiners to evaluate second-year curricular performance of students at Case Western Reserve School of Medicine was examined. The school used the results in making policy-changing decisions. (Author/LBH)

  13. [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.

  14. Medical education: part of the problem and part of the solution.

    PubMed

    Lucey, Catherine Reinis

    2013-09-23

    Medical education today is pedagogically superb, but the graduates of our educational programs are still unable to successfully translate decades of biomedical advances into health care that reliably meets the Institute of Medicine quality criteria. Realizing the promise of high-quality health care will require that medical educators accept that they must fulfill their contract with society to reduce the burden of suffering and disease through the education of physicians. Educational redesign must begin with the understanding that the professional identity of the physician who was successful in the acute disease era of the 20th century will not be effective in the complex chronic disease era of the 21st century. Medical schools and residency programs must restructure their views of basic and clinical science and workplace learning to give equal emphasis to the science and skills needed to practice in and lead in complex systems. They must also rethink their relationships with clinical environments so that the education of students and residents accelerates the transformation in health care delivery needed to fulfill our contract with society. PMID:23857567

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

    PubMed Central

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

    2015-01-01

    Introduction 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. Objective 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. Methods 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. Results 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). Conclusion 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. PMID:26594289

  16. 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

  17. 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

  18. Medication exposure in pregnancy risk evaluation program: the prevalence of asthma medication use during pregnancy.

    PubMed

    Hansen, Craig; Joski, Peter; Freiman, Heather; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, Craig; Cooper, William; Pawloski, Pamala; Li, De-Kun; Beaton, Sarah; Kaplan, Sigal; Scott, Pamela; Hammad, Tarek; Davis, Robert

    2013-11-01

    Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8 % of pregnancies. The objective of this study is to assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. We identified women aged 15-45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans' administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7 %, increasing from 5.5 % in 2001 to 7.8 % in 2007. A total of 9.7 % (n = 55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6, 6.7, and 2.4 % respectively. The prevalence of maintenance-only use doubled during the study period from 0.4 to 0.8 %, while rescue-only use decreased from 7.4 to 5.8 %. In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time.

  19. Medication Exposure in Pregnancy Risk Evaluation Program: The Prevalence of Asthma Medication Use During Pregnancy

    PubMed Central

    Hansen, Craig; Joski, Peter; Freiman, Heather C.; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, T. Craig; Cooper, William O.; Pawloski, Pamala A.; Li, De-Kun; Beaton, Sarah J.; Scott, Pamela E.; Hammad, Tarek; Davis, Robert

    2013-01-01

    Background Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8% of pregnancies. Objective Assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. Methods We identified women aged 15 to 45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans’ administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. Results There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7%, increasing from 5.5% in 2001 to 7.8% in 2007. A total of 9.7% (n=55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6%, 6.7%, and 2.4% respectively. The prevalence of maintenance-only use doubled during the study period from 0.4% to 0.8%, while rescue-only use decreased from 7.4% to 5.8%. Conclusions In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time. PMID:23108737

  20. Revised Medical Criteria for Evaluating Neurological Disorders. Final rule.

    PubMed

    2016-07-01

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate disability claims involving neurological disorders in adults and children under titles II and XVI of the Social Security Act (Act). These revisions reflect our program experience; advances in medical knowledge, treatment, and methods of evaluating neurological disorders; comments we received from medical experts and the public at an outreach policy conference; responses to an advance notice of proposed rulemaking (ANPRM); and public comments we received in response to a Notice of Proposed Rulemaking (NPRM) and a Federal Register notice that reopened the NPRM comment period. PMID:27373016

  1. Revised Medical Criteria for Evaluating Neurological Disorders. Final rule.

    PubMed

    2016-07-01

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate disability claims involving neurological disorders in adults and children under titles II and XVI of the Social Security Act (Act). These revisions reflect our program experience; advances in medical knowledge, treatment, and methods of evaluating neurological disorders; comments we received from medical experts and the public at an outreach policy conference; responses to an advance notice of proposed rulemaking (ANPRM); and public comments we received in response to a Notice of Proposed Rulemaking (NPRM) and a Federal Register notice that reopened the NPRM comment period.

  2. Community-oriented medical emergency programme: development and evaluation issues.

    PubMed

    Osonnaya, Comfort; Osonnaya, Kingsley; Burke, Edward William

    2002-09-01

    A community-oriented medical emergency programme for multidisciplinary healthcare professionals on the Higher Professional Diploma in International Healthcare Studies, at the United Medical Education College, London is described. The main aim of the course is to introduce students to the clinical skills of dealing with medical emergency problems and situations. Students are also exposed to how medical emergency is practised in the community. The four-week programme consists of 16 sessions of clinical skills teaching where students are attached to various community clinics, 10 sessions of college teaching, consisting of talks, workshops and interactive small-group work and four sessions encouraging students to learn independently in a self-directed learning format. Student and tutor evaluations of the programme demonstrate that its aims are being met. However, further adaptation of the module to increase the range and quantity of clinical cases for student learning is being planned.

  3. 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…

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for... care in the ICF. (b) In an institution for Individuals with Intellectual Disabilities or persons with...— (i) Admission to the ICF; or (ii) Continued care in the ICF for individuals who apply for...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for... care in the ICF. (b) In an institution for Individuals with Intellectual Disabilities or persons with...— (i) Admission to the ICF; or (ii) Continued care in the ICF for individuals who apply for...

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for... care in the ICF. (b) In an institution for the mentally retarded or persons with related conditions... available in the home, family and community; and (8) A recommendation concerning— (i) Admission to the...

  7. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for... care in the ICF. (b) In an institution for the mentally retarded or persons with related conditions... available in the home, family and community; and (8) A recommendation concerning— (i) Admission to the...

  8. 42 CFR 456.370 - Medical, psychological, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Medical, psychological, and social evaluations. (a) Before admission to an ICF or before authorization for... care in the ICF. (b) In an institution for Individuals with Intellectual Disabilities or persons with...— (i) Admission to the ICF; or (ii) Continued care in the ICF for individuals who apply for...

  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. Organization and development of pediatric medical-psychiatric units. Part II: Clinical management issues.

    PubMed

    Kahan, B B; Sexson, S B

    1991-11-01

    Scant literature exists regarding combined medical-psychiatric units for pediatric populations. The present article is the second in a two-part series describing issues relevant to the organization and development of such a unit within a tertiary-care children's hospital. Case examples of medical-psychiatry patients are presented, together with summary patient statistics for the first 3 years of operation. Additionally, issues regarding the physical layout, treatment program, and staffing are discussed. PMID:1765256

  12. Hepatitis C: Part II. Prevention counseling and medical evaluation.

    PubMed

    Moyer, L A; Mast, E E; Alter, M J

    1999-01-15

    An estimated 3.9 million Americans are infected with hepatitis C virus (HCV), and most do not know that they are infected. This group includes persons who are at risk for HCV-associated chronic liver disease and who also serve as reservoirs for transmission of HCV to others. Because there is no vaccine to prevent HCV infection and immune globulin is not effective for postexposure prophylaxis, prevention of HCV infection is paramount. Patients who are at risk of exposure to HCV should be advised on steps they might take to minimize their risk of infection. Patients who are infected with HCV should be counseled on ways to prevent transmission of HCV to others and to avoid hepatotoxins. They should also be examined for liver disease and referred for treatment, if indicated. PMID:9930128

  13. 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. PMID:27605635

  14. 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.

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

    PubMed

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

    2015-09-01

    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.

  16. 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. PMID:26617379

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. Evaluation of nursing students' training in medical law.

    PubMed

    Kurban, Nevin Kuzu; Savaş, Halide; Cetinkaya, Bengü; Turan, Türkan; Kartal, Asiye

    2010-11-01

    There is no co-ordinated focus on liabilities arising from nurses' medical interventions in terms of occupational, administrative, civil legal and criminal activities. However, the Turkish Criminal Code, the Turkish Medical Ethics Code of Practice, and guidelines for patients' rights offer some framework for the relevant ethical principles and responsibilities of nurses. The aim of this study was to investigate the evaluation of nursing students' training in their legal liabilities. The sample consisted of 309 students who were taking a course entitled 'Nurses' legal liabilities under Turkish criminal and civil law arising from medical interventions'. Data were obtained by means of self-administered questionnaires and McNemar's test was used to evaluate the answers. In conclusion, after their training, a great majority of the students demonstrated an improvement in terms of their percentage of correct answers relating to malpractice. This does not, however, mean that they will not face malpractice charges after graduating, but their increased awareness of the issue may encourage them to make more effort to reduce the risk of mistakes. It is recommended that nursing faculty carry out studies into medical malpractice, that they focus more on this subject in nursing education, and that all nursing schools review their curricula from the point of view of malpractice.

  2. 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...

  3. 78 FR 63501 - Request To Submit a Two-Part Application-Northwest Medical Isotopes, LLC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... Rules of Practice and Procedure,'' on April 24, 1974 (39 FR 14506). The intent of this final rule was to... licenses under 10 CFR part 52, ``Licenses, Certifications, and Approvals for Nuclear Power Plants'' (72 FR...-99 and its decay product, technetium-99m, in nuclear medicine procedures. Northwest Medical...

  4. [Quality evaluation for pharmaceutical products and medical supplies: proper use].

    PubMed

    Miyamoto, Etsuko

    2014-01-01

      In the proper use of medicine, the quality of medical supplies is an important factor. Use of generic products not only reduces drug costs for the patient, but also offers substantial advantages for governments in reducing medical expenses. When evaluation of the quality of generic products is centered on tablets, products with qualities that are unstable over time may be encountered. Some dosage forms require suitable pharmaceutical tests, processes, and apparatuses, such as those for evaluating orally disintegrating tablets or cutaneous preparations. For example, although simple test equipment has been proposed for patches, a unified method is required. The pharmacist plays an important role in choosing high-quality generic products; however, a substantial amount of information needs to be made available to the public in order to achieve that goal.

  5. Resistance to antibiotics at medical centres in different parts of the world.

    PubMed

    O'Brien, T F

    1986-10-01

    The diameters of the zones of inhibition of consecutive clinical isolates around antibiotic susceptibility test discs at medical centres in different parts of the world were computer filed and analysed by a series of programs that evaluate test quality and compare results. Percentages of isolates resistant to ampicillin at 18 centres ranged from 16 to 73 for Escherichia coli and from 3 to 56 for Proteus mirabilis. Percentages resistant to chloramphenicol ranged from 2 to 48 for E. coli, from 5 to 52 for Klebsiella pneumoniae, and from 8 to 67 for Serratia marcescens. Gentamicin resistance did not exceed 4% at any of 18 centres and was less than 1 at 14 of them for isolates of E. coli, while K. pneumoniae showed less than 2% resistance at six centres but averaged 22% at another eight. Multi-resistant isolates were ten-fold more frequent at eight centres than at the remaining six. Too few centres were sampled to characterize individual countries except in the United States where resistance seemed generally less prevalent.

  6. Automated Evaluation of Medical Software Usage: Algorithm and Statistical Analyses.

    PubMed

    Cao, Ming; Chen, Yong; Zhu, Min; Zhang, Jiajie

    2015-01-01

    Evaluating the correctness of medical software usage is critically important in healthcare system management. Turf [1] is a software that can effectively collect interactions between user and computer. In this paper, we propose an algorithm to compare the recorded human-computer interaction events with a predefined path. Based on the pass/fail results, statistical analysis methods are proposed for two applications: to identify training effects and to compare products of the same functionality.

  7. Messages of Medication: Effects of Actual versus Informed Medication Status on Hyperactive Boys' Expectancies and Self-Evaluation.

    ERIC Educational Resources Information Center

    Whalen, Carol K.; And Others

    1991-01-01

    After 15 boys with attention-deficit hyperactivity disorder were informed that they had taken either medication or placebo, they completed computer tasks, self-assessments, and causal judgments. Boys predicted better performance when told they were on medication. For self-evaluations, medication status and information interacted, with boys…

  8. 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...—Evaluation Standards Standard 1: The primary objective of the project must be to assist individuals...

  9. A framework for evaluating and utilizing medical terminology mappings.

    PubMed

    Hussain, Sajjad; Sun, Hong; Sinaci, Anil; Erturkmen, Gokce Banu Laleci; Mead, Charles; Gray, Alasdair J G; McGuinness, Deborah L; Prud'Hommeaux, Eric; Daniel, Christel; Forsberg, Kerstin

    2014-01-01

    Use of medical terminologies and mappings across them are considered to be crucial pre-requisites for achieving interoperable eHealth applications. Built upon the outcomes of several research projects, we introduce a framework for evaluating and utilizing terminology mappings that offers a platform for i) performing various mappings strategies, ii) representing terminology mappings together with their provenance information, and iii) enabling terminology reasoning for inferring both new and erroneous mappings. We present the results of the introduced framework from SALUS project where we evaluated the quality of both existing and inferred terminology mappings among standard terminologies. PMID:25160255

  10. 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.

  11. 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.

  12. 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.

  13. Using evaluation to improve medical student rural experience.

    PubMed

    Moffatt, Jennifer J; Wyatt, Janine E

    2016-04-01

    Objective The aim of this evaluation was to see whether interventions implemented to improve the Rural Medicine Rotation made this a more effective rural medical education experience. Multiple interventions targeting the student experience, lecturers and preceptors were implemented. Methods A quasi-experimental design using pre- and post-measures was used. The participants were all University of Queensland, School of Medicine, Rural Medicine Rotation students who completed the 2009 and 2010 rural medicine rotation evaluations. There were 769 students, with an 84% response rate in 2009 and an 80% response rate in 2010. In addition, all the 25 program preceptors who were visited in 2009 and the 34 who were visited in 2010 participated in the study. Results The implementation of interventions resulted in significant improvement in three outcome measures, namely teaching effectiveness, provision of an environment supportive of learning in a rural/remote setting and opportunities for professional growth. Two of the three other outcome measures - ensuring a safe clinical placement and opportunities for procedural skills experience and development - were very positively evaluated in both 2009 and 2010. Conclusions The interventions contributed to a more effective rural medical education experience, providing students with the opportunity to develop skills and knowledge relevant for rural medicine and to gain an understanding of the context in which rural medicine is practiced. What is known about the topic? Many Australian medical schools offer students rural-based educational opportunities based on the premise that placing medical students in a rural setting may ultimately lead to them choosing careers in rural medicine. However, there is a paucity of evidence on the factors that are considered necessary for medical students to gain a positive rural experience of short conscripted rural placements. What does the paper add? This paper identifies successful interventions

  14. Using evaluation to improve medical student rural experience.

    PubMed

    Moffatt, Jennifer J; Wyatt, Janine E

    2016-04-01

    Objective The aim of this evaluation was to see whether interventions implemented to improve the Rural Medicine Rotation made this a more effective rural medical education experience. Multiple interventions targeting the student experience, lecturers and preceptors were implemented. Methods A quasi-experimental design using pre- and post-measures was used. The participants were all University of Queensland, School of Medicine, Rural Medicine Rotation students who completed the 2009 and 2010 rural medicine rotation evaluations. There were 769 students, with an 84% response rate in 2009 and an 80% response rate in 2010. In addition, all the 25 program preceptors who were visited in 2009 and the 34 who were visited in 2010 participated in the study. Results The implementation of interventions resulted in significant improvement in three outcome measures, namely teaching effectiveness, provision of an environment supportive of learning in a rural/remote setting and opportunities for professional growth. Two of the three other outcome measures - ensuring a safe clinical placement and opportunities for procedural skills experience and development - were very positively evaluated in both 2009 and 2010. Conclusions The interventions contributed to a more effective rural medical education experience, providing students with the opportunity to develop skills and knowledge relevant for rural medicine and to gain an understanding of the context in which rural medicine is practiced. What is known about the topic? Many Australian medical schools offer students rural-based educational opportunities based on the premise that placing medical students in a rural setting may ultimately lead to them choosing careers in rural medicine. However, there is a paucity of evidence on the factors that are considered necessary for medical students to gain a positive rural experience of short conscripted rural placements. What does the paper add? This paper identifies successful interventions

  15. 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. PMID:17125411

  16. 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

  17. Using alternative methodologies for evaluating patient medication leaflets.

    PubMed

    Krass, Ines; Svarstad, Bonnie L; Bultman, Dara

    2002-05-01

    A variety of direct and indirect methods have been used to evaluate written medication information; however, no published research has validated assessment tools or presented direct consumer assessment of patient information leaflets (PILs) provided in US community pharmacy (CP). We report on two new instruments: the medication information design assessment scale (MIDAS), an indirect measure of design quality administered by the investigators, and the consumer information rating form (CIRF), a direct measure of comprehensibility, utility, and overall design quality applied by a consumer panel. These were used to assess two types of PILs: 36 CP-PILs obtained from community pharmacies and 3 Model-PILs incorporating recommended design characteristics. The validity of the MIDAS was demonstrated in two ways. First, as predicted, the Model-PILs were rated more positively by consumers. We also found a significant positive correlation between the number of design criteria incorporated in a CP-PIL (as measured by the MIDAS score) and the consumers rating of design quality (CIRF). In conclusion, we confirmed the importance of design characteristics in the production of written medication information and have also developed and validated two easy-to-use tools for the assessment of written medication information.

  18. The computerized medical record in gastroenterology: part 4. Health curriculum vitae.

    PubMed

    Jeanty, C

    1978-12-01

    The health curriculum vitae consists mainly of a chronological sequence of diagnoses, which are the mainstays of the medical record. Each diagnosis is connected vertically in the health curriculum vitae with its aetiological factors and its medical or surgical treatments in a casual concatenation; and horizontally throughout the other three parts of the record with its relevant functional, morphological (descriptive) and numerical laboratory data in a diagnostic association. The health curriculum vitae uses the Systematized Nomenclature of Medicine (SNOMED), the International Nomenclature of the Diseases of the Gastrointestinal Tract (CIOMS) and the International Standard Classification of Occupations of the Internationl Labour Office.

  19. 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

  20. 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.

  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. 76 FR 27380 - Proposed Information Collection (Report of Medical Examination for Disability Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... AFFAIRS Proposed Information Collection (Report of Medical Examination for Disability Evaluation); Comment... disability benefits. DATES: Written comments and recommendations on the proposed collection of information.... Title: Report of Medical Examination for Disability Evaluation, VA Form 21-2545. OMB Control...

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

    PubMed

    Cohen, Peter J

    2009-01-01

    In Part I of this article, I examined the role of the Food and Drug Administration (FDA) in drug approval and then detailed the known risks of medical marijuana (any form of Cannabis sativa used--usually by smoking--to treat a wide variety of pathologic states and diseases). Part II of the article will begin by reviewing the benefits of Cannabis sativa as documented by well designed scientific studies that have been published in the peer-reviewed literature. I will then propose that ability of scientists to conduct impartial studies designed to answer the question of marijuana's role in medical therapy has been greatly hampered by political considerations. I will posit that in spite of the considerable efforts of policymakers, it is becoming apparent that marijuana's benefits should be weighed against its well-described risks. I will conclude that political advocacy is a poor substitute for dispassionate analysis and that neither popular votes nor congressional "findings" should be permitted to trump scientific evidence in deciding whether or not marijuana is an appropriate pharmaceutical agent to use in modern medical practice. Whether or not marijuana is accepted as a legitimate medical therapy should remain in the hands of the usual drug-approval process and that the statutory role of the Food and Drug Administration should be dispositive.

  4. [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.

  5. Television spots win national award. Part of OSF Saint Francis Medical Center's branding effort.

    PubMed

    Rees, Tom

    2004-01-01

    "Miracles in Medicine," a series of award-winning television spots, was produced for OSF Saint Francis Medical Center, Peoria, Ill., by The Roberts Group, Inc., Waukesha, Wis. They are an integral part of a broader branding campaign, launched in May 2003, that includes newspaper, radio, and outdoor elements. The spots were deemed so successful, the branding effort was expanded to include Children's Hospital of Illinois.

  6. Television spots win national award. Part of OSF Saint Francis Medical Center's branding effort.

    PubMed

    Rees, Tom

    2004-01-01

    "Miracles in Medicine," a series of award-winning television spots, was produced for OSF Saint Francis Medical Center, Peoria, Ill., by The Roberts Group, Inc., Waukesha, Wis. They are an integral part of a broader branding campaign, launched in May 2003, that includes newspaper, radio, and outdoor elements. The spots were deemed so successful, the branding effort was expanded to include Children's Hospital of Illinois. PMID:15162576

  7. 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.

  8. Marco (Medical Record Communications) - System Concept, Design and Evaluation

    PubMed Central

    Moffatt, P. H.; Heisler, B. D.; Mela, W. D.; Alpert, J. J.; Goldstein, H.M.

    1978-01-01

    MARCO, an interfacility communication system, has been designed to promote safe relevant health care delivery to the inner city pediatric patient receiving care in a network consisting of Boston City Hospital and its affiliated Neighborhood Health Centers. This application of computer technology to communication of medical information compiled on an individual patient in multiple locations has implications for private group practice as well as other urban networks similar to our own. This paper provides the MARCO system concept, the system design and evaluation of its success after two years of operation.

  9. Evaluating innovation. Part 1: The concept of progressive scholarly acceptance.

    PubMed

    Schnurman, Zane; Kondziolka, Douglas

    2016-01-01

    Understanding how the relevant medical community accepts new therapies is vital to patients, physicians, and society. Increasingly, focus is placed on how medical innovations are evaluated. But recognizing when a treatment has become accepted practice-essentially, acceptance by the scientific community-remains a challenge and a barrierto investigating treatment development. This report aims to demonstrate the theory, method, and limitations of a model for measuring a new metric that the authors term "progressive scholarly acceptance." A model was developed to identify when the scientific community has accepted an innovation, by observing when researchers have moved beyond the initial study of efficacy. This model could enable further investigations into the methods and influences of treatment development.

  10. [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.

  11. [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. PMID:23358781

  12. 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%.

  13. 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%. PMID:27164203

  14. 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

  15. 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. PMID:16912146

  16. Methodologies for medication adherence evaluation: Focus on psoriasis topical treatment.

    PubMed

    Teixeira, Ana; Teixeira, Maribel; Almeida, Vera; Torres, Tiago; Sousa Lobo, José Manuel; Almeida, Isabel Filipa

    2016-05-01

    Adherence to topical treatment has been less studied in comparison with systemic therapeutic regimens and is poorly understood. High-quality research on this area is essential to outline a strategy to increase medication adherence and clinical outcomes. For a more comprehensive understanding of this issue, a systematic review of the methodologies for topical treatment adherence evaluation in psoriasis was undertaken. Twenty one studies were selected from the literature which used six different adherence methodologies. Merely three studies used multiple adherence measurement methods. The most used method was questionnaire (44%) which was also associated with higher variability of the adherence results. One possible explanation is the lack of a validated questionnaire designed specifically for the evaluation of adherence to topical treatment. Only one method (medication weight) takes into consideration the applied dose. However, the estimation of the expected weight is complex, which renders this method, as used presently, less effective. The use of a dosing device could improve its accuracy and be helpful to clearly instruct the patients about the correct dose. As there is no single method that allows an accurate and complete assessment of adherence it is recommended to use a combination of methods, including self-report and medicines' weight measurements.

  17. 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

  18. [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

  19. 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

  20. The strategic role of education in the prevention of medication errors in nursing: part 2.

    PubMed

    Cleary-Holdforth, Joanne; Leufer, Therese

    2013-05-01

    It has been established that medication errors are a significant cause for concern in healthcare settings. In Part 1 of this paper the gravity of this problem in addition to the some of the contributing factors were discussed. The shared nature of the problem across disciplines was highlighted in addition to the potential benefits of multi-disciplinary collaboration in resolution of the problem. The contribution that education can make in this regard is unquestionable both at pre-registration (undergraduate) and post-registration level. A variety of pragmatic proposals will be presented for consideration. In addition, clinical and educational measures that have been shown to reduce medication errors will also be proffered and the way(s) forward to ensure optimal medication management and patient safety will be explored from a nursing perspective. The specific aim of this paper is to illuminate the significant role that education, in both academic and clinical settings, can play in the preparation of nurses for their roles in medication management and the marked reduction in errors and improved patient outcomes in this area of practice that they can yield.

  1. Experimental Evaluation of an Invasive Medical Instrument Based on a Displacement Measurement System.

    PubMed

    Fotiadis, Dimitris A; Astaras, Alexandros; Bamidis, Panagiotis D; Papathanasiou, Kostas; Kalfas, Anestis

    2015-09-01

    This paper presents a novel method for tracking the position of a medical instrument's tip. The system is based on phase locking a high frequency signal transmitted from the medical instrument's tip to a reference signal. Displacement measurement is established having the loop open, in order to get a low frequency voltage representing the medical instrument's movement; therefore, positioning is established by means of conventional measuring techniques. The voltage-controlled oscillator stage of the phase-locked loop (PLL), combined to an appropriate antenna, comprises the associated transmitter located inside the medical instrument tip. All the other low frequency PLL components, low noise amplifier and mixer, are located outside the human body, forming the receiver part of the system. The operating details of the proposed system were coded in Verilog-AMS. Simulation results indicate robust medical instrument tracking in 1-D. Experimental evaluation of the proposed position tracking system is also presented. The experiments described in this paper are based on a transmitter moving opposite a stationary receiver performing either constant velocity or uniformly accelerated movement, and also together with two stationary receivers performing constant velocity movement again. This latter setup is implemented in order to demonstrate the prototype's accuracy for planar (2-D) motion measurements. Error analysis and time-domain analysis are presented for system performance characterization. Furthermore, preliminary experimental assessment using a saline solution container to more closely approximate the human body as a radio frequency wave transmission medium has proved the system's capability of operating underneath the skin.

  2. Experimental Evaluation of an Invasive Medical Instrument Based on a Displacement Measurement System.

    PubMed

    Fotiadis, Dimitris A; Astaras, Alexandros; Bamidis, Panagiotis D; Papathanasiou, Kostas; Kalfas, Anestis

    2015-09-01

    This paper presents a novel method for tracking the position of a medical instrument's tip. The system is based on phase locking a high frequency signal transmitted from the medical instrument's tip to a reference signal. Displacement measurement is established having the loop open, in order to get a low frequency voltage representing the medical instrument's movement; therefore, positioning is established by means of conventional measuring techniques. The voltage-controlled oscillator stage of the phase-locked loop (PLL), combined to an appropriate antenna, comprises the associated transmitter located inside the medical instrument tip. All the other low frequency PLL components, low noise amplifier and mixer, are located outside the human body, forming the receiver part of the system. The operating details of the proposed system were coded in Verilog-AMS. Simulation results indicate robust medical instrument tracking in 1-D. Experimental evaluation of the proposed position tracking system is also presented. The experiments described in this paper are based on a transmitter moving opposite a stationary receiver performing either constant velocity or uniformly accelerated movement, and also together with two stationary receivers performing constant velocity movement again. This latter setup is implemented in order to demonstrate the prototype's accuracy for planar (2-D) motion measurements. Error analysis and time-domain analysis are presented for system performance characterization. Furthermore, preliminary experimental assessment using a saline solution container to more closely approximate the human body as a radio frequency wave transmission medium has proved the system's capability of operating underneath the skin. PMID:25265618

  3. 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

  4. [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.

  5. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed....

  6. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed....

  7. 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....

  8. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed....

  9. 49 CFR 391.47 - Resolution of conflicts of medical evaluation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false Resolution of conflicts of medical evaluation. 391... Qualifications and Examinations § 391.47 Resolution of conflicts of medical evaluation. (a) Applications... field in which the medical conflict arose. The specialist should be one agreed to by the motor...

  10. 49 CFR 391.47 - Resolution of conflicts of medical evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Resolution of conflicts of medical evaluation. 391... Qualifications and Examinations § 391.47 Resolution of conflicts of medical evaluation. (a) Applications... field in which the medical conflict arose. The specialist should be one agreed to by the motor...

  11. 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

  12. [Evaluation of medication side-effects from an economic perspective].

    PubMed

    Segura, Omar; Maldonado, Carlos

    2003-12-01

    Pharmacovigilance is a health sciences discipline devoted to the data collection, data analysis and decision-making related to adverse drug reactions (ADR). It has played an expanded theoretical and practical role since the 1960's. However, few studies have made a careful analysis of the decision-making costs in evaluating ADRs. Herein, the relevant literature is reviewed concerning the costs generated due to the attention of the drug adverse events in medical practice. Examples are taken from international literature which offer by extrapolation of the potential future costs of ADR in Colombia. The objective is to sensitize and generate insights about the need for implementation and development of a national pharmacovigilance system. PMID:14968918

  13. 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."

  14. Clinical behavioral pharmacology: methods for evaluating medications and contingency management.

    PubMed Central

    Burgio, L D; Page, T J; Capriotti, R M

    1985-01-01

    We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance. PMID:3997697

  15. 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.

  16. 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

  17. Severity-of-illness systems. An overview for medical directors--Part one.

    PubMed

    Pine, M; Smith, D W

    1990-01-01

    To a baseball fan, the weight of a player's bat is not very important, and the grace with which it is swung has only slightly more appeal. Both these factors matter far less than how often and with what results the bat meets the ball. Similarly, in today's competitive health care environment, the medical director has to focus on results. Not only external demands from constituencies such as insurers, payers, consumers, and regulators, but also internal pressures for sound management decisions require accurate information about the outcomes of care. In this two-part article, the authors examine the contributions that severity-of-illness systems can make to outcomes monitoring.

  18. 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.

  19. [Exploring Current Problems and Corresponding Strategies for Evaluation of Innovative Medical Devices in China].

    PubMed

    Du, Ranran; Ouyang, Zhaolian; Li, Yang; Yang, Yuan; Yang, Guozhong; Chi, Hui

    2015-03-01

    Through the analysis of the current status and problems of innovative medical devices evaluation, tnis paper discussed the strategies of evaluation, and ultimately raises the frame of evaluation, so as to provide reference for scientific evaluation of medical devices in China.

  20. 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

  1. Evaluating community engagement as part of the public health system.

    PubMed

    South, Jane; Phillips, Gemma

    2014-07-01

    Community participation and leadership is a central tenet of public health policy and practice. Community engagement approaches are used in a variety of ways to facilitate participation, ranging from the more utilitarian, involving lay delivery of established health programmes, to more empowerment-oriented approaches. Evaluation methods within public health, adapted from clinical medicine, are most suited to evaluating community engagement as an 'intervention', in the utilitarian sense, focusing on the health impacts of professionally determined programmes. However, as communities are empowered and professional control is relinquished, it is likely to be harder to capture the full effects of an intervention and so the current evidence base is skewed away from knowledge about the utility of these approaches. The aim of this paper is to stimulate debate on the evaluation of community engagement. Building on current understandings of evaluation within complex systems, the paper argues that what is needed is a paradigm shift from viewing the involvement of communities as an errant form of public health action, to seeing communities as an essential part of the public health system. This means moving from evaluation being exclusively focused on the linear causal chain between the intervention and the target population, to seeking to build understanding of whether and how the lay contribution has impacted on the social determinants of health, including the system through which the intervention is delivered. The paper proposes some alternative principles for the evaluation of community engagement that reflect a broader conceptualisation of the lay contribution to public health.

