Oosterom-Calo, Rony; Te Velde, Saskia J; Stut, Wim; Brug, Johannes
2015-07-20
It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions. To further promote medication adherence and physical activity among HF patients, we developed an intervention for hospitalized HF patients. The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment, defining change objectives, selecting determinants and strategies, and developing the materials. The resulting intervention, Motivate4Change, makes use of interactive technology and provides HF patients with personalized feedback and advice. Specific change objectives were defined. The relevant behavioral determinants for the physical activity program were practical knowledge on physical activity performance and self-efficacy for, and perceived benefits of, physical activity. For medication-taking, the selected determinants were practical knowledge on medication-taking, perceived barriers to medication-taking, beliefs about the necessity and harm regarding the medication prescribed, and beliefs about overprescribing and harm of medication in general. The change objectives and behavior change determinants were translated in feedback and advice strategies in an interactive technology program that included tailored feedback and advice, and role models in videos in which the behaviors and overcoming barriers were demonstrated. Relevant stakeholders were involved in the interventions development process. The intervention was pretested among HF patients and adjustments were made accordingly. The interactive technology physical activity and medication adherence promotion program for hospitalized HF patients was systematically developed using the intervention mapping protocol and was based on the available theory and evidence regarding HF self-management behavior change. The intervention's efficacy is yet to be determined in evaluation research.
Health care utilization of mexican patients with medically unexplained physical symptoms.
Rodriguez González, Azucena Maribel; Ramírez Aranda, José Manuel; de Los Santos Reséndiz, Homero; Lara Duarte, María Yolanda; Pazaran Zanella, Santiago Oscar; Méndez López, Jafet Felipe; Gil Alfaro, Issa; Islas Ruz, Félix Gilberto; Navarrete Floriano, Gloria; Guillen Salomón, Edith; Texon Fernández, Obdulia; Cruz Duarte, Silvia; Romo Salazar, Juan Carlos; Pérez Ruiz, Claudia Elsa; López Salas, Sara de Jesús; Benítez Amaya, Lizbeth; Zapata Gallardo, Javier Nahum
2016-09-30
To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al . Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs.
Physical disability contributes to caregiver stress in dementia caregivers.
Bruce, David G; Paley, Glenys A; Nichols, Pamela; Roberts, David; Underwood, Peter J; Schaper, Frank
2005-03-01
Previous findings of studies on the impact of physical illness on caregiver health have been inconsistent. The authors wanted to determine whether physical disability, as determined by the SF-12 survey that provides information on both physical and mental health problems, contributes to caregiver stress. The authors interviewed 91 primary caregivers (aged 38-85 years) of persons with dementia who had been referred by their family physicians for the first time for formal support services or memory evaluation. Caregivers completed the SF-12 version of the Medical Outcomes Study Short Form Health Survey that generates Mental Component Summary (MCS) and Physical Component Summary (PCS) scores and reported on caregiver stress and concurrent medical conditions and medications. Most caregivers reported stress (76.9%), having medical conditions (72.4%), or taking medications (67%). The MCS but not the PCS scores were significantly lower than community norms, indicating an excess of disability due to mental health problems. Nevertheless, 40.7% had PCS scores indicating some degree of physical disability. Using multiple logistic regression analysis, PCS scores but not the presence of medical problems were independently associated with caregiver stress. Chronic disability as assessed by SF-12 PCS scores is independently associated with caregiver stress. These data suggest that caregivers of persons with dementia should be assessed for disabling physical conditions and mental health problems. In addition, reducing the impact of physical disability could ameliorate caregiver stress.
20 CFR 416.923 - Multiple impairments.
Code of Federal Regulations, 2010 CFR
2010-04-01
... determining whether your physical or mental impairment or impairments are of a sufficient medical severity... process. If we do not find that you have a medically severe combination of impairments, we will determine...
Biomedical physics in continuing medical education: an analysis of learning needs.
Rotomskis, Ricardas; Karenauskaite, Violeta; Balzekiene, Aiste
2009-01-01
To examine the learning and practice needs of medical professionals in the field of continuing education of biomedical physics in Lithuania. The study was based on a questionnaire survey of 309 medical professionals throughout Lithuania, 3 focus group discussions, and 18 interviews with medical and physics experts. The study showed that medical professionals lack knowledge of physics: only 15.1% of the respondents admitted that they had enough knowledge in biomedical physics to understand the functioning of the medical devices that they used, and 7.5% of respondents indicated that they had enough knowledge to understand and adopt medical devices of the new generation. Physics knowledge was valued more highly by medical professionals with scientific degrees. As regards continuing medical education, it was revealed that personal motivation (88.7%) and responsibility for patients (44.3%) were the most important motives for upgrading competencies, whereas workload (65.4%) and financial limits (45.3%) were the main obstacles. The most popular teaching methods were those based on practical work (78.9%), and the least popular was project work (27.8%). The study revealed that biomedical physics knowledge was needed in both specializations and practical work, and the most important factor for determining its need was professional aspirations. Medical professionals' understanding of medical devices, especially those of the new generation, is essentially functional in nature. Professional upgrading courses contain only fragmented biomedical physics content, and new courses should be developed jointly by experts in physics and medicine to meet the specialized needs of medical professionals.
Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile
2015-04-01
The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
5 CFR 339.202 - Medical standards.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Medical standards. 339.202 Section 339.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.202 Medical standards. OPM may establish...
5 CFR 339.202 - Medical standards.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Medical standards. 339.202 Section 339.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.202 Medical standards. OPM may establish...
5 CFR 339.202 - Medical standards.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Medical standards. 339.202 Section 339.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.202 Medical standards. OPM may establish...
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 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...
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 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...
5 CFR 339.202 - Medical standards.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Medical standards. 339.202 Section 339.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.202 Medical standards. OPM may establish...
5 CFR 339.205 - Medical evaluation programs.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Medical evaluation programs. 339.205 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...
5 CFR 339.202 - Medical standards.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Medical standards. 339.202 Section 339.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.202 Medical standards. OPM may establish...
MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
5 CFR 339.203 - Physical requirements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Physical requirements. 339.203 Section... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.203 Physical requirements. Agencies are authorized to establish physical requirements for individual positions without OPM approval when such...
5 CFR 339.203 - Physical requirements.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Physical requirements. 339.203 Section... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.203 Physical requirements. Agencies are authorized to establish physical requirements for individual positions without OPM approval when such...
5 CFR 339.203 - Physical requirements.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Physical requirements. 339.203 Section... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.203 Physical requirements. Agencies are authorized to establish physical requirements for individual positions without OPM approval when such...
5 CFR 339.203 - Physical requirements.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Physical requirements. 339.203 Section... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.203 Physical requirements. Agencies are authorized to establish physical requirements for individual positions without OPM approval when such...
5 CFR 339.203 - Physical requirements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Physical requirements. 339.203 Section... QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.203 Physical requirements. Agencies are authorized to establish physical requirements for individual positions without OPM approval when such...
MO-F-204-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Szczykutowicz, T.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
MO-F-204-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zambelli, J.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
MO-F-204-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
McKenney, S.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
MO-F-204-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
MacDougall, R.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
WE-D-213-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
MacDougall, R.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Simiele, S.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bevins, N.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zambelli, J.
Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less
8 CFR 312.1 - Literacy requirements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... unable, because of a medically determinable physical or mental impairment or combination of impairments... English language as noted in paragraph (a) of this section. The loss of any cognitive abilities based on..., the term medically determinable means an impairment that results from anatomical, physiological, or...
8 CFR 312.1 - Literacy requirements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... unable, because of a medically determinable physical or mental impairment or combination of impairments... English language as noted in paragraph (a) of this section. The loss of any cognitive abilities based on..., the term medically determinable means an impairment that results from anatomical, physiological, or...
8 CFR 312.1 - Literacy requirements.
Code of Federal Regulations, 2013 CFR
2013-01-01
... unable, because of a medically determinable physical or mental impairment or combination of impairments... English language as noted in paragraph (a) of this section. The loss of any cognitive abilities based on..., the term medically determinable means an impairment that results from anatomical, physiological, or...
Survey on Views and Knowledge of House Officers on Medical-Legal Issues.
ERIC Educational Resources Information Center
Beninger, Paul R.; And Others
1985-01-01
House medical staff of the University of California, Davis, Medical Center were administered a questionnaire to determine their knowledge of relevant medical-legal principles. Responses from 111 house staff indicated that pediatrics, physical medicine, and rehabilitation staff confronted more medical-legal issues than pathology staff. (SW)
Medication and physical activity and physical fitness in severe mental illness.
Perez-Cruzado, David; Cuesta-Vargas, Antonio; Vera-Garcia, Elisa; Mayoral-Cleries, Fermín
2018-05-23
Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers. Copyright © 2018 Elsevier B.V. All rights reserved.
28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.
Code of Federal Regulations, 2010 CFR
2010-07-01
... upon gaining physical control of the inmate. When possible, staff shall seek such assistance at the... seek the guidance of qualified health personnel (based upon a review of the inmate's medical record) to identify physical or mental problems. When mental health staff or qualified health personnel determine that...
van Westrienen, Paula Elisabeth; Pisters, Martijn F; Toonders, Suze Aj; Gerrits, Marloes; Veenhof, Cindy; de Wit, Niek J
2018-05-08
Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms. In the next step, we developed a proactive blended and integrated mental health and physical therapy intervention program (PARASOL) to reduce complaints of moderate medically unexplained physical symptoms, stimulate self-management, and prevent chronicity. The primary objective of this study is to investigate the effectiveness of the blended PARASOL intervention on the impact of symptoms and quality of life in patients with moderate medically unexplained physical symptoms compared with usual care. Secondary objectives are to study the effect on severity of physical and psychosocial symptoms, general health, physical behavior, illness perception, and self-efficacy in patients with moderate medically unexplained physical symptoms as well as to determine the cost-effectiveness of the program. This paper presents the study protocol of a multicenter cluster randomized clinical trial. Adult patients with moderate medically unexplained physical symptoms will be identified from electronic medical record data using the PRESUME screening method and proactively recruited for participation in the study. Cluster randomization will be performed at the level of the participating health care centers. In total 248 patients with moderate medically unexplained physical symptoms (124 patients per arm) are needed. The PARASOL intervention is a 12-week blended primary care program consisting of 4 face-to-face consultations with the mental health nurse and 5 physical therapy sessions, supplemented with a Web-based program. The Web-based program contains (1) information modules and videos on self-management and educative themes, (2) videos and instructions on prescribed home exercises, and (3) assignments to gradually increase the physical activity. The program is directed at patients' perception of symptoms as well as modifiable prognostic risk factors for chronicity using therapeutic neuroscience education. It encourages self-management, as well as an active lifestyle using a cognitive behavioral approach and graded activity. Primary outcomes are impact of symptoms and quality of life. Secondary outcomes are severity of physical and psychosocial symptoms, general health, physical behavior, illness perceptions, self-efficacy, and cost-effectiveness. All measurements will be performed at baseline, 3 and 12 months after baseline. Retrospective cost questionnaires will also be sent at 6 and 9 months after baseline and these will be used for the cost-effectiveness analysis. The intervention has been developed, and the physical therapists and mental health nurses in the participating experimental health care centers have received two days of training on the content of the blended PARASOL intervention. The recruitment of health care centers started in June 2016 and inclusion of patients began in March 2017. Follow-up assessments of patients are expected to be completed in March 2019. This study is the first randomized clinical trial to determine the effectiveness (including cost-effectiveness) of a proactive, blended, and integrated mental health and physical therapy care program for patients with moderate medically unexplained physical symptoms. The findings will help to improve the treatment for patients with moderate medically unexplained physical symptoms and prevent chronicity. Netherlands Trial Register NTR6755; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6755 (Archived by WebCite at http://www.webcitation.org/6ywporY7u). ©Paula Elisabeth van Westrienen, Martijn F Pisters, Suze AJ Toonders, Marloes Gerrits, Cindy Veenhof, Niek J de Wit. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.05.2018.
25 CFR 700.333 - Determination of disability.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES... engage in any substantial gainful activity by reason of any medically determined physical or mental... continuous period of not less than twelve months. A physical or mental impairment is an impairment that...
Haist, Steven A; Wilson, John F; Fosson, Sue E; Brigham, Nancy L
1997-01-01
OBJECTIVE To determine if fourth-year medical students are as effective as faculty in teaching the physical examination to first-year medical students. DESIGN Stratified randomization of the first-year students. SETTING A public medical school. PARTICIPANTS All 100 first-year medical students in one medical school class were randomly assigned (controlling for gender) to either a faculty or a fourth-year student preceptor for the Physical Examination Module. MAIN RESULTS The first-year students of faculty preceptors scored no differently on the written examination than the students of the fourth-year medical student preceptors (82.8% vs 80.3%, p = .09) and no differently on a standardized patient practical examination (95.5% vs 95.4%, p = .92). Also, the first-year students rated the two groups of preceptors similarly on an evaluation form, with faculty rated higher on six items and the student preceptors rated higher on six items (all p > .10). The fourth-year student preceptors rated the experience favorably. CONCLUSIONS Fourth-year medical students were as successful as faculty in teaching first-year medical students the physical examination as measured by first-year student’s performances on objective measures and ratings of teaching effectiveness.
20 CFR 416.927 - Evaluating opinion evidence.
Code of Federal Regulations, 2011 CFR
2011-04-01
... to do any substantial gainful activity by reason of any medically determinable physical or mental..., BLIND, AND DISABLED Determining Disability and Blindness Medical Considerations § 416.927 Evaluating... continuous period of not less than 12 months. (See § 416.905.) If you are a child, you can be found disabled...
20 CFR 416.927 - Evaluating opinion evidence.
Code of Federal Regulations, 2013 CFR
2013-04-01
... to do any substantial gainful activity by reason of any medically determinable physical or mental..., BLIND, AND DISABLED Determining Disability and Blindness Medical Considerations § 416.927 Evaluating... continuous period of not less than 12 months. (See § 416.905.) If you are a child, you can be found disabled...
20 CFR 416.927 - Evaluating opinion evidence.
Code of Federal Regulations, 2012 CFR
2012-04-01
... to do any substantial gainful activity by reason of any medically determinable physical or mental..., BLIND, AND DISABLED Determining Disability and Blindness Medical Considerations § 416.927 Evaluating... continuous period of not less than 12 months. (See § 416.905.) If you are a child, you can be found disabled...
20 CFR 416.927 - Evaluating opinion evidence.
Code of Federal Regulations, 2014 CFR
2014-04-01
... to do any substantial gainful activity by reason of any medically determinable physical or mental..., BLIND, AND DISABLED Determining Disability and Blindness Medical Considerations § 416.927 Evaluating... continuous period of not less than 12 months. (See § 416.905.) If you are a child, you can be found disabled...
ERIC Educational Resources Information Center
Gasparini, William; Knobé, Sandrine; Didierjean, Romaine
2015-01-01
Objective: This study sought to determine the effects of an innovative public health programme offering physical and sports activities on medical prescription to chronically ill patients. Method: Semi-structured interviews were conducted with programme participants at two time points: at the start of their activity (n?=?33) and 3?months after the…
20 CFR 220.13 - Establishment of permanent disability for work in regular railroad occupation.
Code of Federal Regulations, 2013 CFR
2013-04-01
... to be used in determining the weight to be attributed to certain types of evidence. If, after... evidence presented that the claimant can no longer perform his or her regular railroad occupation for...'s medically documented physical and mental impairment(s) to determine if the employee is medically...
20 CFR 220.13 - Establishment of permanent disability for work in regular railroad occupation.
Code of Federal Regulations, 2012 CFR
2012-04-01
... to be used in determining the weight to be attributed to certain types of evidence. If, after... evidence presented that the claimant can no longer perform his or her regular railroad occupation for...'s medically documented physical and mental impairment(s) to determine if the employee is medically...
20 CFR 220.13 - Establishment of permanent disability for work in regular railroad occupation.
Code of Federal Regulations, 2014 CFR
2014-04-01
... to be used in determining the weight to be attributed to certain types of evidence. If, after... evidence presented that the claimant can no longer perform his or her regular railroad occupation for...'s medically documented physical and mental impairment(s) to determine if the employee is medically...
Evaluation in a competency-based educational system.
May, B J
1977-01-01
Competency-based curricula have been implemented at the Medical College of Georgia to prepare students to meet entry level competencies as physical therapists and physical therapist assistants. Criteria-referenced evaluations are used to determine if students have achieved the desired competencies. Performance is measured against the criteria and not other students. The process of developing the system currently in use at the Medical College of Georgia is delineated in some detail and some of the advantages of the system for physical therapy education are discussed.
Tobacco abuse and physical activity among medical students
2009-01-01
Objective This lifestyle is mainly determined during childhood and connected with poor public prophylactic health policy. The aim of this study was to estimate physical activity and level of tobacco abuse, as well as knowledge about health behaviours, among medical students. Methods Questionnaires were completed by Polish (243) and foreign medical students (80). Results It was stated that about 20% of the students smoked cigarettes. Female students from Norway took up smoking significantly more often than other participants, whereas there were more smokers among those from Poland. There was a significantly larger percentage of smoking males from Norway than among male Polish students. The same students presented a low level of physical activity. The smallest level of physical activity was characteristic of the Polish women. Conclusion This situation requires an intensification of activities aimed at supporting pro-health lifestyles and the elimination of unfavourable effects, especially among medical students. PMID:20156733
Medical physics education from the view of the possible structural changes.
Ferencova, E; Kukurova, E
2001-01-01
Teaching subject physics at the university level represents a specific didactic transformation of the scientific field--physics. The determination of the content, extent, used methods, mutual relation to other subjects of curriculum as well as to the entrance knowledge of students are the most important parts of pedagogical activities in the educational process. Based on own experiences, successes and mistakes in teaching so-called medical physics the authors discuss didactic procedures which should support the interest and creativity of students. Some changes in the structure of physics education are recommended. The usefulness of the international collaboration in the framework of projects such as TEMPUS, ERASMUS is also remembered.
Hypothesis-driven physical examination curriculum.
Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James
2017-12-01
Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada
Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob
2012-01-01
The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223
Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada.
Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob
2012-01-05
The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.
Correlates of physical activity level among hemodialysis patients in Selangor, Malaysia.
Wong, S W; Chan, Y M; Lim, T S
2011-12-01
There is mounting evidence demonstrating the importance of adequate physical activity to promote better well-being among hemodialysis patients. Available data pertaining to the levels of physical activity and its determinants among hemodialysis patients is, however, scarce in Malaysia. The objectives of this study are hence to determine the levels of physical activity and it associated factors among hemodialysis patients. A total of 70 subjects were recruited from three dialysis centres in Selangor. A face-to-face interview was conducted to obtain socio-demographic data and subjects' knowledge on dietary sources. Medical history, biochemical parameters and weight status were obtained from medical records. Physical activity level (PAL) was assessed using the Global Physical Activity Questionnaire (GPAQ). A total of 81.4% and 18.6% of the respondents had low and moderate PALs, respectively. Thus, none of the respondents had high PAL. Serum creatinine, education level, personal income and knowledge score on potassium-related medical complications were factors found to correlate significantly with PAL. Multiple linear regression analysis showed that higher PAL was predicted by a lower knowledge score on dietary sodium source, higher education and higher serum creatinine. Despite consistent documentation of the potential positive impact of physical exercise on hemodialysis outcomes, the level of physical activity remains low among these patients. It is hoped that these findings can add to the existing body of knowledge and serve as a supporting document for the formulation of appropriate interventions to improve the status of physical activity among hemodialysis patients in Malaysia.
Students' Physical and Psychological Reactions to Forensic Dissection: Are There Risk Factors?
ERIC Educational Resources Information Center
Sergentanis, Theodoros N.; Papadodima, Stavroula A.; Evaggelakos, Christos I.; Mytilinaios, Dimitrios G.; Goutas, Nikolaos D.; Spiliopoulou, Chara A.
2010-01-01
The reactions of students to forensic dissection encompass psychologico-emotional and physical components. This exploratory study aimed to determine risk factors for students' adverse physical and psychological reactions to forensic dissection. All sixth-year medical students (n = 304) attending the compulsory practical course in forensic medicine…
20 CFR 404.1523 - Multiple impairments.
Code of Federal Regulations, 2010 CFR
2010-04-01
... impairments. In determining whether your physical or mental impairment or impairments are of a sufficient... disability determination process. If we do not find that you have a medically severe combination of...
Medical physics aspects of cancer care in the Asia Pacific region
Kron, T; Cheung, KY; Dai, J; Ravindran, P; Soejoko, D; Inamura, K; Song, JY; Bold, L; Srivastava, R; Rodriguez, L; Wong, TJ; Kumara, A; Lee, CC; Krisanachinda, A; Nguyen, XC; Ng, KH
2008-01-01
Medical physics plays an essential role in modern medicine. This is particularly evident in cancer care where medical physicists are involved in radiotherapy treatment planning and quality assurance as well as in imaging and radiation protection. Due to the large variety of tasks and interests, medical physics is often subdivided into specialties such as radiology, nuclear medicine and radiation oncology medical physics. However, even within their specialty, the role of radiation oncology medical physicists (ROMPs) is diverse and varies between different societies. Therefore, a questionnaire was sent to leading medical physicists in most countries/areas in the Asia/Pacific region to determine the education, role and status of medical physicists. Answers were received from 17 countries/areas representing nearly 2800 radiation oncology medical physicists. There was general agreement that medical physicists should have both academic (typically at MSc level) and clinical (typically at least 2 years) training. ROMPs spent most of their time working in radiotherapy treatment planning (average 17 hours per week); however radiation protection and engineering tasks were also common. Typically, only physicists in large centres are involved in research and teaching. Most respondents thought that the workload of physicists was high, with more than 500 patients per year per physicist, less than one ROMP per two oncologists being the norm, and on average, one megavoltage treatment unit per medical physicist. There was also a clear indication of increased complexity of technology in the region with many countries/areas reporting to have installed helical tomotherapy, IMRT (Intensity Modulated Radiation Therapy), IGRT (Image Guided Radiation Therapy), Gamma-knife and Cyber-knife units. This and the continued workload from brachytherapy will require growing expertise and numbers in the medical physics workforce. Addressing these needs will be an important challenge for the future. PMID:21611001
45 CFR 675.1 - Purpose and authority.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION MEDICAL CLEARANCE... Antarctica. Medical screening examinations are necessary to determine the presence of any physical or...) Presidential Memorandum No. 6646 (February 5, 1982) (available from the National Science Foundation, Office of...
45 CFR 675.1 - Purpose and authority.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION MEDICAL CLEARANCE... Antarctica. Medical screening examinations are necessary to determine the presence of any physical or...) Presidential Memorandum No. 6646 (February 5, 1982) (available from the National Science Foundation, Office of...
45 CFR 675.1 - Purpose and authority.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION MEDICAL CLEARANCE... Antarctica. Medical screening examinations are necessary to determine the presence of any physical or...) Presidential Memorandum No. 6646 (February 5, 1982) (available from the National Science Foundation, Office of...
45 CFR 675.1 - Purpose and authority.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION MEDICAL CLEARANCE... Antarctica. Medical screening examinations are necessary to determine the presence of any physical or...) Presidential Memorandum No. 6646 (February 5, 1982) (available from the National Science Foundation, Office of...
Fit for purpose? Evaluation of an MSc. in medical physics.
van der Putten, W J
2014-05-01
The National University of Ireland in Galway established a Master in Science (MSc.) program in medical physics in 2002. The course was designed to be 90 ECTS(1) credits and of one calendar year duration. From the outset the MSc. was designed to be part of an overall medical physics training program. MSc. programs are now widely used as part of the training and education of medical physicists. There is however paucity of data on the effectiveness of such courses and the purpose of the study reported here is to provide information on one particular MSc. course in medical physics. This is relevant to medical physicists who are involved in the development and running of medical physics training programs. The study used as methodology the Kirkpatrick levels of professional training. It was conducted through an online survey, both from students who graduated from the course and from students who were in the process of completing the course. The survey proved to be an effective way to determine attributes of modules such as learning outcomes, knowledge imparted, quality of teaching materials and others. The survey proved to be remarkably able to demonstrate interventions in the individual course modules. Although the course was shown to be effective in the imparting of the knowledge required to become a qualified medical physicist several areas for improvement were identified. These are mainly in the areas of increased practical experience and in course delivery. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Tao, Yu-Hui; Wu, Yu-Lung; Huang, Wan-Yun
2017-01-01
The evidence literature suggests that physical therapy practitioners are subjected to a high probability of acquiring work-related injuries, but only a few studies have specifically investigated Taiwanese physical therapy practitioners. This study was conducted to determine the relationships among individual and group hospital-level factors that contribute to the medical expenses for the occupational injuries of physical therapy practitioners in Taiwan. Physical therapy practitioners in Taiwan with occupational injuries were selected from the 2013 National Health Insurance Research Databases (NHIRD). The age, gender, job title, hospitals attributes, and outpatient data of physical therapy practitioners who sustained an occupational injury in 2013 were obtained with SAS 9.3. SPSS 20.0 and HLM 7.01 were used to conduct descriptive and hierarchical linear model analyses, respectively. The job title of physical therapy practitioners at the individual level and the hospital type at the group level exert positive effects on per person medical expenses. Hospital hierarchy moderates the individual-level relationships of age and job title with the per person medical expenses. Considering that age, job title, and hospital hierarchy affect medical expenses for the occupational injuries of physical therapy practitioners, we suggest strengthening related safety education and training and elevating the self-awareness of the risk of occupational injuries of physical therapy practitioners to reduce and prevent the occurrence of such injuries.
Abortion Services and Military Medical Facilities
2010-07-08
long -lasting physical health damage to the mother would result if the pregnancy were carried to term when so determined by two physicians. Nor are...with regard to the “severe and long -lasting physical health damage to the mother that would result if the pregnancy were carried to term when so...in uniform by as much as 50%.42 Under the Administration’s long - term defense spending plans, 5,600 civilian medical personnel will be cut from the
Rogers, Elizabeth A; Yost, Kathleen J; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Anderson, Roger T; Eton, David T
2017-01-01
Aims To validate a comprehensive general measure of treatment burden, the Patient Experience with Treatment and Self-Management (PETS), in people with diabetes. Methods We conducted a secondary analysis of a cross-sectional survey study with 120 people diagnosed with type 1 or type 2 diabetes and at least one additional chronic illness. Surveys included established patient-reported outcome measures and a 48-item version of the PETS, a new measure comprised of multi-item scales assessing the burden of chronic illness treatment and self-care as it relates to nine domains: medical information, medications, medical appointments, monitoring health, interpersonal challenges, health care expenses, difficulty with health care services, role activity limitations, and physical/mental exhaustion from self-management. Internal reliability of PETS scales was determined using Cronbach’s alpha. Construct validity was determined through correlation of PETS scores with established measures (measures of chronic condition distress, medication satisfaction, self-efficacy, and global well-being), and known-groups validity through comparisons of PETS scores across clinically distinct groups. In an exploratory test of predictive validity, step-wise regressions were used to determine which PETS scales were most associated with outcomes of chronic condition distress, overall physical and mental health, and medication adherence. Results Respondents were 37–88 years old, 59% female, 29% non-white, and 67% college-educated. PETS scales showed good reliability (Cronbach’s alphas ≥0.74). Higher PETS scale scores (greater treatment burden) were correlated with more chronic condition distress, less medication convenience, lower self-efficacy, and worse general physical and mental health. Participants less (versus more) adherent to medications and those with more (versus fewer) health care financial difficulties had higher mean PETS scores. Medication burden was the scale that was most consistently associated with well-being and patient-reported adherence. Conclusion The PETS is a reliable and valid measure for assessing perceived treatment burden in people coping with diabetes. PMID:29184456
Rogers, Elizabeth A; Yost, Kathleen J; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Anderson, Roger T; Eton, David T
2017-01-01
To validate a comprehensive general measure of treatment burden, the Patient Experience with Treatment and Self-Management (PETS), in people with diabetes. We conducted a secondary analysis of a cross-sectional survey study with 120 people diagnosed with type 1 or type 2 diabetes and at least one additional chronic illness. Surveys included established patient-reported outcome measures and a 48-item version of the PETS, a new measure comprised of multi-item scales assessing the burden of chronic illness treatment and self-care as it relates to nine domains: medical information, medications, medical appointments, monitoring health, interpersonal challenges, health care expenses, difficulty with health care services, role activity limitations, and physical/mental exhaustion from self-management. Internal reliability of PETS scales was determined using Cronbach's alpha. Construct validity was determined through correlation of PETS scores with established measures (measures of chronic condition distress, medication satisfaction, self-efficacy, and global well-being), and known-groups validity through comparisons of PETS scores across clinically distinct groups. In an exploratory test of predictive validity, step-wise regressions were used to determine which PETS scales were most associated with outcomes of chronic condition distress, overall physical and mental health, and medication adherence. Respondents were 37-88 years old, 59% female, 29% non-white, and 67% college-educated. PETS scales showed good reliability (Cronbach's alphas ≥0.74). Higher PETS scale scores (greater treatment burden) were correlated with more chronic condition distress, less medication convenience, lower self-efficacy, and worse general physical and mental health. Participants less (versus more) adherent to medications and those with more (versus fewer) health care financial difficulties had higher mean PETS scores. Medication burden was the scale that was most consistently associated with well-being and patient-reported adherence. The PETS is a reliable and valid measure for assessing perceived treatment burden in people coping with diabetes.
Factors associated with stress among medical students.
Qamar, Khadija; Khan, Najamus Saqib; Bashir Kiani, Muhammad Rizwan
2015-07-01
To determine the probable factors responsible for stress among undergraduate medical students. The qualitative descriptive study was conducted at a public-sector medical college in Islamabad, Pakistan, from January to April 2014. Self-administered open-ended questionnaires were used to collect data from first year medical students in order to study the factors associated with the new environment. There were 115 students in the study with a mean age of 19±6.76 years. Overall, 35(30.4%) students had mild to moderate physical problems, 20(17.4%) had severe physical problems and 60(52.2%) did not have any physical problem. Average stress score was 19.6±6.76. Major elements responsible for stress identified were environmental factors, new college environment, student abuse, tough study routines and personal factors. Majority of undergraduate students experienced stress due to both academic and emotional factors.
20 CFR 718.202 - Determining the existence of pneumoconiosis.
Code of Federal Regulations, 2010 CFR
2010-04-01
... radiologic technologist or technician and there is no evidence that the claim has been fraudulently... term other evidence means medical tests such as blood-gas studies, pulmonary function studies or physical examinations or medical histories which establish the presence of a chronic pulmonary, respiratory...
76 FR 66269 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-26
... determine medical/physical fitness. The Marketing and Regulatory Programs (MRP) of the Animal Plant and... using the MRP-5 form (Self-Certification Medical Statement). Need and Use of the Information: The information collected from the prospective employees assists the MRP officials, administrative personnel, and...
ERIC Educational Resources Information Center
Cooper, Shelly C.; Hamann, Donald L.; Frost, Robert
2012-01-01
Musicians have recognized that physical problems often accompany playing, yet examinations of performance-related injuries and medical problems remain relatively new. The type of instrument played can affect musicians' pain-related problems as well as physical stature. The focus of this study was to determine whether physical intervention--easily…
Raza, Sajjad; Sheikh, Muhammad Adil; Hussain, Muhammad Fawwad Ahmed; Siddiqui, Saad Ebrahim; Muhammad, Rabia; Aziz, Sina; Qamar, Salima; Saleem, Mohammad Azfar; Waki, Nida; Faruqi, Hina; Zia, Aisha
2010-11-01
To determine the prevalence of major risk factors including dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and physical activity in medical students of government teaching hospitals of Karachi. A cross sectional study was conducted on students of Dow Medical College, Karachi, Pakistan through a structured pre-tested questionnaire. Non-probability purposive sampling was used. Smoking, hypertension, family history of cardiovascular disease (CVD), overweight and low physical activity levels are risk factors the presence of which can lead to development of CVD. Prevalence of these risk factors was determined by asking appropriate questions and through measurement of BMI and blood pressure for overweight and hypertension respectively. Awareness of risk factors was determined through knowledge of the effect of various food substances on development of CVD and of adoption of dietary changes keeping in mind the risk of developing CVD. SPSS 16.0 was used for statistical analysis. A total of 132 medical students were included in the study of which 57 (43.2%) and 75 (56.8%) were male and female respectively with mean age of 20.85 +/- 1.21 years. About 15.9% of students had elevated blood pressure i.e. > or = 140/90 mmHg. Twenty eight percent of the total students were found to be underweight and 17.4% were overweight, 5% had some history of CVD, 56.8% had family history of CVD, 9.4% were smokers and 29.5% had high physical activity level. About 87.1% had modified their diet for preventing CVD. Most of the students had adequate knowledge about the cardiovascular risk factors Majority of students were not overweight. A high prevalence of cardiovascular risk factors; family history and elevated blood pressure was present. Awareness in terms of knowledge was satisfactory but implementation in terms of diet modification and adequate physical activity was lacking.
20 CFR 718.202 - Determining the existence of pneumoconiosis.
Code of Federal Regulations, 2012 CFR
2012-04-01
... radiologist or qualified radiologic technologist or technician and there is no evidence that the claim has... with this paragraph. (A) The term other evidence means medical tests such as blood-gas studies, pulmonary function studies or physical examinations or medical histories which establish the presence of a...
20 CFR 718.202 - Determining the existence of pneumoconiosis.
Code of Federal Regulations, 2011 CFR
2011-04-01
... radiologist or qualified radiologic technologist or technician and there is no evidence that the claim has... with this paragraph. (A) The term other evidence means medical tests such as blood-gas studies, pulmonary function studies or physical examinations or medical histories which establish the presence of a...
20 CFR 718.202 - Determining the existence of pneumoconiosis.
Code of Federal Regulations, 2014 CFR
2014-04-01
... radiologist or qualified radiologic technologist or technician and there is no evidence that the claim has... with this paragraph. (A) The term other evidence means medical tests such as blood-gas studies, pulmonary function studies or physical examinations or medical histories which establish the presence of a...
20 CFR 718.202 - Determining the existence of pneumoconiosis.
Code of Federal Regulations, 2013 CFR
2013-04-01
... radiologist or qualified radiologic technologist or technician and there is no evidence that the claim has... with this paragraph. (A) The term other evidence means medical tests such as blood-gas studies, pulmonary function studies or physical examinations or medical histories which establish the presence of a...
Li, Yongqiang; Reinhardt, Jan D; Gosney, James E; Zhang, Xia; Hu, Xiaorong; Chen, Sijing; Ding, Mingpu; Li, Jianan
2012-06-01
To characterize a spinal cord injury (SCI) population from the 2008 Sichuan earthquake in China; to evaluate functional outcomes of physical rehabilitation interventions; to assess potential determinants of rehabilitation effectiveness; and to assess medical complications and management outcomes. A total of 51 earthquake victims with SCI were enrolled and underwent rehabilitation programming. Functional rehabilitation outcomes included ambulation ability, wheelchair mobility and activities of daily living (ADL) assessed with the Modified Barthel Index at the beginning and end of rehabilitation. Effectiveness of rehabilitation and the effect of other predictors were evaluated by mixed effects regression. Outcomes of medical complication management were determined by comparison of the incidence of respective complications at the beginning and end of rehabilitation. Ambulation, wheelchair mobility and ADL were significantly improved with rehabilitation programming. Both earlier rescue and earlier onset of rehabilitation were significant positive predictors of rehabilitation effectiveness, whereas delayed onset of rehabilitation combined with prolonged time to rescue resulted in a lesser positive effect. Medical complications were managed effectively in 63% (pressure ulcers) to 85% (deep vein thrombosis) of patients during rehabilitation. Earthquake victims with SCI may achieve significantly improved functional rehabilitation functional outcomes on a formal, institutional-based physical rehabilitation programme.