  2. 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. PMID:21120414

  3. 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

  4. 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…

  5. 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

  6. 75 FR 69129 - Proposed Revision of Information Collection: Comment Request National Medical Support Notice-Part B

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ... Medical Support Notice--Part B AGENCY: Employee Benefits Security Administration. ACTION: Notice. SUMMARY... collection requirements on respondents. Currently, the Employee Benefits Security Administration (EBSA) is..., Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue,...

  7. 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.

  8. 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…

  9. Evaluation as Learning: Course Evaluation as Part of the Learning Process.

    ERIC Educational Resources Information Center

    Martensson, Paer

    This paper describes an example of a course evaluation where the evaluation process becomes an important part of the learning process. The setting is an action-learning based course in an executive program. The participants apply a framework (the X-model) for perceiving processes to their own learning. The framework is presented, and experiences…

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

    PubMed Central

    Káplár, Zoltán; Lǐ, Yáo T.

    2015-01-01

    Background 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. Methods 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. Results 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

  11. The use of information technology in improving medical performance. Part II. Physician-support tools.

    PubMed

    Gawande, A A; Bates, D W

    2000-02-14

    Increasing data from a few sites demonstrate that information technologies can improve physician decision making and clinical effectiveness. For example, computer-based physician order entry systems, automated laboratory alert systems, and artificial neural networks have demonstrated significant reductions in medical errors. In addition, Internet services to disseminate new knowledge and safety alerts to physicians more rationally and effectively are rapidly developing, and telemedicine to improve rural access to specialty services is undergoing substantial growth. However, even technologies demonstrated to yield beneficial effects have not yet achieved widespread adoption, though the pace of change appears to be increasing as the Internet takes hold. Scientific evaluation of many technologies is also lacking, and the dangers of some of these technologies may be underappreciated. Research on the effects of specific technologies should be a priority. Policies should be developed to press information technology companies, such as pharmaceutical and medical device manufacturers, to recognize the importance of clinical evaluation. Research could also analyze the characteristics of effective technologies and of physicians and organizations who implement these technologies effectively.

  12. 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.

  13. 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.

  14. Patient access to medical records--from issue to law. Part I: An historical perspective.

    PubMed

    Morgan, C

    1984-05-01

    The growing interest of the individual in gaining control of his destiny, reflected over the past two decades in the consumer movement, has run a course parallel to the establishment of patient rights in consumption of health services. The desire to know the particulars of his health care is one such area of consumer interest, and across the nation, this desire to know is fast becoming an absolute right to know. Although in some states this right has become established through the courts, it would appear to be more satisfactorily ensured by means of specific legislation. The state of Maryland has enacted a statute which guarantees the patient access to his own medical record information: this process is surveyed as a means of expanding the evolutionary process from issue to law. Part II of this article, which will appear in the next issue of JAMRA provides an action model for states in which similar change is sought.

  15. 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

    ... Scientific and Medical Literature and Information on Non-Standardized Allergenic Extracts in the Diagnosis... scientific and medical literature and information concerning the use of non-standardized allergenic extracts... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

  16. 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

  17. 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…

  18. 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:…

  19. Planning a pharmacy-led medical mission trip, part 3: development and implementation of an elective medical missions advanced pharmacy practice experience (APPE) rotation.

    PubMed

    Brown, Dana A; Ferrill, Mary J

    2012-01-01

    With an increasing number of new pharmacy schools/colleges and expansion of existing ones, pharmacy schools/colleges are often in need of elective rotation experiences as part of the final year advanced pharmacy practice experience (APPE) program. Offering a medical missions elective APPE in either a domestic or international setting is a unique opportunity to expose pharmacy students to direct patient care. APPE students can be involved in triaging patients, compounding and dispensing medications, and providing patient education. As part of this APPE, pharmacy students are expected to complete projects such as formulary development, case presentations, book club discussions, journal reflections, manuscript preparations, and trip logistics planning. An elective APPE focused on medical missions facilitates the learning process and promotes the emergence of team leaders and leadership skills in general.

  20. [Evaluations and examinations at the Tromsø medical school. Evaluation by students after graduation].

    PubMed

    Tollan, A; Magnus, J H

    1993-01-10

    The medical curriculum at the University of Tromsø is based on an organ-system model with full integration of the three main disciplines (basic science, clinical and community medicine). There are only three examinations during the six-year course. We present the results of a survey among the first 417 physicians educated at the Medical School in Tromsø. A mailed questionnaire was answered by 84.2%. More than 80% stated that it was of great importance to evaluate the form and contents of the lectures and their supervisors' teaching abilities. More than 96% found that integration of the examinations was achieved in accordance with the intention. Furthermore, the examinations were also relevant for them as physicians.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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…

  7. 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

  8. Evaluation of intravenous medication errors with smart infusion pumps in an academic medical center.

    PubMed

    Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W

    2013-01-01

    While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted.

  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. An evaluation of personal medical services: the times they are a changin'.

    PubMed

    Riley, Anthony J; Harding, Geoffrey; Meads, Geoffrey; Underwood, Martin R; Carter, Yvonne H

    2003-05-01

    The Personal Medical Services (PMS) pilot sites, launched in England in 1997 by the Secretary of State for the then Conservative government, introduced a local contract for primary care, aimed at promoting flexibility, innovation and policy participation. As part of the National Evaluation of PMS, this paper considers the professional and organisational relationships established between service providers working in those PMS sites which specifically set out to address inequalities in access to primary care for vulnerable populations. The introduction of PMS enabled a change of cultural values in primary care, particularly regarding GPs' relationships with nurses and practice staff. However, PMS has not necessarily led to equal partnerships within primary care teams. Rather,in the selected sites evaluated new interprofessional relationships emerged. There was evidence of intra and interprofessional partnerships being forged, providing the basis for further improved intersectoral collaboration. There was also evidence that the GP based medical model made way for a community oriented/public health model with emphasis on health maintenance for the vulnerable. PMID:12745295

  12. 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).

  13. 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.

  14. 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.

  15. Critical Illness in Pregnancy: Part II: Common Medical Conditions Complicating Pregnancy and Puerperium.

    PubMed

    Guntupalli, Kalpalatha K; Karnad, Dilip R; Bandi, Venkata; Hall, Nicole; Belfort, Michael

    2015-11-01

    The first of this two-part series on critical illness in pregnancy dealt with obstetric disorders. In Part II, medical conditions that commonly affect pregnant women or worsen during pregnancy are discussed. ARDS occurs more frequently in pregnancy. Strategies commonly used in nonpregnant patients, including permissive hypercapnia, limits for plateau pressure, and prone positioning, may not be acceptable, especially in late pregnancy. Genital tract infections unique to pregnancy include chorioamnionitis, group A streptococcal infection causing toxic shock syndrome, and polymicrobial infection with streptococci, staphylococci, and Clostridium perfringens causing necrotizing vulvitis or fasciitis. Pregnancy predisposes to VTE; D-dimer levels have low specificity in pregnancy. A ventilation-perfusion scan is preferred over CT pulmonary angiography in some situations to reduce radiation to the mother's breasts. Low-molecular-weight or unfractionated heparins form the mainstay of treatment; vitamin K antagonists, oral factor Xa inhibitors, and direct thrombin inhibitors are not recommended in pregnancy. The physiologic hyperdynamic circulation in pregnancy worsens many cardiovascular disorders. It increases risk of pulmonary edema or arrhythmias in mitral stenosis, heart failure in pulmonary hypertension or aortic stenosis, aortic dissection in Marfan syndrome, or valve thrombosis in mechanical heart valves. Common neurologic problems in pregnancy include seizures, altered mental status, visual symptoms, and strokes. Other common conditions discussed are aspiration of gastric contents, OSA, thyroid disorders, diabetic ketoacidosis, and cardiopulmonary arrest in pregnancy. Studies confined to pregnant women are available for only a few of these conditions. We have, therefore, reviewed pregnancy-specific adjustments in the management of these disorders. PMID:26020727

  16. Assessment of medical wastes management practice: a case study of the northern part of Jordan.

    PubMed

    Bdour, A; Altrabsheh, B; Hadadin, N; Al-Shareif, M

    2007-01-01

    This study includes a survey of the procedures available, techniques, and methods of handling and disposing of medical waste at medium (between 100 and 200 beds) to large (over 200 beds) size healthcare facilities located in Irbid city (a major city in the northern part of Jordan). A total of 14 healthcare facilities, including four hospitals and 10 clinical laboratories, serving a total population of about 1.5 million, were surveyed during the course of this research. This study took into consideration both the quantity and quality of the generated wastes to determine generation rates and physical properties. Results of the survey showed that healthcare facilities in Irbid city have less appropriate practices when it comes to the handling, storage, and disposal of wastes generated in comparison to the developed world. There are no defined methods for handling and disposal of these wastes, starting from the personnel responsible for collection through those who transport the wastes to the disposal site. Moreover, there are no specific regulations or guidelines for segregation or classification of these wastes. This means that wastes are mixed, for example, wastes coming from the kitchen with those generated by different departments. Also, more importantly, none of the sites surveyed could provide estimated quantities of waste generated by each department, based upon the known variables within the departments. Average generation rates of total medical wastes in the hospitals were estimated to be 6.10 kg/patient/day (3.49 kg/bed/day), 5.62 kg/patient/day (3.14 kg/bed/day), and 4.02 kg/patient/day (1.88 kg/bed/day) for public, maternity, and private hospitals, respectively. For medical laboratories, rates were found to be in the range of 0.053-0.065 kg/test-day for governmental laboratories, and 0.034-0.102 kg/test-day for private laboratories. Although, based on the type of waste, domestic or general waste makes up a large proportion of the waste volume, so that if

  17. 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.

  18. LIMITING OCCUPATIONAL MEDICAL EVALUATIONS UNDER THE AMERICANS WITH DISABILITIES ACT AND THE GENETIC INFORMATION NONDISCRIMINATION ACT.

    PubMed

    Rothstein, Mark A; Roberts, Jessica; Guidotti, Tee L

    2015-01-01

    Although medical care delivery by one's personal physician is the paradigmatic American healthcare arrangement, in the workplace setting, many Americans undergo medical evaluations to assess their fitness for duty or degree of impairment. This Article explores the complex and evolving legal status of occupational medical evaluations. Beginning with the legal and ethical frameworks of occupational medical practice, the Article then examines the effects of increasingly detailed legal regulation under the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act on employees, employers, and physicians. PMID:26863849

  19. 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. PMID:18830833

  20. Pain Medication Management Processes Used by Oncology Outpatients and Family Caregivers Part I: Health Systems Contexts

    PubMed Central

    Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine

    2014-01-01

    Context 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. Objective 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 psycho-educational 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. Methods 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. Results 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. Conclusion 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 healthcare reform initiatives. PMID:24704800

  1. 20 CFR 30.908 - How will the FAB evaluate new medical evidence submitted to challenge the impairment...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How will the FAB evaluate new medical... Medical Evidence of Impairment § 30.908 How will the FAB evaluate new medical evidence submitted to... impairment evaluation that differs from the impairment evaluation relied upon by the district office, the...

  2. 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)

  3. 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.

  4. 78 FR 7695 - Revised Medical Criteria for Evaluating Genitourinary Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    .... ADDRESSES: You may submit comments by any one of three methods-- Internet, fax, or mail. Do not submit the... personal information, such as Social Security numbers or medical information. ] 1. Internet: We strongly recommend that you submit your comments via the Internet. Please visit the Federal eRulemaking portal...

  5. 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…

  6. [Medical certification standards in the evaluation of inability to work].

    PubMed

    Kaczmarek, Tadeusz; Marcinkowski, Jerzy T

    2007-01-01

    The authors attempt to address the question whether it is possible to establish medical certification standards that would be helpful in assessing inability to work. The need for developing such relatively uniform certification standards is indicated in the Report of the Supreme Chamber of Control issued in July 2005. Searching for the answer to the question to what degree such standards can be established, the authors briefly present and review the presently enforced "certification standards" and provided several examples from the history of social security and medical certification in Poland. They also discuss the first Polish textbook of medical certification published by Dr. Franciszek Witaszek in 1935. Another "historical example" recalled in the paper is the textbook edited by Professor Karol Szaniewicz (1959) and entitled: "Medical certification for disability and employment". The authors also mention that several years ago, the Central Institute of Occupational Medicine published an "Occupational guide" that might be of help in developing certification standards in cases of inability to work.

  7. 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…

  8. [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.

  9. Op Patwin Part 2: HMS illustrious' medical response to typhoon Haiyan.

    PubMed

    Dew, A

    2014-01-01

    Operation PATWIN was the United Kingdom's (UK) response to the disaster caused by Typhoon Haiyan. The UK deployed a force including HMS DARING and HMS ILLUSTRIOUS and this article describes the medical response including the deployment of a Role 2 medical team and the hosting of a UK civilian medical team UK Med. The deployment followed humanitarian guidelines in UK doctrine and contained in the Oslo guidelines, but demonstrated a unique example of a civilian team supported by the military.

  10. The medical film 1897-1997: Part II. The second half-century.

    PubMed

    Essex-Lopresti, M

    1998-06-01

    Following the reluctance of teachers to use film for undergraduate and postgraduate medical education up until the Second World War, the active promotion of medical films after the war was encouraged by the production of catalogues of films available and the publication of medical film reviews both in journals and in books. This resulted in an increased use of films in the three decades following the war until videorecordings began to take their place and film projection is now a rarity in centres of medical education. PMID:9876406

  11. [Evaluating radiation dose load in medical personnel of radiologic diagnostic departments].

    PubMed

    Trunov, B V; Koroleva, E P

    2014-01-01

    The article deals with materials on radiation hygienic evaluation of radiologic diagnostic departments in various medical institutions of Moscow. The studies covered work of medical staffers in X-ray examination and in contact with short-lived isotope generators. The authors outlined the examination types and stages with maximal radiation danger. Disimetric information obtained during the study helped to calculate values of equivalent, effective doses of radiation for medical personnel and maximal potential doses.

  12. Program Evaluation at HEW: Research versus Reality. Part 2: Education.

    ERIC Educational Resources Information Center

    Abert, James G., Ed.

    Intended for both the student and the practitioner of evaluation, this book describes the state of the practice of program evaluation. Its focus is mainly institutional. Results of evaluation studies are of secondary importance. An introductory chapter written by the editor discusses evaluation at the Office of Education from 1967 through 1973.…

  13. 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…

  14. 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

  15. 23 CFR Appendix E to Part 1240 - Determination of Federal Medical Savings

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Economic Cost of Motor Vehicle Crashes, 1994,” 2 NHTSA measured both the medical costs and payment sources for motor vehicle crashes. NHTSA will adjust the national medical cost figures from this report to....J. The Economic Cost of Motor Vehicle Crashes, 1994. Washington, DC: U.S. Department...

  16. 23 CFR Appendix E to Part 1240 - Determination of Federal Medical Savings

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Economic Cost of Motor Vehicle Crashes, 1994,” 2 NHTSA measured both the medical costs and payment sources for motor vehicle crashes. NHTSA will adjust the national medical cost figures from this report to....J. The Economic Cost of Motor Vehicle Crashes, 1994. Washington, DC: U.S. Department...

  17. Use of Functional Analysis Methodology in the Evaluation of Medication Effects.

    ERIC Educational Resources Information Center

    Crosland, Kimberly A.; Zarcone, Jennifer R.; Lindauer, Steven E.; Valdovinos, Maria G.; Zarcone, Troy J.; Hellings, Jessica A.; Schroeder, Stephen R.

    2003-01-01

    The atypical antipsychotic medication risperidone was evaluated using a double-blind, placebo-controlled design to treat destructive behavior in two males (ages 6 and 24) with autism. Destructive behavior during the demand condition was significantly reduced during the medication phases, whereas it continued to occur to obtain tangible items and…

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan requirements for medical care evaluation studies. 456.242 Section 456.242 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization...

  19. 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 studies. 456.242 Section 456.242 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization...

  20. 42 CFR 456.243 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Content of medical care evaluation studies. 456.243 Section 456.243 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

  1. 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 Section 456.243 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

  2. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false UR plan requirements for medical care evaluation studies. 456.242 Section 456.242 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization...

  3. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false UR plan requirements for medical care evaluation studies. 456.242 Section 456.242 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization...

  4. 42 CFR 456.243 - Content of medical care evaluation studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Content of medical care evaluation studies. 456.243 Section 456.243 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

  5. 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 Section 456.243 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

  6. 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

  7. Medical criminalistics.

    PubMed

    Pollak, S

    2007-01-17

    Medical criminalistics is an essential part of legal/forensic medicine. It includes the clinical examination of surviving victims and suspects, the inspection of the scene in suspicious deaths with subsequent performance of medico-legal autopsies, the assessment of (biological) traces and the reconstruction of criminal events under medical aspects. Just as the circumstances of life and the manifestations of crime are changing with time, there is a permanent alteration regarding the issues of medical criminalistics. Legal/forensic medicine is a university subject in most countries and therefore, research work is one of the main tasks also in medical criminalistics. In contrast to clinical medicine and basic research, some common study designs are not suitable for the special needs of medical criminalistics, whereas other types are more appropriate like epidemiological evaluations, cross-sectional studies and (retrospective) observation studies. Moreover, experimental model tests and case reports also rate high in medical criminalistics. PMID:16822631

  8. Medical criminalistics.

    PubMed

    Pollak, S

    2007-01-17

    Medical criminalistics is an essential part of legal/forensic medicine. It includes the clinical examination of surviving victims and suspects, the inspection of the scene in suspicious deaths with subsequent performance of medico-legal autopsies, the assessment of (biological) traces and the reconstruction of criminal events under medical aspects. Just as the circumstances of life and the manifestations of crime are changing with time, there is a permanent alteration regarding the issues of medical criminalistics. Legal/forensic medicine is a university subject in most countries and therefore, research work is one of the main tasks also in medical criminalistics. In contrast to clinical medicine and basic research, some common study designs are not suitable for the special needs of medical criminalistics, whereas other types are more appropriate like epidemiological evaluations, cross-sectional studies and (retrospective) observation studies. Moreover, experimental model tests and case reports also rate high in medical criminalistics.

  9. Pain Medication Management Processes Used by Oncology Outpatients and Family Caregivers Part II: Home and Lifestyle Contexts

    PubMed Central

    Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine

    2014-01-01

    Context 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. Objectives 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 (RCT) of a psycho-educational 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. Methods This qualitative study was conducted as part of a RCT 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. Results 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. Conclusion Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and family caregivers when cancer treatment and supportive care is 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. PMID:24709364

  10. Benefits and Challenges of Focus Groups in the Evaluation of a New Graduate Entry Medical Programme

    ERIC Educational Resources Information Center

    Nestel, Debra; Ivkovic, Amelie; Hill, Robyn A.; Warrens, Anthony N.; Paraskevas, Paraskeva A.; McDonnell, Jacqueline A.; Mudarikwa, Ruvimbo S.; Browne, Chris

    2012-01-01

    Programme evaluation is essential for quality assurance in education. In this paper, we describe our evaluation strategy for the first year of a new medical programme. Although we used multiple methods in the evaluation, the use of the focus group method was core. This paper reports our experiences of focus groups for this purpose. We describe the…

  11. Towards effective evaluation and reform in medical education: a cognitive and learning sciences perspective.

    PubMed

    Patel, Vimla L; Yoskowitz, Nicole A; Arocha, Jose F

    2009-12-01

    Health professions education is dealing with major transformations in light of the changing nature of the health care delivery system, including the use of technology for "just in time" delivery of care, evidence-based practice, personalized medical care and learning, as health professionals strive to integrate biomedical advances and clinical practice. This has forced the medical education community to reassess the current teaching and learning practices and more importantly, the evaluation of the medical education process. There have been recent advances in cognitive and learning sciences theories, some of which can inform medical educators about best teaching and learning practices and their impact on the evaluation process. An understanding of these theories provides a sound rationale for choosing specific instructional strategies and choosing evaluation measures that assess the curricular objectives. The review begins with an overview of evaluation and assessment in education, followed by an overview of major theories from the cognitive and learning sciences. Next, the role of cognitive and learning sciences theories in informing the process of medical education evaluation is discussed, including its impact on student learning, performance and professional competence, as well as recommendations for reform of medical curricula based on such theories. The paper continues with the elaboration of current trends in health sciences education, particularly medical education, and available evidence for the impact on student learning and performance as well as areas where more research is needed.

  12. 'Ten Golden Rules' for Designing Software in Medical Education: Results from a Formative Evaluation of DIALOG.

    ERIC Educational Resources Information Center

    Jha, Vikram; Duffy, Sean

    2002-01-01

    Reports the results of an evaluation of Distance Interactive Learning in Obstetrics and Gynecology (DIALOG) which is an electronic program for continuing education. Presents 10 golden rules for designing software for medical practitioners. (Contains 26 references.) (Author/YDS)

  13. Are the UK systems of innovation and evaluation of medical devices compatible? The role of NICE's Medical Technologies Evaluation Programme (MTEP).

    PubMed

    Chapman, A M; Taylor, C A; Girling, A J

    2014-08-01

    The economic evaluation of medical products and services is increasingly prioritised by healthcare decision makers and plays a key role in informing funding allocation decisions. It is well known that there are a number of methodological difficulties in the health technology assessment of medical devices, particularly in the provision of efficacy evidence. By contrasting devices with pharmaceuticals, the way in which the differing systems of innovation mould the UK's industry landscape is described and substantiated with market statistics. In recognition of the challenges faced by industry, as well as the growing need for cost-effective allocation of National Health Service (NHS) resources, the National Institute for Health and Care Excellence (NICE) led the development of the Medical Technologies Evaluation Programme (MTEP), which launched in 2009/2010. The review of the UK's medical devices market supports the programme's three principal aims: to simplify access to evaluation, speed up the process, and increase evaluative capacity for devices within NICE. However, an analysis of the output of MTEP's first 3 years suggests that it has some way to go to meet each of these aims.

  14. Evaluating parallel relational databases for medical data analysis.

    SciTech Connect

    Rintoul, Mark Daniel; Wilson, Andrew T.

    2012-03-01

    Hospitals have always generated and consumed large amounts of data concerning patients, treatment and outcomes. As computers and networks have permeated the hospital environment it has become feasible to collect and organize all of this data. This raises naturally the question of how to deal with the resulting mountain of information. In this report we detail a proof-of-concept test using two commercially available parallel database systems to analyze a set of real, de-identified medical records. We examine database scalability as data sizes increase as well as responsiveness under load from multiple users.

  15. An investigative model evaluating how consumers process pictorial information on nonprescription medication labels.

    PubMed

    Sansgiry, S S; Cady, P S

    1997-01-01

    Currently, marketed over-the-counter (OTC) medication labels were simulated and tested in a controlled environment to understand consumer evaluation of OTC label information. Two factors, consumers' age (younger and older adults) and label designs (picture-only, verbal-only, congruent picture-verbal, and noncongruent picture-verbal) were controlled and tested to evaluate consumer information processing. The effects exerted by the independent variables, namely, comprehension of label information (understanding) and product evaluations (satisfaction, certainty, and perceived confusion) were evaluated on the dependent variable purchase intention. Intention measured as purchase recommendation was significantly related to product evaluations and affected by the factor label design. Participants' level of perceived confusion was more important than actual understanding of information on OTC medication labels. A Label Evaluation Process Model was developed which could be used for future testing of OTC medication labels. PMID:10168485

  16. [G. W. Leibniz: medicine and the sciences of life. Ist part: Leibniz as a "medical practioner].

    PubMed

    Chazaud, J

    1995-01-01

    A universal thinker, Leibniz always expressed a marked interest for matters of life. A reader and a correspondent of the most famous physicians of his time, he exhorted them - with some results - to found their theories on the ground of detailed comparative observations and of verified experiments, firmly distinguishing scientific and metaphysic points of view. He worked out a primal organismic theory, but devoted himself mostly to set up a coherent medical training programme and a requiring health policy. Nevertheless, beyond anecdote, Leibniz never pretended to be a medical practioner, but thought he was a "medically-minded" philosopher.

  17. Toward meaningful evaluation of medical trainees: the influence of participants' perceptions of the process.

    PubMed

    Watling, Christopher J; Lingard, Lorelei

    2012-05-01

    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 influence over whether the feedback they receive actually facilitates learning, but similar research on perceptions of feedback in the medical setting has been limited. In this review, we examine the literature on recipient perceptions of feedback and how those perceptions influence the contribution that feedback makes to their learning. A focused exploration of relevant work on this subject in higher education and industrial psychology settings is followed by a detailed examination of available research on perceptions of evaluation processes in medical settings, encompassing both trainee and evaluator perspectives. We conclude that recipients' and evaluators' perceptions of an evaluation process profoundly affect the usefulness of the evaluation and the extent to which it achieves its goals. Attempts to improve evaluation processes cannot, therefore, be limited to assessment tool modification driven by reliability and validity concerns, but must also take account of the critical issue of feedback reception and the factors that influence it. Given the unique context of clinical performance evaluation in medicine, a research agenda is required that seeks to more fully understand the complexity of the processes of giving, receiving, interpreting, and using feedback as a basis for real progress toward meaningful evaluation.

  18. Evaluation of Web-Based Consumer Medication Information: Content and Usability of 4 Australian Websites

    PubMed Central

    Tariq, Amina; Richardson, Lauren; Byrne, Mary; Robinson, Maureen; Li, Ling; Westbrook, Johanna I; Baysari, Melissa T

    2016-01-01

    Background Medication is the most common intervention in health care, and written medication information can affect consumers’ medication-related behavior. Research has shown that a large proportion of Australians search for medication information on the Internet. Objective To evaluate the medication information content, based on consumer medication information needs, and usability of 4 Australian health websites: Better Health Channel, myDr, healthdirect, and NPS MedicineWise . Methods To assess website content, the most common consumer medication information needs were identified using (1) medication queries to the healthdirect helpline (a telephone helpline available across most of Australia) and (2) the most frequently used medications in Australia. The most frequently used medications were extracted from Australian government statistics on use of subsidized medicines in the community and the National Census of Medicines Use. Each website was assessed to determine whether it covered or partially covered information and advice about these medications. To assess website usability, 16 consumers participated in user testing wherein they were required to locate 2 pieces of medication information on each website. Brief semistructured interviews were also conducted with participants to gauge their opinions of the websites. Results Information on prescription medication was more comprehensively covered on all websites (3 of 4 websites covered 100% of information) than nonprescription medication (websites covered 0%-67% of information). Most websites relied on consumer medicines information leaflets to convey prescription medication information to consumers. Information about prescription medication classes was less comprehensive, with no website providing all information examined about antibiotics and antidepressants. Participants (n=16) were able to locate medication information on websites in most cases (accuracy ranged from 84% to 91%). However, a number of

  19. Optimal evaluation of infectious medical waste disposal companies using the fuzzy analytic hierarchy process

    SciTech Connect

    Ho, Chao Chung

    2011-07-15

    Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms.

  20. Optimal evaluation of infectious medical waste disposal companies using the fuzzy analytic hierarchy process.

    PubMed

    Ho, Chao Chung

    2011-07-01

    Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms.

  1. [The evaluation of costs: standards of medical care and clinical statistic groups].

    PubMed

    Semenov, V Iu; Samorodskaia, I V

    2014-01-01

    The article presents the comparative analysis of techniques of evaluation of costs of hospital treatment using medical economic standards of medical care and clinical statistical groups. The technique of evaluation of costs on the basis of clinical statistical groups was developed almost fifty years ago and is largely applied in a number of countries. Nowadays, in Russia the payment for completed case of treatment on the basis of medical economic standards is the main mode of payment for medical care in hospital. It is very conditionally a Russian analogue of world-wide prevalent system of diagnostic related groups. The tariffs for these cases of treatment as opposed to clinical statistical groups are counted on basis of standards of provision of medical care approved by Minzdrav of Russia. The information derived from generalization of cases of treatment of real patients is not applied.

  2. Strategies against burnout and anxiety in medical education--implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students.

    PubMed

    Wild, Katharina; Scholz, Michael; Ropohl, Axel; Bräuer, Lars; Paulsen, Friedrich; Burger, Pascal H M

    2014-01-01

    Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the results of our students participating in Relacs with results from eight semester medical students (n = 88), assessed with the same questionnaires at similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated parameters in contrast to those students who did not attend the course.

  3. 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.

  4. The medical film 1897-1997: Part I. The first half-century.

    PubMed

    Essex-Lopresti, M

    1998-03-01

    Medicine has frequently been in the forefront of applying new illustrative media to its needs, and cinematographic film is a good example. Within a year of the introduction of moving pictures, cine-film was used for medical research and to a lesser extent for teaching. The profession took advantage of the spread of cinemas by making health education films, and during the first half century of cinematography surgeons were keen to have their operations filmed. Medical educators were slow to include film in their teaching programmes and several organizations were formed to encourage their use. After the Second World War, medical films for undergraduate and postgraduate education became accepted until, as the medical film reached its centenary, cine-film declined in favour of video-recordings. PMID:9764516

  5. Evaluation of doctors’ performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

    PubMed Central

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Background Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students’ perceptions regarding lecture quality in a new medical school. Methods This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012–2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. Results The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Conclusion Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning. PMID:25878516

  6. Medical and surgical evaluation and care of illness in space

    NASA Technical Reports Server (NTRS)

    Siegel, John H.

    1994-01-01

    This report summarizes the work done on the contract NAG9-567, which was activated at the New Jersey Medical School-UMDNJ in April 1992 and carried on during the 1992-93 year to the present 1993-94 year which was terminated in May 1994. The initial examination stage was completed of an interactive program for the recording of physical and physiologic injury information obtained from examination of an injured person, who might be an astronaut sustaining traumatic injury, due to a burn or physical trauma, either in space or in an earth bound training environment. In this report three aspects will be discussed: 1) a description of the system of diagnostic examination graphics, 2) a description of the organization of the therapeutic advisory systems with a demonstration of two specific modules, and 3) a brief technical description of the organization of the programming system carried out on a UNIX based work station using a WINDOWS environment.

  7. 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.

  8. 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. PMID:12321001

  9. Bioassays for evaluation of medical products derived from bacterial toxins.

    PubMed

    Sesardic, Thea

    2012-06-01

    Bioassays play central role in evaluation of biological products and those derived from bacterial toxins often rely exclusively on in vivo models for assurance of safety and potency. This chapter reviews existing regulatory approved methods designed to provide information on potency and safety of complex biological medicines with an insight into strategies considered for alternative procedures.