ERIC Educational Resources Information Center
Youdas, James W.; Krause, David A.; Hellyer, Nathan J.; Rindflesch, Aaron B.; Hollman, John H.
2013-01-01
Medical professionals and public consumers expect that new physical therapy graduates possess cognitive, technical, and behavioral skills required to provide safe and high-quality care to patients. The purpose of this study was to determine if a repertoire of ten professional behaviors assessed at the beginning of doctorate of physical therapy…
The relative role of "A" level chemistry, physics and biology in the medical course.
Tomilson, R W; Clack, G B; Pettingale, K W; Anderson, J; Ryan, K C
1977-03-01
The performance of 209 students in the 2nd MBBS, first clinical year and final MBBS examinations has been compared retrospectively with their grades in chemistry, physics and biology at "A" level. The mean grade has also been determined for students from different social classes and secondary education. Significant differences in marks for biology were found between successful and not so successful students, especially in the pre-clinical part of the course. Significnat differences in marks and significant correlations were also found for physics but not to any great extent for chemistry. The relative role of these three basic sciences in the medical course is discussed. The suggestion is made that there is a need for a re-appraisal of the privleged position of chemistry and an unquestioned science requirement for entry to medical school.
Effect of a Physical Examination Teaching Program on the Behavior of Medical Residents
McMahon, Graham T; Marina, Ovidiu; Kritek, Patricia A; Katz, Joel T
2005-01-01
Context The reliance on physical examination as a diagnostic aid is in decline. Objective To determine whether an educational program can increase the use of physical examination by medical residents. Design and Participants A series of educational workshops were provided to 47 second- and third-year medical residents at a large academic teaching hospital. Measurements Interns and students reported the frequency and depth of clinical examination performance on morning rounds by their residents before and up to six months after the workshops. Behavior before and after the workshops was compared using a mixed model. Results A total of 374 reports were returned (77% response). After adjusting for the type of service and observer, there was a statistically significant 23% increase (P=.02) in the performance of physical examination among residents who attended the course. Residents significantly increased the fraction of patients they examined on rounds (absolute increase 11%, P=.002) but did not increase the depth of their examination. The change was greatest on general medical teams, among whom the performance of physical examination had been least frequent. Teaching and feedback events on medicine teams by residents to their interns (2.8 and 1.1 events per 2 weeks, respectively) and medical students (5.9 and 2.8 events per 2 weeks, respectively) remained infrequent. Conclusions A skills improvement program can significantly increase the frequency of physical examination, but teaching and feedback events remain sporadic and infrequent. PMID:16050879
Development, Impact, and Measurement of Enhanced Physical Diagnosis Skills
ERIC Educational Resources Information Center
Smith, Miriam A.; Burton, William B.; Mackay, Meggan
2009-01-01
Evidence suggests that the quality and frequency of bedside clinical examination have declined. We undertook the study to (1) determine whether intensive instruction in physical examination enhances medical student skills and (2) develop a tool to evaluate those skills using a modified observed structured clinical examination (OSCE). This was a…
Detainee Medical Operations during Operation Iraqi Freedom: Determination of a Transition Plan
2007-06-15
physical therapist , when the physical pherapist leaves Iraq for authorized rest and relaxation (R&R) leave, the physical therapy section is not...professor of international Law at the Columbia College and had fought in conflicts across Europe prior to immigrating to America. Francis Lieber had...organization in which physically detainees a person alleged to have committed offenses and is responsible for the health and welfare of the prisoners. A
Influence of form structure on the anesthesia preoperative evaluation.
Marco, Alan P; Buchman, Debra; Lancz, Colleen
2003-09-01
To determine the impact of changes in form design on the capture of administrative and clinical data elements. Randomized retrospective chart review. Academic health center. Patients undergoing surgical procedures in the operating rooms at Medical College Hospital. The principal intervention was the implementation of a newly designed anesthesiology preoperative evaluation form with the intent to improve data capture. Charts were reviewed for the presence or absence of the following indicators: Addressograph Stamp, Proposed Surgery, Current Medications, Medication Doses/Frequency, Allergies, ASA Physical Status, Anesthesia Plan, Attending Note, and fasting (NPO) Status. Completion of Proposed Surgery and ASA Physical Status was lower for the structured form. Completion of Attending Notes was higher with the new form. Medication Doses were more often completed, but they remained below desired levels on the new form. Design of a form can have a significant impact on the completion rate of form elements. Visual cues such as a labeled space for medication doses may improve the completion of these elements. Design layout can also have an influence on completion. In this case, changes to the layout may have impeded the completion rate for ASA Physical Status.
Nasim, Sara; Khan, Mahjabeen; Aziz, Sina
2014-03-01
To determine the association of terrorism with psychiatric morbidity by Hospital Anxiety Depression scale among medical students in Karachi, Pakistan. The questionnaire based cross-sectional survey was conducted from February to March 2011 and comprised students of the Institute of Physical and Medical Rehabilitation and the Dow Medical College, Dow University of Health Sciences, Karachi. The study tool was a validated Hospital Anxiety Depression scale questionnaire. The data was analysed on SPSS 16. Factor analysis was performed to check which factors had the most influence. Overall there were 1036 respondents. The impact of terrorism on physical, social and mental health was 40 (3.9%), 178 (17.2%) and 818 (79%) respectively. There was an association of terrorism in 980 (84.6%) respondents with psychiatric morbidity. There was an association of terrorism with psychiatric morbidity in majority of respondents. The significant risk factors were age, gender, physical, mental and social health and the desire to live in Pakistan.
Physical therapy mandates by Medicare administrative contractors: effective or wasteful?
Fehring, Thomas K; Fehring, Keith; Odum, Susan M; Halsey, David
2013-10-01
Documentation of medical necessity for arthroplasty has come under scrutiny by Medicare. In some jurisdictions three months of physical therapy prior to arthroplasty has been mandated. The purpose of this study was to determine the efficacy and cost of this policy to treat advanced osteoarthritis. A systematic review was performed to assimilate efficacy data for physical therapy in patients with advanced osteoarthritis. The number of arthroplasties performed annually was obtained to calculate cost. Evidence-based studies documenting the efficacy of physical therapy in treating advanced arthritis are lacking with a potential cost of 36-68 million dollars. Physical therapy mandates by administrative contractors are not only ineffective but are costly without patient benefit. Medical necessity documentation should be driven by orthopedists not retroactively by Medicare contractors. Copyright © 2013 Elsevier Inc. All rights reserved.
Kim, Juhee; Greaney, Mary L
2014-07-01
Children with special health care needs (SHCN) may be at greater risk of obesity than children without SHCN. A new classification system categorizes SHCN among children by service type using the following categories: No-SHCN, medication use only, services use only, medication + service use, and functional limitations. Research is needed to examine obesity and obesity-related behaviors among children using the new classification system. To determine the prevalence of inadequate vigorous physical activity (VPA), high screen time and obesity by SHCN category using the new classification system. Multivariate regression models were fitted for inadequate VPA, high screen time, and obesity to determine if there were differences in these outcomes by SHCN category, adjusting for multistage-sampling and survey-design effects using a nationally representative sample of children in the National Survey of Children's Health 2007. 22.9% of the sample was classified as having SHCN: 9% medication use only, 5% medication + service use, 4% service use only, and 5% functional limitations. Children in the medication use only and medication + service use groups were not at increased risk for inadequate VPA, high screen time, or obesity. Children in the service use only and functional limitation groups had increased odds of high screen time and obesity, which disappeared after controlling for confounders. However, the higher odds of inadequate VPA remained significant in the service use only [OR (95% CI) = 2.00 (1.34-3.00)] and the functional limitations groups with 2.21 (1.55-3.15). Physical activity promotion programs are needed for children with SHCN, especially children with functional limitations and those who require service use only and do not use prescribed medication. Copyright © 2014 Elsevier Inc. All rights reserved.
28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.
Code of Federal Regulations, 2011 CFR
2011-07-01
... of force situations, staff shall seek the assistance of mental health or qualified health personnel... seek the guidance of qualified health personnel (based upon a review of the inmate's medical record) to identify physical or mental problems. When mental health staff or qualified health personnel determine that...
28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.
Code of Federal Regulations, 2012 CFR
2012-07-01
... of force situations, staff shall seek the assistance of mental health or qualified health personnel... seek the guidance of qualified health personnel (based upon a review of the inmate's medical record) to identify physical or mental problems. When mental health staff or qualified health personnel determine that...
28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.
Code of Federal Regulations, 2013 CFR
2013-07-01
... of force situations, staff shall seek the assistance of mental health or qualified health personnel... seek the guidance of qualified health personnel (based upon a review of the inmate's medical record) to identify physical or mental problems. When mental health staff or qualified health personnel determine that...
28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.
Code of Federal Regulations, 2014 CFR
2014-07-01
... of force situations, staff shall seek the assistance of mental health or qualified health personnel... seek the guidance of qualified health personnel (based upon a review of the inmate's medical record) to identify physical or mental problems. When mental health staff or qualified health personnel determine that...
Integrating physical examination and trunk anatomy; a new course for second year medical students.
Adibi, Iman; Hasani, Nasibeh; Ashoorioun, Vahid; Sadrearhami, Shohreh; Monajemi, Ali Reza
2007-11-01
The aim of this study was to determine the effect of an integrated course of physical examination and trunk anatomy on second year medical students' attitude and knowledge of anatomy. Thirty nine second year medical students attended a physical examination course (5 small group sessions) related to topics in trunk anatomy (2004/05). Students in control group attended routine anatomy lectures and problem based learning discussions relevant to their physiology course. Routine final anatomy exam (65 multiple choices questions) was performed. Attitude toward course impacts in intervention group were assessed by a likert questionnaire (18 items). A T-test was performed to compare anatomy scores. The Intervention group had higher score exam anatomy (46.6 +/- 6.3) than others (41.4 +/- 6.0, p = 0.04). The mean score of attitude questionnaire was 3.48 (SD = 0.8). In conclusion teaching physical examinations integrated with trunk anatomy improves students' knowledge and motivated them in learning anatomy.
Wylie, Ann; Furmedge, Daniel S; Appleton, Amber; Toop, Helen; Coats, Tom
2009-03-01
The study aimed to firstly provide a small self-selecting group of medical students with the opportunity to explore current approaches and opportunities addressing the prevention of childhood obesity and, secondly, to consider what aspects could be part of the taught curriculum. Medical students in their third and fourth year were invited to self-design special study modules (SSMs) exploring interventions and processes addressing the growing concern about childhood obesity. One student looked at the role of the primary care teams, two looked at community-based opportunities to improve physical activity in urban areas where there is significant deprivation and one student explored the complex role of the media as a social determinant of dietary patterns and sedentary behaviour. Primary care health professionals questioned their role in regard to raising the topic of obesity in the consultation and had limited awareness of current NICE guidelines and local interventions for referral. Local authority physical activity programmes have an important role in preventing and tackling obesity and although the media are regulated, there is limited impact on reducing obesity. Conversely, the influence of the media is complex and enables medical students and teachers to be aware of some of the social determinants influencing health-related behaviour. About a third of UK GP practices have some role in medical undergraduate education. It will therefore be inevitable that students will encounter GPs working with prevention and management of childhood obesity, however limited, and this will increasingly be part of the teaching agenda, whether formal and planned or opportunistic. Curricula could include being familiar with the evidence that informs NICE guidelines, observing these guidelines being implemented and their limitations, awareness of local schemes for referral to prevent or treat obesity and the influence of wider determinants on diet and physical activity behaviour, including the media.
Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians
Olson, Shawn M.; Odo, Nnaemeka U.; Duran, Alisa M.; Pereira, Anne G.; Mandel, Jeffrey H.
2014-01-01
Background Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified. Objective To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians. Methods A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire. Results Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99). Conclusions Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted. PMID:26140116
Oeffinger, Kevin C; Mertens, Ann C; Hudson, Melissa M; Gurney, James G; Casillas, Jacqueline; Chen, Hegang; Whitton, John; Yeazel, Mark; Yasui, Yutaka; Robison, Leslie L
2004-01-01
We wanted to determine the type of outpatient medical care reported by young adult survivors of childhood cancer and to examine factors associated with limited medical care. We analyzed data from 9,434 adult childhood cancer survivors enrolled in a retrospective cohort study who completed a baseline questionnaire. They had a mean age of 26.8 years (range 18 to 48 years), 47% were female, 12% were minorities, and 16% were uninsured. Four self-reported outcome measures were used to determine outpatient medical care in a 2-year period: general contact with the health care system, general physical examination, cancer-related medical visit, and medical visit at a cancer center. Eighty-seven percent reported general medical contact, 71.4% a general physical examination, 41.9% a cancer-related visit, and 19.2%, a visit at a cancer center. Factors associated with not reporting a general physical examination, a cancer-related visit, or a cancer center visit included no health insurance (odds ratio [OR] = 2.34; 95% confidence interval [CI], 1.97-2.77), male sex (OR = 1.65; 95% CI, 1.44-1.88), lack of concern for future health (OR = 1.57; 95% CI, 1.36-1.82), and age 30 years or older in comparison with those 18 to 29 years (OR = 1.56; 95% CI, 1.35-1.81). The likelihood of reporting a cancer-related visit or a general physical examination decreased significantly as the survivor aged or the time from cancer diagnosis increased. This trend was also significant for those treated with therapies associated with substantial risk for cardiovascular disease or breast cancer. Primary care physicians provide health care for most of this growing high-risk population. To optimize risk-based care, it is critical that cancer centers and primary care physicians develop methods to communicate effectively and longitudinally.
Oeffinger, Kevin C.; Mertens, Ann C.; Hudson, Melissa M.; Gurney, James G.; Casillas, Jacqueline; Chen, Hegang; Whitton, John; Yeazel, Mark; Yasui, Yutaka; Robison, Leslie L.
2004-01-01
BACKGROUND We wanted to determine the type of outpatient medical care reported by young adult survivors of childhood cancer and to examine factors associated with limited medical care. METHODS We analyzed data from 9,434 adult childhood cancer survivors enrolled in a retrospective cohort study who completed a baseline questionnaire. They had a mean age of 26.8 years (range 18 to 48 years), 47% were female, 12% were minorities, and 16% were uninsured. Four self-reported outcome measures were used to determine outpatient medical care in a 2-year period: general contact with the health care system, general physical examination, cancer-related medical visit, and medical visit at a cancer center. RESULTS Eighty-seven percent reported general medical contact, 71.4% a general physical examination, 41.9% a cancer-related visit, and 19.2%, a visit at a cancer center. Factors associated with not reporting a general physical examination, a cancer-related visit, or a cancer center visit included no health insurance (odds ratio [OR] = 2.34; 95% confidence interval [CI], 1.97–2.77), male sex (OR = 1.65; 95% CI, 1.44–1.88), lack of concern for future health (OR = 1.57; 95% CI, 1.36–1.82), and age 30 years or older in comparison with those 18 to 29 years (OR = 1.56; 95% CI, 1.35–1.81). The likelihood of reporting a cancer-related visit or a general physical examination decreased significantly as the survivor aged or the time from cancer diagnosis increased. This trend was also significant for those treated with therapies associated with substantial risk for cardiovascular disease or breast cancer. CONCLUSIONS Primary care physicians provide health care for most of this growing high-risk population. To optimize risk-based care, it is critical that cancer centers and primary care physicians develop methods to communicate effectively and longitudinally. PMID:15053285
Medical Physics Panel Discussion
NASA Astrophysics Data System (ADS)
Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew
2006-03-01
The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.
United States Counterinsurgency Theory
2010-04-01
energies should be directed.‖ 34 The DoD Dictionary defines a COG as the source of power that provides moral or physical strength, freedom of action...planners to determine the physical or geographic points, key events, functions, and systems that will provide unity of effort and unity of action during a...medical, and education; governance or arbitration; and expression or self- actualization of religion or political expression. The absence of physical
Brovold, Therese; Skelton, Dawn A; Sylliaas, Hilde; Mowe, Morten; Bergland, Astrid
2014-07-01
The purpose of this study was to determine the relationship among health-related quality of life (HRQOL), physical fitness, and physical activity in older patients after recent discharge from hospital. One hundred fifteen independent-living older adults (ages 70-92 years) were included. HRQOL (Medical Outcomes Study 36-item Short Form Health Survey), physical activity (Physical Activity Scale for the Elderly), and physical fitness (Senior Fitness Test) were measured 2-4 weeks after discharge. Higher levels of physical activity and physical fitness were correlated with higher self-reported HRQOL. Although cause and effect cannot be determined from this study, the results suggest that a particular focus on the value of physical activity and physical fitness while in hospital and when discharged from hospital may be important to encourage patients to actively preserve independence and HRQOL. It may be especially important to target those with lower levels of physical activity, poorer physical fitness, and multiple comorbidities.
20 CFR 404.1615 - Making disability determinations.
Code of Federal Regulations, 2011 CFR
2011-04-01
... relating to the claimant's physical or mental impairments and as necessary to determine the capacities of... psychologist has completed the medical portion of the case review and any applicable residual functional capacity assessment. (See § 404.1616 for the qualifications we consider necessary for a psychologist to be...
20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2012 CFR
2012-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disabled worker, or child's insurance benefits based on disability before age 22 or, with respect to.... (b) There are different rules for determining disability for individuals who are statutorily blind...
20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2011 CFR
2011-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disabled worker, or child's insurance benefits based on disability before age 22 or, with respect to.... (b) There are different rules for determining disability for individuals who are statutorily blind...
20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2010 CFR
2010-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disabled worker, or child's insurance benefits based on disability before age 22 or, with respect to.... (b) There are different rules for determining disability for individuals who are statutorily blind...
Exploring medical students' attitudes towards peer physical examination.