  10. 78 FR 69324 - Revised Medical Criteria for Evaluating Hematological Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... revise the criteria in the Listing of Impairments (listings) that we use to evaluate cases involving... the Federal eRulemaking portal at http://www.regulations.gov , or in person, during regular business... hematological disorders. For example: \\1\\ (50 FR 50068) \\2\\ We published some revisions to the...

  11. Evaluation of an Online Bioterrorism Continuing Medical Education Course

    ERIC Educational Resources Information Center

    Casebeer, Linda; Andolsek, Kathryn; Abdolrasulnia, Maziar; Green, Joseph; Weissman, Norman; Pryor, Erica; Zheng, Shimin; Terndrup, Thomas

    2006-01-01

    Introduction: 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…

  12. The communication skills course for second year medical students at Hannover Medical School: An evaluation study based on students' self-assessments.

    PubMed

    von Lengerke, Thomas; Kursch, Angelika; Lange, Karin

    2011-01-01

    In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year.Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, "5"=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted.The highest learning needs were found for the "to show how"-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking ("to know how": mean difference = +1.7, "to show how": +1.8, p<.0001 as with all tests) and the "to know how"-item regarding the disclosure of diagnoses (+1.6), followed by the "to show how"-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one's own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated

  13. The communication skills course for second year medical students at Hannover Medical School: An evaluation study based on students' self-assessments

    PubMed Central

    von Lengerke, Thomas; Kursch, Angelika; Lange, Karin

    2011-01-01

    In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year. Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, “5”=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted. The highest learning needs were found for the “to show how”-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking (“to know how”: mean difference = +1.7, “to show how”: +1.8, p<.0001 as with all tests) and the “to know how”-item regarding the disclosure of diagnoses (+1.6), followed by the “to show how”-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one’s own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding

  14. Talking about psychiatric medications: a parent-to-parent perspective (for children and youth) part I.

    PubMed

    Cooper, Susan; Rimm, Michael L; Arensdorf, Alfred M

    2007-10-01

    This article presents a format for parent-to-parent and parent-to-professional guidance on psychiatric medications for children and youth. It reviews progress in Hawai'i's system of care for child mental health. Between 1999 and 2006, Hawai'i had nationally and internationally renowned experts in psychiatric medication conduct CME for Hawai'i's primary care and specialist care physicians. These conferences have included consumers and non-physician mental health colleagues. The importance of involvement of consumers in the process of rational decision-making for the individual child or youth is an emphasis in the system of care in Hawai'i. The approach featured in Susan Cooper's "Meditation on Medication" presentation in the 2005 symposium breakout for parents demonstrates the genuine collaboration with consumers that may be a partial remedy for the data that shows an overall poor adherence to prescribed interventions.

  15. Physician-entrepreneurship: a user's manual, part 1: critical questions for early-stage medical ventures.

    PubMed

    Lexa, Frank James; Lexa, Frank J

    2005-07-01

    The medical field is one of the most exciting in America for entrepreneurs. Radiologists and other medical practitioners are in a unique position to take advantage of opportunities to invent and create innovative products and services. Physicians have led many of the most important revolutionary and evolutionary changes that have occurred in the field in the past 100 years. However, many radiologists find the process of entrepreneurship a daunting one and are often deterred from acting on their ideas. This article addresses the key issues and challenges that entrepreneurs face when embarking on new enterprises. Although most of these issues face all entrepreneurs at this stage, this article focuses on medical innovation and its particular challenges. This article concentrates on the kinds of questions that physician-entrepreneurs need to ask before jumping in, the types of common pitfalls that await those who don't address these issues, and some answers to seek if you are to beat the odds and succeed.

  16. 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.

  17. Design, formulation, and evaluation of ginger medicated chewing gum

    PubMed Central

    Aslani, Abolfazl; Ghannadi, Alireza; Rostami, Farnaz

    2016-01-01

    Background: Various ginger compounds improve gastrointestinal problems and motion sickness. The main effects of ginger allocate to some phenolics such as gingerols and shogaols that act as their active agents. Chewing gums are among convenient dosage forms which patients prefer due to their advantages. Hence, this study tried to design, formulate, and evaluate ginger chewing gum of favorable taste and texture to avoid motion sickness and have gastro-protective and anti-oxidant effect. Materials and Methods: Dried ginger rhizomes were percolated to extract ginger compounds. Total phenolics were measured in 70% hydro-alcoholic extract of ginger by gallic and tannic acid standards using Folin–Ciocalteu’s reagent. Chewing gums containing 50 mg of concentrated extract were prepared. Content uniformity, weight variation, release pattern, organoleptic, and mechanical properties were evaluated. Results: Phenolic content was measured 61.50 ± 5.27 mg/g and 76.75 ± 5.45 mg/g of concentrated extract as gallic acid and tannic acid equivalents, respectively. Release pattern of formulations with different gum bases and sweeteners demonstrated almost 100% release of drug. Evaluation of organoleptic properties was on 10 healthy volunteers and later prepared formulations exhibited better characteristics. Formulations without any flavorants have higher acceptability. Evaluation of mechanical properties showed higher stiffness of F15. Conclusion: Ginger chewing gum comprises admissible properties to be used as a modern drug delivery system due to its advantageous results in motion sickness. It passed all the specified tests for an acceptable chewing gum. Thus, it may be successfully produced to help GI problems. PMID:27563640

  18. Evaluation of Medical Students During a Clinical Clerkship in Internal Medicine

    ERIC Educational Resources Information Center

    O'Donohue, W. J., Jr.; Wergin, Jon F.

    1978-01-01

    During a three-month clinical clerkship in medicine 175 medical students were evaluated. A proficiency assessment process was developed that included preceptor evaluation of on-the-job performance as well as oral and written examinations. Data analysis showed small correlations among the three measurements of competence. (Author/LBH)

  19. An Evaluating Study on ESP Medical Textbook: Instructors and Learners' Needs Analysis

    ERIC Educational Resources Information Center

    Salehi, Hadi; Khadivar, Zahra; Babaee, Ruzbeh; Singh, Hardev Kaur Ap Jujar

    2015-01-01

    Textbook evaluation is determining the productivity and value of textbooks with respect to stated objectives, standards, or criteria. This study was an attempt to evaluate the ESP medical textbook, which is taught at some universities in Iran. To gather the necessary data, two researcher-made questionnaires and one interview protocol were used.…

  20. Evaluation of an ESP Medical Textbook: Instructors and Learners' Perceptions in Focus

    ERIC Educational Resources Information Center

    Salehi, Hadi; Khadivar, Zahra; Mehrabi, Mahmood

    2015-01-01

    Evaluation is basically a matching process, which concerns matching learners' needs to available solutions. Through analysis and assessment of ESP textbooks, a much more promising and desirable approach to a theory of ESP takes place. To this aim, the purpose of the present study was to evaluate the ESP medical textbook. To gather the necessary…

  1. Evaluation of virtual microscopy in medical histology teaching.

    PubMed

    Mione, Sylvia; Valcke, Martin; Cornelissen, Maria

    2013-01-01

    Histology stands as a major discipline in the life science curricula, and the practice of teaching it is based on theoretical didactic strategies along with practical training. Traditionally, students achieve practical competence in this subject by learning optical microscopy. Today, students can use newer information and communication technologies in the study of digital microscopic images. A virtual microscopy program was recently introduced at Ghent University. Since little empirical evidence is available concerning the impact of virtual microscopy (VM) versus optical microscopy (OM) on the acquisition of histology knowledge, this study was set up in the Faculty of Medicine and Health Sciences. A pretest-post test and cross-over design was adopted. In the first phase, the experiment yielded two groups in a total population of 199 students, Group 1 performing the practical sessions with OM versus Group 2 performing the same sessions with VM. In the second phase, the research subjects switched conditions. The prior knowledge level of all research subjects was assessed with a pretest. Knowledge acquisition was measured with a post test after each phase (T1 and T2). Analysis of covariance was carried out to study the differential gain in knowledge at T1 and T2, considering the possible differences in prior knowledge at the start of the study. The results pointed to non-significant differences at T1 and at T2. This supports the assumption that the acquisition of the histology knowledge is independent of the microscopy representation mode (VM versus OM) of the learning material. The conclusion that VM is equivalent to OM offers new directions in view of ongoing innovations in medical education technology.

  2. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part I, 10-14.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction, lesson plans, and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the first of…

  3. [Development of emergency medical services in Germany - Western part of Germany].

    PubMed

    Sefrin, Peter

    2013-11-01

    Initially the premise of the rescue services was to deliver patients to medical care as quickly as possible. Due to the demands of the Heidelberger surgeon Kirchner a rethinking was initiated prior to World War 2. It was not until the 1960s that this concept was taken up again and physicians were incorporated into the rescue services. A prerequisite for this in the technical field was the development of physician escorted rescue vehicles for the prehospital management of road accident victims. After the economic and medical benefits of the deployment of emergency physicians had been demonstrated, the mandatory participation of emergency physicians was laid down in the laws on rescue services by the West German federal states. With increasing acceptance, there was a shift of the patient collective from accident victims to acute internal medical and neurological emergency cases. In order to realize the necessary efficacy of the cost-intensive organization the German Medical Council formulated guidelines for the qualification of emergency physicians.

  4. 20 CFR Appendix 2 to Part 220 - Medical-Vocational Guidelines

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... medically determinable impairment(s). 203.00Maximum sustained work capability limited to medium work as a... his or her maximum sustained work capability for sedentary, light, medium, heavy, or very heavy work... at the various functional levels (sedentary, light, medium, heavy, and very heavy) as supported...

  5. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part II, 10-15.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction and lesson plans and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the second…

  6. Changes in Emotions Related to Medication Used to Treat ADHD. Part II: Clinical Approaches

    ERIC Educational Resources Information Center

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

    2011-01-01

    ADHD is one of the most common neurobehavioral disorders of childhood, and FDA-approved medications offer an efficacious treatment option. However, case reports and anecdotal sources suggest that children can have emotional responses, both salutary and detrimental, to these agents. We have previously conducted a comprehensive literature review and…

  7. Early days in the St. Mary's Medical School Photographic Department: Part 1.

    PubMed

    Cardew, P

    1992-10-01

    This article gives an account of the problems which faced medical photographers in the late 1940s and early 1950s. The lack of suitable equipment particularly in regard to cinematography led to ingenious but laborious techniques. The attitude of teaching staff towards the use of lantern slides was coloured by the cumbersome apparatus of the period. PMID:1339783

  8. [Medical resource utilization and allocation in Japan--evaluation of surgical expenditures].

    PubMed

    Hiki, Yoshiki

    2004-05-01

    We evaluated the appropriateness of medical cost allocation in Japan from the global aspect especially the percentage of the national budget for medical cost to gross national product (GDP). Base on OECD-Health Data in 2002, Japan was ranked high in the world in terms of medical services but was ranked the second lowest in terms of the percentage of medical cost to GDP (7.6%) among G7 advanced countries. In addition, at surgical departments, allocated medical cost is mostly used for surgical supplies and instruments, and only negligibly for doctor's fee. Unless this situation is improved, the surgical department in Japan will decline. Improvement measures should be taken without delay.

  9. [SIGAPS: a software package for the evaluation of medical publications].

    PubMed

    Derancourt, C; Devos, P; Moore, N; Rouvillain, J-L

    2014-01-01

    The "système d'interrogation, de gestion et d'analyse des publications scientifiques" (System for Identification, Management and Analysis of Scientific Publications), or SIGAPS, is an innovative tool of French design that enables the identification and analysis of bibliographic references produced by a given researcher or unit using the Medline database (PubMed). This evaluation takes into account the author's rank of signature and the impact factor of the journal of publication within the discipline in question. The limits are those of the impact factor. Analyses produced by SIGAPS enable financial assessment to be made by hospitals.

  10. Medical educational culture: introducing patients to applicants as part of the medical school interview: feasibility and initial impact show and tell

    PubMed Central

    Sims, Shireen Madani; Lynch, James W.

    2016-01-01

    Introduction The College of Medicine at our institution underwent a major curricular revision in order to develop a patient-centered context for learning. The admission process was revised to reflect this change, adopting a holistic review process, with the hope of attracting students who were particularly well suited to a patient-centered curriculum and learning culture. Methods Patients from a single practitioner, who were accustomed to working with medical students, were asked if they would like to select the next generation of physicians. The patient's experience included a brief didactic presentation related to the patient's diagnosis and treatment. This was followed by an informal session with the applicants and the physician, where they shared their story in a small group setting. They were encouraged to share their experiences with the healthcare system, both positive and negative. The goal was to allow applicants to glean the importance of the human aspects of disease in our institutional culture of learning. Results The response and experience were overwhelmingly positive for the patients who donated their time to participate and for our applicants. Follow-up surveys indicated that our applicants found the experience to be unique and positive. Many of the students who chose to attend our university cited the interview experience and learning culture as factors that influenced their choice of medical schools. In addition, the Liaison Committee on Medical Education cited the favorability of the admission process in their recent site visit. Discussion Now in its fifth year, we can say that the inclusion of patients as part of the interview day is feasible as part of our admission process. We continue to make changes and monitor our progress, and we have added several other faculty members and specialties in order to ensure the program is sustainable. PMID:27520404

  11. 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…

  12. Impact of Multiple Pharmacy Use on Medication Adherence and Drug-drug Interactions in Older Adults with Medicare Part D

    PubMed Central

    Marcum, Zachary A.; Driessen, Julia; Thorpe, Carolyn T.; Gellad, Walid F.; Donohue, Julie M.

    2014-01-01

    Objective To assess the association between multiple pharmacy use and medication adherence and potential drug-drug interactions (DDIs) among older adults. Design, Setting, and Participants Cross-sectional propensity score-weighted analysis of 2009 claims data from a nationally representative sample of 926,956 Medicare Part D beneficiaries aged >65 continuously enrolled in fee-for-service Medicare and Part D that year, and filled >1 prescription at a community/retail or mail order pharmacy. Multiple pharmacy use was defined as concurrent (overlapping time periods) or sequential use (non-overlapping time periods) of >2 pharmacies in the year. Measurements Medication adherence was calculated using a proportion of days covered ≥0.80 for eight therapeutic categories (β-blockers, renin angiotensin system antagonists, calcium channel blockers, statins, sulfonylureas, biguanides [i.e., metformin], thiazolidinediones, and dipeptidyl peptidase-IV inhibitors). Potential DDIs arising from use of certain drugs across a broad set of classes were defined as the concurrent filling of two interacting drugs. Results Overall, 38.1% of the sample used multiple pharmacies. Those using multiple pharmacies (both concurrently and sequentially) consistently had higher adjusted odds of non-adherence (ranging from 1.10 to 1.31, p<0.001) across all chronic medication classes assessed after controlling for socio-demographic, health status and access to care factors, compared to single pharmacy users. The adjusted predicted probability of exposure to a DDI was also slightly higher for those using multiple pharmacies concurrently (3.6%) compared to single pharmacy users (3.2%, AOR 1.11, 95% CI 1.08–1.15) but lower in individuals using multiple pharmacies sequentially (2.8%, AOR 0.85, 95% CI 0.81–0.91). Conclusions Filling prescriptions at multiple pharmacies was associated with lower medication adherence across multiple chronic medications, and a small but statistically significant

  13. [The sociological survey in the organization of evaluation of quality of medical care in the system of mandatory medical insurance].

    PubMed

    Bul'khina, G R

    2010-01-01

    The three-year experience of medical insurance company "ASKO-VAZ" of implementing the technique of sociologic surveys is discussed. The purpose was to study the degree of citizens? satisfaction of their interaction with medical sub-system in receiving medical care. The issue of awareness of medical personnel about functioning of system of mandatory medical insurance was examined.

  14. Planning a pharmacy-led medical mission trip, part 2: servant leadership and team dynamics.

    PubMed

    Brown, Dana A; Brown, Daniel L; Yocum, Christine K

    2012-06-01

    While pharmacy curricula can prepare students for the cognitive domains of pharmacy practice, mastery of the affective aspects can prove to be more challenging. At the Gregory School of Pharmacy, medical mission trips have been highly effective means of impacting student attitudes and beliefs. Specifically, these trips have led to transformational changes in student leadership capacity, turning an act of service into an act of influence. Additionally, building team unity is invaluable to the overall effectiveness of the trip. Pre-trip preparation for teams includes activities such as routine team meetings, team-building activities, and implementation of committees, as a means of promoting positive team dynamics. While in the field, team dynamics can be fostered through activities such as daily debriefing sessions, team disclosure times, and provision of medical services.

  15. A biography and bibliography: the recent trends in bioethics and medical genetics in Japan (Part I).

    PubMed

    Fujiki, N

    2000-01-01

    1. Introduction. 2. History of Bioethics in Japan. 3. First international bioethics seminar in Fukui on human dignity and medicine (1987). 4. Second international bioethics seminar in Fukui--international association of human biologists--japan society of human genetics joint symposium on medical genetics and society (1990). 5. Third international bioethics seminar in Fukui on human genome research and society (1992). 6. Fourth international bioethics seminar in Fukui on intractable neurological disorders, human genome research and society (1993). 7. Fifth international bioethics seminar in Fukui on the MURS japan/IBC UNESCO joint seminar on the protection of the human genome and scientific responsibility (1995). 8. Sixth international bioethics seminar in Fukui--UNESCO Asian bioethics conference- and who assisted satellite symposium on medical genetics services and bioethics, in Kobe and Fukui (1997). 9. Coming seventh international bioethics seminar in Fukui on pharmaco-genomics and DNA polymorphism (2000). 10. Conclusion.

  16. SFE/SFHTA/AFCE consensus on primary aldosteronism, part 7: Medical treatment of primary aldosteronism.

    PubMed

    Pechère-Bertschi, Antoinette; Herpin, Daniel; Lefebvre, Hervé

    2016-07-01

    Spironolactone, which is a potent mineralocorticoid receptor antagonist, represents the first line medical treatment of primary aldosteronism (PA). As spironolactone is also an antagonist of the androgen and progesterone receptor, it may present side effects, especially in male patients. In case of intolerance to spironolactone, amiloride may be used to control hypokaliemia and we suggest that eplerenone, which is a more selective but less powerful antagonist of the mineralocorticoid receptor, be used in case of intolerance to spironolactone and insufficient control of hypertension by amiloride. Specific calcic inhibitors and thiazide diuretics may be used as second or third line therapy. Medical treatment of bilateral forms of PA seem to be as efficient as surgical treatment of lateralized PA for the control of hypertension and the prevention of cardiovascular and renal morbidities. This allows to propose medical treatment of PA to patients with lateralized forms of PA who refuse surgery or to patients with PA who do not want to be explored by adrenal venous sampling to determine whether they have a bilateral or lateralized form. PMID:27315759

  17. Selected Medication Safety Risks to Manage in 2016-Part II; Methylergonovine Errors in Obstetrics.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2016-06-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:27354742

  18. Selected Medication Safety Risks to Manage in 2016-Part I Intravenous Fat Emulsion Needs a Filter.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2016-05-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:27303086

  19. Physician-entrepreneurship: a user's manual, part 1: critical questions for early-stage medical ventures.

    PubMed

    Lexa, Frank James; Lexa, Frank J

    2005-07-01

    The medical field is one of the most exciting in America for entrepreneurs. Radiologists and other medical practitioners are in a unique position to take advantage of opportunities to invent and create innovative products and services. Physicians have led many of the most important revolutionary and evolutionary changes that have occurred in the field in the past 100 years. However, many radiologists find the process of entrepreneurship a daunting one and are often deterred from acting on their ideas. This article addresses the key issues and challenges that entrepreneurs face when embarking on new enterprises. Although most of these issues face all entrepreneurs at this stage, this article focuses on medical innovation and its particular challenges. This article concentrates on the kinds of questions that physician-entrepreneurs need to ask before jumping in, the types of common pitfalls that await those who don't address these issues, and some answers to seek if you are to beat the odds and succeed. PMID:17411886

  20. Spectral analysis for evaluation of myocardial tracers for medical imaging

    SciTech Connect

    Huesman, Ronald H.; Reutter, Bryan W.; Marshall, Robert C.

    2000-10-11

    Kinetic analysis of dynamic tracer data is performed with the goal of evaluating myocardial radiotracers for cardiac nuclear medicine imaging. Data from experiments utilizing the isolated rabbit heart model are acquired by sampling the venous blood after introduction of a tracer of interest and a reference tracer. We have taken the approach that the kinetics are properly characterized by an impulse response function which describes the difference between the reference molecule (which does not leave the vasculature) and the molecule of interest which is transported across the capillary boundary and is made available to the cell. Using this formalism we can model the appearance of the tracer of interest in the venous output of the heart as a convolution of the appearance of the reference tracer with the impulse response. In this work we parameterize the impulse response function as the sum of a large number of exponential functions whose predetermined decay constants form a spectrum, and each is required only to have a nonnegative coefficient. This approach, called spectral analysis, has the advantage that it allows conventional compartmental analysis without prior knowledge of the number of compartments which the physiology may require or which the data will support.

  1. Trained student pharmacists’ telephonic collection of patient medication information: Evaluation of a structured interview tool

    PubMed Central

    Margolis, Amanda R.; Martin, Beth A.; Mott, David A.

    2016-01-01

    lists to facilitate MTM sessions in the community pharmacy setting. Evaluating the sustainability of using student pharmacists or trained technicians to collect medication lists is needed. PMID:27000165

  2. 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.

  3. Porosity evaluation in aircraft composite parts using laser-ultrasound

    NASA Astrophysics Data System (ADS)

    Dubois, Marc; Deaton, John B.; Lorraine, Peter W.; Drake, Tommy E.; Acres, Paul H.; Osterkamp, Mark A.

    2001-04-01

    In polymer-matrix composites, porosity must be evaluated and ultrasonic inspection is a proven technique to assess this parameter. To standardize reject criteria among different ultrasonic systems, ultrasonic systems must be quantitatively compared. Samples with different levels of porosity fabricated especially for a round robin were scanned using the laser-ultrasound facility built at Lockheed Martin Aerospace Fort Worth. The results obtained agree qualitatively and quantitatively with the results obtained on the same samples using conventional ultrasonic systems. Overall, the laser-ultrasound accuracy is equivalent to the average conventional system but with an inspection speed more than ten times faster.

  4. Medically Underserved Girls Receive Less Evaluation for Short Stature

    PubMed Central

    Feemster, Kristen A.; Pati, Susmita; Ramos, Mark; Grundmeier, Robert; Cucchiara, Andrew J.; Stallings, Virginia A.

    2011-01-01

    OBJECTIVE: To determine if gender is associated with diagnostic evaluation by primary care pediatricians caring for children with growth-faltering. PATIENTS AND METHODS: This was a retrospective study of children who were attending 4 urban pediatric primary care practices affiliated with a tertiary pediatric hospital. Growth-faltering was defined as height at the <5th percentile or a z-score decrease of ≥1.5 SDs before 18 months of age or ≥1 SD thereafter. For each child, height z score, age, gender, race, insurance, diagnostic tests, and subspecialist appointments were examined. RESULTS: Of 33 476 children, 3007 had growth-faltering (mean height: −1.5 ± 1.0 vs 0.3 ± 0.9 SDs in those without growth-faltering). Boys comprised 53% of the growth-faltering group (vs 51% of the nonfaltering group; P < .01). Among children with growth-faltering, 2.8% had endocrinology appointments (vs 0.8% of others; P < .0001) and 6% had gastroenterology appointments (vs 1.5% of others; P < .0001). Subspecialty care was not associated with gender. Pediatricians ordered diagnostic tests for a significantly greater proportion of children with growth-faltering than others. In multivariate analysis of height z score among children with growth-faltering, tests for chromosomes (1.4% of short girls vs 0.4% of short boys; P < .005) and growth hormone/insulin-like growth factor axis (0.9% of short girls vs 1.8% of short boys; P < .05) were associated with gender. Thirty-five percent of the girls for whom chromosome testing was performed were 12 years old or older. CONCLUSIONS: Patterns in diagnostic testing of children with growth-faltering by their pediatricians may lead to underdiagnosis of Turner syndrome and growth hormone deficiency among girls. PMID:21422085

  5. [Experience of medical backup of military parade on Red Square. Authors showed data about medical backup of military personnel taking part in the parade on Red Square dedicating to anniversary of victory in the Great Patriotic War].

    PubMed

    Malykh, A B; Iakovlev, S V; Valevskiĭ, V V

    2014-03-01

    Authors showed data about medical backup of military personnel taking part in the parade on Red Square dedicating to anniversary of Victory in the Great Patriotic War. Experience of running such events allowed to work out an algorithm for medical service: preparatory stage, training stage, running of parade, stage of move out to permanent base. During the parade on Red Square for medical care asked 18 people (participants of parade and civilians). Authors came to conclusion that as a result of medical backup of military personnel taking part in the parade no infectious and group diseases were registered.

  6. [Evaluation of disability pensions by a medical polyclinic: 1990-1995].

    PubMed

    Siegenthaler, M; Osterwalder, P; Vetter, W

    1998-10-21

    The question if and in what manner changes of the labour market, in first line increasing unemployment, may influence the composition of the collective demanding a disability pension on one hand and the diagnoses relevant for assessment of requests on the other hand have been investigated as well as possible influences on the criteria for assessments. To this end all expert reports elaborated by the Medical Outpatient Clinic of the University Hospital of Zürich and submitted to the disability insurance between 1990 and 1995 have been evaluated retrospectively. The results show that the fraction of men remained stable around 70% over the whole observation period. The number of persons employed in auxiliary functions remained also constantly high. Over the whole period of observation there was a high, growing percentage of foreign applicants. The most marked change during the observation period was a significant increase of unemployment in the collective. This increase particularly affected applicants with higher ranking jobs or persons over 50. Foreigners became an important part of the unemployed applicants. Rheumatoid disorders and "back pain" in particular were of increasing importance among the relevant diagnoses for assessment of disability. There was a significant decline in the extent of invalidity acknowledged in marked contrast to our initial expectation that the strictness of the applied criteria would weaken when confronted with an increasing number of applications. PMID:9844487

  7. Hospice and palliative medicine: curriculum evaluation and learner assessment in medical education.

    PubMed

    Sanchez-Reilly, Sandra; Ross, Jeanette S

    2012-01-01

    Major efforts have been pursued to improve palliative care education for physicians at all levels of their training. Such changes include the incorporation of palliative care curriculum and guidelines, an established process for competency-based evaluation and certification, faculty development, innovative educational experiences, the improvement of textbooks, and the establishment of accredited palliative medicine fellowships. Hospice and palliative medicine (HPM) has been clearly defined as a subspecialty and a crucial area of medical education. As innovative curricular approaches have become available to educate medical and other interprofessional trainees, this article aims to describe different models and methods applied in curriculum evaluation, tailoring such approaches to the field of palliative medicine. A stepwise process of curriculum development and evaluation is described, focusing on available curriculum evaluation competency-based tools for each level of learners. As HPM evolves and its educational programs grow, curriculum evaluation will provides invaluable feedback to institutions and programs in many ways. PMID:22268408

  8. Health care professionals’ pain narratives in hospitalized children’s medical records. Part 1: Pain descriptors

    PubMed Central

    Rashotte, Judy; Coburn, Geraldine; Harrison, Denise; Stevens, Bonnie J; Yamada, Janet; Abbott, Laura K

    2013-01-01

    BACKGROUND: Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children. OBJECTIVES: To describe health care professionals’ use of written language related to the quality and quantity of pain experienced by hospitalized children. METHODS: Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used. RESULTS: Pain narratives were documented a total of 5390 times in 1518 of the 3822 children’s medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (eg, vocal, motor, facial and activities cues), affective and physiological cues, and children’s descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers. CONCLUSIONS: The richness and complexity of vocabulary used by clinicians to document children’s pain lend support to the concept that the word ‘pain’ is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children’s pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals. PMID:24093122

  9. Legal Care as Part of Health Care: The Benefits of Medical-Legal Partnership.

    PubMed

    Murphy, Johnna S; Lawton, Ellen M; Sandel, Megan

    2015-10-01

    Many of the social determinants of health are rooted in legal problems. Medical-legal partnerships (MLPs) have the potential to positively change clinical systems. This change can be accomplished by integrating legal staff into health care clinics to educate staff and residents on social determinants of health and their legal origins. When the MLP team works directly with patients to identify and address legal needs that improve health outcomes, and incorporate legal insights and solutions into health care practice where the patient population is overwhelmingly impacted by social conditions, outcomes are beneficial to children and families.

  10. 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.

  11. 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.

  12. A clinical laboratory paradigm for evaluating medication effects on alcohol consumption: naltrexone and nalmefene.

    PubMed

    Drobes, David J; Anton, Raymond F; Thomas, Suzanne E; Voronin, Konstantin

    2003-04-01

    Opiate antagonist medications have been shown to improve alcoholism treatment, but few human laboratory-based studies investigating mechanisms for these effects have been conducted on alcohol dependent persons. The present study was designed to determine the impact of two opiate antagonists on alcohol consumption among nontreatment-seeking alcoholics (n=125) and social drinkers (n=90). Participants were randomly assigned to receive placebo, naltrexone (titrated to 50 mg/day), or nalmefene (titrated to 40 mg/day) for 8 days with an alcohol laboratory session on the final day. Alcohol consumption was monitored in the natural environment during the first 5 medication days, and during a choice consumption paradigm following a standard 'priming' alcohol dose in a bar-laboratory setting. Social drinkers consumed less alcohol than alcoholics during the prelab medication period and the laboratory choice consumption paradigm, and they attained lower blood alcohol levels than alcoholics following the priming drink. Both opiate antagonist medications equally reduced drinking amounts and frequency among alcoholics but not social drinkers, relative to placebo, during natural environment and bar-lab alcohol consumption evaluations. Greater medication side effects, mostly mild in nature, were observed in participants taking nalmefene. These findings demonstrate that both naltrexone and nalmefene can lead to reductions in alcohol consumption among alcoholics who are not attempting to reduce drinking. Similar laboratory paradigms may offer substantial advantages for observing these effects during evaluation of other medications as well.

  13. Current trends in medical ethics education in Japanese medical schools.

    PubMed

    Kurosu, Mitsuyasu

    2012-09-01

    The Japanese medical education program has radically improved during the last 10 years. In 1999, the Task Force Committee on Innovation of Medical Education for the 21st Century proposed a tutorial education system, a core curriculum, and a medical student evaluation system for clinical clerkship. In 2001, the Model Core Curriculum of medical education was instituted, in which medical ethics became part of the core material. Since 2005, a nationwide medical student evaluation system has been applied for entrance to clinical clerkship. Within the Japan Society for Medical Education, the Working Group of Medical Ethics proposed a medical ethics education curriculum in 2001. In line with this, the Japanese Association for Philosophical and Ethical Research in Medicine has begun to address the standardization of the curriculum of medical ethics. A medical philosophy curriculum should also be included in considering illness, health, life, death, the body, and human welfare.