Rees, Charlotte E; Bradley, Paul; McLachlan, John C
2004-02-01
With opportunities for dissection and examination of sick patients decreasing, the role of peer physical examination (PPE) is increasing. This study explores students' attitudes towards PPE and the relationship between attitudes and demographics. A total of 129 first-year medical students from the Peninsula Medical School completed the Examining Fellow Students (EFS) questionnaire. At least 97% of students were comfortable participating in PPE of all body parts except breast and inguinal regions. Over 20% of students were unwilling to participate in PPE of the breast and inguinal regions. Students were more comfortable with PPE within gender than across gender. Females were more likely to be uncomfortable with PPE. Further research with larger sample sizes is required to determine whether attitudes are related to age and religious faith.
Medical physics: the perfect intermediate level physics class
NASA Astrophysics Data System (ADS)
Christensen, Nelson
2001-07-01
Medical physics is currently a rapidly growing field of physics. Numerous academic, clinical and industrial opportunities are open to physicists in the medical world. I report on an intermediate level physics course on medical physics taught at Carleton College. The topics covered in this course cover all areas of physics, but with examples drawn from medical applications. In addition to physics majors, this course appeals to biology, chemistry and pre-medical students who have a keen interest in physics.
Integrating Musculoskeletal Education and Patient Care at Medical Student-Run Free Clinics.
McQuillan, Thomas; Wilcox-Fogel, Nate; Kraus, Emily; Ladd, Amy; Fredericson, Michael
2017-11-01
Student-run free clinics (SRFCs) have emerged as an important educational component of United States (U.S.) medical schools. Despite the prevalence of musculoskeletal (MSK) problems presenting to SRFCs, students and clinics are often unprepared to diagnose and to treat common MSK complaints. We sought to determine the scope of diagnosis and treatment at a medical student-run free clinic specializing in musculoskeletal care using physical medicine and rehabilitation (PM&R) residents. Secondary goals included reviewing student satisfaction and determining the appropriateness of the clinic in medical education. Retrospective chart review, anonymous online survey. Primary care, free student clinic affiliated with tertiary academic medical center. A total of 20 medical student volunteers, 6 PM&R residents, and 91 community patients. We established a musculoskeletal clinic as a specialty referral clinic for the 2 primary care SRFCs with institutional support from a partner medical school. We then reviewed clinical operations retrospectively using electronic medical records and student satisfaction based on an online survey. We analyzed patient demographics and chief complaints, referrals provided, and medical services rendered. We also used a 5-point Likert scale to assess student satisfaction. A monthly musculoskeletal referral clinic was established with the oversight of PM&R attendings and residents. The clinic received 91 referrals and managed 61 unique patients over a 2.5-year study period. The most common presentations to the clinic involved knee pain (n = 17, 27.9%) and back pain (n = 16, 26.2%). Pro bono relationships with community and institutional partners enabled all patients to receive medical examinations, physical therapy visits, plain film radiographs, and insurance consultations free of charge. Student satisfaction with teaching and patient care was high, with 19 of 20 students reporting their experience as "good" or "excellent." SRFCs represent an underused opportunity to enhance MSK education among medical students by treating a variety of common MSK complaints in an underserved population. Not applicable. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
76 FR 16847 - Agency Information Collection Activities: Proposed Request and Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-25
... Collections The DDSs collect MER from the claimant's medical sources to determine the claimant's physical or mental status prior to making a disability determination. Average burden Estimated Collection instrument... emergency care, treatment of on-the-job illnesses and injuries, and health care for employees with chronic...
López-Roig, Sofía; Pastor, María-Ángeles; Peñacoba, Cecilia; Lledó, Ana; Sanz, Yolanda; Velasco, Lilian
2016-08-01
Physical exercise is recognized as a component of the evidence-based guidelines for treatment of fibromyalgia. Walking is a low-moderate intensity exercise easily adaptable to a fibromyalgia patient's situation. The present study aims to estimate the prevalence of unsupervised walking for exercise in women with fibromyalgia, to describe their level of physical activity and to identify their predictors among socio-demographic, symptom perception and medical advice to walk. A cross-sectional survey with 920 women (all members of fibromyalgia associations) completed the International Physical Activity Questionnaire-Short Form and self-reported scales to assess symptom perception, walking, medical advice to walk and physical comorbidity. The prevalence of reported walking regularly as physical exercise was 30.8 % and it was predicted by medical advice (odds ratio, OR 1.876), age (OR 1.021) and fatigue intensity (OR 0.912). The prevalence of physical activity was 16 % for high-intensity activity, 40 % for moderate activity and 44 % for low activity. Predictors of low versus moderate and high physical activity were pain intensity (OR 1.171) and fatigue impact perception (OR 1.076). Evidence shows a low percentage of women with fibromyalgia walking regularly for physical exercise. Most reported low or moderate physical activity. The results indicate the importance of doctors' advice in promoting walking. Symptom perception and socio-demographic characteristics were weak predictors. Further work is required to examine other determinants of these low levels.
The Determinants of Participation in Physical Activity in Malaysia
Cheah, Yong Kang; Poh, Bee Koon
2014-01-01
Objectives In light of the importance of physical activity, the aim of the present study is to examine the factors affecting participation in physical activity among adults in Malaysia. Methods A logistic regression model and the Third National Health and Morbidity Survey consisting of 30,992 respondents were used. Results Age, income, gender, education, marital status, region, house locality, job characteristics, and medical conditions are significantly associated with participation in physical activity. In particular, old individuals, high income earners, females, the well-educated, widowed or divorced individuals, East Malaysians, urban dwellers, the unemployed, and individuals who are not diagnosed with hypercholesterolemia are less likely to be physically active than others. Conclusion Because sociodemographic and health factors play an important role in determining physical activity, the government should take them into account when formulating policy. PMID:24955308
Mapping the literature of physical therapy.
Wakiji, E M
1997-01-01
Physical therapy is a fast growing profession because of the aging population, medical advances, and the public's interest in health promotion. This study is part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section's project to map the allied health literature. It identifies the core journals in physical therapy by analyzing the cited references of articles in two established physical therapy journals, Physical Therapy and Archives of Physical Medicine and Rehabilitation, during the period 1991 through 1993. This bibliometric analysis also determines the extent to which these journals are covered by the primary indexing sources, Allied and Alternative Medicine (AMED), the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and MEDLINE. In this study, fourteen journals were found to supply one-third of all references studied. Ninety-five journals provided an additional third of the references. MEDLINE rated the highest as the indexing tool of choice for these 109 journals. The study results can assist in collection development decisions, advise physical therapists as to the best access to their core literature, and influence database producers to increase their coverage of the literature important to physical therapy. PMID:9285129
Chalé-Rush, Angela; Guralnik, Jack M; Walkup, Michael P; Miller, Michael E; Rejeski, W Jack; Katula, Jeffrey A; King, Abby C; Glynn, Nancy W; Manini, Todd M; Blair, Steven N; Fielding, Roger A
2010-10-01
To determine whether participation in usual moderate-intensity or more-vigorous physical activity (MVPA) is associated with physical function performance and to identify sociodemographic, psychosocial, and disease-related covariates that may also compromise physical function performance. Cross-sectional analysis of baseline variables of a randomized controlled intervention trial. Four academic research centers. Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability (scoring <10 on the Short Physical Performance Battery (SPPB)) and able to complete the 400-m walk test within 15 minutes. Minutes of MVPA (dichotomized according to above or below 150 min/wk of MVPA) assessed according to the Community Healthy Activities Model Program for Seniors questionnaire, SPPB score, 400-m walk test, sex, body mass index (BMI), depressive symptoms, age, and number of medications. The SPPB summary score was associated with minutes of MVPA (ρ=0.16, P=.001). In multiple regression analyses, age, minutes of MVPA, number of medications, and depressive symptoms were associated with performance on the composite SPPB (P<.05). There was an association between 400-m walk time and minutes of MVPA (ρ=-0.18; P<.001). In multiple regression analyses, age, sex, minutes of MVPA, BMI, and number of medications were associated with performance on the 400-m walk test (P<.05). Minutes of MVPA, sex, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
Careers in Medical Physics and the American Association of Physicists in Medicine
NASA Astrophysics Data System (ADS)
Amols, Howard
2006-03-01
The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members is based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.
20 CFR 220.120 - The claimant's residual functional capacity.
Code of Federal Regulations, 2011 CFR
2011-04-01
... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...
20 CFR 220.120 - The claimant's residual functional capacity.
Code of Federal Regulations, 2012 CFR
2012-04-01
... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...
20 CFR 220.120 - The claimant's residual functional capacity.
Code of Federal Regulations, 2013 CFR
2013-04-01
... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...
20 CFR 220.120 - The claimant's residual functional capacity.
Code of Federal Regulations, 2014 CFR
2014-04-01
... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...
Lin, Chia-Der; Lin, Blossom Yen-Ju
2016-08-22
In the education field, learning experiences are considered learners' properties and are viewed as a key determinant in explaining learners' learning processes, especially for training novices such as clerks with varying levels of commitment to the medical profession. This study explored whether clerks' achievement goal motivation orientations might buffer the negative well-being to a certain extent, considering their training demands during clinical training. Ninety-four clerks at a tertiary medical center were longitudinally traced during their 2-year clerkship spanning from September 2013 to April 2015. Web-based, validated, structured, self-administered questionnaires were used to evaluate the clerks' properties of achievement goal motivation orientation and personal background at the beginning of the clerkship. Regular surveys were conducted to evaluate their perceptions of training demands and burnout at each specialty rotation. Overall, 2230 responses were analyzed, and linear mixed-effects models were used to examine the repeated measures of the clerks. The results revealed that higher perceived psychological and physical demands of training were related to higher perceived burnout during the 2-year clerkship. Although both the clerks' task and ego orientations were related to reduced burnout (direct effects), only task orientation was indicated to exert a buffering effect on their perception of physical demands on burnout in the 1st year of the clerkship. Considering the negative effects of training demands (psychological and physical), we observed a limited effect of the task achievement motivation orientation of medical students; therefore, additional studies might focus on strategies to facilitate medical students in clerkships in addressing both the psychological and physical demands inherent in training workplaces to improve their learning experience and well-being.
NASA Astrophysics Data System (ADS)
Amols, Howard
2006-03-01
The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members are based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.
Marzec, Mary L; Scibelli, Andrew F; Edington, Dee W
2013-07-01
To investigate predictors of absenteeism and discuss potential implications for policy/program design. Health Risk Appraisal (HRA) data and self-reported and objective absenteeism (personnel records) were used to develop a structural equation model, controlling for age, sex, and job classification. A Medical Condition Burden Index (MCBI) was created by summing the number of self-reported medical conditions. Higher MCBI and stress were direct predictors of absenteeism. Physical activity was not associated with absenteeism but mediated both stress and MCBI. Because stress impacted both absenteeism and MCBI, organizations may benefit by placing stress management as a priority for wellness program and policy focus. Physical activity was not directly associated with absenteeism but was a mediating variable for stress and MCBI. Measures of stress and physical health may be more meaningful as outcome measures for physical activity programs than absenteeism.
Li, Xinjian; Cheng, Minna; Zhang, Hao; Ke, Ting; Chen, Yisheng
2015-03-01
This study aims to explore the prevalence and determinations of physical inactivity among hospital employees in Shanghai, China. A cross-sectional study of 4612 employees aged 19 to 68 years was conducted through stratified cluster sampling from different classes of Shanghai hospitals in 2011. The total physical activity was evaluated using the metabolic equivalent according to the Global Physical Activity Questionnaire. Among the participants, 38.5%, 32.3%, and 64.6% of the employees are inactive at work, commuting, and taking leisure time, respectively. Up to 41.8% of the men and 37.8% of the women (P = 0.012) are physically inactive. When the age and educational level are adjusted, male doctors and medical technicians show a higher percentage of physical inactivity than male workers in logistics (P = 0.001). Among females, employees who are working in second- and third-class hospitals show a higher proportion of physical inactivity than those who are working in community health care centers. Logistic regression analyses show that the odds ratios (ORs) of leisure-time physical inactivity associated with the intensity of physical activity at work are 2.259, 2.897, and 4.266 for men (P < 0.001) and 2.456, 3.259, and 3.587 for women (P < 0.001), respectively. The time during commuting activities is significantly associated with leisure-time physical inactivity in either sex (OR = 2.116 for men and 2.173 for women, P < 0.001). Hospital employees, particularly doctors and medical technicians, show a higher proportion of physical inactivity than other inhabitants in Shanghai. The time and intensity of activity at work and commuting are associated with leisure-time activities.
Physical comorbidities in men with mood and anxiety disorders: a population-based study
2013-01-01
Background The mind-body nexus has been a topic of growing interest. Further data are however required to understand the specific relationship between mood and anxiety disorders and individual physical health conditions, and to verify whether these psychiatric disorders are linked to overall medical burden. Methods This study examined data collected from 942 men, 20 to 97 years old, participating in the Geelong Osteoporosis Study. A lifetime history of mood and anxiety disorders was identified using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP). The presence of medical conditions (lifetime) was self-reported and confirmed by medical records, medication use or clinical data. Anthropometric measurements and socioeconomic status (SES) were determined and information on medication use and lifestyle was obtained via questionnaire. Logistic regression models were used to test the associations. Results After adjustment for age, socioeconomic status, and health risk factors (body mass index, physical activity and smoking), mood disorders were associated with gastro oesophageal reflux disease (GORD), recurrent headaches, blackouts and/or epilepsy, liver disorders and pulmonary disease in older people, whilst anxiety disorders were significantly associated with thyroid, GORD and other gastrointestinal disorders, and psoriasis. Increased odds of high medical burden were associated with both mood and anxiety disorders. Conclusions Our study provides further population-based evidence supporting the link between mental and physical illness in men. Understanding these associations is not only necessary for individual management, but also to inform the delivery of health promotion messages and health care. PMID:23618390
Disparity between Physical Capacity and Participation in Seniors with Chronic Disease
Ashe, Maureen C.; Eng, Janice J.; Miller, William C.; Soon, Judith A.
2011-01-01
Consistently low rates of physical activity are reported for older adults and there is even lower participation if a chronic disease is present. Purpose To explore the predictors of physical capacity and participation in older community-dwelling individuals living with multiple chronic diseases. Methods This was a descriptive cross-sectional investigation of physical capacity (physiological potential) and physical activity participation (recorded engagement in physical activity). Multiple regression and odds ratios were used to investigate determinants of physical capacity (6 Minute Walk Test) and physical activity participation (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire; pedometer steps/day). Results 200 community dwelling ambulatory participants living with 2 or more chronic disease were assessed. Sixty-five percent (65%) were women and the mean age was 74 ± 6 years (range 65–90 years). Mobility (Timed Up and Go) was a consistent determinant across all 3 primary outcomes. For the Six Minute Walk Test, determinants included mobility, BMI, grip strength, number of medications, leg strength, balance and Chronic Disease Management Self Efficacy Scale (r2=0.58; P=.000). The determinants for the self-reported participation measure (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire) was mobility (r2=0.04; P=.007). For the mean daily pedometer steps, the determinants included mobility, body mass index (BMI), age and Chronic Disease Management Self-Efficacy Scale (r2=0.27; P=.000). There were higher risks for inactivity associated with impairments compared with the presence of a chronic disease. In addition, over 1/3 of participants had sufficient physical capacity, but did not meet minimal recommendations of physical activity. Conclusion This study suggests that it is easier to predict an individual’s physical capacity than their actual physical participation. PMID:17596782
Liu, He; Zhao, Siqi; Jiao, Mingli; Wang, Jingtao; Peters, David H.; Qiao, Hong; Zhao, Yuchong; Li, Ye; Song, Lei; Xing, Kai; Lu, Yan; Wu, Qunhong
2015-01-01
Using a cross-sectional survey design from 11 public tertiary hospitals (a specialist hospital, four Chinese medicine hospitals, and six general hospitals) in the urban areas of Heilongjiang, we determined the nature of workplace violence that medical staff have encountered in Chinese hospitals and identified factors associated with those experiences of violence. A total of 1129 health workers participated. The specialist hospital had the highest prevalence of physical violence (35.4%), while the general hospitals had the highest prevalence of non-physical violence (76%). Inexperienced medical staff (p < 0.001) were more likely to suffer non-physical violence than physical violence in Chinese medicine hospitals compared to experienced staff. Medical units (p = 0.001) had a high risk of non-physical violence, while surgical units (p = 0.005) had a high risk of physical violence. In general hospitals, staff with higher levels of anxiety about workplace violence were more vulnerable to both physical violence (1.67, 95% CI 1.36–2.10) and non-physical violence (1.309, 95% CI 1.136–1.508) compared to those with lower levels of anxiety, while rotating shift workers had a higher odds of physical violence (2.2, 95% CI 1.21–4.17) and non-physical violence (1.65, 95% CI 1.13–2.41) compared to fixed day shift workers. Thus, prevention should focus not only on high-risk sections of hospitals, but also on the nature of the hospital itself. PMID:26086703
Seeing Is Believing: Evaluating a Point-of-Care Ultrasound Curriculum for 1st-Year Medical Students.
Nelson, Bret P; Hojsak, Joanne; Dei Rossi, Elizabeth; Karani, Reena; Narula, Jagat
2017-01-01
Point-of-care ultrasound has been a novel addition to undergraduate medical education at a few medical schools. The impact is not fully understood, and few rigorous assessments of educational outcomes exist. This study assessed the impact of a point-of-care ultrasound curriculum on image acquisition, interpretation, and student and faculty perceptions of the course. All 142 first-year medical students completed a curriculum on ultrasound physics and instrumentation, cardiac, thoracic, and abdominal imaging. A flipped classroom model of preclass tutorials and tests augmenting live, hands-on scanning sessions was incorporated into the physical examination course. Students and faculty completed surveys on impressions of the curriculum, and all students under-went competency assessments with standardized patients. The curriculum was a mandatory part of the physical examination course and was taught by experienced clinician-sonographers as well as faculty who do not routinely perform sonography in their clinical practice. Students and faculty agreed that the physical examination course was the right time to introduce ultrasound (87% and 80%). Students demonstrated proper use of the ultrasound machine functions (M score = 91.55), and cardiac, thoracic, and abdominal system assessments (M score = 80.35, 79.58, and 71.57, respectively). Students and faculty valued the curriculum, and students demonstrated basic competency in performance and interpretation of ultrasound. Further study is needed to determine how to best incorporate this emerging technology into a robust learning experience for medical students.