  14. Sources of stress among emergency medical technicians (Part I): What does the research say?

    PubMed

    Boudreaux, E; Mandry, C

    1996-01-01

    Research repeatedly has demonstrated that organisms exhibit adaptive physiological, emotional, and behavioral responses when exposed to noxious or threatening environmental stimuli. However, when the noxious stimuli are excessive or prolonged, efforts to cope may become overwhelmed, and the adaptive responses can turn into maladaptive reactions (e.g., illness, depression, and impaired performance). According to this model of stress, people who work in occupations that continually place them in danger or repeatedly force them to encounter psychologically demanding or distressing situations would appear to be at greater risk for developing adverse stress reactions. Both anecdotal evidence and empirical research suggest that prehospital emergency medical services (EMS) may be a particularly high-stress field, placing emergency medical technicians (EMTs) at risk for developing such maladaptive stress reactions. This article reviews and synthesizes the empirical literature investigating the sources of stress among EMTs, and concludes with critical comments and guidelines for future research. The authors intend this review to be a resource for investigators conducting research in this area, as well as a convenient summary for anyone interested in learning more about the stressors EMTs experience, particularly mental health professionals and EMS administrators coordinating stress-management programs for EMTs.

  15. The view from the trenches: part 1-emergency medical response plans and the need for EPR screening.

    PubMed

    Gougelet, Robert M; Rea, Michael E; Nicolalde, Roberto J; Geiling, James A; Swartz, Harold M

    2010-02-01

    Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a "dirty bomb," hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, the authors propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities List (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provide a solid framework for this response. The effective screening of potentially-exposed victims directly following a nuclear attack could decrease the number of patients seeking immediate medical care by greater than 90%. PMID:20065673

  16. The View from the Trenches Part 1: Emergency Medical Response Plans and the Need for EPR Screening

    PubMed Central

    Gougelet, Robert M.; Rea, Michael E.; Nicolalde, Roberto J.; Geiling, James A.; Swartz, Harold M.

    2014-01-01

    Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a “dirty bomb,” hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, we propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities list (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provides a solid framework for this response. The effective screening of potentially exposed victims directly following a nuclear attack could potentially decrease the number of patients seeking immediate medical care by greater than 90%. PMID:20065673

  17. Medical grand rounds. West Virginia University Health Sciences Center. Bites and stings. Part 1. Spiders.

    PubMed

    Ullrich, I H

    1989-04-01

    Most animals can bite or sting. In narrowing the kingdom down to those that harm humans, the field still is vast. It would be interesting to explore the rich variety of pathology produced in us by moray eels, lionfish, sea urchins, jellyfish, sting rays, fire ants, kissing bugs, flies, lice, mosquitoes, ticks, mites, fleas, puss caterpillars, centipedes, snakes, dogs and cats, camels, and myriad other creatures including homo sapiens (not a trivial biter)--but for this grand rounds, the topic will simply be spiders (Part 1), bees and vespid (Part 2). Vespids are the wasps, yellow jackets and hornets.

  18. The right to die and physician-assisted suicide medical, legal, and ethical aspects (Part I).

    PubMed

    Wecht, C H

    1998-01-01

    Part 1 of this paper examines the issue of the "Right to Die", and its relationship to the discipline of Bioethics and the doctrine of Informed Consent. The discussion underlines the role and rights of the patient. A number of relevant judgments are quoted, with their implications. Part 2, to be published in our next issue, continues the discussion, with emphasis on the subject of physician-assisted suicide and the activities of Dr. Kevorkian. Further legal cases are quoted with relevant analysis, together with proposed legislation under the title "Death with Dignity". Finally, the author points to possible future developments in this controversial issue.

  19. [Concept, implementation and evaluation of an interfaculty Master of Medical Education Programme].

    PubMed

    Jünger, Jana; Fischer, Martin R; Duelli, Roman; Putz, Reinhard; Resch, Franz

    2008-01-01

    The implementation of new medical licensing regulations (AAppO 2003) was the starting point for radical curricular changes in all German medical schools. In 2004, the postgraduate and interfaculty Master of Medical Education (MME) degree programme was established at the University of Heidelberg under the auspices of the Medical Faculty Association (Medizinischer Fakultätentag, MFT) and supported by the Association for the Promotion of Science and Humanities in Germany (Stifterverband für die Deutsche Wissenschaft). This new degree programme is intended to train multipliers and leaders in medical education, to build a German-speaking network and to strengthen educational research. The eight one-week MME modules are organised by seven locations in Germany (Munich, Tuebingen, Muenster/Essen, Berlin, Heidelberg, Cologne, Dresden) and an annually changing international faculty. The instructor teams are composed of national and international experts. Major focal points include: curriculum development, education theory, teaching and exam methods, evaluations, team building and group dynamics, project management, leadership, and faculty development, as well as educational research. The modules are connected with each other longitudinally: each participant conducts a project to improve teaching in his or her own faculty and writes a master's thesis about an educational research project. Overall, the participants earn 60 ECTS (European Credit Transfer System) in the course of two years while working. So far 100 participants (25 per year) from 33 of 34 medical faculties have started the program and 19 participants (50% of the participants from Cohort 1, 29% of the participants from Cohort 2) completed the program. The evaluation of the individual modules showed a very high level of participant satisfaction. In two modules, the evaluation results demonstrated a need for change. In 2006, an external evaluation conducted by international experts positively highlighted the MME

  20. [Concept, implementation and evaluation of an interfaculty Master of Medical Education Programme].

    PubMed

    Jünger, Jana; Fischer, Martin R; Duelli, Roman; Putz, Reinhard; Resch, Franz

    2008-01-01

    The implementation of new medical licensing regulations (AAppO 2003) was the starting point for radical curricular changes in all German medical schools. In 2004, the postgraduate and interfaculty Master of Medical Education (MME) degree programme was established at the University of Heidelberg under the auspices of the Medical Faculty Association (Medizinischer Fakultätentag, MFT) and supported by the Association for the Promotion of Science and Humanities in Germany (Stifterverband für die Deutsche Wissenschaft). This new degree programme is intended to train multipliers and leaders in medical education, to build a German-speaking network and to strengthen educational research. The eight one-week MME modules are organised by seven locations in Germany (Munich, Tuebingen, Muenster/Essen, Berlin, Heidelberg, Cologne, Dresden) and an annually changing international faculty. The instructor teams are composed of national and international experts. Major focal points include: curriculum development, education theory, teaching and exam methods, evaluations, team building and group dynamics, project management, leadership, and faculty development, as well as educational research. The modules are connected with each other longitudinally: each participant conducts a project to improve teaching in his or her own faculty and writes a master's thesis about an educational research project. Overall, the participants earn 60 ECTS (European Credit Transfer System) in the course of two years while working. So far 100 participants (25 per year) from 33 of 34 medical faculties have started the program and 19 participants (50% of the participants from Cohort 1, 29% of the participants from Cohort 2) completed the program. The evaluation of the individual modules showed a very high level of participant satisfaction. In two modules, the evaluation results demonstrated a need for change. In 2006, an external evaluation conducted by international experts positively highlighted the MME

  1. Undergraduate medical education programme renewal: a longitudinal context, input, process and product evaluation study.

    PubMed

    Mirzazadeh, Azim; Gandomkar, Roghayeh; Hejri, Sara Mortaz; Hassanzadeh, Gholamreza; Koochak, Hamid Emadi; Golestani, Abolfazl; Jafarian, Ali; Jalili, Mohammad; Nayeri, Fatemeh; Saleh, Narges; Shahi, Farhad; Razavi, Seyed Hasan Emami

    2016-02-01

    The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education programme. The eight-year longitudinal evaluation study consisted of four phases compatible with the four components of the CIPP model. In the first phase, we explored the strengths and weaknesses of the traditional programme as well as contextual needs, assets, and resources. For the second phase, we proposed a model for the programme considering contextual features. During the process phase, we provided formative information for revisions and adjustments. Finally, in the fourth phase, we evaluated the outcomes of the new undergraduate medical education programme in the basic sciences phase. Information was collected from different sources such as medical students, faculty members, administrators, and graduates, using various qualitative and quantitative methods including focus groups, questionnaires, and performance measures. The CIPP model has the potential to guide policy makers to systematically collect evaluation data and to manage stakeholders' reactions at each stage of the reform in order to make informed decisions. However, the model may result in evaluation burden and fail to address some unplanned evaluation questions.

  2. Costs and Their Assessment to Users of a Medical Library, Part III: Allocating Fixed Joint Costs.

    ERIC Educational Resources Information Center

    Bres, E.; And Others

    Part III of the study describes a model for completing the cost assessment (justification) process by accounting for the fixed joint costs; a "fair" and equitable mechanism is developed in the context of game-theoretic approach. An n-person game is constructed in which the "players" are the institutions served by the library, but whose…

  3. Strategies for medical data extraction and presentation part 1: current limitations and deficiencies.

    PubMed

    Reiner, Bruce

    2015-04-01

    Data overload is a burgeoning challenge for the medical imaging community; with resulting technical, clinical, and economic ramifications. A primary concern for radiologists is the timely, efficient, and accurate extraction of imaging and clinical data, which collectively are essential in determining accurate diagnosis. In current practice, imaging data retrieval is limited by the fact that imaging and report data are de-coupled from one another, along with the non-standardized and often ambiguous free text data contained within narrative radiology reports. Clinical data retrieval is equally challenging and flawed by the lack of information system integration, paucity of clinical order entry data, and diminished role of the technologist in providing clinical data. These combined factors have the potential to adversely affect radiologist performance and clinical outcomes by diminishing workflow, report accuracy, and diagnostic confidence. New and innovative strategies are required to improve and automate data extraction and presentation, in a context- and user-specific fashion. PMID:25666903

  4. Drug Abuse Among Medical Students at a Nigerian University: Part 1. Prevalence and Pattern of Use

    PubMed Central

    Ihezue, U. H.

    1988-01-01

    Using a structured pro forma, 728 out of 775 medical undergraduates at a Nigerian university were surveyed for the prevalence and pattern of drug use. An operational definition of substance abuse was made, and 28 percent of students fell within that criterion. Male abusers (81 percent) exceeded female abusers (19 percent). Substances most commonly abused were alcohol (60 percent), minor tranquilizers (48 percent), tobacco (35 percent), and narcotics (29 percent), particularly codeine. Only 11 percent abused cannabis. While most students were polydrug users, there was a low frequency of daily drug use. A general lifetime (occasional use) prevalence of substance use of 56 percent was found. Drugs consumed on a daily basis were alcohol (2 percent) and tobacco (6 percent). The prevalence of drug use was highest among the fourth and final year students. The majority of students were occasional abusers; there was no evidence of physical dependence. PMID:3257527

  5. New strategies for medical data mining, part 3: automated workflow analysis and optimization.

    PubMed

    Reiner, Bruce

    2011-02-01

    The practice of evidence-based medicine calls for the creation of "best practice" guidelines, leading to improved clinical outcomes. One of the primary factors limiting evidence-based medicine in radiology today is the relative paucity of standardized databases. The creation of standardized medical imaging databases offer the potential to enhance radiologist workflow and diagnostic accuracy through objective data-driven analytics, which can be categorized in accordance with specific variables relating to the individual examination, patient, provider, and technology being used. In addition to this "global" database analysis, "individual" radiologist workflow can be analyzed through the integration of electronic auditing tools into the PACS. The combination of these individual and global analyses can ultimately identify best practice patterns, which can be adapted to the individual attributes of end users and ultimately used in the creation of automated evidence-based medicine workflow templates.

  6. [Medical and legal aspects of genital mutilation and circumcision part I: female genital mutilation (FGM)].

    PubMed

    Dettmeyer, Reinhard; Laux, Johannes; Friedl, Hannah; Zedler, Barbara; Bratzke, Hansjürgen; Parzeller, Markus

    2011-01-01

    Female genital mutilation (FGM) is considered to be against the law and against morality not only in Western countries, although a woman of age and able to consent may sometimes think differently. The procedure may have serious physical and emotional consequences for the girl or woman. Nevertheless there are attempts to justify the procedure with medical and hygienic pseudoarguments, ideology, freedom of religion, cultural identity and social adequacy. Outside the Western world, some people claim that religion and culture alone justify the practice. In Germany, parents can lose the right to determine the residence of their daughter, if she is faced with the risk of genital mutilation in order to prevent that the child or girl is taken to her home country. Genital mutilation as a gender-specific threat is recognized as a reason to grant asylum or prevent deportation. Proposals to make genital mutilation a separate punishable offence are presently discussed by the legislator.

  7. Drug abuse among medical students at a Nigerian university: Part 1. Prevalence and pattern of use.

    PubMed

    Ihezue, U H

    1988-01-01

    Using a structured pro forma, 728 out of 775 medical undergraduates at a Nigerian university were surveyed for the prevalence and pattern of drug use. An operational definition of substance abuse was made, and 28 percent of students fell within that criterion. Male abusers (81 percent) exceeded female abusers (19 percent). Substances most commonly abused were alcohol (60 percent), minor tranquilizers (48 percent), tobacco (35 percent), and narcotics (29 percent), particularly codeine. Only 11 percent abused cannabis. While most students were polydrug users, there was a low frequency of daily drug use. A general lifetime (occasional use) prevalence of substance use of 56 percent was found. Drugs consumed on a daily basis were alcohol (2 percent) and tobacco (6 percent). The prevalence of drug use was highest among the fourth and final year students. The majority of students were occasional abusers; there was no evidence of physical dependence. PMID:3257527

  8. Using ultrasound to teach anatomy in the undergraduate medical curriculum: an evaluation of the experiences of tutors and medical students

    PubMed Central

    2014-01-01

    This paper describes the experiences of staff and students at two UK medical schools, who introduced portable ultrasound (PU) as an imaging technology to deliver clinical anatomy teaching and to aid skill development in interpretation of cross-sectional anatomy (CSA). A sonographer contributed to curriculum design and teaching, but mostly anatomy tutors delivered the teaching. This case study method evaluates staff and student perspectives on the ultrasound-based anatomy teaching. Quantitative data and qualitative data were collected and analysed. Staff were positive about the experience. They described their expectations for students and solutions for practical issues regarding the teaching, but were concerned about their competency in scanning and wanted bespoke training for sonoanatomy teaching. Curriculum development was accelerated through engagement with a sonographer and an ultrasound champion. Students were extremely positive about their experience; they valued the expertise of a sonographer who taught more challenging sonoanatomy, but were equally positive regarding teaching sessions led by well-trained anatomy tutors who taught more simple sonoanatomy. Students affirmed most tutors’ expectations that ultrasound could reinforce existing anatomical knowledge, added clinical contextualisation, but not that use of ultrasound (US) assisted in interpreting CSA. Students valued the introduction to the technology and found sonoimage interpretation challenging, but not insurmountable. Students wanted more instruction on ultrasound physics, an expansion of ultrasound curriculum, with smaller groups and opportunities to scan volunteers. These data support the case for the use of PU to deliver anatomy teaching and to prime medical students for later clinical encounters with PU. PMID:27433233

  9. Ethical and professional considerations providing medical evaluation and care to refugee asylum seekers.

    PubMed

    Asgary, Ramin; Smith, Clyde L

    2013-01-01

    A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions.

  10. Potential medications for the treatment of alcohol use disorder: An evaluation of clinical efficacy and safety.

    PubMed

    Litten, Raye Z; Wilford, Bonnie B; Falk, Daniel E; Ryan, Megan L; Fertig, Joanne B

    2016-01-01

    Alcohol use disorder (AUD), as currently defined in the Diagnostic and Statistical Manual, 5th Edition (DSM-5), is a heterogeneous disorder stemming from a complex interaction of neurobiological, genetic, and environmental factors. As a result of this heterogeneity, there is no one treatment for AUD that will work for everyone. During the past 2 decades, efforts have been made to develop a menu of medications to give patients and clinicians more choices when seeking a therapy that is both effective and which has limited side effects. To date, 3 medications have been approved by the US Food and Drug Administration (FDA) to treat alcohol dependence: disulfiram, naltrexone, and acamprosate. In addition to these approved medications, researchers have identified new therapeutic targets and, as a result, a number of alternative medications are now being evaluated for treatment of AUD in human studies. Although not approved by the FDA for the treatment of AUD, in some cases, these alternative medications are being used off-label by clinicians for this purpose. These potential medications are reviewed here. They include nalmefene, varenicline, gabapentin, topiramate, zonisamide, baclofen, ondansetron, levetiracetam, quetiapine, aripiprazole, and serotonin reuptake inhibitors. The effectiveness of these medications has been mixed-some show good efficacy with side effects that are mild to moderate in intensity; others have mixed or promising results but are awaiting findings from ongoing studies; and still others show poor efficacy, despite promising preliminary results. Medications development remains a high priority. Key initiatives for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) include supporting the discovery and development of more effective and safer medications, advancing the field of personalized medicine, and forging public and private partnerships to investigate new and more effective compounds. PMID:26928397

  11. Potential medications for the treatment of alcohol use disorder: An evaluation of clinical efficacy and safety.

    PubMed

    Litten, Raye Z; Wilford, Bonnie B; Falk, Daniel E; Ryan, Megan L; Fertig, Joanne B

    2016-01-01

    Alcohol use disorder (AUD), as currently defined in the Diagnostic and Statistical Manual, 5th Edition (DSM-5), is a heterogeneous disorder stemming from a complex interaction of neurobiological, genetic, and environmental factors. As a result of this heterogeneity, there is no one treatment for AUD that will work for everyone. During the past 2 decades, efforts have been made to develop a menu of medications to give patients and clinicians more choices when seeking a therapy that is both effective and which has limited side effects. To date, 3 medications have been approved by the US Food and Drug Administration (FDA) to treat alcohol dependence: disulfiram, naltrexone, and acamprosate. In addition to these approved medications, researchers have identified new therapeutic targets and, as a result, a number of alternative medications are now being evaluated for treatment of AUD in human studies. Although not approved by the FDA for the treatment of AUD, in some cases, these alternative medications are being used off-label by clinicians for this purpose. These potential medications are reviewed here. They include nalmefene, varenicline, gabapentin, topiramate, zonisamide, baclofen, ondansetron, levetiracetam, quetiapine, aripiprazole, and serotonin reuptake inhibitors. The effectiveness of these medications has been mixed-some show good efficacy with side effects that are mild to moderate in intensity; others have mixed or promising results but are awaiting findings from ongoing studies; and still others show poor efficacy, despite promising preliminary results. Medications development remains a high priority. Key initiatives for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) include supporting the discovery and development of more effective and safer medications, advancing the field of personalized medicine, and forging public and private partnerships to investigate new and more effective compounds.

  12. A review of student evaluation of teaching: applications to veterinary medical education.

    PubMed

    Beran, Tanya N; Donnon, Tyrone; Hecker, Kent

    2012-01-01

    Student evaluation of teaching is ubiquitous to teaching in colleges and universities around the world. Since the implementation of student evaluations in the 1970s in the US, considerable research has been devoted to their appropriate use as a means of judging the effectiveness of teaching. The present article aims to (1) examine the evidence for the reliability, validity, and utility of student ratings; (2) provide seven guidelines for ways to identify effective instruction, given that the purpose of student evaluation is to assess effective teaching; and (3) conclude with recommendations for the integration of student ratings into the continuous evaluation of veterinary medical education.

  13. Discounting pain in the absence of medical evidence is explained by negative evaluation of the patient.

    PubMed

    De Ruddere, Lies; Goubert, Liesbet; Stevens, Michaël; de C Williams, Amanda C; Crombez, Geert

    2013-05-01

    This study investigated the effect on observer responses of the presence/absence of information about medical evidence for pain and psychosocial influences on the patient's pain experience. Additionally, the moderating role of the patient's pain expressions and the mediating role of the observer's belief in deception and evaluation of the patient was examined. Sixty-two participants were presented with videos of 4 patients, each accompanied by a vignette describing the presence or absence of both medical evidence for the pain and psychosocial influences on the patient's pain. Participants estimated patients' pain and rated their own sympathy and inclination to help; they re-estimated patients' pain when the patient's self-report of pain was provided. Finally, participants evaluated each patient as positive or negative and the likelihood that the patient was feigning pain. Participants gave lower ratings on pain, sympathy, and help when medical evidence was absent. Further, in the presence of psychosocial influences, participants took patients' self-reported pain less into account. Next, only for patients expressing high-intensity pain, information about both medical evidence and psychosocial influences was taken into account. Finally, the observer's evaluation of the patient and his/her belief in deception fully, respectively partially, explained the effect of medical evidence. The results indicate that discounting pain in the absence of medical evidence may involve negative evaluation of the patient. Further, the patient's pain expression is a moderating variable, and psychosocial influences negatively impact the degree to which patients' self-reports are taken into account. The results indicate that contextual information impacts observer responses to pain.

  14. Integrating and Evaluating Geriatrics in Medical School: A Novel Approach for the Challenge

    ERIC Educational Resources Information Center

    Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie

    2011-01-01

    Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…

  15. 49 CFR 391.47 - Resolution of conflicts of medical evaluation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... upon which the party making application relies in the form set out in 49 CFR 386.37. (9) The... U.S.C. 1801, et seq.); 49 CFR 1.48, 301.60) ... 49 Transportation 5 2014-10-01 2014-10-01 false Resolution of conflicts of medical evaluation....

  16. 49 CFR 391.47 - Resolution of conflicts of medical evaluation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... upon which the party making application relies in the form set out in 49 CFR 386.37. (9) The... (49 U.S.C. 1801, et seq.); 49 CFR 1.48, 301.60) ... 49 Transportation 5 2012-10-01 2012-10-01 false Resolution of conflicts of medical evaluation....

  17. Introduction: Feature Issue on Phantoms for the Performance Evaluation and Validation of Optical Medical Imaging Devices

    PubMed Central

    Hwang, Jeeseong; Ramella-Roman, Jessica C.; Nordstrom, Robert

    2012-01-01

    The editors introduce the Biomedical Optics Express feature issue on “Phantoms for the Performance Evaluation and Validation of Optical Medical Imaging Devices.” This topic was the focus of a technical workshop that was held on November 7–8, 2011, in Washington, D.C. The feature issue includes 13 contributions from workshop attendees. PMID:22741084

  18. Is Wikipedia a Reliable Learning Resource for Medical Students? Evaluating Respiratory Topics

    ERIC Educational Resources Information Center

    Azer, Samy A.

    2015-01-01

    The aim of the present study was to critically evaluate the accuracy and readability of English Wikipedia articles on the respiratory system and its disorders and whether they can be a suitable resource for medical students. On April 27, 2014, English Wikipedia was searched for articles on respiratory topics. Using a modified DISCERN instrument,…

  19. Baylor SBIRT Medical Residency Training Program: Model Description and Initial Evaluation

    ERIC Educational Resources Information Center

    Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.

    2012-01-01

    The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the…

  20. Evaluating Preclinical Medical Students by Using Computer-Based Problem-Solving Examinations.

    ERIC Educational Resources Information Center

    Stevens, Ronald H.; And Others

    1989-01-01

    A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)

  1. The Medical Evaluation of the Special Child: A Guide for Parents and Teachers. Monograph #24.

    ERIC Educational Resources Information Center

    Eddleton, Cindy

    This monograph describes the basic physical/neurological examination of children with special needs and how such an exam fits into the multidisciplinary evaluation and development of individualized programming for such children. The first section addresses the importance of the medical history. Next, the basic exam is described, followed by…

  2. Toward Diversity-Responsive Medical Education: Taking an Intersectionality-Based Approach to a Curriculum Evaluation

    ERIC Educational Resources Information Center

    Muntinga, M. E.; Krajenbrink, V. Q.; Peerdeman, S. M.; Croiset, G.; Verdonk, P.

    2016-01-01

    Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a "narrow" or a "broad" definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at…

  3. 76 FR 44086 - Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... claims for disability compensation or pension, including claims for benefits based on the need of a...' incapacity of self- support. VA uses the data to determine the level of disability. An agency may not conduct... AFFAIRS Agency Information Collection (Report of Medical Examination for Disability Evaluation)...

  4. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  5. An Evaluation of a Medical School Smoking Policy: A Student Research Project

    ERIC Educational Resources Information Center

    Decker, Jesse; Ronay, Ashley; Telfer, Megan; Becker, Craig M.; Cremeens, Jennifer; Swinker, Marian

    2012-01-01

    A medical school at a Southeastern university implemented a tobacco free policy to promote a healthy environment for its employees, patients, and visitors. Eighteen months post policy implementation, undergraduate students in the Department of Health Education and Promotion evaluated the satisfaction, awareness, and perceived…

  6. Fostering Student Adjustment to Medical School: Evaluation of One Innovative Curricular Approach.

    ERIC Educational Resources Information Center

    Dennis, Kay S.

    This study evaluated an innovative curriculum for first-year medical students which was designed to render the undergraduate curriculum more humanistic in socializing students into medicine. The Personal, Professional, and Leadership (PPL) development program provides guided, semi-structured opportunities to create "communities of learning" by…

  7. Clinical Problem Solving Exercises for Pre-Clinical Medical Education: A Design, Implementation and Preliminary Evaluation.

    ERIC Educational Resources Information Center

    Bordage, Georges

    Clinical problem solving exercises for preclinical medical education that were developed at Michigan State University School of Osteopathic Medicine are described. Two types of outcomes were set as priorities in the design and implementation of the problem solving sessions: small group peer interactions as instructional and evaluative resources;…

  8. End-user searching in a medical school curriculum: an evaluated modular approach.

    PubMed Central

    Bradigan, P S; Mularski, C A

    1989-01-01

    Librarians at the Ohio State University Health Sciences Library developed and taught a four-week elective minimodule on database searching to second-year medical students. The behavioral objectives, design, implementation, and formal evaluation of the program are described. The authors point out the need for a systematic means of assisting all future physicians to develop information retrieval and management skills. PMID:2676048

  9. An Evaluation of the Significance of Work-Related Influence Factors on Fitness and the Development of Medical and Orthopaedic Conditions in Military Executives

    PubMed Central

    Becker, Michael; Finze, Susanne; Holtherm, Christoph; Hinder, Jens; Lison, Andreas

    2016-01-01

    Occupational health promotion is an effective tool to improve the state of health of employees. As part of occupational health promotion in the German Bundeswehr, top-ranking military executives are offered a medical examination and training programme. Health-related data is collected as a basis for training and lifestyle counselling. This data was subjected to a retrospective evaluation in order to identify occupational risk factors and their correlation with cardiovascular resilience, trunk strength, and the development of orthopaedic and internal disorders. A total of 122 military executives (all male, age 54.6 ± 4.2 years) answered a questionnaire aimed at evaluating private and occupational stress factors. The medical history was followed by a medical and orthopaedic examination involving a lactate performance test (treadmill or bicycle ergometry) and an isometric trunk strength measurement. The data obtained was then statistically evaluated. For military executives, work-related travelling and commuting involve a high risk of medical and orthopaedic conditions. Regular exercise leads to improved fitness levels. In order to prevent medical problems, military executives working long hours should regularly take part in fitness and weight training under professional instructions. PMID:27774505

  10. How Medicare Part D Benefit Phases Affect Adherence with Evidence-Based Medications Following Acute Myocardial Infarction

    PubMed Central

    Stuart, Bruce; Davidoff, Amy; Erten, Mujde; Gottlieb, Stephen S; Dai, Mingliang; Shaffer, Thomas; Zuckerman, Ilene H; Simoni-Wastila, Linda; Bryant-Comstock, Lynda; Shenolikar, Rahul

    2013-01-01

    Objective. Assess impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction. Data Source. Random 5 percent sample of Medicare beneficiaries. Study Design. Difference-in-difference analysis of drug adherence by AMI patients stratified by low-income subsidy (LIS) status and benefit phase. Data Collection/Extraction Methods. Subjects were identified with an AMI diagnosis in Medicare Part A files between April 2006 and December 2007 and followed until December 2008 or death (N = 8,900). Adherence was measured as percent of days covered (PDC) per month with four drug classes used in AMI treatment: angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs), beta-blockers, statins, and clopidogrel. Monthly exposure to Part D benefit phases was calculated from flags on each Part D claim. Principal Findings. For non-LIS enrollees, transitioning from the initial coverage phase into the Part D coverage gap was associated with statistically significant reductions in mean PDC for all four drug classes: statins (−7.8 percent), clopidogrel (−7.0 percent), beta-blockers (−5.9 percent), and ACE inhibitor/ARBs (−5.1 percent). There were no significant changes in adherence associated with transitioning from the gap to the catastrophic coverage phase. Conclusions. As the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence. Those reliant on generic drugs are less likely to be affected. PMID:23742013

  11. Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores

    PubMed Central

    Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

    2016-01-01

    Background To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Methods Data from 392 admitted students in the graduating classes of 2010–2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson’s correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Results Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Conclusions Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1. PMID:27103953

  12. Prospective Evaluation of Cases of Discharge against Medical Advice in Abuja, Nigeria

    PubMed Central

    Anthonia, Obalim-Chris; Chinwe, Igwilo; Oluwafemi, Adewumi; Ganiyu, Aremu; Haroun, Adamu; Chinwe, Eziechila; Joshua, Aiyekomogbon

    2015-01-01

    Background. Discharge against medical advice (DAMA) is a global clinical phenomenon contributing significantly to adverse patients' outcome. Literatures abound on self-discharges in specific medical subpopulations. However, multidisciplinary studies on this subject in our region are few. Aim. To prospectively evaluate cases of DAMA in a wholesale multidisciplinary perspective at Federal Staff Medical Centre, Abuja, and suggest strategies to reduce it. Patients and Methods. All consecutive patients who DAMA from our medical centre between June 2013 and May 2014 were included in the study. Data harvested from the standard proforma were analyzed using IBM SPSS version 19.0. Results. We recorded an overall DAMA rate of 2.1%. The majority of the patients were paediatric cases (n = 63, 44.6%) while closed long bone fractures represented the leading diagnosis (n = 35, 24.8%). The most commonly cited reasons for leaving the hospital were financial constraints (n = 46, 32.6%) and seeking alternative therapy (n = 25, 17.7%). Conclusion. The DAMA rate in our study is comparable to some urban hospitals elsewhere. However, the leading reasons for this phenomenon are unacceptable in the current medical best practice. Thus, strengthening the Health Insurance Scheme, strict control of traditional medical practices, and focused health education are recommended strategies to reduce DAMA. PMID:25821850

  13. Evaluation of the antipsychotic medication review process at four long-term facilities in Alberta

    PubMed Central

    Birney, Arden; Charland, Paola; Cole, Mollie; Aslam Arain, Mubashir

    2016-01-01

    Purpose The goal of this evaluation was to understand how four long-term care (LTC) facilities in Alberta have implemented medication reviews for the Appropriate Use of Antipsychotics (AUA) initiative. We aimed to determine how interprofessional (IP) collaboration was incorporated in the antipsychotic medication reviews and how the reviews had been sustained. Methods Four LTC facilities in Alberta participated in this evaluation. We conducted semistructured interviews with 18 facility staff and observed one antipsychotic medication review at each facility. We analyzed data according to the following key components that we identified as relevant to the antipsychotic medication reviews: the structure of the reviews, IP interactions between the staff members, and strategies for sustaining the reviews. Results The duration of antipsychotic medication reviews ranged from 1 to 1.5 hours. The number of professions in attendance ranged from 3 to 9; a pharmacist led the review at two sites, while a registered nurse led the review at one site and a nurse practitioner at the remaining site. The number of residents discussed during the review ranged from 6 to 20. The process at some facilities was highly IP, demonstrating each of the six IP competencies. Other facilities conducted the review in a less IP manner due to challenges of physician involvement and staff workload, particularly of health care aides. Facilities that had an nurse practitioner on site were more efficient with the process of implementing recommendations resulting from the medication reviews. Conclusion The LTC facilities were successful in implementing the medication review process and the process seemed to be sustainable. A few challenges were observed in the implementation process at two facilities. IP practice moved forward the goals of the AUA initiative to reduce the inappropriate use of antipsychotics. PMID:27785044

  14. Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

    NASA Technical Reports Server (NTRS)

    Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy

    2010-01-01

    Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

  15. [The sociological evaluation of quality of medical care rendered to the patients with body overweight and obesity].