46 CFR 10.302 - Medical and physical requirements.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 46 Shipping 1 2014-10-01 2014-10-01 false Medical and physical requirements. 10.302 Section 10.302... CREDENTIAL Medical Certification § 10.302 Medical and physical requirements. (a) To qualify for a medical certificate, a mariner must provide evidence of meeting the medical and physical standards in this section on...
22 CFR 11.1 - Junior Foreign Service officer career candidate appointments.
Code of Federal Regulations, 2010 CFR
2010-04-01
... competence to perform the work of a Foreign Service officer at home and abroad, potential for growth in the.... The medical examination shall be conducted to determine the candidate's physical fitness to perform...
Chalé-Rush, Angela; Guralnik, Jack M.; Walkup, Michael P.; Miller, Michael E.; Rejeski, W. Jack; Katula, Jeffrey A.; King, Abby C.; Glynn, Nancy W.; Manini, Todd M.; Blair, Steven N.; Fielding, Roger A.
2010-01-01
OBJECTIVES To determine if participation in usual moderate-intensity or more vigorous physical activity (MVPA) is associated with physical function performance and to identify socio-demographic, psychosocial and disease-related covariates that may also compromise physical function performance. DESIGN Cross-sectional analysis of baseline variables of randomized controlled intervention trial. SETTING Four separate academic research centers. PARTICIPANTS Four hundred twenty-four older adults aged 70–89 years at risk for mobility-disability (scoring <10 on the Short Physical Performance Battery, SPPB) and able to complete the 400 m walk test within 15 minutes. MEASUREMENTS Minutes of MVPA (dichotomized according to above or below 150 min•wk−1 of MVPA) assessed by the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, SPPB score, 400 M walk test, gender, body mass index (BMI), depressive symptoms, age and number of medications. RESULTS The SPPB summary score was associated with minutes of MVPA (ρ = 0.16, P = 0.001). In multiple regression analyses, age, minutes of MVPA, number of medications and depressive symptoms were associated with performance on the composite SPPB (P < 0.05). There was an association between 400 m walk time and minutes of MVPA (ρ = −0.18; P = 0.0002). In multiple regression analyses, age, gender, minutes of MVPA, BMI and number of medications were associated with performance on the 400 m walk test (P < 0.05). CONCLUSION Minutes of MVPA, gender, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and all should be taken into consideration in the prevention of mobility-disability. PMID:20738437
ERIC Educational Resources Information Center
Jamniczky, Heather A.; McLaughlin, Kevin; Kaminska, Malgorzata E.; Raman, Maitreyi; Somayaji, Ranjani; Wright, Bruce; Ma, Irene W. Y.
2015-01-01
Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n?=?137) completed…
Tsapaki, Virginia; Kagadis, George C; Brambilla, Marco; Ciocca, Mario; Clark, Catharine H; Delis, Harry; Mettivier, Giovanni
2017-09-01
Medical Physics is the scientific healthcare profession concerned with the application of the concepts and methods of physics in medicine. The European Federation of Organisations for Medical Physics (EFOMP) acts as the umbrella organization for European Medical Physics societies. Due to the rapid advancements in related scientific fields, medical physicists must have continuous education through workshops, training courses, conferences, and congresses during their professional life. The latest developments related to this increasingly significant medical speciality were presented during the 1st European Congress of Medical Physics 2016, held in Athens, September 1-4, 2016, organized by EFOMP, hosted by the Hellenic Association of Medical Physicists (HAMP), and summarized in the current volume. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Code of Federal Regulations, 2010 CFR
2010-04-01
... adjustment to other work. (a) If you have done only arduous unskilled physical labor. If you have no more... you have a severe, medically determinable impairment(s) (see §§ 416.920(c), 416.921, and 416.923), are... consider the rules in appendix 2 to subpart P of part 404 of this chapter. [68 FR 51166, Aug. 26, 2003] ...
Physics teaching in the medical schools of Taiwan.
Hsu, Jiann-wien; Hsu, Roy
2012-02-01
We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is proposed. We hope this preliminary study can provide a useful reference for physics colleagues in the medical schools of Taiwan to revolutionize the dynamics of teaching physics to the medical students of Taiwan. Copyright © 2011. Published by Elsevier B.V.
46 CFR 10.215 - Medical and physical requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 1 2013-10-01 2013-10-01 false Medical and physical requirements. 10.215 Section 10.215... CREDENTIAL General Requirements for All Merchant Mariner Credentials § 10.215 Medical and physical requirements. (a) Medical and Physical Exams. To qualify for an MMC an applicant must meet the medical and...
46 CFR 10.215 - Medical and physical requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Medical and physical requirements. 10.215 Section 10.215... CREDENTIAL General Requirements for All Merchant Mariner Credentials § 10.215 Medical and physical requirements. (a) Medical and Physical Exams. To qualify for an MMC an applicant must meet the medical and...
Impact of implementing an EMR on physical exam documentation by ambulance personnel.
Katzer, R; Barton, D J; Adelman, S; Clark, S; Seaman, E L; Hudson, K B
2012-01-01
Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. The absolute increase in mean physical exam component documentation was 36% (95% CI = 29-43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation.
Impact of implementing an EMR on physical exam documentation by ambulance personnel
Katzer, R.; Barton, D.J.; Adelman, S.; Clark, S.; Seaman, E.L.; Hudson, K.B.
2012-01-01
Objectives Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. Methods This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. Results The absolute increase in mean physical exam component documentation was 36% (95% CI = 29–43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. Conclusions This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation. PMID:23646077
Is physical activity of medical personnel a role model for their patients.
Biernat, Elżbieta; Poznańska, Anna; Gajewski, Antoni K
2012-01-01
Sedentary lifestyle and other health behaviors such as smoking or alcohol consumption are well documented risk factors of several diseases. Numerous works by doctors and other healthcare professionals have been dedicated to the study of smoking and alcohol consumption. In contrast, the prevalence of physical activity of doctors or other medical personnel, who are well positioned to provide physical activity counseling to patients, remains almost unknown. Most studies were focused on male physicians and used a small total sample from one hospital. To study the situation in Warsaw, data on a random sample of medical personnel was analyzed in order to determine the prevalence of sport (both competitive and non-competitive leisure sport activity) and physical activity. The participants were a random sample of Warsaw medical doctors, nurses, and other medical personnel (764 persons). Data was collected face-to-face in November 2008 by well trained interviewers. The respondents were asked about their participation in competitive sport or non-competitive leisure sport activities during the previous year. The short, last seven days, Polish version of International Physical Activity Questionnaire (IPAQ) was used for the assessment of physical activity level. In the whole sample, the prevalence in competitive sport was low but significantly higher among men, but there were no significant differences between genders in division for different professional groups. Men more often took part in non-competitive leisure sport activities. A high level of physical activity was a rare characteristic for the majority of studied men and women (10.9 and 13.5%, respectively). A low level of physical activity was dominant among men and women (44.0 and 49.6% respectively). Independent risk factors of low physical activity were: not participating in sport or leisure sport activities (OR [95% CI] 3.70; 1.64-8.33 and 2.08; 1.37-.23 for men and women, respectively), being employed in an Out-patient Clinic (OR 2.86; 1.54-5.28 and 2.03; 1.42-2.90), overweight (only for men - OR 1.91; 1.10-3.31), and working as a doctor (for both men and women - 1.43; 1.05-1.94). All kinds of healthcare workers in Warsaw reported low physical activity, which could influence their physical activity counseling.
Drummond, Rachel; Gall, John A M
2017-02-01
Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA ® . With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Angtuaco, Teresita L; Hopkins, Robert H; DuBose, Terry J; Bursac, Zoran; Angtuaco, Michael J; Ferris, Ernest J
2007-06-01
This project was designed to test the feasibility of introducing ultrasound to senior medical students as a primary diagnostic tool in the evaluation of patients. Specifically, its aim was to determine if it is possible for medical students untrained in sonography to gain basic competence in performing abdominal ultrasound with limited didactic and hands-on instructions. Registered sonographers provided the students with hands-on instructions on the use of a compact ultrasound system. They were likewise shown how to evaluate specific organs and perform measurements. The results of the student measurements and those obtained by the sonographers were compared. There was close correlation between the results obtained by sonographers and students on both normal and abnormal findings. This supports the concept that medical students can be taught basic ultrasound skills with limited didactic and hands-on instructions with the potential of using these skills in the patient clinics as an adjunct to routine physical diagnosis.
Influencing factors of alexithymia in Chinese medical students: a cross-sectional study.
Zhu, Yaxin; Luo, Ting; Liu, Jie; Qu, Bo
2017-04-04
A much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors. A cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach's α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student's t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0. Of the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach's α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05). Gender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.
The physical phenotype of frailty for risk stratification of older medical inpatients.
Forti, P; Maioli, F; Zagni, E; Lucassenn, T; Montanari, L; Maltoni, B; Luca Pirazzoli, G; Bianchi, G; Zoli, M
2014-12-01
To determine the usefulness of physical phenotype of frailty, cognitive impairment, and serum albumin for risk stratification of elderly medical impatients. Prospective, observational cohort study. A general internal medicine unit of a university hospital in Italy. Inpatients with an average age of 80.8 ± 7.5 yr (N = 470). Frailty was defined using the Study of Osteoporotic Fractures Index, a parsimonious version of the physical phenotype (two of the following markers: weight loss, inability to rise five times from a chair, and exhaustion). Two frailty markers from non-physical dimensions were also evaluated: cognitive impairment (Mini-Cog score < 3) and low serum albumin on ward admission (< 3,5 gr/dl). Logistic regression adjusted for preadmission and admission-related confounders was used to investigate whether the physical phenotype of frailty and the two non-physical markers were associated with ward length of stay and unfavorable discharge (death plus any other ward discharge disposition different from direct return home). Areas Under the receiver operating characteristic Curve (AUCs) and Likelihood Ratios (LRs) were used for evaluation of discriminatory ability and clinical usefulness of significant predictors. The physical phenotype of frailty was associated with both study outcomes (p < 0.010) but the association was mainly mediated by chair standing ability. Non-physical markers were associated only with unfavourable discharge (p < 0.001). All of these predictors, either alone or in combination, had poor discriminatory ability (AUCs < 0.70) and poor clinical usefulness (+LRs near 1) for the study outcomes. The physical phenotype of frailty appears of limited clinical use for risk stratification of older medical inpatients. Combination with markers from non-physical dimensions does not improve its prognostic abilities.
Spasticity management in multiple sclerosis.
Hughes, Christina; Howard, Ileana M
2013-11-01
Spasticity is a prevalent and potentially disabling symptom common in individuals with multiple sclerosis. Adequate evaluation and management of spasticity requires a careful assessment of the patient's history to determine functional impact of spasticity and potential exacerbating factors, and physical examination to determine the extent of the condition and culpable muscles. A host of options for spasticity management are available: therapeutic exercise, physical modalities, complementary/alternative medicine interventions, oral medications, chemodenervation, and implantation of an intrathecal baclofen pump. Choice of treatment hinges on a combination of the extent of symptoms, patient preference, and availability of services. Copyright © 2013 Elsevier Inc. All rights reserved.
Competency and capacity: the legal and medical interface.
Purser, Kelly; Magner, Eilis S; Madison, Jeanne
2009-05-01
The loss of legal competency, in the context of wills, enduring powers of attorney and advance directives, presents a challenge to individual autonomy. Both legal and medical practitioners have roles to play in determining when, and if, to infringe upon a person's sovereignty in order to provide for their protection. However, there is some evidence that inter-professional discussions are characterised by tension. Medical expertise is necessary to assess physical and mental capacity, but the legal concern is with competency, two distinct terms. It is argued here that cooperation between the legal and medical professions is essential in this area of practice. This article attempts to promote discussion of this objective by proposing therapeutic jurisprudence as a theoretical framework in which to reassess competency determinations, by reviewing the institutional structure and by suggesting that the adoption of a common and consistent terminology is essential.
Radiation Oncology Physics and Medical Physics Education
NASA Astrophysics Data System (ADS)
Bourland, Dan
2011-10-01
Medical physics, an applied field of physics, is the applications of physics in medicine. Medical physicists are essential professionals in contemporary healthcare, contributing primarily to the diagnosis and treatment of diseases through numerous inventions, advances, and improvements in medical imaging and cancer treatment. Clinical service, research, and teaching by medical physicists benefits thousands of patients and other individuals every day. This talk will cover three main topics. First, exciting current research and development areas in the medical physics sub-specialty of radiation oncology physics will be described, including advanced oncology imaging for treatment simulation, image-guided radiation therapy, and biologically-optimized radiation treatment. Challenges in patient safety in high-technology radiation treatments will be briefly reviewed. Second, the educational path to becoming a medical physicist will be reviewed, including undergraduate foundations, graduate training, residency, board certification, and career opportunities. Third, I will introduce the American Association of Physicists in Medicine (AAPM), which is the professional society that represents, advocates, and advances the field of medical physics (www.aapm.org).
Experience of workplace violence during medical speciality training in Turkey.
Acik, Yasemin; Deveci, S Erhan; Gunes, Gulsen; Gulbayrak, Canan; Dabak, Sennur; Saka, Gunay; Vural, Gulsen; Can, Gunay; Bilgin, Nursel Gamsiz; Dundar, Pinar Erbay; Erguder, Toker; Tokdemir, Mehmet
2008-08-01
To determine the type, extent and effects of workplace violence among residents during postgraduate speciality training in various departments of medical schools in Turkey. A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured 'violence questionnaire' addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience. A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%). Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.
Evaluation of physical and chemical changes in pharmaceuticals flown on space missions.
Du, Brian; Daniels, Vernie R; Vaksman, Zalman; Boyd, Jason L; Crady, Camille; Putcha, Lakshmi
2011-06-01
Efficacy and safety of medications used for the treatment of astronauts in space may be compromised by altered stability in space. We compared physical and chemical changes with time in 35 formulations contained in identical pharmaceutical kits stowed on the International Space Station (ISS) and on Earth. Active pharmaceutical content (API) was determined by ultra- and high-performance liquid chromatography after returning to Earth. After stowage for 28 months in space, six medications aboard the ISS and two of matching ground controls exhibited changes in physical variables; nine medications from the ISS and 17 from the ground met the United States Pharmacopeia (USP) acceptance criteria for API content after 28 months of storage. A higher percentage of medications from each flight kit had lower API content than the respective ground controls. The number of medications failing API requirement increased as a function of time in space, independent of expiration date. The rate of degradation was faster in space than on the ground for many of the medications, and most solid dosage forms met USP standard for dissolution after storage in space. Cumulative radiation dose was higher and increased with time in space, whereas temperature and humidity remained similar to those on the ground. Exposure to the chronic low dose of ionizing radiation aboard the spacecraft as well as repackaging of solid dosage forms in flight-specific dispensers may adversely affect stability of pharmaceuticals. Characterization of degradation profiles of unstable formulations and identification of chemical attributes of stability in space analog environments on Earth will facilitate development of space-hardy medications.
Use of traditional eye medicine and self-medication in rural India: A population-based study.
Gupta, Noopur; Vashist, Praveen; Tandon, Radhika; Gupta, Sanjeev K; Kalaivani, Mani; Dwivedi, S N
2017-01-01
To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like 'kajal'(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.
Use of traditional eye medicine and self-medication in rural India: A population-based study
Gupta, Noopur; Tandon, Radhika; Gupta, Sanjeev K.; Kalaivani, Mani; Dwivedi, S. N.
2017-01-01
Objective To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. Methods A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Results Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like ‘kajal’(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Conclusion Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices. PMID:28829812
10 CFR 1046.11 - Medical and physical fitness qualification standards.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Medical and physical fitness qualification standards. 1046... INTERESTS Protective Force Personnel § 1046.11 Medical and physical fitness qualification standards. (a... personnel any individual who fails to meet the applicable medical and physical fitness qualification...
10 CFR 1046.11 - Medical and physical fitness qualification standards.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Medical and physical fitness qualification standards. 1046... INTERESTS Protective Force Personnel § 1046.11 Medical and physical fitness qualification standards. (a... personnel any individual who fails to meet the applicable medical and physical fitness qualification...
10 CFR 1046.11 - Medical and physical fitness qualification standards.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Medical and physical fitness qualification standards. 1046... INTERESTS Protective Force Personnel § 1046.11 Medical and physical fitness qualification standards. (a... personnel any individual who fails to meet the applicable medical and physical fitness qualification...
Clinically oriented three-year medical physics curriculum: a new design for the future.
Nachiappan, Arun C; Lee, Stephen R; Willis, Marc H; Galfione, Matthew R; Chinnappan, Raj R; Diaz-Marchan, Pedro J; Bushong, Stewart C
2012-09-01
Medical physics instruction for diagnostic radiology residency at our institution has been redesigned with an interactive and image-based approach that encourages clinical application. The new medical physics curriculum spans the first 3 years of radiology residency and is integrated with the core didactic curriculum. Salient features include clinical medical physics conferences, fundamentals of medical physics lectures, practicums, online modules, journal club, and a final review before the American Board of Radiology core examination.
A description of physical therapists' knowledge in managing musculoskeletal conditions.
Childs, John D; Whitman, Julie M; Sizer, Phillip S; Pugia, Maria L; Flynn, Timothy W; Delitto, Anthony
2005-06-17
Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions.