    PubMed

    Alekseeva, N S; Lobykina, E N; Salmina-Khvostova, O I

    2009-01-01

    The evaluation of quality of medical care rendered to the patients with body overweight and obesity was carried out in the conditions of curative preventive institution and private medical clinics on the municipal level. The study revealed the problems related to the organization of medical care provision to this category of patients addressing to the public medical institutions. The conclusion is made about the need of enhancing the actual system of medical care of patients with body overweight and obesity. It is rational to consider patients' opinion during the optimization of the available high quality medical care.

  16. Use of Preclinical Drug vs. Food Choice Procedures to Evaluate Candidate Medications for Cocaine Addiction

    PubMed Central

    Banks, Matthew L; Hutsell, Blake A; Schwienteck, Kathryn L; Negus, S. Stevens

    2015-01-01

    Opinion Statement Drug addiction is a disease that manifests as an inappropriate allocation of behavior towards the procurement and use of the abused substance and away from other behaviors that produce more adaptive reinforcers (e.g. exercise, work, family and social relationships). The goal of treating drug addiction is not only to decrease drug-maintained behaviors, but also to promote a reallocation of behavior towards alternative, nondrug reinforcers. Experimental procedures that offer concurrent access to both a drug reinforcer and an alternative, nondrug reinforcer provide a research tool for assessment of medication effects on drug choice and behavioral allocation. Choice procedures are currently the standard in human laboratory research on medications development. Preclinical choice procedures have been utilized in biomedical research since the early 1940’s, and during the last 10–15 years, their use for evaluation of medications to treat drug addiction has increased. We propose here that parallel use of choice procedures in preclinical and clinical studies will facilitate translational research on development of medications to treat cocaine addiction. In support of this proposition, a review of the literature suggests strong concordance between preclinical effectiveness of candidate medications to modify cocaine choice in nonhuman primates and rodents and clinical effectiveness of these medications to modify either cocaine choice in human laboratory studies or metrics of cocaine abuse in patients with cocaine use disorder. The strongest evidence for medication effectiveness in preclinical choice studies has been obtained with maintenance on the monoamine releaser d-amphetamine, a candidate agonist medication for cocaine use analogous to use of methadone to treat heroin abuse or nicotine formulations to treat tobacco dependence. PMID:26009706

  17. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

    PubMed Central

    Chien, Wai Tong; Yip, Annie LK

    2013-01-01

    During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients’ needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have recommended that a combination of treatment modalities be adopted to meet the complex health needs of people with schizophrenia spectrum disorders. In view of the heterogeneity of the

  18. Medical and social aspects of pregnancy among adolescents. Part II. Comparative study of abortions and deliveries.

    PubMed

    Rautanen, E; Kantero, R L; Widholm, O

    1977-01-01

    Socio-medical aspects concerning 193 pregnant patients under the age of 18 were analysed. Of these patients 131 had an interruption of the pregnancy and 62 gave birth to a baby. All the abortion patients were unmarried. The mean age in the abortion group was 16.8 years and in the delivery group 17.2 years. The girls of this study had their first experience of sexual intercourse very early, 32% under the age of 15. The frequency of complications after abortion was 18.5%. In the delivery group the prematurity and prenatal mortality were at least twice as great as in the general population. The girls who gave birth to their babies often came from lower social strata and the relationships in their families were more harmonious than in those who had had abortions. The birth of the baby or the decision to have an abortion is not accidental. The different behaviour patterns have a different background regarding both the personal and the environmental characteristics. The decision of the patient whether to abort or not was influenced by the attitude of the immediate family. The relations between family members were better in the homes of the girls who had a baby than in the homes of those who belonged to the abortion group. In both groups more than 40% of the subjects had suffered the risk of being emotionally deprived because of environmental conditions, including crowded housing and limited economic means. Almost all the subjects knew about the means of prevention, although they may not have had proper instruction and sufficient knowledge of their use. The services given by the goverment to adolescent pregnant patients are insufficient and require immediate attention by society.

  19. Evaluation of medical devices in thoracic radiograms in intensive care unit - time to pay attention!

    PubMed Central

    Moreira, Ana Sofia Linhares; Afonso, Maria da Graça Alves; Dinis, Mónica Ribeiro dos Santos Alves; dos Santos, Maria Cristina Granja Teixeira

    2016-01-01

    Objective To identify and evaluate the correct positioning of the most commonly used medical devices as visualized in thoracic radiograms of patients in the intensive care unit of our center. Methods A literature search was conducted for the criteria used to evaluate the correct positioning of medical devices on thoracic radiograms. All the thoracic radiograms performed in the intensive care unit of our center over an 18-month period were analyzed. All admissions in which at least one thoracic radiogram was performed in the intensive care unit and in which at least one medical device was identifiable in the thoracic radiogram were included. One radiogram per admission was selected for analysis. The radiograms were evaluated by an independent observer. Results Out of the 2,312 thoracic radiograms analyzed, 568 were included in this study. Several medical devices were identified, including monitoring leads, endotracheal and tracheostomy tubes, central venous catheters, pacemakers and prosthetic cardiac valves. Of the central venous catheters that were identified, 33.6% of the subclavian and 23.8% of the jugular were malpositioned. Of the endotracheal tubes, 19.9% were malpositioned, while all the tracheostomy tubes were correctly positioned. Conclusion Malpositioning of central venous catheters and endotracheal tubes is frequently identified in radiograms of patients in an intensive care unit. This is relevant because malpositioned devices may be related to adverse events. In future studies, an association between malpositioning and adverse events should be investigated. PMID:27737432

  20. Physical evaluation system to determine medical risk and indicated dental therapy modifications.

    PubMed

    McCarthy, F M; Malamed, S F

    1979-08-01

    The physical evaluation system allows the practitioner to rapidly classify each patient according to medical risk and thus to provide dental treatment comfortably and safely. The evaluation system serves as a guide to the level of dental therapy, deisions of management, and modification of treatment for the medically compromised patient. Extensive use of the ADA physical status classification system in dentistry would allow meaningful studies of morbidity and mortality that are related to various management protocols and could conceivably have an impact on insurance schedules associated with psychosedation modalities and general anethesia on an out patient basis. A physical evaluation system cannot substitute for knowledge and good judgment. Recommended categories of physical status and modification of treatment should not be considered as absolutes, but as guides. Wheras the guidelines may appear to be inflexible, they should not be considered as such. Deviation from recommendations is often justified and is expected.

  1. [Analysis of the medical and psychosocial evaluations required by the new public curator law].

    PubMed

    Nélisse, C; Uribé, I

    1992-01-01

    The new Public Curator Act systematically requires medical and psychosocial evaluations. In confronting the letter and the spirit of the law to its regulations and operating procedures (and inversely), this article outlines the various tasks that will fall under the responsibility of health and social service professionals. Following a brief presentation of the law, the authors describe how the role of these professionals is limited to evaluations for the purpose of conducting expert appraisements, a matter which raises a great deal of concern. In addition, the two key notions of "inaptitude" and "need" are discussed in their legal sense, along with their consequences from the medical evaluation and psychosocial standpoints. The latter in particular will be analyzed regarding implementation difficulties. The authors conclude with a general commentary that is likely to give meaning to that simple and sometimes routine gesture consisting of "completing a form".

  2. [Rapid antigen detection tests for diagnosis of group A streptococcal pharyngitis: comparative evaluation of sensitivity and practicability of 16 in vitro diagnostics medical devices performed in July 2002 by the French health products safety agency (Afssaps) as part of its market control mission].

    PubMed

    Charlier-Bret, N; Boucher, B; Poyart, C; Quesne, G; Bingen, E; Doit, C; Ho, C T; Deschênes, M; Maisonneuve, P

    2004-10-01

    Within the scope of its health products control mission, the French Health Products Safety Agency (Afssaps) collaborating with two expert's sites, has assessed the 16 tests available on the French market in 2002 for rapid diagnosis of the Streptococcus A tonsillitis. The purpose of this study was to verify the reliability and rapidity of these tests and to give some information to the users about their analytical criteria and practicability characteristics. The analytical study has been performed on a same panel of four reference strains of Streptococcus pyogenes dilutions to determine the limit of detection of all the reagents in the same condition of methodology. The limit of detection has been calculated with the results expressed in colony forming unit by ml (CFU/ml). The practicability study has permitted to analyze the quality of the presentation, the easiness of the final reading and of performing tests. A score has been established for each rapid test. A classification of the analytical sensitivity (limit of detection) and practicability (score) of these 16 devices has been established. The limit of detection of the reagents giving the best results allows the detection of the lowest bacterial concentration of the panel which is 10(5) CFU/ml. Regarding practicability, the results suggest that, the immunochromatographic strip methods have the best score in a view with the use by a non medical laboratory. PMID:15465261

  3. An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

    NASA Technical Reports Server (NTRS)

    Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

    2003-01-01

    Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS

  4. Evaluation of the personalized bar-code identification card to verify high-risk, high-alert medications.

    PubMed

    Thomas, Maria

    2013-09-01

    An effective intervention to decrease medication errors related to high-risk, high-alert medications is to implement double checks and second verification using the five rights of medication administration. To evaluate the effectiveness and use of the Personalized Bar-Code Identification card in verifying high-risk, high-alert medications, the High-Risk, High-Alert Medication Verification Audit Tool was used to collect data from the medical records of patients who received high-risk, high-alert medications in four ICUs. Data were collected for administered high-risk, high-alert medication, primary registered nurses who administered the high-risk, high-alert medication, and secondary registered nurses who verified the medication. The percentage of medications that were "not verified," "Personalized Bar-Code Identification verified," and "verified" using a method other than the Personalized Bar-Code Identification was calculated and compared using Z tests for two proportions. The percentage of Personalized Bar-Code Identification-verified medications (83.5%) was significantly higher than the percentage of medications that were not verified (10.9%) (Z = 38.43, P < .05). Also, the difference between the proportion of the Personalized Bar-Code Identification-verified medications and those that were verified using another method (5.6%) was significant (Z = 41.42, P < .05). The results show that nurses generally tend to follow the standardized procedure for verifying high-risk, high-alert medications in the four ICUs.

  5. Recommendations for the medical evaluation of children prior to adoption in South Africa.

    PubMed

    Haeri Mazanderani, Ahmad F; du Plessis, Nicolette M; Lumb, Janet; Feucht, Ute D; Myburgh, Marcelle; Mayaphi, Simnikiwe H; Lekalakala, Molebogeng R; Swanepoel, De Wet; Georgakis, Hellen; Avenant, Theunis

    2014-06-19

    The current legislative framework in South Africa (SA) supports adoption as the preferred form of care for children with inadequate or no parental or family support. There are an estimated 3.8 million orphans in SA, with approximately 1.5 - 2 million children considered adoptable. As a means of improving services, newly drafted adoption guidelines from the National Department of Social Development will in future require both non-profit and private sector adoption agencies to obtain a medical report on a child prior to placement. However, no local guidelines specify what an appropriate medical examination entails or how it should be reported. For the purposes of proposing and developing such guidelines, an open forum was convened at the Institute of Pathology, University of Pretoria, in March 2013. These 'Recommendations for the medical evaluation of children prior to adoption in South Africa' emanate from this meeting.

  6. Evaluation of a Meta-1-based automatic indexing method for medical documents.

    PubMed

    Wagner, M M; Cooper, G F

    1992-08-01

    This paper describes MetaIndex, an automatic indexing program that creates symbolic representations of documents for the purpose of document retrieval. MetaIndex uses a simple transition network parser to recognize a language that is derived from the set of main concepts in the Unified Medical Language System Metathesaurus (Meta-1). MetaIndex uses a hierarchy of medical concepts, also derived from Meta-1, to represent the content of documents. The goal of this approach is to improve document retrieval performance by better representation of documents. An evaluation method is described, and the performance of MetaIndex on the task of indexing the Slice of Life medical image collection is reported.

  7. Economic Evaluation of Endoscopic Sinus Surgery versus Continued Medical Therapy for Refractory Chronic Rhinosinusitis

    PubMed Central

    Rudmik, Luke; Soler, Zachary M.; Mace, Jess C.; Schlosser, Rodney J.; Smith, Timothy L.

    2014-01-01

    Objective To evaluate the long-term cost-effectiveness of endoscopic sinus surgery (ESS) compared to continued medical therapy for patients with refractory chronic rhinosinusitis (CRS). Study Design Cohort-style Markov decision tree economic evaluation Methods The economic perspective was the US third party payer with a 30 year time horizon. The two comparative treatment strategies were: 1) ESS followed by appropriate postoperative medical therapy and 2) continued medical therapy alone. Primary outcome was the incremental cost per quality adjusted life year (QALY). Costs were discounted at a rate of 3.5% in the reference case. Multiple sensitivity analyses were performed including differing time-horizons, discounting scenarios, and a probabilistic sensitivity analysis (PSA). Results The reference case demonstrated that the ESS strategy cost a total of $48,838.38 and produced a total of 20.50 QALYs. The medical therapy alone strategy cost a total of $28,948.98 and produced a total of 17.13 QALYs. The incremental cost effectiveness ratio (ICER) for ESS versus medical therapy alone is $5,901.90 per QALY. The cost-effectiveness acceptability curve from the PSA demonstrated that there is 74% certainty that the ESS strategy is the most cost-effective decision for any willingness to pay threshold greater then $25,000. The time horizon analysis suggests that ESS becomes the cost-effective intervention within the 3rd year after surgery. Conclusion Results from this study suggest that employing an ESS treatment strategy is the most cost-effective intervention compared to continued medical therapy alone for the long-term management of patients with refractory CRS. PMID:25186499

  8. Retrospective evaluation of undergraduate medical education by doctors at the end of their residency time in hospitals: consequences for the anatomical curriculum.

    PubMed

    Pabst, R; Rothkötter, H J

    1997-12-01

    Reform of the undergraduate medical curriculum, including the debate on which of its parts or subjects are superfluous, is a topic of interest in many countries. On being examined at the end of their specialization period, doctors were asked to grade the relevance of all subjects in the undergraduate curriculum for training to become a medical doctor. The subjects that gained the highest grades were internal medicine, gross anatomy, physical examination course, physiology, and pharmacology. The five subjects graded least relevant were biomathematics, terminology, social medicine, medical physics, and medical chemistry. More than 80% of the doctors expressed interest in special lectures and courses, e.g., in topographic anatomy at the beginning of their postgraduate training. Retrospective evaluations at the end of residency time are helpful "evidence" to be considered in reforming the medical curriculum, and in particular in defining "core" and "optional" parts of the curriculum. The data show that anatomy is graded as highly relevant in the undergraduate medical curriculum by doctors at the end of their postgraduate training.

  9. A Statistical Evaluation of the Diagnostic Performance of MEDAS-The Medical Emergency Decision Assistance System

    PubMed Central

    Georgakis, D. Christine; Trace, David A.; Naeymi-Rad, Frank; Evens, Martha

    1990-01-01

    Medical expert systems require comprehensive evaluation of their diagnostic accuracy. The usefulness of these systems is limited without established evaluation methods. We propose a new methodology for evaluating the diagnostic accuracy and the predictive capacity of a medical expert system. We have adapted to the medical domain measures that have been used in the social sciences to examine the performance of human experts in the decision making process. Thus, in addition to the standard summary measures, we use measures of agreement and disagreement, and Goodman and Kruskal's λ and τ measures of predictive association. This methodology is illustrated by a detailed retrospective evaluation of the diagnostic accuracy of the MEDAS system. In a study using 270 patients admitted to the North Chicago Veterans Administration Hospital, diagnoses produced by MEDAS are compared with the discharge diagnoses of the attending physicians. The results of the analysis confirm the high diagnostic accuracy and predictive capacity of the MEDAS system. Overall, the agreement of the MEDAS system with the “gold standard” diagnosis of the attending physician has reached a 90% level.

  10. Community Characteristics Associated With Seeking Medical Evaluation for Suspected Child Sexual Abuse in Greater Houston.

    PubMed

    Greeley, Christopher Spencer; Chuo, Ching-Yi; Kwak, Min Ji; Henin, Sally S; Donnaruma-Kwoh, Marcella; Ferrell, Jamie; Giardino, Angelo Peter

    2016-06-01

    Child sexual abuse (CSA) affects over 62,000 children annually in the United States. A primary obstacle to the success of a public health prevention strategy is the lack of knowledge around community level risk factors for CSA. We evaluated community level characteristics for children seeking care for suspected CSA in the Greater Houston area for 2009. There was a total incidence rate of medical evaluations for suspected CSA of 5.9/1000 children. We abstracted the medical charts of 1982 (86 %) children who sought a medical evaluation for suspected CSA at three main medical systems in the Greater Houston area for 2009. We evaluated 18 community level variables from the American Community Survey for the 396 zip codes these children lived in. The mean number of cases per Greater Houston zip code was 2.77 (range 0-27), with 62 % of zip codes not having a case at any of the three sites surveyed. Zip codes with a higher than Houston average rate of vacant houses, never married females and unemployed labor force with high family poverty rate, were associated with an increased rate of children seeking care for suspected CSA. We demonstrated zip codes level characteristics which were associated with an increased rate of children seeking care for suspected CSA. Our modelling process and our data have implications for community based strategies aimed at improved surveillance or prevention of CSA. The process of identifying locally specific community level factors suggests target areas which have particular socioeconomic characteristics which are associated with increased rate of seeking CSA evaluations. PMID:26803840

  11. Dietary Supplements and Health Aids - A Critical Evaluation Part 2 - Macronutrients and Fiber.

    ERIC Educational Resources Information Center

    Dubick, Michael A.

    1983-01-01

    Part 1 of this evaluation of dietary supplements and health aids (SE 533 788) focused on various therapeutic claims made for vitamins and minerals. This part examines health-promoting claims made for selected macronutrients and fiber. Macronutrients examined include selected proteins, amino acids, enzymes, carbohydrates, and lipids. (JN)

  12. How do you deliver a good obstetrician? Outcome-based evaluation of medical education.

    PubMed

    Asch, David A; Nicholson, Sean; Srinivas, Sindhu K; Herrin, Jeph; Epstein, Andrew J

    2014-01-01

    The goal of medical education is the production of a workforce capable of improving the health and health care of patients and populations, but it is hard to use a goal that lofty, that broad, and that distant as a standard against which to judge the success of schools or training programs or particular elements within them. For that reason, the evaluation of medical education often focuses on elements of its structure and process, or on the assessment of competencies that could be considered intermediate outcomes. These measures are more practical because they are easier to collect, and they are valuable when they reflect activities in important positions along the pathway to clinical outcomes. But they are all substitutes for measuring whether educational efforts produce doctors who take good care of patients.The authors argue that the evaluation of medical education can become more closely tethered to the clinical outcomes medical education aims to achieve. They focus on a specific clinical outcome-maternal complications of obstetrical delivery-and show how examining various observable elements of physicians' training and experience helps reveal which of those elements lead to better outcomes. Does it matter where obstetricians trained? Does it matter how much experience they have? Does it matter how good they were to start? Each of these questions reflects a component of the production of a good obstetrician and, most important, defines a good obstetrician as one whose patients in the end do well.

  13. Web tools for effective retrieval, visualization, and evaluation of cardiology medical images and records

    NASA Astrophysics Data System (ADS)

    Masseroli, Marco; Pinciroli, Francesco

    2000-12-01

    To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.

  14. Evaluation and diagnosis of the hair loss patient: part I. History and clinical examination.

    PubMed

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

    2014-09-01

    Hair loss (alopecia) is a common problem and is often a major source of distress for patients. The differential diagnosis of alopecia includes both scarring and nonscarring alopecias. In addition, many hair shaft disorders can produce hair shaft fragility, resulting in different patterns of alopecia. Therefore, an organized and systematic approach is needed to accurately address patients' complaints to achieve the correct diagnosis. Part 1 of this 2-part continuing medical education article on alopecia describes history taking and the clinical examination of different hair loss disorders. It also provides an algorithmic diagnostic approach based on the most recent knowledge about different types of alopecia. PMID:25128118

  15. Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON§ Project

    PubMed Central

    Peloso, Paul M; Khan, Mahweesh; Gross, Anita R; Carlesso, Lisa; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C; Walton, Dave; Goldsmith, Charlie H; Langevin, Pierre; Shi, Qiyun

    2013-01-01

    Objectives: To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain. Search Strategy: Computerized databases and grey literature were searched from 2006 to 2012. Selection Criteria: Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review. Main Results: We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions: While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain. PMID:24155805

  16. [Biomechanical study of medical hard tissue adhesive bonding butterfly fracture fragment in middle part of fresh human tibia].

    PubMed

    Lu, Bo; Tu, Zhongqi; Pei, Fuxing; Chen, Mengshi; Liu, Lei

    2004-06-01

    A medical hard tissue adhesive, octyl-a-cyanoacrylate, was tested in 6 fresh human tibiae. A 90 degrees butter-fly fracture fragment was made in the middle part of tibia by bandsaw. The compressive stress, torsional stress and angular deflection were assessed before and after osteoectomy respectively. After adhesive bonding, the compressive stress, torsional stress and angular deflection were tested again. The butterfly fracture fagment decreased the bending strength, torsion strength, yielding strength of tibia bone. In torsion test, the torque of tibia before osteoectomy is greater than bonded tibia, the bonded tibia is greater than that of the unbonded tibia. In compression test, before adhesive bonding broken, the compressive curve slope of tibia before osteoectomy is greater than that of bonded tibia, the bonded tibia is greater than that of the unbonded tibia. In angular deflection test before adhesive bonding of broken,the curve slope of tibia before osteoectomy is not different from that of bonded tibia (P>0.05), the slope the bonded tibia is greater than the slope of unbonded tibia(P<0.05). The elastic modulus, rigidity coefficient and moment of area inertia show no statistical difference between the bonded tibia and intact tibia. The used of medical hard tissue adhesive to bond the fracture fragment could improve the bending strength, torsion strength, yielding strength of tibia bone. In operation, it can reduce the soft tissue injury when the fracture fragment is being fixed, and this will benefit bone healing.

  17. [Experiences and recommendations of the German Federal Institute for Drugs and Medical Devices (BfArM) concerning clinical investigation of medical devices and the evaluation of serious adverse events (SAE)].

    PubMed

    Renisch, B; Lauer, W

    2014-12-01

    An integral part of the conformity assessment process for medical devices is a clinical evaluation based on clinical data. Particularly in the case of implantable devices and products of risk class III clinical trials must be performed. Since March 2010 applications for the authorization of clinical trials as well as for the waiver of the authorization requirement must be submitted centrally in Germany to the appropriate federal authority, the Federal Institute for Drugs and Medical Devices (BfArM) or the Paul Ehrlich Institute (PEI). In addition to authorization, approval by the responsible ethics committee is also required under law in order to begin clinical testing of medical devices in Germany. In this paper, the legal framework for the clinical testing of medical devices as well as those involved and possible procedures including evaluation criteria for the initial application of a trial and subsequent amendments are presented in detail. In addition, the reporting requirements for serious adverse events (SAEs) are explained and possible consequences of the evaluation are presented. Finally, a summary of application and registration numbers for all areas of extensive experience of the BfArM as well as requests and guidance for applicants are presented.

  18. Toward diversity-responsive medical education: taking an intersectionality-based approach to a curriculum evaluation.

    PubMed

    Muntinga, M E; Krajenbrink, V Q E; Peerdeman, S M; Croiset, G; Verdonk, P

    2016-08-01

    Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a 'narrow' or a 'broad' definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at using an intersectionality-based approach to define diversity-related learning objectives and to evaluate how biomedical and sociocultural aspects of diversity were integrated into a medical curriculum in the Netherlands. We took a three-phase mixed methods approach. In phase one and two, we defined essential learning objectives based on qualitative interviews with school stakeholders and diversity literature. In phase three, we screened the written curriculum for diversity content (culture, sex/gender and class) and related the results to learning objectives defined in phase two. We identified learning objectives in three areas of education (medical knowledge and skills, patient-physician communication, and reflexivity). Most diversity content pertained to biomedical knowledge and skills. Limited attention was paid to sociocultural issues as determinants of health and healthcare use. Intersections of culture, sex/gender and class remained mostly unaddressed. The curriculum's diversity-responsiveness could be improved by an operationalization of diversity that goes beyond biomedical traits of assumed homogeneous social groups. Future efforts to take an intersectionality-based approach to curriculum evaluations should include categories of difference other than culture, sex/gender and class as separate, equally important patient identities or groups. PMID:26603884

  19. Evaluating the role of gigabit speed wide-area networks in remote medical treatment

    NASA Astrophysics Data System (ADS)

    Tohme, Walid G.; Rodgers, James E.; Mun, Seong K.; Freedman, Matthew T.; Hansen, Mark; Cook, Jay F.; Popescu, George; Yun, David Y.; Garcia, Hong-Mei C.

    1995-05-01

    This paper assesses the utility of gigabit speed wide-area networks such as the ACTS (Advanced Communication Technology Satellite) in enabling the delivery of medical expertise and service to remote regions, providing radiation treatment planning with access to supercomputers, and conducting workload redistribution. The first part of this multi- institutional effort between the University of Hawaii, Georgetown University Medical Center (GUMC) and the Ohio Supercomputer Center (OSC) uses a T1-VSAT (very small aperture terminal) for transmitting teleradiology images. The second part of the project uses high data rate (HDR) communications through the ACTS satellite at OC-3 transmission speeds (155 Mbps). This allows 3-D volume rendering of radiation therapy planning images between GUMC and OSC as well as the transmission of high-volume teleradiology loads between Tripler Army Medical Center (TAMC) and GUMC. It is shown that while the bandwidth required to perform 3D interactive radiation treatment planning is around 300 Mbps, OC-3 rates can be adequate. Another important application is workload redistribution either for hospitals that need to reroute a certain percentage of their workload to other institutions of the same magnitude but with different subspecialties or for peak workload leveling. This paper shows that gigabit speed wide area networks such as the ACTS-HDR network are required in order to achieve effective remote treatment planning as well as high volume teleradiology for workload redistribution.

  20. Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings

    PubMed Central

    Goldbach, Hayley; Chang, Aileen Y; Kyer, Andrea; Ketshogileng, Dineo; Taylor, Lynne; Chandra, Amit; Dacso, Matthew; Kung, Shiang-Ju; Rijken, Taatske; Fontelo, Paul; Littman-Quinn, Ryan; Seymour, Anne K; Kovarik, Carrie L

    2014-01-01

    Objective Many mobile phone resources have been developed to increase access to health education in the developing world, yet few studies have compared these resources or quantified their performance in a resource-limited setting. This study aims to compare the performance of resident physicians in answering clinical scenarios using PubMed abstracts accessed via the PubMed for Handhelds (PubMed4Hh) website versus medical/drug reference applications (Medical Apps) accessed via software on the mobile phone. Methods A two-arm comparative study with crossover design was conducted. Subjects, who were resident physicians at the University of Botswana, completed eight scenarios, each with multi-part questions. The primary outcome was a grade for each question. The primary independent variable was the intervention arm and other independent variables included residency and question. Results Within each question type there were significant differences in ‘percentage correct’ between Medical Apps and PubMed4Hh for three of the six types of questions: drug-related, diagnosis/definitions, and treatment/management. Within each of these question types, Medical Apps had a higher percentage of fully correct responses than PubMed4Hh (63% vs 13%, 33% vs 12%, and 41% vs 13%, respectively). PubMed4Hh performed better for epidemiologic questions. Conclusions While mobile access to primary literature remains important and serves an information niche, mobile applications with condensed content may be more appropriate for point-of-care information needs. Further research is required to examine the specific information needs of clinicians in resource-limited settings and to evaluate the appropriateness of current resources in bridging location- and context-specific information gaps. PMID:23535665

  1. What makes a top research medical school? A call for a new model to evaluate academic physicians and medical school performance.

    PubMed

    Goldstein, Matthew J; Lunn, Mitchell R; Peng, Lily

    2015-05-01

    Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out. As a result, the analysis performed by U.S. News & World Report (USN&WR) has become the default tool to compare U.S. medical schools. Medical educators must explore more rigorous and equitable approaches to analyze and understand the performance of medical schools. In particular, a better understanding and more thorough evaluation of the most successful institutions in producing academic physicians with biomedical research careers are needed. In this Perspective, the authors present a new model to evaluate medical schools' production of academic physicians who advance medicine through basic, clinical, translational, and implementation science research. This model is based on relevant and accessible objective criteria that should replace the subjective criteria used in the current USN&WR rankings system. By fostering a national discussion about the most meaningful criteria that should be measured and reported, the authors hope to increase transparency of assessment standards and ultimately improve educational quality.

  2. What makes a top research medical school? A call for a new model to evaluate academic physicians and medical school performance.

    PubMed

    Goldstein, Matthew J; Lunn, Mitchell R; Peng, Lily

    2015-05-01

    Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out. As a result, the analysis performed by U.S. News & World Report (USN&WR) has become the default tool to compare U.S. medical schools. Medical educators must explore more rigorous and equitable approaches to analyze and understand the performance of medical schools. In particular, a better understanding and more thorough evaluation of the most successful institutions in producing academic physicians with biomedical research careers are needed. In this Perspective, the authors present a new model to evaluate medical schools' production of academic physicians who advance medicine through basic, clinical, translational, and implementation science research. This model is based on relevant and accessible objective criteria that should replace the subjective criteria used in the current USN&WR rankings system. By fostering a national discussion about the most meaningful criteria that should be measured and reported, the authors hope to increase transparency of assessment standards and ultimately improve educational quality. PMID:25607941

  3. 20 CFR 416.969 - Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter. 416.969 Section 416.969 Employees' Benefits SOCIAL... appendix 2 of subpart P of part 404 of this chapter. The Dictionary of Occupational Titles...

  4. Evaluating digital libraries in the health sector. Part 1: measuring inputs and outputs.

    PubMed

    Cullen, Rowena

    2003-12-01

    This is the first part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. In this first part, some approaches to evaluation that have been proposed for mainstream digital information services are examined for their suitability to provide models for the health sector. The paper summarizes some major national and collaborative initiatives to develop measures for digital libraries, and analyses these approaches in terms of their relationship to traditional measures of library performance, which are focused on inputs and outputs, and their relevance to current debates among health information specialists. The second part* looks more specifically at evaluative models based on outcomes, and models being developed in the health sector.

  5. Evaluating digital libraries in the health sector. Part 2: measuring impacts and outcomes.

    PubMed

    Cullen, Rowena

    2004-03-01

    This is the second part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. Part 1 focuses on approaches to evaluation that have been proposed for mainstream digital information services. This paper investigates evaluative models developed for some innovative digital library projects, and some major national and international electronic health information projects. The value of ethnographic methods to provide qualitative data to explore outcomes, adding to quantitative approaches based on inputs and outputs is discussed. The paper concludes that new 'post-positivist' models of evaluation are needed to cover all the dimensions of the digital library in the health sector, and some ways of doing this are outlined.

  6. New library buildings. Part VIII. The Library of the Health Sciences, University of Illinois at the Medical Center, Chicago.

    PubMed Central

    Theall, J N; Pizer, I H

    1976-01-01

    The new Library of the Health Sciences at the University of Illinois at the Medical Center is described and illustrated. The building was under construction for thirteen months, using phased construction techniques, and opened in October 1973. The library is a self-contained and physically independent building consisting of three levels above ground and one lower level, comprising an area of 130,000 sq. ft. gross and 88,000 sq. ft. net. The building provides space for 350,000 volumes, 1,037 readers, and a staff of 100. The cost of construction was $5,140,500 plus $858,500 for furnishings and equipment. Among the special features are a twenty-four-hour multimedia services department and a full-circulating style book detection system. Included in the article is an evaluation of the library after two years of occupancy. Images PMID:974296

  7. Evaluating medical marijuana dispensary policies: spatial methods for the study of environmentally-based interventions.

    PubMed

    Freisthler, Bridget; Kepple, Nancy J; Sims, Revel; Martin, Scott E

    2013-03-01

    In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1,000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries.

  8. Evaluating Medical Marijuana Dispensary Policies: Spatial Methods for the Study of Environmentally-Based Interventions

    PubMed Central

    Freisthler, Bridget; Kepple, Nancy J.; Sims, Revel; Martin, Scott E.

    2013-01-01

    In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries. PMID:22821130

  9. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed Central

    Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

    2002-01-01

    Medical practice today, more than ever before, places greater demands on physicians to see more patients, provide more complex medical services and adhere to stricter regulatory rules, leaving little time for coding and billing. Yet, the need to adequately document medical records, appropriately apply billing codes and accurately charge insurers for medical services is essential to the medical practice's financial condition. Many physicians rely on office staff and billing companies to process their medical bills without ever reviewing the bills before they are submitted for payment. Some physicians may not be receiving the payment they deserve when they do not sufficiently oversee the medical practice's coding and billing patterns. This article emphasizes the importance of monitoring and auditing medical record documentation and coding application as a strategy for achieving compliance and reducing billing errors. When medical bills are submitted with missing and incorrect information, they may result in unpaid claims and loss of revenue to physicians. Addressing Medical Audits, Part I--A Strategy for Achieving Compliance--CMS, JCAHO, NCQA, published January 2002 in the Journal of the National Medical Association, stressed the importance of preparing the medical practice for audits. The article highlighted steps the medical practice can take to prepare for audits and presented examples of guidelines used by regulatory agencies to conduct both medical and financial audits. The Medicare Integrity Program was cited as an example of guidelines used by regulators to identify coding errors during an audit and deny payment to providers when improper billing occurs. For each denied claim, payments owed to the medical practice are are also denied. Health care is, no doubt, a costly endeavor for health care providers, consumers and insurers. The potential risk to physicians for improper billing may include loss of revenue, fraud investigations, financial sanction

  10. Dizziness in the older adult, Part 1. Evaluation and general treatment strategies.

    PubMed

    Eaton, Deborah A; Roland, Peter S

    2003-04-01

    Dizziness is one of the most common complaints among patients age 50 and older who present to primary care physicians. The evaluation of dizziness is challenging due to the wide range of diagnostic possibilities, including four symptom categories each with multiple potential underlying causes. Although each cause has specific treatment options, general management strategies can be applied to all patients presenting with dizziness. These strategies include use of medications to control acute vestibular and autonomic symptoms as well as vestibular rehabilitation exercises. Difficult cases that do not respond to treatment efforts should be referred to an otolaryngologist for further evaluation and treatment. PMID:12708153

  11. Evaluation of a personal and professional development module in an undergraduate medical curriculum in India

    PubMed Central

    Komattil, Ramnarayan; Hande, Shyamala Handattu; Mohammed, Ciraj Ali; Subramaniam, Barathi

    2016-01-01

    The study aimed at evaluating the personal and professional development (PPD) module in the undergraduate medical curriculum in Melaka Manipal Medical College, India. PPD hours were incorporated in the curriculum. A team of faculty members and a faculty coordinator identified relevant topics and students were introduced to topics such as medical humanities, leadership skills, communication skills, ethics, professional behavior, and patient narratives. The module was evaluated using a prevalidated course feedback questionnaire which was administered to three consecutive batches of students from March 2011 to March 2013. To analyze faculty perspectives, one to one in-depth interviews and focus group discussions were conducted by the coordinators with faculty members who conducted the PPD classes. Analysis of the course feedback form revealed that majority (80%) of students agreed that the module was well prepared and was "highly relevant" to the profession. Faculty found the topics new and interdisciplinary and there was a sense of sharing responsibility and workload by the faculty. PPD modules are necessary components of the curriculum and help to mould students while they are still acquiescent as they assume their roles as doctors of the future. PMID:26838576

  12. Evaluation of a personal and professional development module in an undergraduate medical curriculum in India.

    PubMed

    Komattil, Ramnarayan; Hande, Shyamala Handattu; Mohammed, Ciraj Ali; Subramaniam, Barathi

    2016-03-01

    The study aimed at evaluating the personal and professional development (PPD) module in the undergraduate medical curriculum in Melaka Manipal Medical College, India. PPD hours were incorporated in the curriculum. A team of faculty members and a faculty coordinator identified relevant topics and students were introduced to topics such as medical humanities, leadership skills, communication skills, ethics, professional behavior, and patient narratives. The module was evaluated using a prevalidated course feedback questionnaire which was administered to three consecutive batches of students from March 2011 to March 2013. To analyze faculty perspectives, one to one in-depth interviews and focus group discussions were conducted by the coordinators with faculty members who conducted the PPD classes. Analysis of the course feedback form revealed that majority (80%) of students agreed that the module was well prepared and was "highly relevant" to the profession. Faculty found the topics new and interdisciplinary and there was a sense of sharing responsibility and workload by the faculty. PPD modules are necessary components of the curriculum and help to mould students while they are still acquiescent as they assume their roles as doctors of the future.

  13. Changing medical students' perception of the evaluation culture: Is it possible?

    PubMed

    Colbert-Getz, Jorie M; Baumann, Steven

    2016-01-01

    Student feedback is a critical component of the teacher-learner cycle. However, there is not a gold standard course or clerkship evaluation form and limited research on the impact of changing the evaluation process. Results from a focus group and pre-implementation feedback survey coupled with best practices in survey design were used to improve all course/clerkship evaluation for academic year 2013-2014. In spring 2014 we asked all subjected students in University of Utah School of Medicine, United States of America to complete the same feedback survey (post-implementation survey). We assessed the evaluation climate with 3 measures on the feedback survey: overall satisfaction with the evaluation process; time students gave effort to the process; and time students used shortcuts. Scores from these measures were compared between 2013 and 2014 with Mann-Whitney U-tests. Response rates were 79% (254) for 2013 and 52% (179) for 2014. Students' overall satisfaction score were significantly higher (more positive) post-implementation compared to pre-implementation (P<0.001). There was no change in the amount of time students gave effort to completing evaluations (P=0.981) and no change for the amount of time they used shortcuts to complete evaluations (P=0.956). We were able to change overall satisfaction with the medical school evaluation culture, but there was no change in the amount of time students gave effort to completing evaluations and times they used shortcuts to complete evaluations. To ensure accurate evaluation results we will need to focus our efforts on time needed to complete course evaluations across all four years.

  14. Changing medical students' perception of the evaluation culture: Is it possible?

    PubMed

    Colbert-Getz, Jorie M; Baumann, Steven

    2016-01-01

    Student feedback is a critical component of the teacher-learner cycle. However, there is not a gold standard course or clerkship evaluation form and limited research on the impact of changing the evaluation process. Results from a focus group and pre-implementation feedback survey coupled with best practices in survey design were used to improve all course/clerkship evaluation for academic year 2013-2014. In spring 2014 we asked all subjected students in University of Utah School of Medicine, United States of America to complete the same feedback survey (post-implementation survey). We assessed the evaluation climate with 3 measures on the feedback survey: overall satisfaction with the evaluation process; time students gave effort to the process; and time students used shortcuts. Scores from these measures were compared between 2013 and 2014 with Mann-Whitney U-tests. Response rates were 79% (254) for 2013 and 52% (179) for 2014. Students' overall satisfaction score were significantly higher (more positive) post-implementation compared to pre-implementation (P<0.001). There was no change in the amount of time students gave effort to completing evaluations (P=0.981) and no change for the amount of time they used shortcuts to complete evaluations (P=0.956). We were able to change overall satisfaction with the medical school evaluation culture, but there was no change in the amount of time students gave effort to completing evaluations and times they used shortcuts to complete evaluations. To ensure accurate evaluation results we will need to focus our efforts on time needed to complete course evaluations across all four years. PMID:26924629

  15. Evaluating the state of the art in coreference resolution for electronic medical records

    PubMed Central

    Bodnari, Andreea; Shen, Shuying; Forbush, Tyler; Pestian, John; South, Brett R

    2012-01-01

    Background The fifth i2b2/VA Workshop on Natural Language Processing Challenges for Clinical Records conducted a systematic review on resolution of noun phrase coreference in medical records. Informatics for Integrating Biology and the Bedside (i2b2) and the Veterans Affair (VA) Consortium for Healthcare Informatics Research (CHIR) partnered to organize the coreference challenge. They provided the research community with two corpora of medical records for the development and evaluation of the coreference resolution systems. These corpora contained various record types (ie, discharge summaries, pathology reports) from multiple institutions. Methods The coreference challenge provided the community with two annotated ground truth corpora and evaluated systems on coreference resolution in two ways: first, it evaluated systems for their ability to identify mentions of concepts and to link together those mentions. Second, it evaluated the ability of the systems to link together ground truth mentions that refer to the same entity. Twenty teams representing 29 organizations and nine countries participated in the coreference challenge. Results The teams' system submissions showed that machine-learning and rule-based approaches worked best when augmented with external knowledge sources and coreference clues extracted from document structure. The systems performed better in coreference resolution when provided with ground truth mentions. Overall, the systems struggled in solving coreference resolution for cases that required domain knowledge. PMID:22366294

  16. Assessing Medicare Part D Claim Completeness Using Medication Self-reports: The Role of Veteran Status and Generic Drug Discount Programs

    PubMed Central

    Zhou, Lei; Stearns, Sally C.; Thudium, Emily M.; Alburikan, Khalid A.; Rodgers, Jo Ellen

    2015-01-01

    Objective Medicare Part D claims are commonly used for research, but missing claims could compromise their validity. This study assessed two possible causes of missing claims: veteran status and Generic Drug Discount Programs (GDDP). Methods We merged medication self-reports from telephone interviews in the Atherosclerosis Risk in Communities Study (ARIC) with Part D claims for six medications (three were commonly in GDDP in 2009). Merged records (4,468) were available for 2,905 ARIC participants enrolled in Part D. Multinomial logit regression provided estimates of the association of concordance (self-report & Part D, self-report only, or Part D only) with veteran and GDDP status, controlling for participant socio-demographics. Results Sample participants were 74±5 years of age, 68% white and 63% female; 19% were male veterans. Compared to females, male veterans were 11% (95% CI: 7%–16%) less likely to have matched medications in self-report & Part D and 11% (95% CI: 7%–16%) more likely to have self-report only. Records for GDDP versus non-GDDP medications were 4% (95% CI: 1%–7%) more likely to be in self-report & Part D and 3% (95% CI: 1%–5%) less likely to be in Part D only, with no difference in self-report only. Conclusions Part D claims were more likely to be missing for veterans, but claims for medications commonly available through GDDP were more likely to match with self-reports. While researchers should be aware of the possibility of missing claims, GDDP status was associated with a higher rather than lower likelihood of claims being complete in 2009. PMID:25793271

  17. An innovative calibration based integral photography rendering algorithm for medical application and its evaluation.

    PubMed

    Chen, Guowen; Zhang, Xinran; Fan, Zhencheng; Liao, Hongen

    2015-01-01

    Autostereoscopic has long been proposed to fulfill medical display in image-guided surgery and clinical education to provide more intuitive position information of clinical interest zone thus improving surgery safety and accuracy. As one category of flexible autostereoscopic 3D display, computer generated integral photography (CGIP) has been studied in medical application by many researches for its convenience and cost-efficiency. However, IP still suffers from inaccurate light field reconstruction, which limits its practicality in surgery. In this paper, we propose and apply a flexible fish-eye model based micro lens array (MLA) distortion calibration method and pre-distorted retracing rendering algorithm to render elemental image array (EIA) of CGIP. Furthermore, we also evaluate light field of the proposed algorithm in depth cue, and signal noise ratio of IP images by phantom experiment.

  18. Spouses of Persian Gulf War I veterans: medical evaluation of a U.S. cohort.

    PubMed

    Eisen, Seth A; Karlinsky, Joel; Jackson, Leila W; Blanchard, Melvin; Kang, Han K; Murphy, Frances M; Alpern, Renee; Reda, Domenic J; Toomey, Rosemary; Battistone, Michael J; Parks, Becky J; Klimas, Nancy; Pak, Hon S; Hunter, Joyce; Lyons, Michael J; Henderson, William G

    2006-07-01

    Ten years after the 1991 Persian Gulf War (GW I), a comprehensive evaluation of a national cohort of deployed veterans (DV) demonstrated a higher prevalence of several medical conditions, in comparison to a similarly identified cohort of nondeployed veterans (NDV). The present study determined the prevalence of medical conditions among nonveteran spouses of these GW I DV and NDV. A cohort of 490 spouses of GW I DV and 537 spouses of GW I NDV underwent comprehensive face-to-face examinations. No significant differences in health were detected except that spouses of DV were less likely to have one or more of a group of six common skin conditions. We conclude that, 10 years after GW I, the general physical health of spouses of GW I DV is similar to that of spouses of NDV.

  19. An innovative calibration based integral photography rendering algorithm for medical application and its evaluation.

    PubMed

    Chen, Guowen; Zhang, Xinran; Fan, Zhencheng; Liao, Hongen

    2015-01-01

    Autostereoscopic has long been proposed to fulfill medical display in image-guided surgery and clinical education to provide more intuitive position information of clinical interest zone thus improving surgery safety and accuracy. As one category of flexible autostereoscopic 3D display, computer generated integral photography (CGIP) has been studied in medical application by many researches for its convenience and cost-efficiency. However, IP still suffers from inaccurate light field reconstruction, which limits its practicality in surgery. In this paper, we propose and apply a flexible fish-eye model based micro lens array (MLA) distortion calibration method and pre-distorted retracing rendering algorithm to render elemental image array (EIA) of CGIP. Furthermore, we also evaluate light field of the proposed algorithm in depth cue, and signal noise ratio of IP images by phantom experiment. PMID:26737227

  20. Concept of using a benchmark part to evaluate rapid prototype processes

    NASA Technical Reports Server (NTRS)

    Cariapa, Vikram

    1994-01-01

    A conceptual benchmark part for guiding manufacturers and users of rapid prototyping technologies is proposed. This is based on a need to have some tool to evaluate the development of this technology and to assist the user in judiciously selecting a process. The benchmark part is designed to have unique product details and features. The extent to which a rapid prototyping process can reproduce these features becomes a measure of the capability of the process. Since rapid prototyping is a dynamic technology, this benchmark part should be used to continuously monitor process capability of existing and developing technologies. Development of this benchmark part is, therefore, based on an understanding of the properties required from prototypes and characteristics of various rapid prototyping processes and measuring equipment that is used for evaluation.

  1. Population-based medical and disease management: an evaluation of cost and quality.

    PubMed

    Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas

    2006-02-01

    Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.

  2. Scientific evaluation and pricing of medical devices and associated procedures in France.

    PubMed

    Gilard, Martine; Debroucker, Frederique; Dubray, Claude; Allioux, Yves; Aper, Eliane; Barat-Leonhardt, Valérie; Brami, Michèle; Carbonneil, Cédric; Chartier-Kastler, Emmanuel; Coqueblin, Claire; Fare, Sandrine; Giri, Isabelle; Goehrs, Jean-Marie; Levesque, Karine; Maugendre, Philippe; Parquin, François; Sales, Jean-Patrick; Szwarcensztein, Karine

    2013-01-01

    Medical devices are many and various, ranging from tongue spatulas to implantable or invasive devices and imaging machines; their lifetimes are short, between 18 months and 5 years, due to incessant incremental innovation; and they are operator-dependent: in general, the clinical user performs a fitting procedure (hip implant or pacemaker), a therapeutic procedure using a non-implantable invasive device (arrhythmic site ablation probe, angioplasty balloon, extension spondyloplasty system, etc.) or follow-up of an active implanted device (long-term follow-up of an implanted cardiac defibrillator or of a deep brain stimulator in Parkinson's patients). A round-table held during the XXVIII(th) Giens Workshops meeting focused on the methodology of scientific evaluation of medical devices and the associated procedures with a view to their pricing and financing by the French National Health Insurance system. The working hypothesis was that the available data-set was sufficient for and compatible with scientific evaluation with clinical benefit. Post-registration studies, although contributing to the continuity of assessment, were not dealt with. Moreover, the focus was restricted to devices used in health establishments, where the association between devices and technical medical procedures is optimally representative. An update of the multiple regulatory protocols governing medical devices and procedures is provided. Issues more specifically related to procedures as such, to non-implantable devices and to innovative devices are then dealt with, and the proposals and discussion points raised at the round-table for each of these three areas are presented.

  3. An evaluation of drug promotional literatures published in scientific medical journals

    PubMed Central

    Vachhani, Pooja M.; Solanki, Manish N.; Desai, Mira K.

    2016-01-01

    Objectives: Evaluation and comparison of ethical standards of published drug promotional literatures (DPLs) between different Indian and non-Indian scientific medical journals regarding compliance to the World Health Organization (WHO) and International Federation of Pharmaceutical Manufacturers and Associations (IFPMAs) guidelines. Materials and Methods: A cross-sectional, observational study was carried out at pharmacology department. DPLs published in Indian and non-Indian scientific medical journals available at central library of medical college during the period of 6 months were collected according to selection criteria. DPLs were evaluated and compared for compliance to ethical standards of drug promotion laid by the WHO and IFPMA. Data were analyzed using Fisher's exact test. Results: Out of total 178 DPLs, 103 DPLs were from Indian journals and 75 DPLs were from non-Indian journals. When compared regarding compliance to all the 11 ethical criteria of WHO, no significant difference was found between DPLs published in Indian and non-Indian journals. However, DPLs from indian journals contained significantly less information regarding dosage regimen (P = 0.0096), adverse drug reactions (P = 0.0028), warnings (P = 0.0104) and major drug interactions (P < 0.0001) as compared to non-Indian journals. Compliance to all the five IFPMA criteria was significantly higher in DPLs of non-Indian journals (88%) than Indian journals (39%) (P < 0.0001). Conclusion: Noncompliance to ethical standards of WHO and IFPMA guidelines is more common in DPLs of Indian journals as compared to non-Indian journals. Thus strict implementation of regulatory measures regarding DPLs published in Indian medical journals is recommended. PMID:27413355

  4. An eclectic model for evaluating web-based continuing medical education courseware systems.

    PubMed

    Curran, V R

    2000-09-01

    World Wide Web and compact disc-read only memory technologies have introduced new prospects for delivering continuing medical education (CME) to rural and remote physicians. However, evidence concerning the effectiveness of these technologies in providing CME, and approaches to their evaluation, is limited. The rationale for this study was to design a model for evaluating the effectiveness of computer-mediated CME courseware. An eclectic, evaluation-planning matrix was designed by selecting various concepts from the literature and was used in planning and developing the evaluation model. The model was field-tested by evaluating a computer-mediated courseware program on dermatological office procedures, and a meta-evaluation was conducted to assess the effectiveness of the evaluation methods and procedures. The findings suggest that the model was useful in collecting data to inform decision making and to improve the instructional product. The field test results revealed that computer-mediated instruction was effective in delivering CME at a distance. PMID:11067194

  5. Influences of faculty evaluating system on educational performance of medical school faculty

    PubMed Central

    2016-01-01

    Purpose: The promotion of educators is challenged by the lack of accepted standards to evaluate the quality and impact of educational activities. Traditionally, promotion is related to research productivity. This study developed an evaluation tool for educational performance of medical school faculty using educator portfolios (EPs). Methods: Design principles and quantitative items for EPs were developed in a consensus workshop. These principles were tested in a simulation and revised based on feedback. The changes of total educational activities following introduction of the system were analyzed. Results: A total of 71% faculty members answered the simulation of the system and the score distributed widely (mean±standard deviation, 65.43±68.64). The introduction of new system significantly increased the total educational activities, especially in assistant professors. Conclusion: The authors offer comprehensive and practical tool for enhancing educational participation of faculty members. Further research for development of qualitative evaluation systems is needed. PMID:27363501

  6. Portfolio as a tool to evaluate clinical competences of traumatology in medical students

    PubMed Central

    Santonja-Medina, Fernando; García-Sanz, M Paz; Martínez-Martínez, Francisco; Bó, David; García-Estañ, Joaquín

    2016-01-01

    This article investigates whether a reflexive portfolio is instrumental in determining the level of acquisition of clinical competences in traumatology, a subject in the 5th year of the degree of medicine. A total of 131 students used the portfolio during their clinical rotation of traumatology. The students’ portfolios were blind evaluated by four professors who annotated the existence (yes/no) of 23 learning outcomes. The reliability of the portfolio was moderate, according to the kappa index (0.48), but the evaluation scores between evaluators were very similar. Considering the mean percentage, 59.8% of the students obtained all the competences established and only 13 of the 23 learning outcomes (56.5%) were fulfilled by >50% of the students. Our study suggests that the portfolio may be an important tool to quantitatively analyze the acquisition of traumatology competences of medical students, thus allowing the implementation of methods to improve its teaching. PMID:26929675

  7. [A new form of postgraduate medical training: evaluating the status of operationalised postgraduate training].

    PubMed

    Beer, André-Michael; Fey, Stefan; Siebolds, Marcus; Kiwitt, Paul

    2009-01-01

    Following structured forms of postgraduate training, which are already in use internationally, there are more and more reports on operationalised procedures of postgraduate training in Germany as well. The transparency, which is required by law in order to make medical postgraduate training demonstrable in terms of Sect. 8 of the new regulation on postgraduate training, creates a demand for evaluations. However, only 10 to 20% of the participants in postgraduate training use these evaluations to demonstrate their results scientifically. The aim of the present paper was to show that--with regard to content--the conceptual integration of operationalised programmes for postgraduate training is able to compensate for the given limited time frames and formally tightened structures of postgraduate training in the sense of the quality assurance required by the legislator. The evaluation showed that this can be made possible through ensuring the participants' satisfaction and achieving the goals of postgraduate training.

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  9. Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users

    PubMed Central

    Wood, Evan; Kerr, Thomas; Lloyd-Smith, Elisa; Buchner, Chris; Marsh, David C; Montaner, Julio SG; Tyndall, Mark W

    2004-01-01

    Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined. PMID:15535885

  10. Critical Elements in the Medical Evaluation of Suspected Child Physical Abuse

    PubMed Central

    Olson, Lenora M.; Keenan, Heather T.

    2015-01-01

    BACKGROUND: Previous research has described variability in medical evaluation of suspected abuse. The objective of this study was to identify, through expert consensus, required and highly recommended elements of a child abuse pediatrics (CAP) evaluation for 3 common presentations of suspected physical abuse in children aged 0 to 60 months. METHODS: Twenty-eight CAPs recruited from 2 national organizations formed the expert panel for this modified Delphi Process. An initial survey was developed for each presentation based on demographics, history of present illness, past medical, family and social history, laboratory, radiology, and consultation elements present in at least 10% of CAP consultations collected for a larger study. CAPs ranked each element on a 9-point scale then reviewed and discussed summary results through a project blog over 3 rounds. Required and highly recommended elements were defined as elements ranked as 9 and 8, respectively, by ≥75% of experts after the final round. RESULTS: From 96 elements in the initial surveys, experts identified 30 Required elements and 37 Highly Recommended elements for CAP evaluation of intracranial hemorrhage, 21 Required and 33 Highly Recommended elements for CAP evaluation of long bone fracture, and 18 Required and 16 Highly Recommended elements for CAP evaluation of isolated skull fracture. CONCLUSIONS: This guideline reflects expert consensus and provides a starting point for development of child abuse assessment protocols for quality improvement or research. Additional research is required to determine whether this guideline can reduce variability and/or improve reliability in the evaluation and diagnosis of child physical abuse. PMID:26101359

  11. Functional and Dysfunctional Characteristics of the Prevailing Model of Clinical Evaluation Systems in North American Medical Schools.

    ERIC Educational Resources Information Center

    Hunt, D. Daniel

    1992-01-01

    Drawing from survey data (n=138 medical schools in the United States and Canada), a study analyzed medical schools' systems for evaluating student progress in clinical experiences. The 4-stage model used by most schools, common and unique characteristics, and 17 symptoms of system errors, signaling a need for system review, are outlined.…

  12. A Case Study of the Impact of a Sytematic Evaluation Process in a Graduate Medical Education Residency Program

    ERIC Educational Resources Information Center

    Kromrei, Heidi T.

    2014-01-01

    The Accreditation Council for Graduate Medical Education has charged institutions that sponsor accredited Graduate Medical Education programs (residency and fellowship specialty programs) with overseeing implementation of mandatory annual program evaluation efforts to ensure compliance with regulatory requirements. Physicians receive scant, if…

  13. The Role of Academic Psychiatry Faculty in the Treatment and Subsequent Evaluation and Promotion of Medical Students: An Ethical Conundrum

    ERIC Educational Resources Information Center

    Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.

    2008-01-01

    Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The…

  14. Test de Evaluacion de Conocimientos Medicos-CIIPME (Test of Evaluation of Medical Knowledge-CIIPME). Publication No. 42.

    ERIC Educational Resources Information Center

    Alfici, C.; And Others

    The purpose of this research is to build a test for the evaluation of the knowledge needed by medical students before entering clinical courses in medical school. The criterion for this was provided by teachers in both the pre-clinical and clinical subjects. The Pilot instrument consisted of 335 items that covered 8 sections. Each one of these…

  15. Gender perspective in medicine: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science

    PubMed Central

    Risberg, Gunilla; Hamberg, Katarina; Johansson, Eva E

    2006-01-01

    Background During the past few decades, research has reported gender bias in various areas of clinical and academic medicine. To prevent such bias, a gender perspective in medicine has been requested, but difficulties and resistance have been reported from implementation attempts. Our study aimed at analysing this resistance in relation to what is considered good medical research. Method We used a theoretical model, based on scientific competition, to understand the structures of scientific medicine and how they might influence the resistance to a gender perspective in medicine. The model was originally introduced to discuss how pluralism improves rationality in the social sciences. Results The model provided a way to conceptualise different fields of research in medicine: basic research, applied research, medical philosophy, and 'empowering' research. It clarified how various research approaches within medicine relate to each other, and how they differ and compete. It also indicated why there might be conflicts between them: basic and applied research performed within the biomedical framework have higher status than gender research and other research approaches that are performed within divergent research paradigms. Conclusion This hierarchy within medical research contributes to the resistance to a gender perspective, causing gender bias and making medical scientific rationality suboptimal. We recommend that the theoretical model can be applied in a wider medical context when different and hierarchically arranged research traditions are in conflict. In this way, the model might contribute to shape a medical community where scientific pluralism is acknowledged to enlarge, not to disturb, the scientific rationality of medicine. PMID:16928283

  16. Evaluation of adherence to immunosuppressive drugs in kidney transplantation by control of medication dispensing.

    PubMed

    Brahm, M M T; Manfro, R C; Mello, D; Cioato, S; Gonçalves, L F S

    2012-10-01

    Nonadherence to immunosuppressive medications represents a burden to organ transplantation being associated with rejection episodes and graft loss. In this cross-sectional study we evaluated the prevalence and risk factors for nonadherence in kidney transplant patients by measuring the retrieval of the immunosuppressive drugs in the registry kept by the state Rio Grande do Sul public health system. We considered nonadherence the failure to retrieval of medication at least one time over a 1-year period of evaluation. In 288 patients evaluated, the frequency of failure to retrieve was 58.7%. Being fully employed (66.4% × 33.6%, P = .008) and younger age at transplantation (39 ± 13 × 46 ± 11, P = .011) were associated with nonadherence. Multivariate analysis showed a greater prevalence ratio (PR) of non- adherence in patients using tacrolimus. Estimated glomerular filtration rate was significantly lower in the nonadherence groups as compared with adherent groups (45.3 ± 21.6 × 51.3 ± 19.4, P = .016). In conclusion, we found a high prevalence of nonadherence to immunosuppressive drugs with association to active working situation and use of tacrolimus. Importantly, glomerular filtration rate was found to be lower in nonadherent patients.