Kemper, Han C G; Verhagen, E A L M; Milo, D; Post, G B; Van Lenthe, F; Van Mechelen, W; Twisk, J W R; De Vente, W
2002-01-01
In the Amsterdam Growth and Health Longitudinal Study (AGAHLS), a group of apparently healthy males and females (n = 200) were interviewed about their physical activities on eight separate occasions over a period of 20 years between 13 and 33 years of age (multi-measured group: MM). Information about their health was given based on their personally measured lifestyle (activity, diet, smoking) and biological risk characteristics for chronic diseases (medical check-ups). A comparable group of boys and girls (n = 200) was only measured on two occasions (bi-measured group: BM): at 13 and 33 years. Physical activity was estimated with a structured interview. Total physical activity and sports activity were estimated in three intensity levels (light, moderate, and heavy). It was hypothesized that the eight repeated medical check-ups with health information in the MM group would result in a healthier lifestyle with respect to the determinants and levels of habitual physical activity compared to the BM group. Contrary to the hypothesis, males and females in the BM group showed a significantly higher increase or a lower decrease in physical activities compared to the MM group. This negative effect on the physical activity pattern at 33 years in the MM group may have been caused by more underreporting of physical activities than in the BM group. In conclusion, there does not appear to be a significant effect of long-term (multi-measured) health information with medical check-ups during adolescence and young adulthood on level of physical activity in males and females at 33 years of age. Copyright 2002 Wiley-Liss, Inc.
[The physical problems in medicine].
Bao, Shang-lian; Wang, Wei-dong; Fan, Tie-shuan
2007-05-01
According to the World Health Organization (WHO), the basic sciences to support the human health are chemistry, physics and informatics. Chemistry is the base of pharmacy. Physics is the base of medical instruments and equipments (MIE). The diagnosis and therapy of diseases are relying on informatics. Therefore, as the fusion results of physics and medicine, medical physics is the creative source science of MIE. Among all diagnosis tools, medical imaging devices are the fastest-developed and the most-complicated MIE since Roentgen discovered X-ray which was quickly used in medical diagnosis in 1895. Among all treatment tools, the radiotherapeutical devices are the most-widely used and the most effective MIE for tumor treatments since Mrs. Courier found the nature radiation isotope Radium at the end of 19th century and began to use it in tumor therapy. Although the research and development (R&D) of so-complicated MIE need many subjects of science and engineering, the kernel science is medical physics. With the results of more than 50 years' development in developed countries, medical physics has defined its own field, which is the medical imaging physics and the radiotherapeutical physics. But, the definition has been expanded to be wider and wider. Therefore, we should pay more attention to the establishment of Medical Physics in China. In order to develop medical physics in china, the bases of R&D and clinical practice should be also built.
46 CFR 12.25-20 - Physical and medical requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Physical and medical requirements. 12.25-20 Section 12.25-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN... Member of the Engine Department § 12.25-20 Physical and medical requirements. The physical and medical...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-06
...-HQ-2012-0002] RIN 1992-AA40 Protective Force Personnel Medical, Physical Readiness, Training, and... the proposed rule to amend the standards for medical, physical performance, training, and access... proposed rule to revise the standards for medical, physical performance, training, and access...
46 CFR 12.25-20 - Physical and medical requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 1 2013-10-01 2013-10-01 false Physical and medical requirements. 12.25-20 Section 12.25-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN... Member of the Engine Department § 12.25-20 Physical and medical requirements. The physical and medical...
46 CFR 12.25-20 - Physical and medical requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Physical and medical requirements. 12.25-20 Section 12.25-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN... Member of the Engine Department § 12.25-20 Physical and medical requirements. The physical and medical...
46 CFR 12.25-20 - Physical and medical requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Physical and medical requirements. 12.25-20 Section 12.25-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN... Member of the Engine Department § 12.25-20 Physical and medical requirements. The physical and medical...
Medical physics in Europe following recommendations of the International Atomic Energy Agency.
Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla
2016-03-01
Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral responsibility to effectively transpose Basic Safety Standards into national legislation in order to ensure high quality and safety in patient healthcare.
Medical physics in Europe following recommendations of the International Atomic Energy Agency
Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla
2016-01-01
Background Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Conclusions Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral responsibility to effectively transpose Basic Safety Standards into national legislation in order to ensure high quality and safety in patient healthcare. PMID:27069451
Education and training of medical physics in Iran: The past, the present and the future.
Mahdavi, Seyed Rabi; Rasuli, Behrouz; Niroomand-Rad, Azam
2017-04-01
The aim of this study was to investigate the current status of education and training programs in medical physics in Iran. A questionnaire was designed and sent to 274 IAMP (Iranian Association of Medical Physicists) members focusing on these two topics: the educational situation (course syllabus, number of faculty members, number of PhD and MSc students and sub-fields offered in the department) and the professional situation (work experience, workplaces of medical physicists, postgraduate degrees that were granted and the amount of therapy and imaging equipment). Medical physics education in Iran is provided at 14 universities at master and doctorate levels. All medical physics departments offer an MSc program and 6 of them offer a PhD program. Most medical physics faculty (24%) work in the radiotherapy physics sub-specialty. Also, about 95 medical physics students graduate every year. There are six major peer-reviewed Iranian journals that publish medical physics papers in English. In addition, there are 74 radiotherapy machines including Co-60 and LINACs (LINear ACcelerators) across Iran as of 2013. The curriculum of medical physics programs (MSc and PhD) in Iran must be improved to include long-term clinical courses in the four major sub-specialties of radiotherapy, medical imaging, nuclear medicine and radiation protection. It is hoped that clinical medical physicists will go through nationally-accredited exams before assuming independent clinical responsibilities. Moreover, the work situation of the medical physics profession in Iran should be clear and the government authorities must recognize importance of this interdisciplinary field in medicine. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Medical physics is alive and well and growing in South East Asia.
Ng, K; Pirabul, R; Peralta, A; Soejoko, D
1997-03-01
In recent years there has been a significant economic growth in South East Asia, along with it a concurrent development of medical physics. The status of four countries--Malaysia, Thailand, the Philippines and Indonesia are presented. Medical physicists in these countries have been experiencing the usual problems of lack of recognition, low salaries, and insufficient facilities for education and training opportunities. However the situation has improved recently through the initiative of local enthusiastic medical physicists who have started MS graduate programs in medical physics and begun organizing professional activities to raise the profile of medical physics. The tremendous support and catalytic roles of the American Association of Physicists in Medicine (AAPM) and international organizations such as International Organization for Medical Physics (IOMP), International Atomic Energy Agency (IAEA), World Health Organization (WHO), and International Center for Theoretical Physics (ICTP) have been instrumental in achieving progress. Contributions by these organizations include co-sponsorship of workshops and conferences, travel grants, medical physics libraries programs, and providing experts and educators. The demand for medical physicists is expected to rise in tandem with the increased emphasis on innovative technology for health care, stringent governmental regulation, and acceptance by the medical community of the important role of medical physicists.
ERIC Educational Resources Information Center
Laughlin, John S.
1983-01-01
Traces the development of basic radiation physics that underlies much of today's medical physics and looks separately at the historical development of two major subfields of medical physics: radiation therapy and nuclear medicine. Indicates that radiation physics has made important contributions to solving biomedical problems in medical…
Development of Minimum Physical Fitness Standards for the Canadian Armed Forces. Phase 2
1987-03-31
consistently has been shown to be physically demanding; maximal h-eart rate response and near-maximal blood lactate post- exercise values are elicited, confirming...were near-maximal (i.e. their heart rates and post- exercise blood lactate responses ), in close agreement with the literature reported for load-carrying...factors which determine the cardiovascular responses to sustained and rhythmic exercise . Canadian Medical Association Journal, 96, 706-715. Lind, A
General Consideration in the History, Physical Examination, and Safety Determination.
Buchanan, Jonathan; Dexter, William; Powell, Amy; Wright, Justin
2015-12-01
A thorough medical history is perhaps the most important aspect when evaluating an athlete before wilderness adventure. A physical examination should follow focusing on conditions that may be affected by changes in atmospheric pressure, extremes of temperature, or altitude. This information can then be used to make safety recommendations ensuring that adventurers are able to safely enjoy participation in the wilderness pursuit of their choice. Copyright © 2015. Published by Elsevier Inc.
Kosteniuk, Julie G; Morgan, Debra G; D'Arcy, Carl K
2013-01-01
The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs. A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008. Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access). When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.
Kosteniuk, Julie G.; Morgan, Debra G.; D'Arcy, Carl K.
2013-01-01
Objectives: The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs. Methods: A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008. Results: Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access). Conclusions: When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information. PMID:23405045
10 CFR 1046.11 - Medical and physical fitness qualification standards.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 4 2014-01-01 2014-01-01 false Medical and physical fitness qualification standards. 1046... INTERESTS (Eff. until 3-10-14) Protective Force Personnel § 1046.11 Medical and physical fitness... fitness qualification standards as set forth in appendix A, to this subpart, “Medical and Physical Fitness...
Waheedi, Mohammad; Awad, Abdelmoneim; Hatoum, Hind T; Enlund, Hannes
2017-02-01
Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeutic targets with adherence to self-care measures in a sample of patients with type 2 diabetes in Kuwait. Setting Primary care chronic care clinics within the Ministry of Health of Kuwait. Methods A cross sectional survey was carried out with 238 patients from six clinics. A multistage stratified clustered sampling method was used to first randomly select the clinics and the patients. Self-reported adherence to three behaviours: medication taking, diet and physical activity. Results Respondents were able to correctly report a mean (SD) of 1.6 (1.3) out of 5 of the pre-specified treatment targets. Optimal adherence to physical activity, diet and medications was reported in 25, 33 and 47 % of the study cohort, respectively. A structural equation model analysis showed better knowledge of therapeutic goals and own current levels translated into better adherence to medications, diet and physical activity. Conclusion Knowledge of therapeutic goals and own recent levels is associated with adherence to medications, diet, or physical activity in this Kuwaiti cohort of patients with diabetes. Low adherence to self-care management and poor overall knowledge of diabetes is a big challenge to successful diabetes care in Kuwait.
Health students' expectations of the ideal educational environment: a qualitative research.
Aghamolaei, Teamur; Shirazi, Mandana; Dadgaran, Ideh; Shahsavari, Hooman; Ghanbarnejad, Amin
2014-10-01
Educational environment is an important determinant of students' behavior and its elements are associated with academic achievement and course satisfaction. The aim of this study was to determine students' expectations of the ideal educational environment. This was a qualitative study with content analysis approach. Using a theoretical sampling method, we selected eight students from Health School of Hormozgan University of Medical Sciences, studying health education, public health, environmental health, occupational health and medical entomology. To collect data, semi-structured interviews were used and continued until reaching data saturation. Qualitative content analysis was used to analyze the data. Students' expectations of the ideal educational environment emerged in four main themes including school atmosphere, teaching, human aspects (with three subthemes including teachers, students, and school staff) and non-human aspects (with two subthemes including educational equipment and physical environment). Educational environment is a multidimensional issue and to achieve an ideal educational environment, educational planners should meet the students' expectations of the school atmosphere, teaching, teachers, students, school staff, educational equipment and physical environment.
Evaluations of children who have disclosed sexual abuse via facilitated communication.
Botash, A S; Babuts, D; Mitchell, N; O'Hara, M; Lynch, L; Manuel, J
1994-12-01
To review the findings of interdisciplinary team evaluations of children who disclosed sexual abuse via facilitated communication. Case series. Tertiary care hospital outpatient child sexual abuse program in central New York. Between January 1990 and March 1993, 13 children who disclosed sexual abuse via facilitated communication and were referred to a university hospital child abuse referral and evaluation center. The range of previously determined developmental diagnosis included mental retardation, speech delay, and autism. None. Medical records were reviewed for (1) disclosure, (2) physical evidence, (3) child's behavioral and medical history, (4) disclosures by siblings, (5) perpetrator's confession, (6) child protective services determinations, and (7) court findings. Four children had evidence of sexual abuse: two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed. These results neither support nor refute validation of facilitated communication. However, many children had other evidence of sexual abuse, suggesting that each child's case should be evaluated without bias.
Gubata, Marlene E; Urban, Nadia; Cowan, David N; Niebuhr, David W
2013-07-01
Mental health disorders contribute substantially to medical and occupational morbidity. The role of fitness and physical activity in the prevention of mental health disorders is not well established, but epidemiologic data suggest that physical activity can protect against anxiety and depression. The analyses presented in this report, from a prospective cohort study, evaluate the association between fitness (as measured by a 5-minute step test), and being overweight (defined as exceeding weight and body fat allowances) at military entrance, with subsequent onset of mental disorder diagnosis in the first year of service. The association between risk factors and mental disorder diagnosis was analyzed using multivariate Poisson regression with the adjusted incidence rate ratio (aIRR) as the measure of association. Among weight-qualified participants, factors associated with increased incidence of mental disorder included failing the physical fitness test (aIRR: 1.36, p<0.0001), female sex (aIRR: 2.17, p<0.0001), and smoking (aIRR: 1.49, p<0.0001). Among fit participants, being overweight was not significantly associated with mental disorder (aIRR: 1.11, p=0.1540). This test has potential military utility as an adjunct part of the medical examination process. Additional research is needed among civilians to determine if similar associations exist. If so, intervention studies should be conducted to determine if improving physical fitness reduces subsequent psychiatric disorder risk, particularly among young adults entering into stressful situations. Published by Elsevier Inc.
Diagnostic medical physicists and their clinical activities.
Cypel, Yasmin S; Sunshine, Jonathan H
2004-02-01
The primary objective of this study was to obtain basic, descriptive information about medical physicists involved in diagnostic radiology-related activities, the diagnostic-related activities that they performed, and the time spent on these activities. A survey was sent to a randomly selected sample of 1511 medical physicists from July through October 2001 using primarily e-mail methods; a total of 851 surveys was received, for a response rate of 56%. Of these, 427 were responses from physicists who do partly or only clinical diagnostic medical physics; it is this group for which results are presented. Fifty-four percent of the physicists who reported doing any clinical diagnostic medical physics performed clinical activities only in diagnostic medical physics. Fourteen percent of all those doing clinical diagnostic medical physics were women. Over 97% of the physicists doing clinical diagnostic medical physics reported having graduate degrees in physics; 53% had PhDs. The mean total weekly hours worked by physicists doing clinical diagnostic medical physics was 42. Medical physicists doing only clinical diagnostic activities reported working approximately 40 hours weekly, whereas those doing partly clinical diagnostic medical physics reported working 14 hours weekly in the field (approximately one-third of their work time). Radiography and fluoroscopy, computed tomography, nuclear medicine, and mammography are all fields in which the majority of those doing any clinical diagnostic medical physics are active. Full-time physicists working only in diagnostic medical physics were responsible for a median of 25 units of equipment, compared with a median of 10 units for those working only partly in the field. Number of units evaluated, frequency of evaluation, and hours per evaluation were reported for almost 20 types of equipment. Medical physicists performing diagnostic clinical activities typically are responsible for a large number and wide variety of imaging equipment. It would be helpful to study their work further, focusing in particular on whether there is a shortage, as is true of diagnostic radiologists, and whether the variety of responsibilities creates strain.
46 CFR 12.15-5 - Physical and medical requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 1 2013-10-01 2013-10-01 false Physical and medical requirements. 12.15-5 Section 12.15... REQUIREMENTS FOR RATING ENDORSEMENTS Qualified Member of the Engine Department § 12.15-5 Physical and medical requirements. The physical and medical requirements for an endorsement as QMED are found in § 10.215 of this...
46 CFR 12.15-5 - Physical and medical requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Physical and medical requirements. 12.15-5 Section 12.15... REQUIREMENTS FOR RATING ENDORSEMENTS Qualified Member of the Engine Department § 12.15-5 Physical and medical requirements. The physical and medical requirements for an endorsement as QMED are found in § 10.215 of this...
46 CFR 12.15-5 - Physical and medical requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Physical and medical requirements. 12.15-5 Section 12.15... REQUIREMENTS FOR RATING ENDORSEMENTS Qualified Member of the Engine Department § 12.15-5 Physical and medical requirements. The physical and medical requirements for an endorsement as QMED are found in § 10.215 of this...
46 CFR 12.15-5 - Physical and medical requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Physical and medical requirements. 12.15-5 Section 12.15... REQUIREMENTS FOR RATING ENDORSEMENTS Qualified Member of the Engine Department § 12.15-5 Physical and medical requirements. The physical and medical requirements for an endorsement as QMED are found in § 10.215 of this...
The contribution of Medical Physics to Nuclear Medicine: looking back - a physicist's perspective.
Hutton, Brian F
2014-12-01
This paper is the first in a series of invited perspectives by four pioneers of Nuclear Medicine imaging and physics. A medical physicist and a Nuclear Medicine clinical specialist each take a backward look and a forward look at the contributions of Medical Physics to Nuclear Medicine. Contributions of Medical Physics are presented from the early discovery of radioactivity, development of first imaging devices, computers and emission tomography to recent development of hybrid imaging. There is evidence of significant contribution of Medical Physics throughout the development of Nuclear Medicine.
Non-Deployable Soldiers: Understanding the Army’s Challenge
2011-05-07
TERMS Medically Not Ready (MNR), Warrior Transition Unit (WTU), Disability Evaluation System (DES), Physical Evaluation Board (PEB), Medical Evaluation... Board (MEB), MOS Medical Retention Board (MMRB), Human Capital Enterprise, Personnel Management, Physical Evaluations System. 16. SECURITY...Medically Not Ready (MNR), Warrior Transition Unit (WTU), Disability Evaluation System (DES), Physical Evaluation Board (PEB), Medical Evaluation
Bore, Miles; Kelly, Brian; Nair, Balakrishnan
2016-01-01
Research has consistently found that the proportion of medical students who experience high levels of psychological distress is significantly greater than that found in the general population. The aim of our research was to assess the levels of psychological distress more extensively than has been done before, and to determine likely predictors of distress and well-being. In 2013, students from an Australian undergraduate medical school (n=127) completed a questionnaire that recorded general demographics, hours per week spent studying, in paid work, volunteer work, and physical exercise; past and current physical and mental health, social support, substance use, measures of psychological distress (Kessler Psychological Distress Scale, depression, anxiety, stress, burnout); and personality traits. Females were found to have higher levels of psychological distress than males. However, in regression analysis, the effect of sex was reduced to nonsignificance when other variables were included as predictors of psychological distress. The most consistent significant predictors of our 20 indicators of psychological distress were social support and the personality traits of emotional resilience and self-control. The findings suggest that emotional resilience skills training embedded into the medical school curriculum could reduce psychological distress among medical students.