  17. Insurance status and admission to hospital for head injuries: are we part of a two-tiered medical system?

    PubMed

    Svenson, J E; Spurlock, C W

    2001-01-01

    Previous studies have shown an association between insurance status and use of resources for inpatient care. We sought to assess whether insurance status influences decisions regarding the evaluation and treatment of head injured patients in the emergency department (ED). Head injured patients were identified from ED data from 4 hospitals reporting to the Kentucky Emergency Medical Services Information System. Multiple regression analysis using admission, ED length of stay, and ED charges as outcome variables was then performed. From 216,137 ED visits there were 8,591 (4%) head injured patients identified from the database. Eliminating those with revisits, transfers to another hospital in the database, and isolated facial lacerations, there were 3,821 cases. Controlling for age, hospital, race, primary diagnosis, and indicators of severity of the injury, insurance status was significantly associated with hospital admission. Those uninsured were the least likely to be admitted (OR 0.41; 95% CI (0.31, 0.50), whereas those with public insurance had an intermediate probability (OR 0.50 95% CI (0.37, 0.68) as compared with those with private insurance. Similarly, ED charges were lower for Medicaid patients than insured patients ($880) and tended to be slightly lower for uninsured patients ($1,043) than insured patients ($1,141) (P =.001). Length of stay in the ED was shorter for publicly insured patients (179 minutes) than uninsured (186 minutes) and privately insured patients (192 minutes) (P =.001). The extent of evaluation and admission for head injured patients is associated with insurance status. This creates a dual standard of care for patients. Practitioners should work to standardize the evaluation of patients independent of paying status. PMID:11146011

  18. Part 2: Evaluation and outcomes of an evidence-based facility design project.

    PubMed

    Krugman, Mary; Sanders, Carolyn; Kinney, Lisa J

    2015-02-01

    Based on the work of a TCAB facility design team at an academic hospital (part 1), an evaluation project was implemented to measure RN work environment perceptions, work activity sampling, and steps walked on 6 units moving into a new acute care pavilion. Pre and post data reported significant nurse satisfaction post move with the new work environment. Workflow sampling data did not reflect significant changes; the pedometer device used to measure nurse steps proved unreliable. Project evaluation data are reported.

  19. Intake risk and dose evaluation methods for workers in radiochemistry labs of a medical cyclotron facility.

    PubMed

    Calandrino, Riccardo; del Vecchio, Antonella; Savi, Annarita; Todde, Sergio; Belloli, Sara

    2009-10-01

    The aim of this paper is to evaluate the risks and doses for the internal contamination of the radiochemistry staff in a high workload medical cyclotron facility. The doses from internal contamination derive from the inhalation of radioactive gas leakage from the cells by personnel involved in the synthesis processes and are calculated from urine sample measurements. Various models are considered for the calculation of the effective committed dose from the analysis of these urine samples, and the results are compared with data obtained from local environmental measurement of the radioactivity released inside the lab.

  20. The Evaluation of Game-based E-learning for Medical Education: a Preliminary Survey

    PubMed Central

    Lin, Chao-Cheng; Li, Yu-Chuan; Bai, Ya-Mei; Chen, Jen-Yeu; Hsu, Chien-Yeh; Wang, Chih-Hung; Chiu, Hung-Wen; Wan, Hsu-Tien

    2005-01-01

    Game-Based e-learning (GBeL) was a newly designed platform for education of students with higher education, especially for medical students. The purpose of this study was to preliminarily evaluate the attraction of GBeL, the motivation toward GBeL and the learning effect. We found more than 80% of students thought that GBeL was attractive and more interesting than traditional class. However, the percentage of enhancing interest to learn and learning more complete and deep knowledge were less than 50%. PMID:16779319

  1. Evaluation of Electromagnetic Fields in a Hospital for Safe Use of Electronic Medical Equipment.

    PubMed

    Ishida, Kai; Fujioka, Tomomi; Endo, Tetsuo; Hosokawa, Ren; Fujisaki, Tetsushi; Yoshino, Ryoji; Hirose, Minoru

    2016-03-01

    Establishment of electromagnetic compatibility is important in use of electronic medical equipment in hospitals. To evaluate the electromagnetic environment, the electric field intensity induced by electromagnetic radiation in broadcasting spectra coming from outside the hospital was measured in a new hospital building before any patients visited the hospital and 6 months after the opening of the hospital. Various incoming radio waves were detected on the upper floors, with no significant difference in measured levels before and after opening of the hospital. There were no cellphone terminal signals before the hospital opened, but these signals were strongly detected at 6 months thereafter. Cellphone base stations signals were strongly detected on the upper floors, but there were no signals at most locations in the basement and in the center of the building on the lower floors. A maximum electrical intensity of 0.28 V/m from cellphone base stations (2.1 GHz) was detected at the south end of the 2nd floor before the hospital opened. This value is lower than the EMC marginal value for general electronic medical equipment specified in IEC 60601-1-2 (3 V/m). Therefore, electromagnetic interference with electronic medical equipment is unlikely in this situation. However, cellphone terminal signals were frequently detected in non-base station signal areas. This is a concern, and understanding signal strength from cellphone base stations at a hospital is important for promotion of greater safety. PMID:26643076

  2. Evaluation of herbal cannabis characteristics by medical users: a randomized trial

    PubMed Central

    Ware, Mark A; Ducruet, Thierry; Robinson, Ann R

    2006-01-01

    Background Cannabis, in herbal form, is widely used as self-medication by patients with diseases such as HIV/AIDS and multiple sclerosis suffering from symptoms including pain, muscle spasticity, stress and insomnia. Valid clinical studies of herbal cannabis require a product which is acceptable to patients in order to maximize adherence to study protocols. Methods We conducted a randomized controlled crossover trial of 4 different herbal cannabis preparations among 8 experienced and authorized cannabis users with chronic pain. Preparations were varied with respect to grind size, THC content and humidity. Subjects received each preparation on a separate day and prepared the drug in their usual way in a dedicated and licensed clinical facility. They were asked to evaluate the products based on appearance (smell, colour, humidity, grind size, ease of preparation and overall appearance) and smoking characteristics (burn rate, hotness, harshness and taste). Five-point Likert scores were assigned to each characteristic. Scores were compared between preparations using ANOVA. Results Seven subjects completed the study, and the product with highest THC content (12%), highest humidity (14%) and largest grind size (10 mm) was rated highest overall. Significant differences were noted between preparations on overall appearance and colour (p = 0.003). Discussion While the small size of the study precludes broad conclusions, the study shows that medical cannabis users can appreciate differences in herbal product. A more acceptable cannabis product may increase recruitment and retention in clinical studies of medical cannabis. PMID:17101054

  3. Development and evaluation of an instrument to assess medical students' cultural attitudes.

    PubMed

    Robins, L S; Alexander, G L; Wolf, F M; Fantone, J C; Davis, W K

    1998-01-01

    This paper describes the development and psychometric evaluation of an instrument designed to assess medical students' comfort with a range of sociocultural issues and intercultural experiences. Each survey item obliged students to reflect on their own sociocultural identities and academic status in relation to others', and to judge how comfortable they would be interacting across perceived boundaries based on sociocultural identity and academic status. More than 90% of University of Michigan first-year medical students (n=153) completed the survey just before classes began. Principal components analysis of the survey's 26 items identified 7 interpretable factors or subscales; the Cronbach alpha reliability coefficients for the 7 subscales and the total scale ranged from .73 to .92. T-tests were used to investigate differences in average ratings among student subgroups (based on gender and ethnicity). To assess the magnitude of the effect of the differences between groups, effect size was computed for each of the means comparisons. Psychometric analyses indicated that this survey was both reliable and valid for assessing students' cultural attitudes. Further, analyses by gender and ethnic subgroup identified meaningful ratings differences in men's and women's reported comfort levels. Our findings suggest that this instrument is useful for assessing students' openness to developing cultural awareness and competence. Educators at other medical schools may find this instrument useful as a needs assessment tool for planning educational programs designed to increase students' cultural competence. PMID:17598290

  4. Design, evaluation, and dissemination of a plastic syringe clip to improve dosing accuracy of liquid medications.

    PubMed

    Spiegel, Garrett J; Dinh, Cindy; Gutierrez, Amanda; Lukomnik, Julia; Lu, Benjamin; Shah, Kamal; Slough, Tara; Yeh, Ping Teresa; Mirabal, Yvette; Gray, Lauren Vestewig; Marton, Stephanie; Adler, Michelle; Schutze, Gordon E; Wickham, Hadley; Oden, Maria; Richards-Kortum, Rebecca

    2013-09-01

    Pediatricians in Africa requested a tool to improve caregiver dosing of liquid antiretroviral medication. We developed, evaluated and disseminated a clip to control the amount of medication drawn into an oral syringe. In a laboratory, a user tested clips of different lengths, corresponding to different volumes, by drawing water into a syringe with a clip. In Texas and Malawi, 149 adults attempted to measure Pepto-Bismol™ using a syringe with a clip, a syringe without a clip, and a dosing cup, in a randomly assigned order. In the laboratory, the volume of liquid, ranging from 1 to 4.5 mL, drawn into the syringe was always within at least 5 μL of the intended dose. In Texas, 84% of doses were accurate within ±10%, vs. 63% using the syringe alone, and 21% with the dosing cup. In Malawi, 98% of doses were accurate to within ±10%, vs. 90% using the syringe alone, and 27% with the dosing cup. For target accuracy values within ±45% (±21%), a significantly higher fraction of Houston (Kamangira) participants delivered an accurate dose using the syringe with the clip than with the syringe alone (p < 0.05). The clip enables a greater proportion of users to accurately measure liquid medication.

  5. Evaluation of Electromagnetic Fields in a Hospital for Safe Use of Electronic Medical Equipment.

    PubMed

    Ishida, Kai; Fujioka, Tomomi; Endo, Tetsuo; Hosokawa, Ren; Fujisaki, Tetsushi; Yoshino, Ryoji; Hirose, Minoru

    2016-03-01

    Establishment of electromagnetic compatibility is important in use of electronic medical equipment in hospitals. To evaluate the electromagnetic environment, the electric field intensity induced by electromagnetic radiation in broadcasting spectra coming from outside the hospital was measured in a new hospital building before any patients visited the hospital and 6 months after the opening of the hospital. Various incoming radio waves were detected on the upper floors, with no significant difference in measured levels before and after opening of the hospital. There were no cellphone terminal signals before the hospital opened, but these signals were strongly detected at 6 months thereafter. Cellphone base stations signals were strongly detected on the upper floors, but there were no signals at most locations in the basement and in the center of the building on the lower floors. A maximum electrical intensity of 0.28 V/m from cellphone base stations (2.1 GHz) was detected at the south end of the 2nd floor before the hospital opened. This value is lower than the EMC marginal value for general electronic medical equipment specified in IEC 60601-1-2 (3 V/m). Therefore, electromagnetic interference with electronic medical equipment is unlikely in this situation. However, cellphone terminal signals were frequently detected in non-base station signal areas. This is a concern, and understanding signal strength from cellphone base stations at a hospital is important for promotion of greater safety.

  6. Commentary: evaluation of driver fitness--the role of continuing medical education.

    PubMed

    Dow, Jamie

    2009-08-01

    Faced with demographic trends that predicted large increases of older drivers within a relatively short period combined with the realization that screening for driver fitness was largely dependent upon health professionals, principally physicians, in 2004 the Société de l'assurance automobile du Québec (SAAQ) initiated measures that sought to achieve better cooperation with the health professionals performing the screening. A program was initiated that sought to improve the health professionals' understanding of road safety considerations. This article examines the measures included in this program and their results. SAAQ statistics show the benefit of the SAAQ's continuing medical education (CME) program. Since the initiation of the program the number of reports submitted by physicians has increased exponentially, whereas police reports have remained constant. Informed physicians report drivers with medical problems that may affect driver fitness when they are aware that the licensing agency's decisions are based principally upon valid functional evaluations. Discretionary reporting may be as effective as mandatory reporting when physicians are knowledgeable about the road safety implications of medical conditions. PMID:19593705

  7. Evaluation of medical and veterinary students' attitudes toward a one health interprofessional curricular exercise.

    PubMed

    Winer, Jenna Nicole; Nakagawa, Keisuke; Conrad, Patricia A; Brown, Lauren; Wilkes, Michael

    2015-01-01

    This study evaluates whether medical and veterinary students' attitudes toward "One Health" and interprofessional education changed after participating in a joint small group learning exercise focused on risk factors associated with zoonotic disease. A survey was distributed to third-year medical students (n = 98) and second-year veterinary students (n = 140), each with a 95% response rate. Overall, 92% of veterinary students and 73% of medical students agreed or strongly agreed that "One Health" was relevant to their desired specialty. Students from both schools largely agreed that interprofessional education should be a goal of the curriculum for their school, and that interprofessional approaches strengthen their overall education. Students reported increased confidence in their communication skills and improved ability to contribute to One Health collaborative teams. This educational intervention, built around a patient case, focused on a variety of learning objectives including skills (such as communication), knowledge (of zoonotic toxoplasmosis) and attitudes (toward collaborative learning and practice). By sparking an interest in One Health during their early professional education, we sought to encourage a new generation of physicians and veterinarians to adopt a more collaborative spirit to their clinical practice, which will ultimately benefit human, animal and environmental health.

  8. Performance evaluation of medical LCD displays using 3D channelized Hotelling observers

    NASA Astrophysics Data System (ADS)

    Platiša, Ljiljana; Marchessoux, Cédric; Goossens, Bart; Philips, Wilfried

    2011-03-01

    High performance of the radiologists in the task of image lesion detection is crucial for successful medical practice. One relevant factor in clinical image reading is the quality of the medical display. With the current trends of stack-mode liquid crystal displays (LCDs), the slow temporal response of the display plays a significant role in image quality assurance. In this paper, we report on the experimental study performed to evaluate the quality of a novel LCD with advanced temporal response compensation, and compare it to an existing state-of-the-art display of the same category but with no temporal response compensation. The data in the study comprise clinical digital tomosynthesis images of the breast with added simulated mass lesions. The detectability for the two displays is estimated using the recent multi-slice channelized Hotelling observer (msCHO) model which is especially designed for multi-slice image data. Our results suggest that the novel LCD allows higher detectability than the existing one. Moreover, the msCHO results are used to advise on the parameters for the follow up image reading study with real medical doctors as observers. Finally, the main findings of the msCHO study were confirmed by a human reader study (details to be published in a separate paper).

  9. Development and evaluation of a pliable biological valved conduit. Part II: Functional and hemodynamic evaluation.

    PubMed

    Sung, H W; Witzel, T H; Hata, C; Tu, R; Shen, S H; Lin, D; Noishiki, Y; Tomizawa, Y; Quijano, R C

    1993-04-01

    Many congenital cardiac malformations may require a valved conduit for the reconstruction of the right ventricular outflow tract. In spite of many endeavors made in the last 25 years, the clinical results of right ventricular outflow tract reconstruction with currently available valved conduits are still not satisfactory. Specific problems encountered clinically include suboptimal hemodynamic performance, conduit kinking or compression, and fibrous peeling from the luminal surface. To address these deficiencies, we undertook the development of a biological valved conduit: a bovine external jugular vein graft with a retained native valve cross-linked with a diglycidyl ether (DE). This study, using a canine model, was to evaluate the functional and hemodynamic performance of this newly developed valved conduit. Three 14 mm conduits, implanted as bypass grafts, right ventricle to pulmonary artery, were evaluated. The evaluation was conducted with a noninvasive color Doppler flow mapping system at pre-implantation, immediately post implantation, one- and three-months post implantation, and prior to retrieval (five-months post implantation). The two-dimensional tomographic inspection of the leaflet motion at various periods post implantation showed that the valvular leaflets in the DE treated conduit was quite pliable. No cardiac failure or valvular dysfunction was observed in any of the studied cases. The color Doppler flow mapping study demonstrated that the valve in the DE treated conduit was competent, with no conduit kinking or compression observed in any of the three cases. The spectral Doppler velocity study evidenced that the transvalvular pressure gradients of the DE treated conduit were minimal as compared to those of the currently available conduits. In conclusion, from the functional and hemodynamic performance points of view, this newly developed valved conduit is superior to those currently available. PMID:8325697

  10. An Analysis of Superintendent Perceptions of Multi-Source Assessment as a Part of Superintendent Evaluation

    ERIC Educational Resources Information Center

    Gaines, Chris

    2009-01-01

    This study examines the perceptions of superintendents regarding the use of multi-source assessment (MSA) as part of superintendent evaluation. Known users of MSA were asked to participate. MSA users are difficult to find and those using it successfully do not understand why more were not interested in using the process. Each superintendent…

  11. 34 CFR 356.31 - How does the Secretary evaluate an application under this part?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false How does the Secretary evaluate an application under this part? 356.31 Section 356.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY...

  12. 34 CFR 356.31 - How does the Secretary evaluate an application under this part?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false How does the Secretary evaluate an application under this part? 356.31 Section 356.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY...

  13. 34 CFR 356.31 - How does the Secretary evaluate an application under this part?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true How does the Secretary evaluate an application under this part? 356.31 Section 356.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY...

  14. 34 CFR 356.31 - How does the Secretary evaluate an application under this part?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false How does the Secretary evaluate an application under this part? 356.31 Section 356.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY...

  15. 34 CFR 356.31 - How does the Secretary evaluate an application under this part?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true How does the Secretary evaluate an application under this part? 356.31 Section 356.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY...

  16. Adolescents in Child Training (Project ACT); Summative Evaluation Report; [Parts 1 and 2].

    ERIC Educational Resources Information Center

    Harris, Joan R.; Puryear, Gwendolyn R.

    The evaluation report examines three ACT demonstration projects (Adolescents in Child Training) in San Antonio, Chicago, and Little Rock designed to involve adolescents in child training through the classroom and actual field experience. Part 1 of the report describes the three projects with respect to their contextual, conceptual, and programatic…

  17. 49 CFR Appendix A to Part 611 - Description of Measures Used for Project Evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Evaluation. A Appendix A to Part 611 Transportation Other Regulations Relating to Transportation (Continued...,” reflects the importance of transit-supportive local land use and related conditions and policies as an... Benefits. (1) The forecast change in criteria pollutant emissions and in greenhouse gas...

  18. 49 CFR Appendix A to Part 611 - Description of Measures Used for Project Evaluation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Evaluation. A Appendix A to Part 611 Transportation Other Regulations Relating to Transportation (Continued...,” reflects the importance of transit-supportive local land use and related conditions and policies as an... Benefits. (1) The forecast change in criteria pollutant emissions and in greenhouse gas...

  19. AN INTEGRATED RESEARCH AGENDA TO EVALUATE TAP WATER DISINFECTION BYPRODUCTS AND HUMAN HEALTH: PART 1

    EPA Science Inventory

    An Integrated Research Agenda to Evaluate Tap Water Disinfection Byproducts and Human Health: Part I

    Michele Lynberg1, David Ashley 2, Pauline Mendola3, J. R. Nuckols4, Kenneth Cantor5, Benjamin Blount 2, Philip Singer6, Charles Wilkes7, Lorraine Backer1, and Peter Langlo...

  20. [Evaluation of the medical value of a drug. A necessity for the Transparency Commission].

    PubMed

    Avouac, B

    1992-01-01

    The marketing approval (AMM) is based on criteria of pharmaceutical quality, efficacy and safety of use. Before marketing, the data are collected by means of double-blind, randomized, prospective clinical trials that compare the study product to a reference product. A post-AMM assessment is needed to define the increase of the medical benefit (ASMR) and the therapeutic value of the new drugs. The quantification of the ASMR is essential for registration on the list of drugs reimbursable for those who benefit from Social Security. The evaluation of the therapeutic value and the nature of the affection treated are the criteria upon which the reimbursement ratio is chosen. After marketing, the reevaluation of the medical benefit and the drugs' usefulness may be compared to the treatment's net medical cost (direct + indirect cost--avoided cost) in cost/utility or cost/benefit studies. The Transparency Commission has worked out a scale of assessment of the ASMR which will orient recommendation, or non-recommendation, of registration on the list of reimbursable drugs as well as price fixing proposals. In the future, the Transparency Commission is to strengthen its position regarding the good use of the drug through a better prescriber information system. Thanks to the pharmaco-epidemiology and the pharmaco-vigilance data, the Transparency Commission will be able to guarantee the post-marketing follow-up of the drugs. The examination of the products' conditions of use, the reevaluation of the treatment's advantages based on the utility studies and the epidemiological surveys, and the cost-benefit studies will contribute to a medical control of health spending linked to drug consumption. PMID:1523604

  1. [Evaluation of the medical value of a drug. A necessity for the Transparency Commission].

    PubMed

    Avouac, B

    1992-01-01

    The marketing approval (AMM) is based on criteria of pharmaceutical quality, efficacy and safety of use. Before marketing, the data are collected by means of double-blind, randomized, prospective clinical trials that compare the study product to a reference product. A post-AMM assessment is needed to define the increase of the medical benefit (ASMR) and the therapeutic value of the new drugs. The quantification of the ASMR is essential for registration on the list of drugs reimbursable for those who benefit from Social Security. The evaluation of the therapeutic value and the nature of the affection treated are the criteria upon which the reimbursement ratio is chosen. After marketing, the reevaluation of the medical benefit and the drugs' usefulness may be compared to the treatment's net medical cost (direct + indirect cost--avoided cost) in cost/utility or cost/benefit studies. The Transparency Commission has worked out a scale of assessment of the ASMR which will orient recommendation, or non-recommendation, of registration on the list of reimbursable drugs as well as price fixing proposals. In the future, the Transparency Commission is to strengthen its position regarding the good use of the drug through a better prescriber information system. Thanks to the pharmaco-epidemiology and the pharmaco-vigilance data, the Transparency Commission will be able to guarantee the post-marketing follow-up of the drugs. The examination of the products' conditions of use, the reevaluation of the treatment's advantages based on the utility studies and the epidemiological surveys, and the cost-benefit studies will contribute to a medical control of health spending linked to drug consumption.

  2. Design and evaluation of a multimodal mHealth based medication management system for patient self administration.

    PubMed

    Schreier, Gunter; Schwarz, Mark; Modre-Osprian, Robert; Kastner, Peter; Scherr, Daniel; Fruhwald, Friedrich

    2013-01-01

    The intake of prescribed medication presents a challenge, in particular for elderly people and in cases where a variety of medications have to be taken in accordance to a complex schedule. To support patients with this task, an mHealth-concept was developed and evaluated in the course of a clinical trial. The system used a multimodal user interface concept, i.e. both RFID tags and barcodes to identify and document the intake of medications. Results of the clinical study with 20 patients indicate that the multimodal mHealth concept utilizing barcode and RFID tags enabled easy-to-use medication management. Although further clinical evaluation is needed to assess whether such a tool can also enhance adherence, the system shows the potential for targeting the problem of medication management with mHealth methods.

  3. Summary of findings from the evaluation of a pilot medically supervised safer injecting facility.

    PubMed

    Wood, Evan; Tyndall, Mark W; Montaner, Julio S; Kerr, Thomas

    2006-11-21

    In many cities, infectious disease and overdose epidemics are occurring among illicit injection drug users (IDUs). To reduce these concerns, Vancouver opened a supervised safer injecting facility in September 2003. Within the facility, people inject pre-obtained illicit drugs under the supervision of medical staff. The program was granted a legal exemption by the Canadian government on the condition that a 3-year scientific evaluation of its impacts be conducted. In this review, we summarize the findings from evaluations in those 3 years, including characteristics of IDUs at the facility, public injection drug use and publicly discarded syringes, HIV risk behaviour, use of addiction treatment services and other community resources, and drug-related crime rates. Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts. These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use.

  4. Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum

    SciTech Connect

    Golden, Daniel W.; Spektor, Alexander; Rudra, Sonali; Ranck, Mark C.; Krishnan, Monica S.; Jimenez, Rachel B.; Viswanathan, Akila N.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.

    2014-01-01

    Purpose: To develop and evaluate a structured didactic curriculum to complement clinical experiences during radiation oncology clerkships at 2 academic medical centers. Methods and Materials: A structured didactic curriculum was developed to teach fundamentals of radiation oncology and improve confidence in clinical competence. Curriculum lectures included: (1) an overview of radiation oncology (history, types of treatments, and basic clinic flow); (2) fundamentals of radiation biology and physics; and (3) practical aspects of radiation treatment simulation and planning. In addition, a hands-on dosimetry session taught students fundamentals of treatment planning. The curriculum was implemented at 2 academic departments in 2012. Students completed anonymous evaluations using a Likert scale to rate the usefulness of curriculum components (1 = not at all, 5 = extremely). Likert scores are reported as (median [interquartile range]). Results: Eighteen students completed the curriculum during their 4-week rotation (University of Chicago n=13, Harvard Longwood Campus n=5). All curriculum components were rated as extremely useful: introduction to radiation oncology (5 [4-5]); radiation biology and physics (5 [5-5]); practical aspects of radiation oncology (5 [4-5]); and the treatment planning session (5 [5-5]). Students rated the curriculum as “quite useful” to “extremely useful” (1) to help students understand radiation oncology as a specialty; (2) to increase student comfort with their specialty decision; and (3) to help students with their future transition to a radiation oncology residency. Conclusions: A standardized curriculum for medical students completing a 4-week radiation oncology clerkship was successfully implemented at 2 institutions. The curriculum was favorably reviewed. As a result of completing the curriculum, medical students felt more comfortable with their specialty decision and better prepared to begin radiation oncology residency.

  5. Preparticipation medical evaluation in professional sport in the UK: theory or practice?

    PubMed Central

    Fuller, C W; Ojelade, E O; Taylor, A

    2007-01-01

    Objective To determine the level of pre‐employment, pre‐season, and post‐injury medical evaluation of players undertaken within UK professional team sports. Design A postal, whole population survey. Setting Elite professional sports teams in England. Population Six groups comprising the following clubs: professional football (Premiership, 15 of 20; Championship, 22 of 24), rugby union (Premiership, 9 of 12; Division 1, 11 of 14), rugby league (Super League, 6 of 11) and cricket (County, 12 of 18). Main outcome measures Number (percentage) of clubs recording players' medical history and undertaking medical examinations of players' cardiovascular, respiratory, neurological, and musculoskeletal systems at pre‐employment, pre‐season and post‐injury. Results The overall response to the survey was 74%, with a range from 55% to 92% among groups. Almost 90% of football (Premiership and Championship) and rugby union (Premiership) clubs took a pre‐employment history of players' general health, cardiovascular, respiratory, neurological, and musculoskeletal systems, but fewer than 50% of cricket and rugby union (Division 1) clubs recorded a history. The majority of football (Premiership and Championship) and rugby union (Premiership) clubs implemented both cardiovascular and musculoskeletal examinations of players before employment. Fewer than 25% of clubs in any of the groups implemented neurological examinations of players at pre‐employment, although 100% of rugby union (Premiership) and rugby league clubs implemented neurological testing during pre‐season. Conclusions None of the sports implemented best practice guidelines for the preparticipation evaluation of players at all stages of their employment. Departures from best practice guidelines and differences in practices between clubs within the same sport leave club physicians vulnerable if their players sustain injuries or ill health conditions that could have been identified and avoided through the

  6. Diagnostic agreement when comparing still and video imaging for the medical evaluation of child sexual abuse.

    PubMed

    Killough, Emily; Spector, Lisa; Moffatt, Mary; Wiebe, Jan; Nielsen-Parker, Monica; Anderst, Jim

    2016-02-01

    Still photo imaging is often used in medical evaluations of child sexual abuse (CSA) but video imaging may be superior. We aimed to compare still images to videos with respect to diagnostic agreement regarding hymenal deep notches and transections in post-pubertal females. Additionally, we evaluated the role of experience and expertise on agreement. We hypothesized that videos would result in improved diagnostic agreement of multiple evaluators as compared to still photos. This was a prospective quasi-experimental study using imaging modality as the quasi-independent variable. The dependent variable was diagnostic agreement of participants regarding presence/absence of findings indicating penetrative trauma on non-acute post-pubertal genital exams. Participants were medical personnel who regularly perform CSA exams. Diagnostic agreement was evaluated utilizing a retrospective selection of videos and still photos obtained directly from the videos. Videos and still photos were embedded into an on-line survey as sixteen cases. One-hundred sixteen participants completed the study. Participant diagnosis was more likely to agree with study center diagnosis when using video (p<0.01). Use of video resulted in statistically significant changes in diagnosis in four of eight cases. In two cases, the diagnosis of the majority of participants changed from no hymenal transection to transection present. No difference in agreement was found based on experience or expertise. Use of video vs. still images resulted in increased agreement with original examiner and changes in diagnostic impressions in review of CSA exams. Further study is warranted, as video imaging may have significant impacts on diagnosis. PMID:26746111

  7. Diagnostic agreement when comparing still and video imaging for the medical evaluation of child sexual abuse.

    PubMed

    Killough, Emily; Spector, Lisa; Moffatt, Mary; Wiebe, Jan; Nielsen-Parker, Monica; Anderst, Jim

    2016-02-01

    Still photo imaging is often used in medical evaluations of child sexual abuse (CSA) but video imaging may be superior. We aimed to compare still images to videos with respect to diagnostic agreement regarding hymenal deep notches and transections in post-pubertal females. Additionally, we evaluated the role of experience and expertise on agreement. We hypothesized that videos would result in improved diagnostic agreement of multiple evaluators as compared to still photos. This was a prospective quasi-experimental study using imaging modality as the quasi-independent variable. The dependent variable was diagnostic agreement of participants regarding presence/absence of findings indicating penetrative trauma on non-acute post-pubertal genital exams. Participants were medical personnel who regularly perform CSA exams. Diagnostic agreement was evaluated utilizing a retrospective selection of videos and still photos obtained directly from the videos. Videos and still photos were embedded into an on-line survey as sixteen cases. One-hundred sixteen participants completed the study. Participant diagnosis was more likely to agree with study center diagnosis when using video (p<0.01). Use of video resulted in statistically significant changes in diagnosis in four of eight cases. In two cases, the diagnosis of the majority of participants changed from no hymenal transection to transection present. No difference in agreement was found based on experience or expertise. Use of video vs. still images resulted in increased agreement with original examiner and changes in diagnostic impressions in review of CSA exams. Further study is warranted, as video imaging may have significant impacts on diagnosis.

  8. Program Evaluation of Remote Heart Failure Monitoring: Healthcare Utilization Analysis in a Rural Regional Medical Center

    PubMed Central

    Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A. Susana; Carroll, Mark

    2015-01-01

    Abstract Background: Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. “Care Beyond Walls and Wires,” a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Materials and Methods: Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. Results: HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. Conclusions: The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems. PMID:25025239

  9. Financial impact of radiological reports on medical-legal evaluation of compensation for meniscal lesions.

    PubMed

    Lelario, M; Ciuffreda, P; Lupo, P; Bristogiannis, C; Vinci, R; Stoppino, L P; De Filippo, M; Macarini, L

    2013-08-01

    To evaluate any discrepancy between radiological reports for clinical purposes and for medicolegal purposes and to quantify its economic impact on repayments made by private insurance companies for meniscal injuries of the knee. The medical records obtained pertaining to 108 knee injury patients (mean age 43.3 years) assessed over a period of 12 months were analysed. Clinical medical reports, aimed at assessing the lesion, and medicolegal reports, drawn up with a view to quantifying compensation, were compared. Unlike reports for clinical purposes in reports for medicolegal purposes, in the evaluation of meniscal lesions, in addition to morphological features of lesions, chronological, topographical, severity and exclusion criteria were applied. To estimate the economic impact resulting from the biological damage, we consulted an actuarial table based on the 9-point minor incapacity classification system. Meniscal lesions not compatible with a traumatic event and therefore not eligible for an insurance payout were found in 56 patients. Of these, 37 failed exclusion criteria, while 19 failed to meet chronological criteria. This difference resulted in a reduction in compensation made by private insurance companies with savings estimated with a saving between euro 203,715.41 and euro 622,315.39. The use of a clinical report for medicolegal purposes can be a source of valuation error, as chronological and/or dynamic information regarding the trauma mechanism may be lacking. Therefore, the use of a full radiological appraisal allows a better damage's assessment and an adequate compensation for injuries.