[Acute responses on lipid profile by practicing cycling].
Díaz-Ríos, Lillian Karina; Rivera-Cisneros, Antonio Eugenio; Macías-Cervantes, Maciste Habacuc; Sánchez-González, Jorge Manuel; Guerrero-Martínez, Francisco Javier
2008-01-01
it has been demonstrated an association between the increase in physical activity and improvements in the lipid profile. to evaluate changes in the serum lipids caused by spinning practice. nine men and twelve women were studied, they underwent to an initial evaluation that included a treadmill effort test, in order to establish the physical fitness level. With the purpose of determine the lipids change, a blood sample was obtained before and after a typical spinning session. The design was prospective, experimental, longitudinal and comparative study. Student's t-test and regression model were used to determine the changes in the lipids concentrations, and its relation with the physical fitness level. A p value < or = 0.05 was required for statistical significance. lipids increase concentrations were observed (p < 0.05), except at triglycerides in men, in which it had a decrease. It was statistically significant relation between the physical fitness level and the percentage of high-density lipoproteins variation (r = 0.44, p = 0.046). the percentage of high-density lipoproteins variation was greater when the values of VO(2)max were higher. At greater level of medical fitness greater positive answer in this lipoproteins. In the case of the rest serum lipids, it was not observed relation between the level of medical fitness and the percentage of variation due to the execution of the spinning session.
Human Factors and ISS Medical Systems: Highlights of Procedures and Equipment Findings
NASA Technical Reports Server (NTRS)
Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.
2005-01-01
As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.
Current status and future trends of medical physics in Mexico
NASA Astrophysics Data System (ADS)
Azorin Nieto, J.
2015-01-01
Medical Physics is an area that applies the principles of physics to medicine, particularly in the prevention, diagnosis and treatment of diseases using ionizing and nonionizing radiation. The main attractive of medical physics is that it has a direct impact on the quality and safety of medical care in humans; this social component with direct implications for the population is of high value for Mexico. This paper describes the concepts of medical physics, trends and the current status of this discipline as a profession, which is directly related to the efforts of clinical research. It is also described what is, in my opinion, the future of medical physics in Mexico, emphasizing the fact that this field requires a substantial boost from universities and hospitals to recruit highly qualified young medical physicists and the support from government agencies such as Secretaria de Salud, Instituto Mexicano del Seguro Social and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado through clinical research projects that allow the necessary evolution of medical physics into the hospital setting.
A Baseline Patient Model to Support Testing of Medical Cyber-Physical Systems.
Silva, Lenardo C; Perkusich, Mirko; Almeida, Hyggo O; Perkusich, Angelo; Lima, Mateus A M; Gorgônio, Kyller C
2015-01-01
Medical Cyber-Physical Systems (MCPS) are currently a trending topic of research. The main challenges are related to the integration and interoperability of connected medical devices, patient safety, physiologic closed-loop control, and the verification and validation of these systems. In this paper, we focus on patient safety and MCPS validation. We present a formal patient model to be used in health care systems validation without jeopardizing the patient's health. To determine the basic patient conditions, our model considers the four main vital signs: heart rate, respiratory rate, blood pressure and body temperature. To generate the vital signs we used regression models based on statistical analysis of a clinical database. Our solution should be used as a starting point for a behavioral patient model and adapted to specific clinical scenarios. We present the modeling process of the baseline patient model and show its evaluation. The conception process may be used to build different patient models. The results show the feasibility of the proposed model as an alternative to the immediate need for clinical trials to test these medical systems.
Views of Medical Physics in the United Kingdom and Ireland, 1980.
1981-05-19
as a means of characteriza- tion. Other studies include determination of electron dosimetry in bone tissue, radiological survey of the population dose...addition to Ellis, who heads the department, they are; Radiobiology and Dosimetry Prof. P.RoJ. Burch Dr. A.Jo Walker Medical Electronics and Computing Dr. F...absorptiometry l radiation dosimetry 1 radiothprapy ultrasound scahning 11 20. ASISTRACT (Cal’th"M 601 fwa side "f M1aaeaam’ 4104 fd=ifr by b1106h .Nbie) This
Preoperative Evaluation and Patient Selection for Office-Based Oral Surgery Anesthesia.
Lieblich, Stuart
2018-05-01
Provision of an outpatient anesthetic requires careful review of the patient's medical history along with salient aspects of the physical examination. The oral and maxillofacial surgeon may need to consult with the patient's medical providers to gain an understanding of the patient's potential risks for an adverse event. This article reviews key aspects of the patient evaluation so that an informed determination of suitability for an office anesthetic can be made. Copyright © 2018 Elsevier Inc. All rights reserved.
The Internet's role in a biodosimetric response to a radiation mass casualty event.
Sugarman, S L; Livingston, G K; Stricklin, D L; Abbott, M G; Wilkins, R C; Romm, H; Oestreicher, U; Yoshida, M A; Miura, T; Moquet, J E; Di Giorgio, M; Ferrarotto, C; Gross, G A; Christiansen, M E; Hart, C L; Christensen, D M
2014-05-01
Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet.
2012-01-01
Background Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the Alberta Moving Beyond Breast Cancer (AMBER) Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death. Methods/Design The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery), 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes. Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1) the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy), quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (2) the determinants of physical activity and health-related fitness including demographic, medical, social cognitive, and environmental variables, (3) the mediators of any observed associations between physical activity, health-related fitness, and health outcomes including biological, functional, and psychosocial, and (4) the moderators of any observed associations including demographic, medical, and biological/disease factors. Taken together, these data will provide a comprehensive inquiry into the outcomes, determinants, mechanisms, and moderators of physical activity and health-related fitness in breast cancer survivors. PMID:23153358
Standards on medical fitness examinations for Navy divers.
Weiss, Michael
2003-01-01
The German Navy employs approximately 480 divers in their primary and secondary role. Before entering diving training, every diver has to pass an intensive physical examination programme at the German Naval Medical Institute (NMI) in Kiel-Kronshagen. Annual follow-ups ensure the currency of the medical findings. Criteria of medical fitness for diving reflect industrial medical standards for hyperbaric workers as well as the general medical guidelines for NATO divers. A diving examination consists of the individual medical history, a physical examination including the neurological status and the assessment of the cardiovascular fitness by ECG and bicycle ergometry. The respiratory system is screened by regular chest x-rays and spirometry or body plethysmography. Blood and urine samples are taken to look for abnormal haematological and metabolic conditions as well as disorders of the genito-urinary system. In order to determine visual fitness, diver's visual acuity, colour vision and stereopsis as well as eye fundi are examined by an eye specialist. Also the ENT examination involves a speciality consultant and consists of audiometry, inspection of the external ear and tympanic membrane and functional tests. To ensure a high standard of dental fitness, screening by a dental officer is part of the annual check-up. Every routine diving medical examination at the NMI includes a pressure test in the hyperbaric chamber. Divers who use nitrox or oxygen-rebreather devices have to pass successfully an oxygen tolerance test under hyperbaric conditions. The annual routine diving medical examination contributes to minimize the risk of accidents in military diving operations.
Clinical learning environment at Shiraz Medical School.
Rezaee, Rita; Ebrahimi, Sedigheh
2013-01-01
Clinical learning occurs in the context of a dynamic environment. Learning environment found to be one of the most important factors in determining the success of an effective teaching program. To investigate, from the attending and resident's perspective, factors that may affect student leaning in the educational hospital setting at Shiraz University of Medical Sciences (SUMS). This study combined qualitative and quantitative methods to determine factors affecting effective learning in clinical setting. Residents evaluated the perceived effectiveness of the university hospital learning environment. Fifty two faculty members and 132 residents participated in this study. Key determinants that contribute to an effective clinical teaching were autonomy, supervision, social support, workload, role clarity, learning opportunity, work diversity and physical facilities. In a good clinical setting, residents should be appreciated and given appropriate opportunities to study in order to meet their objectives. They require a supportive environment to consolidate their knowledge, skills and judgment. © 2013 Tehran University of Medical Sciences. All rights reserved.
Marie Curie's contribution to Medical Physics.
Jean-Claude, Rosenwald; Nüsslin, Fridtjof
2013-09-01
On occasion of its 50th anniversary, the International Organization for Medical Physics (IOMP) from now on is going to celebrate annually an International Day of Medical Physics for which the 7th November, the birthday of Marie Sklodowska Curie, a most exceptional character in science at all and a pioneer of medical physics, has been chosen. This article briefly outlines her outstanding personality, sketches her fundamental discovery of radioactivity and emphasizes the impact of her various achievements on the development of medical physics at large. © 2013 Published by Elsevier Ltd on behalf of Associazione Italiana di Fisica Medica.
The origins of medical physics.
Duck, Francis A
2014-06-01
The historical origins of medical physics are traced from the first use of weighing as a means of monitoring health by Sanctorius in the early seventeenth century to the emergence of radiology, phototherapy and electrotherapy at the end of the nineteenth century. The origins of biomechanics, due to Borelli, and of medical electricity following Musschenbroek's report of the Leyden Jar, are included. Medical physics emerged as a separate academic discipline in France at the time of the Revolution, with Jean Hallé as its first professor. Physiological physics flowered in Germany during the mid-nineteenth century, led by the work of Adolf Fick. The introduction of the term medical physics into English by Neil Arnott failed to accelerate its acceptance in Britain or the USA. Contributions from Newton, Euler, Bernoulli, Nollet, Matteucci, Pelletan, Gavarret, d'Arsonval, Finsen, Röntgen and others are noted. There are many origins of medical physics, stemming from the many intersections between physics and medicine. Overall, the early nineteenth-century definition of medical physics still holds today: 'Physics applied to the knowledge of the human body, to its preservation and to the cure of its illnesses'. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Krops, Leonie A; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U
2018-03-16
Physically disabled people are less physically active compared with healthy people. Existing physical activity (PA) interventions are limited in reach, since they are primarily rehabilitation or school based. The current study aims to develop a community-based intervention for stimulating PA in hard-to-reach physically disabled people. To systematically develop a PA-stimulating intervention, intervention mapping (six steps) was applied. PA level and health-related quality of life of patients after rehabilitation was determined using questionnaires (step 1). Qualitative research was performed to study professionals' and physically disabled people's ideas about intervention objectives, determinants and design (steps 2 and 3). Since experts expressed no need for a new intervention, the existing intervention 'Activity coach' was adapted to the specific target population. The adapted intervention 'Activity coach+' composes a network of intermediate organisations that refers participants to an activity coach, who coaches participants during 1 year. After a preintervention physical assessment by a physiotherapist, participants will be individually guided to existing organised or non-organised activities. An activity tracker will be used to monitor and stimulate PA in daily life (step 4). To support adoption and implementation, meetings between involved parties are organised (step 5). 'Activity coach+' is implemented in community in March 2017, and will be evaluated using a mixed-method analysis. Quantitative evaluation of intervention effects on PA, health and social participation takes place after 0, 2, 4, 6 and 12 months. The implementation process and experiences with the intervention will be determined using qualitative research (step 6). Insights from this study will be used for dissemination and further development of the intervention. The Medical Ethical Committee of the University Medical Center Groningen confirmed that formal ethical approval was not required (METc 2016/630). NTR6858. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Reimbursement versus effort in medical physics practice in radiation oncology.
Herman, Michael G; Mills, Michael D; Gillin, Michael T
2003-01-01
The changes in health care reimbursement have the potential to affect the availability of quality medical physicist service in patient care. A survey was conducted by the AAPM Professional Council and the ACMP to collect cost information for special medical physics consultation, CPT4-77370 and continuing medical physics, CPT4-77336. The data collected from the survey was compared to current reimbursement schemes for a number of special procedures. Under varying reimbursement schemes, the costs of the medical physics services provided cannot be recaptured by the institution. It remains important for medical physicists to assess our utilization of resources and allocation to each of the services we provide and to understand the implications of policy changes at the federal and local levels. 2003 American College of Medical Physics.
Computer Aided Dosimetry and Verification of Exposure to Radiation
NASA Astrophysics Data System (ADS)
Waller, Edward; Stodilka, Robert Z.; Leach, Karen E.; Lalonde, Louise
2002-06-01
In the timeframe following the September 11th attacks on the United States, increased emphasis has been placed on Chemical, Biological, Radiological and Nuclear (CBRN) preparedness. Of prime importance is rapid field assessment of potential radiation exposure to Canadian Forces field personnel. This work set up a framework for generating an 'expert' computer system for aiding and assisting field personnel in determining the extent of radiation insult to military personnel. Data was gathered by review of the available literature, discussions with medical and health physics personnel having hands-on experience dealing with radiation accident victims, and from experience of the principal investigator. Flow charts and generic data fusion algorithms were developed. Relationships between known exposure parameters, patient interview and history, clinical symptoms, clinical work-ups, physical dosimetry, biological dosimetry, and dose reconstruction as critical data indicators were investigated. The data obtained was examined in terms of information theory. A main goal was to determine how best to generate an adaptive model (i.e. when more data becomes available, how is the prediction improved). Consideration was given to determination of predictive algorithms for health outcome. In addition. the concept of coding an expert medical treatment advisor system was developed (U)
10 CFR 1046.11 - Medical and physical fitness qualification standards.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Medical and physical fitness qualification standards. 1046.11 Section 1046.11 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PHYSICAL PROTECTION OF SECURITY INTERESTS Protective Force Personnel § 1046.11 Medical and physical fitness qualification standards. (a...
10 CFR 35.51 - Training for an authorized medical physicist.
Code of Federal Regulations, 2013 CFR
2013-01-01
... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...
10 CFR 35.51 - Training for an authorized medical physicist.
Code of Federal Regulations, 2012 CFR
2012-01-01
... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...
10 CFR 35.51 - Training for an authorized medical physicist.
Code of Federal Regulations, 2014 CFR
2014-01-01
... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...
10 CFR 35.51 - Training for an authorized medical physicist.
Code of Federal Regulations, 2010 CFR
2010-01-01
... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...
26 CFR 1.409A-3 - Permissible payments.
Code of Federal Regulations, 2011 CFR
2011-04-01
... relationship, Employee G provides professional services to clients of Employer U as part of the bona fide... hardship to the service provider resulting from an illness or accident of the service provider, the service... gainful activity by reason of any medically determinable physical or mental impairment that can be...
26 CFR 1.409A-3 - Permissible payments.
Code of Federal Regulations, 2014 CFR
2014-04-01
... relationship, Employee G provides professional services to clients of Employer U as part of the bona fide... hardship to the service provider resulting from an illness or accident of the service provider, the service... gainful activity by reason of any medically determinable physical or mental impairment that can be...
26 CFR 1.409A-3 - Permissible payments.
Code of Federal Regulations, 2013 CFR
2013-04-01
... relationship, Employee G provides professional services to clients of Employer U as part of the bona fide... hardship to the service provider resulting from an illness or accident of the service provider, the service... gainful activity by reason of any medically determinable physical or mental impairment that can be...
26 CFR 1.409A-3 - Permissible payments.
Code of Federal Regulations, 2012 CFR
2012-04-01
... relationship, Employee G provides professional services to clients of Employer U as part of the bona fide... hardship to the service provider resulting from an illness or accident of the service provider, the service... gainful activity by reason of any medically determinable physical or mental impairment that can be...
20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2013 CFR
2013-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on... for individuals who are statutorily blind. We discuss these in §§ 404.1581 through 404.1587. There are...
20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2014 CFR
2014-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on... for individuals who are statutorily blind. We discuss these in §§ 404.1581 through 404.1587. There are...
20 CFR 404.1520 - Evaluation of disability in general.
Code of Federal Regulations, 2010 CFR
2010-04-01
...-step sequential evaluation process we use to decide whether you are disabled, as defined in § 404.1505...-step sequential evaluation process. The sequential evaluation process is a series of five “steps” that... severe medically determinable physical or mental impairment that meets the duration requirement in § 404...
The UNAM M. Sc. program in Medical Physics enters its teen years
NASA Astrophysics Data System (ADS)
Brandan, María-Ester
2010-12-01
The M.Sc. (Medical Physics) program at the National Autonomous University of Mexico UNAM, created in 1997, has graduated a substantial number of medical physicists who constitute today about 30% of the medical physics clinical workforce in the country. Up to present date (May 2010) more than 60 students have graduated, 60% of them hold clinical jobs, 20% have completed or study a Ph.D., and 15% perform activities related to this specialization. In addition to strengthening the clinical practice of medical physics, the program has served as an incentive for medical physics research in UNAM and other centers. We report the circumstances of the program origin, the evolution of its curriculum, the main achievements, and the next challenges.
Pre-Med Physics: What and Why.
ERIC Educational Resources Information Center
Nichparenko, Sue Broadston
1985-01-01
Discusses issues related to the physics concepts/topics needed by health professionals, suggesting that medical students can better understand how the body works by completing meaningful physics courses. Also addresses related concerns expressed by medical students and faculty. A list of 41 physics topics cross-referenced to medical topics is…
Abortion Services and Military Medical Facilities
2010-12-16
used to perform an abortion except where the life of the mother would be endangered if the fetus were carried to term or in a case in which the...and long -lasting physical health damage to the mother would result if the pregnancy were carried to term when so determined by two physicians. Nor...restrictions with regard to the “severe and long -lasting physical health damage to the mother that would result if the pregnancy were carried to term when so
NASA Astrophysics Data System (ADS)
Sutikno, Madnasri; Susilo; Arya Wijayanti, Riza
2016-08-01
A study about X-ray radiation impact on the white mice through radiation dose mapping in Medical Physic Laboratory is already done. The purpose of this research is to determine the minimum distance of radiologist to X-ray instrument through treatment on the white mice. The radiation exposure doses are measured on the some points in the distance from radiation source between 30 cm up to 80 with interval of 30 cm. The impact of radiation exposure on the white mice and the effects of radiation measurement in different directions are investigated. It is founded that minimum distance of radiation worker to radiation source is 180 cm and X-ray has decreased leukocyte number and haemoglobin and has increased thrombocyte number in the blood of white mice.