  10. The medical evaluation of living kidney donors: a survey of US transplant centers.

    PubMed

    Mandelbrot, D A; Pavlakis, M; Danovitch, G M; Johnson, S R; Karp, S J; Khwaja, K; Hanto, D W; Rodrigue, J R

    2007-10-01

    The use of living donors for kidney transplantation in the United States is common, and long-term studies have demonstrated the safety of donation by young, healthy individuals. However, transplant programs have little data to guide them in deciding which donors are unacceptable, and which characteristics are associated with kidney disease or poor psychosocial outcomes after donation. To document current practices in evaluating potential donors, we surveyed all US kidney transplant programs. Compared to a survey 12 years ago, medical criteria for donation are more inclusive in several areas. All responding programs now accept living unrelated donors. Most programs no longer have an upper age limit to be eligible. Programs are now more likely to accept donors with treated hypertension, or a history of kidney stones, provided that certain additional criteria are met. In contrast, medical criteria for donation are more restrictive in other areas, such as younger donor age and low creatinine clearance. Overall, significant variability remains among transplant programs in the criteria used to evaluate donors. These findings highlight the need for more data on long-term outcomes in various types of donors with potential morbidities related to donation.

  11. Injuries to the shoulder in the throwing athlete. Part two: evaluation/treatment.

    PubMed

    Meister, K

    2000-01-01

    In part one of this three-part series (March/April 2000), I concentrated on summarizing the biomechanics of the normal throwing shoulder and the pathophysiology of injury. A classification of injury was presented that was based on the principles contained in that article. Part two of this series will focus on the evaluation and treatment of injuries, expanded from an understanding of the principles learned in part one. The ability to perform a skillful examination, and thus develop an accurate diagnosis, is the foundation for treatment. Fortunately, many difficulties encountered in a thrower's shoulder can be treated with a nonoperative approach. However, in instances where conservative measures fail, an improved understanding of the pathophysiology of injury and the development of improved surgical techniques are leading to more accurate diagnoses and more successful rates of return of the athlete to a premorbid level of activity.

  12. One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Health Care Needs, Part Two--Care Coordination

    ERIC Educational Resources Information Center

    Kondrad, Monica; Zehr, Bonnie; Hanna, Christine; Rote, Vicki; Jain, Sweety

    2007-01-01

    The Medical Home series follows fictional parents Amita and Samir and their premature daughter, Anjali. In Part Two, Amita and Samir bring Anjali home from the hospital, contact the care coordinator who will be responsible for Anjali's care, and go to their first appointment with the pediatrician. Emphasis is placed on the manner in which the…

  13. 20 CFR 416.969 - Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter. 416.969 Section 416.969 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining Disability and Blindness...

  14. Medical management of chronic liver diseases in children (part I): focus on curable or potentially curable diseases.

    PubMed

    El-Shabrawi, Mortada H F; Kamal, Naglaa M

    2011-12-01

    The management of children with chronic liver disease (CLD) mandates a multidisciplinary approach. CLDs can be classified into 'potentially' curable, treatable non-curable, and end-stage diseases. Goals pertaining to the management of CLDs can be divided into prevention or minimization of progressive liver damage in curable CLD by treating the primary cause; prevention or control of complications in treatable CLD; and prediction of the outcome in end-stage CLD in order to deliver definitive therapy by surgical procedures, including liver transplantation. Curative, specific therapies aimed at the primary causes of CLDs are, if possible, best considered by a pediatric hepatologist. Medical management of CLDs in children will be reviewed in two parts, with part I (this article) specifically focusing on 'potentially' curable CLDs. Dietary modification is the cornerstone of management for galactosemia, hereditary fructose intolerance, and certain glycogen storage diseases, as well as non-alcoholic steatohepatitis. It is also essential in tyrosinemia, in addition to nitisinone [2-(nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione] therapy, as well as in Wilson disease along with copper-chelating agents such as D-penicillamine, triethylenetetramine dihydrochloride, and ammonium tetrathiomolybdate. Zinc and antioxidants are adjuvant drugs in Wilson disease. New advances in chronic viral hepatitis have been made with the advent of oral antivirals. In children, currently available drugs for the treatment of chronic hepatitis B virus infection are standard interferon (IFN)-α-2, pegylated IFN-α-2 (PG-IFN), and lamivudine. In adults, adefovir and entecavir have also been licensed, whereas telbivudine, emtricitabine, tenofovir disoproxil fumarate, clevudine, and thymosin α-1 are currently undergoing clinical testing. For chronic hepatitis C virus infection, the most accepted treatment is PG-IFN plus ribavirin. Corticosteroids, with or without azathioprine, remain the basic

  15. Shortcomings in the evaluation of students' clinical skills and behaviors in medical school.

    PubMed

    Kassebaum, D G; Eaglen, R H

    1999-07-01

    The authors review the methods by which U.S. medical schools have evaluated student achievement during the twentieth century, especially for the assessment of noncognitive abilities, including clinical skills and behaviors. With particular reference to the current decade, information collected by the Liaison Committee on Medical Education (LCME) is used to examine the congruence of assessment methods with the rising tide of understanding--and accreditation requirements--that knowledge, competence, and behavioral objectives require different methods of assessment to measure the extent of students' learning in each domain. Amongst 97 medical schools having accreditation surveys between July 1993 and June 1998, only 186 of 751 basic science courses tested students' noncognitive achievements in things such as the preparation for and participation in small-group conferences, the quality of case-based discussion, library research and literature reviews, and research projects, despite staking out scholarship, habits of life-long learning, and reasoned thinking as educational objectives. In the clerkships of these schools, structured and observed assessments of clinical skills--with standardized patients and/or OSCEs--contributed 7.4-23.1% to a student's grade (depending on the clerkship discipline), while the predominant contribution (50-70% across the clerkships) was made by resident and faculty ratings that were based largely on recollections of case presentations and discussions having little relationship to interpersonal skills, rapport with patients, and logical and sequenced history taking and physical examination. On a more optimistic note, the results show that the number of schools using standardized patients in one or more clerkships increased between 1993 and 1998 from 34.1% to 50.4% of the 125 schools in the United States, and the number of schools using standardized patients in comprehensive fourth-year examinations increased from 19.1% to 48% of the total

  16. Houston's medical disaster response to Hurricane Katrina: part 2: transitioning from emergency evacuee care to community health care.

    PubMed

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

    2009-04-01

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

  17. Adherence to antidepressant medications: an evaluation of community pharmacists’ counseling practices

    PubMed Central

    Chong, Wei Wen; Aslani, Parisa; Chen, Timothy F

    2013-01-01

    Background Recent studies have shown that pharmacists have a role in addressing antidepressant nonadherence. However, few studies have explored community pharmacists’ actual counseling practices in response to antidepressant adherence-related issues at various phases of treatment. The purpose of this study was to evaluate counseling practices of community pharmacists in response to antidepressant adherence-related issues. Methods A simulated patient method was used to evaluate pharmacist counseling practices in Sydney, Australia. Twenty community pharmacists received three simulated patient visits concerning antidepressant adherence-related scenarios at different phases of treatment: 1) patient receiving a first-time antidepressant prescription and hesitant to begin treatment; 2) patient perceiving lack of treatment efficacy for antidepressant after starting treatment for 2 weeks; and 3) patient wanting to discontinue antidepressant treatment after 3 months due to perceived symptom improvement. The interactions were recorded and analyzed to evaluate the content of consultations in terms of information gathering, information provision including key educational messages, and treatment recommendations. Results There was variability among community pharmacists in terms of the extent and content of information gathered and provided. In scenario 1, while some key educational messages such as possible side effects and expected benefits from antidepressants were mentioned frequently, others such as the recommended length of treatment and adherence-related messages were rarely addressed. In all scenarios, about two thirds of pharmacists explored patients’ concerns about antidepressant treatment. In scenarios 2 and 3, only half of all pharmacists’ consultations involved questions to assess the patient’s medication use. The pharmacists’ main recommendation in response to the patient query was to refer the patient back to the prescribing physician. Conclusion The

  18. Evaluation of Electronic Medical Record (EMR) at Large Urban Primary Care Sexual Health Centre

    PubMed Central

    Huffam, Sarah; Cummings, Rosey; Chen, Marcus Y.; Sze, Jun K.; Fehler, Glenda; Bradshaw, Catriona S.; Schmidt, Tina; Berzins, Karen; Hocking, Jane S.

    2013-01-01

    Objective Despite substantial investment in Electronic Medical Record (EMR) systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. Methods We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. Results There were 9,752 doctor consultations (in 5,512 consulting hours) in the Paper Medical Record (PMR) period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08) after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17). A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01) and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61). Conclusion The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided. PMID:23593268

  19. Thermoelectric Generators for Automotive Waste Heat Recovery Systems Part II: Parametric Evaluation and Topological Studies

    NASA Astrophysics Data System (ADS)

    Kumar, Sumeet; Heister, Stephen D.; Xu, Xianfan; Salvador, James R.; Meisner, Gregory P.

    2013-06-01

    A comprehensive numerical model has been proposed to model thermoelectric generators (TEGs) for automotive waste heat recovery. Details of the model and results from the analysis of General Motors' prototype TEG were described in part I of the study. In part II of this study, parametric evaluations are considered to assess the influence of heat exchanger, geometry, and thermoelectric module configurations to achieve optimization of the baseline model. The computational tool is also adapted to model other topologies such as transverse and circular configurations (hexagonal and cylindrical) maintaining the same volume as the baseline TEG. Performance analysis of these different topologies and parameters is presented and compared with the baseline design.

  20. Costs and Their Assessment to Users of a Medical Library, Part I: An Overview of Services, Users, and Budgeting of a Medical Library.

    ERIC Educational Resources Information Center

    Bres, E.; And Others

    This study investigated ways in which the costs of a library's direct and indirect services can be equitably allocated to its heterogeneous group of institution users. It was conducted from October 1, 1974 to March 31, 1977. The final report is divided into four parts, each describing a separate issue. Part I discusses the general administrative…

  1. A bayesian two-part latent class model for longitudinal medical expenditure data: assessing the impact of mental health and substance abuse parity.

    PubMed

    Neelon, Brian; O'Malley, A James; Normand, Sharon-Lise T

    2011-03-01

    In 2001, the U.S. Office of Personnel Management required all health plans participating in the Federal Employees Health Benefits Program to offer mental health and substance abuse benefits on par with general medical benefits. The initial evaluation found that, on average, parity did not result in either large spending increases or increased service use over the four-year observational period. However, some groups of enrollees may have benefited from parity more than others. To address this question, we propose a Bayesian two-part latent class model to characterize the effect of parity on mental health use and expenditures. Within each class, we fit a two-part random effects model to separately model the probability of mental health or substance abuse use and mean spending trajectories among those having used services. The regression coefficients and random effect covariances vary across classes, thus permitting class-varying correlation structures between the two components of the model. Our analysis identified three classes of subjects: a group of low spenders that tended to be male, had relatively rare use of services, and decreased their spending pattern over time; a group of moderate spenders, primarily female, that had an increase in both use and mean spending after the introduction of parity; and a group of high spenders that tended to have chronic service use and constant spending patterns. By examining the joint 95% highest probability density regions of expected changes in use and spending for each class, we confirmed that parity had an impact only on the moderate spender class.

  2. Evaluation of an Early Medical School Selection Program for Underrepresented Minority Students.

    ERIC Educational Resources Information Center

    Edelin, Kenneth C.; Ugbolue, Augustine

    2001-01-01

    Correlated medical school performance of underrepresented minority students participating in Boston University's Early Medical School Selection Program with their Scholastic Aptitude Test and Medical College Admission Test scores. Found that students with higher scores had more success completing their first two years of medical school and passing…

  3. Analysis of induced radionuclides in replacement parts and liquid wastes in a medical cyclotron solely used for production of 18F for [18F]FDG.

    PubMed

    Mochizuki, S; Ishigure, N; Ogata, Y; Kobayashi, T

    2013-04-01

    Radioactivities produced in replacement parts and liquid wastes in a medical cyclotron used to produce (18)F for [(18)F]FDG with 10MeV protons were analyzed. Nineteen radionuclides were found in the replacement parts and liquid wastes. Among them, long-lived (56)Co in the Havar foils is critical in terms of radioactive waste management. The estimated dose level of exposure for the operating staff during the replacement of parts was around 310μSv/y, which is smaller than the recommended dose limit for workers.

  4. A new standardized method of evaluating cutaneous irritation from topical medications.

    PubMed

    Uliasz, Annemarie; Lebwohl, Mark

    2008-07-01

    We used a new technique to evaluate and compare cutaneous irritation from various topical medications. Twenty participants with corticosteroid-responsive dermatoses were enrolled. Three target areas of unaffected skin were abraded. A negative control (petrolatum ointment), a positive control (an over-the-counter [OTC] anti-itch preparation containing benzyl alcohol), and a test product (fluticasone propionate lotion 0.05%) were each applied to separate targetareas on the legs. Participants rated the irritation of each target area using a 10-point scale (1 [no symptoms] to 10 [intolerable burning/ stinging requiring removal of the medication]). The mean irritation scores for petrolatum ointment, the OTC anti-itch preparation, and fluticasone propionate lotion 0.05% were 1.20, 6.15, and 2.05, respectively. The difference in irritation between the OTC anti-itch preparation and fluticasone propionate lotion 0.05% was highly significant (P < .0001). The difference in irritation between the OTC anti-itch preparation and petrolatum ointment also was highly significant (P < .0001). The difference in irritation between fluticasone propionate lotion 0.05% and petrolatum ointment also was statistically significant (P = .0104). Irritation scores were then standardized on a 10-point scale, with the irritation score of the negative control given a value of 1.00 and the irritation score of the positive control given a value of 10.00. The standardized irritation score of the test product, fluticasone propionate lotion 0.05%, was calculated to be 2.55. Our assay was able to detect and quantify even minimal cutaneous irritation secondary to application of topical medications.

  5. Field evaluations of residual pesticide applications and misting system on militarily relevant materials against medically important mosquitoes in Thailand

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A key strategy to reduce insect-borne disease is to reduce contact between disease vectors and hosts. In the current study, residual pesticide application and misting system were applied on militarily relevant materials and evaluated against medically important mosquitoes. Field evaluations were car...

  6. The Partnership of Medical Genetics and Oral and Maxillofacial Surgery When Evaluating Craniofacial Anomalies.

    PubMed

    Lin, Angela E

    2015-12-01

    A medical geneticist who has an interest in craniofacial anomalies forms a natural partnership with an oral and maxillofacial surgeon, which facilitates patient care. Using complementary diagnostic and therapeutic skills, the search for a recognizable pattern can lead to a syndrome diagnosis. After the initial examination, there is usually genetic testing to confirm the clinical diagnosis. Once established, care coordination and genetic counseling can be provided for the parents and the patient. Enrolling the patient into a research study could be helpful to understand the diagnosis but, in some circumstances, might not have immediate clinical relevance. A multidisciplinary craniofacial team is generally necessary for long-term management. This article discusses illustrative patients evaluated from 2007 through 2011 with the senior oral and maxillofacial surgeon at the Massachusetts General Hospital (Leonard B. Kaban, DMD, MD). These include single patients with the Nablus mask-like facies syndrome and auriculo-condylar syndrome and a series of 20 patients with Gorlin syndrome followed by a multispecialty team. A successful collaboration between a medical geneticist and an oral and maxillofacial surgeon optimizes the treatment of patients with craniofacial anomalies.

  7. Characterization of a pressure measuring system for the evaluation of medical devices.

    PubMed

    Bonnaire, Rébecca; Verhaeghe, Marion; Molimard, Jérôme; Calmels, Paul; Convert, Reynald

    2014-12-01

    The purpose of this study is to evaluate the possible use of four "FSA" thin and flexible resistive pressure mapping systems, designed by Vista Medical (Winnipeg, Manitoba, Canada), for the measurement of interface pressure exerted by lumbar belts onto the trunk. These sensors were originally designed for the measurement of low pressure applied by medical devices on the skin. Two types of tests were performed: standard metrology tests such as linearity, hysteresis, repeatability, reproducibility and drift, and specific tests for this application such as curvature, surface condition and mapping system superposition. The linear regression coefficient is between 0.86 and 0.98; hysteresis is between 6.29% and 9.41%. Measurements are repeatable. The location, time and operator, measurement surface condition and mapping system superposition have a statistically significant influence on the results. A stable measure is verified over the period defined in the calibration procedure, but unacceptable drift is observed afterward. The measurement stays suitable on a curved surface for an applied pressure above 50 mmHg. To conclude, the sensor has acceptable linearity, hysteresis and repeatability. Calibration must be adapted to avoid drift. Moreover, when comparing different measurements with this sensor, the location, the time, the operator and the measurement surface condition should not change; the mapping system must not be superimposed.

  8. Evaluating interactive computer-based scenarios designed for learning medical technology.

    PubMed

    Persson, Johanna; Dalholm, Elisabeth Hornyánszky; Wallergård, Mattias; Johansson, Gerd

    2014-11-01

    The use of medical equipment is growing in healthcare, resulting in an increased need for resources to educate users in how to manage the various devices. Learning the practical operation of a device is one thing, but learning how to work with the device in the actual clinical context is more challenging. This paper presents a computer-based simulation prototype for learning medical technology in the context of critical care. Properties from simulation and computer games have been adopted to create a visualization-based, interactive and contextually bound tool for learning. A participatory design process, including three researchers and three practitioners from a clinic for infectious diseases, was adopted to adjust the form and content of the prototype to the needs of the clinical practice and to create a situated learning experience. An evaluation with 18 practitioners showed that practitioners were positive to this type of tool for learning and that it served as a good platform for eliciting and sharing knowledge. Our conclusion is that this type of tools can be a complement to traditional learning resources to situate the learning in a context without requiring advanced technology or being resource-demanding. PMID:24898339

  9. Evaluating interactive computer-based scenarios designed for learning medical technology.

    PubMed

    Persson, Johanna; Dalholm, Elisabeth Hornyánszky; Wallergård, Mattias; Johansson, Gerd

    2014-11-01

    The use of medical equipment is growing in healthcare, resulting in an increased need for resources to educate users in how to manage the various devices. Learning the practical operation of a device is one thing, but learning how to work with the device in the actual clinical context is more challenging. This paper presents a computer-based simulation prototype for learning medical technology in the context of critical care. Properties from simulation and computer games have been adopted to create a visualization-based, interactive and contextually bound tool for learning. A participatory design process, including three researchers and three practitioners from a clinic for infectious diseases, was adopted to adjust the form and content of the prototype to the needs of the clinical practice and to create a situated learning experience. An evaluation with 18 practitioners showed that practitioners were positive to this type of tool for learning and that it served as a good platform for eliciting and sharing knowledge. Our conclusion is that this type of tools can be a complement to traditional learning resources to situate the learning in a context without requiring advanced technology or being resource-demanding.

  10. The Partnership of Medical Genetics and Oral and Maxillofacial Surgery When Evaluating Craniofacial Anomalies.

    PubMed

    Lin, Angela E

    2015-12-01

    A medical geneticist who has an interest in craniofacial anomalies forms a natural partnership with an oral and maxillofacial surgeon, which facilitates patient care. Using complementary diagnostic and therapeutic skills, the search for a recognizable pattern can lead to a syndrome diagnosis. After the initial examination, there is usually genetic testing to confirm the clinical diagnosis. Once established, care coordination and genetic counseling can be provided for the parents and the patient. Enrolling the patient into a research study could be helpful to understand the diagnosis but, in some circumstances, might not have immediate clinical relevance. A multidisciplinary craniofacial team is generally necessary for long-term management. This article discusses illustrative patients evaluated from 2007 through 2011 with the senior oral and maxillofacial surgeon at the Massachusetts General Hospital (Leonard B. Kaban, DMD, MD). These include single patients with the Nablus mask-like facies syndrome and auriculo-condylar syndrome and a series of 20 patients with Gorlin syndrome followed by a multispecialty team. A successful collaboration between a medical geneticist and an oral and maxillofacial surgeon optimizes the treatment of patients with craniofacial anomalies. PMID:26608141

  11. Evaluation of PHBHHx and PHBV/PLA fibers used as medical sutures.

    PubMed

    He, Yu; Hu, Zhiwei; Ren, Mengda; Ding, Changkun; Chen, Peng; Gu, Qun; Wu, Qiong

    2014-02-01

    Two types of fibers were prepared by using bio-based materials: a mono-filament made from poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and a multi-filament made from poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and polylactic acid (PLA) blend. The two fibers were evaluated for mechanical properties, biocompatibility and degradability for the potential application as medical sutures. The PHBHHx fiber showed remarkable biocompatibility by H.E. Stainning, with very little impact to the surrounding tissues. The degradation of the fiber was observed by SEM after implantation for 36 weeks, and the major degradation product was detected after 96 weeks. Consistently, the PHBHHx fiber maintained more than half of the mechanical properties after 96 weeks. The other fiber was prepared by twisting PHBV/PLA blend strands to a bunch, and showed high biocompatibility and relatively high degradability. The bunched structure loosed after 36 weeks of implantation. These low-cost and easily prepared fibers have great potential in medical applications, since they could avoid the formation of fibrous capsule, reduce the size of scar, and degrade into non-toxic and even beneficial products.

  12. Numerical evaluation of the production of radionuclides in a nuclear reactor (Part II).

    PubMed

    Mirzadeh, S; Walsh, P

    1998-04-01

    A computer program called LAURA has been developed to predict the production rates of any member of a nuclei network undergoing spontaneous decay and/or induced neutron transformation in a nuclear reactor. The theoretical bases for the development of LAURA were discussed in Part I. In particular, in Part I, we described how an expression based on the Rubinson (1949) approach is used to evaluate the depletion function. In this paper (Part II), we describe the full simulation of radionuclide production including the decomposition of a reaction network into independent linear chains, provisions for periodic reactor shutdown and restart, and implementation of an approximate solution given by Raykin and Shlyakhter (1989) to account for the effect of feedback due to alpha decay. Also included are some examples which demonstrate possible uses for LAURA.

  13. Considerations in the Evaluation of Potential Efficacy of Medications for Alcohol and Drug Use Disorders: An Editorial.

    PubMed

    Egli, M; White, D A; Acri, J B

    2016-01-01

    The societal burden created by alcohol and drug use disorders is estimated to be on the order of hundreds of billions of dollars, creating a need for effective medications to reduce use and prevent relapse. While there are FDA-approved medications to facilitate abstinence and prevent relapse for some indications including, alcohol, tobacco, and opiate use disorders, there are no approved treatments for other abused substances, including cocaine, methamphetamine, and cannabis, leaving these critical medical needs unmet. The development of such medications has fallen largely to the government with efforts spearheaded by the National Institute on Drug Abuse and the National Institute on Alcoholism and Alcohol Abuse. Both agencies have medication development programs with preclinical components that include the standardized evaluation of compounds using animal models. This chapter describes the rationale and considerations involved in the use of such models, including reinstatement of drug self-administration. PMID:27055609

  14. Evaluation of computer-based medical histories taken by patients at home

    PubMed Central

    Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L

    2012-01-01

    The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history—the family and social histories—for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference. PMID:22237866

  15. [HPLC-fingerprint-based quality evaluation on a Tibetan medicine Phyllanthus emblica and its tannin parts].

    PubMed

    Sun, Xue-Fei; Zhang, Hong-Yan; Xia, Qing; Zhao, Hai-Juan; Wu, Ling-Fang; Zhang, Lan-Zhen; Shi, Ren-Bing

    2014-04-01

    This study is to establish the fingerprint for Phyllanthus emblica and their tannin parts from different habitats by HPLC for its quality control. The determination was carried out on a Diamonsil C18 (4.6 mm x 250 mm, 5 microm) column, with methanol-0.2% glacial acetic acid as mobile phase with gradient elution at a flow rate of 1 mL x min(-1). The temperature was maintained at 30 degrees C and the detected wavelength is 260 nm, Thirteen chromatographic peaks were extracted as the common peaks of the fingerprint of P. emblica, and eleven as the common peaks of P. emblica tannin parts, and five peaks were identified by comparing with referent samples. The fingerprints of 8 samples were compared and classified by similarity evaluation, cluster analysis and principal component analysis (PCA). The similarity degrees of eight P. emblica were between 0.763 and 0.993, while tannin parts were between 0.903 and 0.991. All the samples of P. emblica and their tannin parts were classified into 3 categories. The method was so highly reproducible, simple and reliable that it could provide basis for quality control and evaluation of P. emblica from different habitats. PMID:25011249

  16. Evaluation of the deformation parameters of the northern part of Eg

    NASA Astrophysics Data System (ADS)

    Mohamed, Abdel-Monem S.; Radwan, Ali M.; Sharf, Mohamed; Hamimi, Zakaria; Hegazy, Esraa E.; Abou Aly, Nadia; Gomaa, Mahmoud

    2016-06-01

    The northern part of Egypt is a rapidly growing development accompanied by the increased levels of standard living particularly in its urban areas. From tectonic and seismic point of views, the northern part of Egypt is one of the interested regions. It shows an active geologic structure attributed to the tectonic movements of the African and Eurasian plates from one side and the Arabian plate from the other side. From historical point of view and recent instrumental records, the northern part of Egypt is one of the seismo-active regions in Egypt. The investigations of the seismic events and their interpretations had led to evaluate the seismic hazard for disaster mitigation, for the safety of the densely populated regions and the vital projects. In addition to the monitoring of the seismic events, the most powerful technique of Global Navigation Satellite System (GNSS) will be used in determining crustal deformation where a geodetic network covers the northern part of Egypt. Joining the GPS Permanent stations of the northern part of Egypt with the Southern part of Europe will give a clear picture about the recent crustal deformation and the African plate velocity. The results from the data sets are compared and combined in order to determine the main characteristics of the deformation and hazard estimation for specified regions. Final compiled output from the seismological and geodetic analysis will throw lights upon the geodynamical regime of these seismo-active regions. This work will throw lights upon the geodynamical regime and to delineate the crustal stress and strain fields in the study region. This also enables to evaluate the active tectonics and surface deformation with their directions from repeated geodetic observations. The results show that the area under study suffers from continuous seismic activity related to the crustal movements taken place along trends of major faults

  17. Emergency medical services capacities in the developing world: preliminary evaluation and training in Addis Ababa, Ethiopia.

    PubMed

    Pozner, Charles N; Bayleygne, Tesfaye M; Davis, Mark A; Benin-Goren, Odeda; Noble, Vicki E; Halpern, Pinchas

    2003-01-01

    In December 1999, a group of emergency physicians from the United States, Israel, and Ethiopia met for the Second Annual Symposium on Emergency Medicine and to perform an initial evaluation of the prehospital care system in Addis Ababa. The symposium was structured into a workshop on prehospital care and a clinical seminar for emergency medicine providers. This article describes the current prehospital infrastructure in Addis Ababa, Ethiopia. This serves as the basis for more specific needs assessments and training interventions, which are ongoing. The authors present a list of priorities for the development of an emergency medical services (EMS) system for Addis Ababa that was generated in partnership with local government and the World Health Organization. The article contrasts these initial recommendations with those found in the literature on the development of EMS systems in developing nations.

  18. Development and Preliminary Evaluation of a Prototype of a Learning Electronic Medical Record System

    PubMed Central

    King, Andrew J.; Cooper, Gregory F.; Hochheiser, Harry; Clermont, Gilles; Visweswaran, Shyam

    2015-01-01

    Electronic medical records (EMRs) are capturing increasing amounts of data per patient. For clinicians to efficiently and accurately understand a patient’s clinical state, better ways are needed to determine when and how to display EMR data. We built a prototype system that records how physicians view EMR data, which we used to train models that predict which EMR data will be relevant in a given patient. We call this approach a Learning EMR (LEMR). A physician used the prototype to review 59 intensive care unit (ICU) patient cases. We used the data-access patterns from these cases to train logistic regression models that, when evaluated, had AUROC values as high as 0.92 and that averaged 0.73, supporting that the approach is promising. A preliminary usability study identified advantages of the system and a few concerns about implementation. Overall, 3 of 4 ICU physicians were enthusiastic about features of the prototype. PMID:26958296

  19. Using natural experiments to evaluate population health interventions: new Medical Research Council guidance.

    PubMed

    Craig, Peter; Cooper, Cyrus; Gunnell, David; Haw, Sally; Lawson, Kenny; Macintyre, Sally; Ogilvie, David; Petticrew, Mark; Reeves, Barney; Sutton, Matt; Thompson, Simon

    2012-12-01

    Natural experimental studies are often recommended as a way of understanding the health impact of policies and other large scale interventions. Although they have certain advantages over planned experiments, and may be the only option when it is impossible to manipulate exposure to the intervention, natural experimental studies are more susceptible to bias. This paper introduces new guidance from the Medical Research Council to help researchers and users, funders and publishers of research evidence make the best use of natural experimental approaches to evaluating population health interventions. The guidance emphasises that natural experiments can provide convincing evidence of impact even when effects are small or take time to appear. However, a good understanding is needed of the process determining exposure to the intervention, and careful choice and combination of methods, testing of assumptions and transparent reporting is vital. More could be learnt from natural experiments in future as experience of promising but lesser used methods accumulates.

  20. Iliad and Medical HouseCall: evaluating the impact of common sense knowledge on the diagnostic accuracy of a medical expert system.

    PubMed Central

    Bouhaddou, O.; Lambert, J. G.; Morgan, G. E.

    1995-01-01

    Diagnostic expert systems are gaining acceptance among physicians. Recently, a comparative study of the performance of four major commercial diagnostic programs demonstrated that the information they produce contains a certain amount of irrelevancy that the trained physician ignores. Medical HouseCall is a consumer health information expert system based on a medical expert system for physicians, Iliad. To enhance the usefulness of Medical HouseCall to health care consumers, we are interested in significantly reducing the amount of irrelevancy contained in the diagnostic differential list. Testing with over 470 'textbook' cases revealed that a large part of the irrelevancy can be eliminated by adding universal and medical 'common sense' knowledge. Using four performance measures, we compared, on a subset of cases, the differential lists from two versions of the program: the refined knowledge base (1995) and an older version (1994) 'pre-common sense'. The results suggest that the performance of a diagnostic expert system can be significantly improved with the addition of common sense knowledge. PMID:8563388