Attitudes toward the physical examination: a comparison of U.S. and Dominican medical students.
Fagan, Mark J; Lucero, Monica L; Wu, Edward H; Diaz, Joseph A; Reinert, Steven E
2006-01-01
Little information exists regarding whether medical students learning in relatively resource-scarce countries develop greater confidence in their physical examination skills or whether, compared to U.S. medical students, they have more positive attitudes regarding the utility of the physical examination. To compare U.S. And Dominican medical students' attitudes toward the physical examination. We surveyed final-year students at 1 medical school in the United States and 1 in the Dominican Republic regarding self-confidence in and perceived utility of the physical examination. Using 5-point Likert-type scales with response choices ranging from 1 (not at all confident) to 5 (very confident) and 1 (not at all useful) to 5 (very useful), respondents reported their attitudes toward the physical examination overall and toward 14 specific physical examination skills. The survey response rate was 117/164 (71%). Students at the Dominican school, compared to students at the U.S. school, reported significantly greater confidence in their overall physical examination skill (mean response 4.27 vs. 3.79, respectively, p < .001) and more positive views about the utility of the physical examination overall for providing diagnostically useful information (mean response 4.78 vs. 4.42, respectively, p < .001). Results for the specific skills also showed more positive attitudes in the students from the Dominican medical school. Students at a Dominican medical school reported more positive attitudes toward the physical examination than students at a U.S. medical school.
Using Ultrasound to Enhance Medical Students' Femoral Vascular Physical Examination Skills.
Ahn, Justin S; French, Andrew J; Thiessen, Molly E W; Browne, Vaughn; Deutchman, Mark; Guiton, Gretchen; Madigosky, Wendy; Kendall, John L
2015-10-01
To determine whether the addition of ultrasound to traditional physical examination instruction improves junior medical students' abilities to locate the femoral pulse. Initially, 150 second-year medical students were taught the femoral pulse examination using traditional bedside teaching on standardized patients and online didactic videos. Students were then randomized into 2 groups: group 1 received ultrasound training first and then completed the standardized examination; and group 2 performed the standardized examination first and then received ultrasound training. On the standardized patients, the femoral artery was marked with invisible ink before the sessions using ultrasound. Compared to these markers, students were then evaluated on the accuracy of femoral artery pulse palpation and the estimated location of the femoral vein. All students completed a self-assessment survey after the ultrasound sessions. Ultrasound training improved the students' ability to palpate the femoral pulse (P= .02). However, ultrasound did not facilitate correct estimation of the femoral vein's anatomic location (P = .09). Confidence levels in localizing the femoral artery and vein were equal between groups at baseline, and both increased after the ultrasound sessions. The addition of ultrasound teaching to traditional physical examination instruction enhanced medical student competency and confidence with the femoral vascular examination. However, understanding of anatomy may require emphasis on precourse didactic material, but further study is required. © 2015 by the American Institute of Ultrasound in Medicine.
Kvale, Elizabeth; Dionne-Odom, J Nicholas; Redden, David T; Bailey, F Amos; Bakitas, Marie; Goode, Patricia S; Williams, Beverly R; Haddock, Kathlyn Sue; Burgio, Kathryn L
2015-06-01
The use of physical restraints in dying patients may be a source of suffering and loss of dignity. Little is known about the prevalence or predictors for restraint use at end of life in the hospital setting. The objective was to determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Secondary analysis was performed on data from the "Best Practices for End-of-Life Care for Our Nation's Veterans" (BEACON) trial conducted between 2005 and 2011. Medical record data were abstracted from six Veterans Administration Medical Centers (VAMCs). Data on processes of care in the last seven days of life were abstracted from the medical records of 5476 who died in the six VAMCs. We prospectively identified potential risk factors for restraint use at the time of death from among the variables measured in the parent trial, including location of death, medications administered, nasogastric tube, intravenous (IV) fluids, family presence, and receipt of a palliative care consultation. Physical restraint use at time of death was documented in 890 decedents (16.3%). Restraint use varied by location of death, with patients in intensive settings being at higher risk. Restraint use was significantly more likely in patients with a nasogastric tube and those receiving IV fluids, benzodiazepines, or antipsychotics. This is the first study to document that one in six hospitalized veterans were restrained at the time of death and to identify predictors of restraint use. Further research is needed to identify intervention opportunities.
Dionne-Odom, J. Nicholas; Redden, David T.; Bailey, F. Amos; Bakitas, Marie; Goode, Patricia S.; Williams, Beverly R.; Haddock, Kathlyn Sue; Burgio, Kathryn L.
2015-01-01
Abstract Background: The use of physical restraints in dying patients may be a source of suffering and loss of dignity. Little is known about the prevalence or predictors for restraint use at end of life in the hospital setting. Objective: The objective was to determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Methods: Secondary analysis was performed on data from the “Best Practices for End-of-Life Care for Our Nation's Veterans” (BEACON) trial conducted between 2005 and 2011. Medical record data were abstracted from six Veterans Administration Medical Centers (VAMCs). Data on processes of care in the last seven days of life were abstracted from the medical records of 5476 who died in the six VAMCs. We prospectively identified potential risk factors for restraint use at the time of death from among the variables measured in the parent trial, including location of death, medications administered, nasogastric tube, intravenous (IV) fluids, family presence, and receipt of a palliative care consultation. Results: Physical restraint use at time of death was documented in 890 decedents (16.3%). Restraint use varied by location of death, with patients in intensive settings being at higher risk. Restraint use was significantly more likely in patients with a nasogastric tube and those receiving IV fluids, benzodiazepines, or antipsychotics. Conclusions: This is the first study to document that one in six hospitalized veterans were restrained at the time of death and to identify predictors of restraint use. Further research is needed to identify intervention opportunities. PMID:25927909
Jahrami, Haitham Ali; Faris, Mo'ez Al-Islam Ezzat; Saif, Zahraa Qassim; Hammad, Laila Habib
2017-08-01
Acquired dietary habits and lifestyle behaviors of patients with schizophrenia may affect their life expectancy, disease complications and prognosis. The objectives of the current study were to assess the dietary habits and other lifestyle behaviors for Bahraini patients with schizophrenia, and to determine their associations with different medical comorbidities. A case-control study was conducted during the period of March to December 2016. A sample of 120 cases were recruited from the Psychiatric Hospital, Bahrain and age-sex-matched with 120 controls. Controls were recruited from primary health centres, and were free from serious mental illness. Dietary habits and lifestyle behaviors including smoking, alcohol intake and physical activity were assessed using a questionnaire. All medical records were reviewed retrospectively. Logistic regression analysis was used to identify dietary and lifestyle risk factors that are associated with one or more disease comorbidities. Cases had higher prevalence of smoking and alcohol intake, excessive dietary intake, and decreased physical activity (all P<0.05) compared with controls. Cases appeared to be at higher risk for developing chronic medical conditions such as obesity, type 2 diabetes, hypertension, cardiovascular disease, and musculoskeletal disorders. Cases were three times more likely to have up to three or more medical comorbidities compared with controls. Excessive dietary intake and decreased physical activity were identified as the main risk factors. Excessive caloric intake and decreased physical activity represent the main dietary and lifestyle risk factors associated with comorbidities among patients with schizophrenia in Bahrain. Copyright © 2017 Elsevier B.V. All rights reserved.
MO-DE-BRA-05: Developing Effective Medical Physics Knowledge Structures: Models and Methods
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sprawls, P
Purpose: Develop a method and supporting online resources to be used by medical physics educators for teaching medical imaging professionals and trainees so they develop highly-effective physics knowledge structures that can contribute to improved diagnostic image quality on a global basis. Methods: The different types of mental knowledge structures were analyzed and modeled with respect to both the learning and teaching process for their development and the functions or tasks that can be performed with the knowledge. While symbolic verbal and mathematical knowledge structures are very important in medical physics for many purposes, the tasks of applying physics in clinicalmore » imaging--especially to optimize image quality and diagnostic accuracy--requires a sensory conceptual knowledge structure, specifically, an interconnected network of visually based concepts. This type of knowledge supports tasks such as analysis, evaluation, problem solving, interacting, and creating solutions. Traditional educational methods including lectures, online modules, and many texts are serial procedures and limited with respect to developing interconnected conceptual networks. A method consisting of the synergistic combination of on-site medical physics teachers and the online resource, CONET (Concept network developer), has been developed and made available for the topic Radiographic Image Quality. This was selected as the inaugural topic, others to follow, because it can be used by medical physicists teaching the large population of medical imaging professionals, such as radiology residents, who can apply the knowledge. Results: Tutorials for medical physics educators on developing effective knowledge structures are being presented and published and CONET is available with open access for all to use. Conclusion: An adjunct to traditional medical physics educational methods with the added focus on sensory concept development provides opportunities for medical physics teachers to share their knowledge and experience at a higher cognitive level and produce medical professionals with the enhanced ability to apply physics to clinical procedures.« less
Courses in Physics in Medical Colleges
ERIC Educational Resources Information Center
Physics Education, 1975
1975-01-01
Provides information concerning programs in medical physics, radiation biology, and radiation physics at eight British medical colleges. Each institution is separately listed, and the provided information typically includes program descriptions, graduate programs, and main branches of research. (MLH)
Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi
2016-01-01
Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.
Modification of the surfaces of medical devices to prevent microbial adhesion and biofilm formation.
Desrousseaux, C; Sautou, V; Descamps, S; Traoré, O
2013-10-01
The development of devices with surfaces that have an effect against microbial adhesion or viability is a promising approach to the prevention of device-related infections. To review the strategies used to design devices with surfaces able to limit microbial adhesion and/or growth. A PubMed search of the published literature. One strategy is to design medical devices with a biocidal agent. Biocides can be incorporated into the materials or coated or covalently bonded, resulting either in release of the biocide or in contact killing without release of the biocide. The use of biocides in medical devices is debated because of the risk of bacterial resistance and potential toxicity. Another strategy is to modify the chemical or physical surface properties of the materials to prevent microbial adhesion, a complex phenomenon that also depends directly on microbial biological structure and the environment. Anti-adhesive chemical surface modifications mostly target the hydrophobicity features of the materials. Topographical modifications are focused on roughness and nanostructures, whose size and spatial organization are controlled. The most effective physical parameters to reduce bacterial adhesion remain to be determined and could depend on shape and other bacterial characteristics. A prevention strategy based on reducing microbial attachment rather than on releasing a biocide is promising. Evidence of the clinical efficacy of these surface-modified devices is lacking. Additional studies are needed to determine which physical features have the greatest potential for reducing adhesion and to assess the usefulness of antimicrobial coatings other than antibiotics. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
46 CFR 13.125 - Physical and medical requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Physical and medical requirements. 13.125 Section 13.125... TANKERMEN General § 13.125 Physical and medical requirements. Each applicant for an original tankerman endorsement shall meet the physical requirements of § 10.215 of this chapter, excluding paragraph (d)(2) of...
46 CFR 13.125 - Physical and medical requirements.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 46 Shipping 1 2014-10-01 2014-10-01 false Physical and medical requirements. 13.125 Section 13.125... TANKERMEN General § 13.125 Physical and medical requirements. Each applicant for an original tankerman endorsement must meet the physical requirements of part 10, subpart C, of this chapter. [CGD 79-116, 60 FR...
46 CFR 13.125 - Physical and medical requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Physical and medical requirements. 13.125 Section 13.125... TANKERMEN General § 13.125 Physical and medical requirements. Each applicant for an original tankerman endorsement shall meet the physical requirements of § 10.215 of this chapter, excluding paragraph (d)(2) of...
46 CFR 13.125 - Physical and medical requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Physical and medical requirements. 13.125 Section 13.125... TANKERMEN General § 13.125 Physical and medical requirements. Each applicant for an original tankerman endorsement shall meet the physical requirements of § 10.215 of this chapter, excluding paragraph (d)(2) of...
46 CFR 13.125 - Physical and medical requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 1 2013-10-01 2013-10-01 false Physical and medical requirements. 13.125 Section 13.125... TANKERMEN General § 13.125 Physical and medical requirements. Each applicant for an original tankerman endorsement shall meet the physical requirements of § 10.215 of this chapter, excluding paragraph (d)(2) of...
Physics for Physicians: Integrating Science into the Medical Curriculum, 1910-1950.
ERIC Educational Resources Information Center
Hayter, Charles R. R.
1996-01-01
Discusses the emphasis on physics instruction in the medical school curriculum, focusing on the career of J. K. Robertson (1885-1958), who taught physics to medical students at Queen's University in Kingston, Ontario, for nearly half a century. Reviews Robertson's combination of basic and applied physics instruction and emphasis on radiology. (MDM)
Advances in Medical Physics: 2010.
2011-07-01
Advances in Medical Physics: 2010., Wolbarst Anthony B., Karellas Andrew, Krupinski Elizabeth A., Hendee William R., Medical Physics Publishing, Madison, WI, 2010, 368 pp (hardcover). Price: $140.00. ISBN: 978-1-93052-450-7. © 2011 American Association of Physicists in Medicine.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Van Dyk, Jacob
Purpose: There is an increasing awareness of the disparity in Medical Physics needs between high income countries (HICs) and low-to-middle income countries (LMICs). This is especially evident with the growing incidence of cancer in LMICs. Projections from the recent Lancet Oncology Commission on Expanding Global Access to Radiotherapy indicate that an additional 22,000 Medical Physicists will be required by 2035 to provide uniform access to radiation therapy globally. This paper addresses possibilities and challenges associated with closing the Medical Physics gap between HICs and LMICs. Methods: Medical Physics and Oncology related organizations involved in providing support to enhance cancer therapymore » in LMICs were reviewed, especially as related to education, training and human resource development. Results: More than 35 organizations involved in addressing the cancer crisis in LMICs were found. Of these, 16 involve Medical Physics activities, with 7 being specific Medical Physics-related organizations. Ten of the 16 are involved in some LMIC activities with 6 having a major emphasis on LMIC contexts. Conclusions: The development of Medical Physics human resource capacity is a major challenge for LMICs. Fifty-five countries have no radiation therapy capabilities and by implication no capacity to train Medical Physicists. Overt attention with structured and altruistic actions by HIC contexts will help make inroads into the LMIC needs. Clear options throughout career structures in support of global health considerations combined with strong partnerships between interested parties in HICs and LMICs will enhance the development of safe and resource-appropriate strategies for advancing Medical Physics capabilities.« less
76 FR 77546 - Merchant Mariner Medical Advisory Committee; Vacancy
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-13
... issuance of merchant mariner credentials; medical standards and guidelines for the physical qualifications of operators of commercial vessels; medical examiner education; and medical research. DATES... standards and guidelines for the physical qualifications of operators of commercial vessels; medical...
NASA Astrophysics Data System (ADS)
Caruana, C. J.
2011-09-01
The objectives of EC project 'Guidelines on Medical Physics Expert' are to provide for improved implementation of the provisions relating to the Medical Physics Expert within Council Directive 97/43/EURATOM and the proposed recast Basic Safety Standards directive. This includes harmonisation of the mission statement for Medical Physics Services as well as the education and training of the MPE. It also includes detailed knowledge-skills-competence inventories for the Medical Physics Expert in each of Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy. This paper presents the proposed Qualification and Curriculum Frameworks and their application to the Medical Physics Expert in Nuclear Medicine.
Medical Physics Education at the University of Novi Sad - Serbia
NASA Astrophysics Data System (ADS)
Stanković, Slobodanka; Vesković, Miroslav; Klisurić, Olivera; Spasić, Vesna
2007-04-01
Overview of new educational program and training in Medical Physics at the University of Novi Sad is presented, where the medical physics education from undergraduate to doctoral study is established in the last decade. Necessity for basic and additional education and hospital training for medical physicists becomes the evident subject in clinical practice in which physicists and physicians are in close collaboration to ensure high quality of patient care. Learning objectives: to incorporate the latest scientific and professional findings in the field of medical physics, medical diagnostics, therapy and instruments; to accomodate students' pursuits of individual fields by offering elective courses from different areas of current medical practice; to reflect the multidisciplinary spirit of the studies, since teaching is performed by experts from diverse fields.
ERIC Educational Resources Information Center
Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak
2016-01-01
Physical exercise results in an active well-being. It is likely that students' engagement in physical exercise keeps them motivated to perform academic endeavors. This study aimed to assess the relation of time engaged in physical exercise with medical students' motivation for academic work. Prospectively, 296 second-year medical students…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-21
... review, medical center staff, working with the National Health Physics Program, discovered this event. No.... Nuclear Regulatory Commission (NRC) determines to be significant from the standpoint of public health or... had originally reported the event to the New York City Office of Radiological Health in 2006, the...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-16
... Affairs (the licensee), National Health Physics Program (NHPP) reported that a medical event occurred at.... Nuclear Regulatory Commission (NRC) determines to be significant from the standpoint of public health or... that the patient consult with a genetic counselor for any potential health effects to the embryo/fetus...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002... Committee AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug..., minority, or physically challenged candidates. Final selection from each vacancy will be determined by the...
Health students’ expectations of the ideal educational environment: a qualitative research
AGHAMOLAEI, TEAMUR; SHIRAZI, MANDANA; DADGARAN, IDEH; SHAHSAVARI, HOOMAN; GHANBARNEJAD, AMIN
2014-01-01
Introduction: Educational environment is an important determinant of students’ behavior and its elements are associated with academic achievement and course satisfaction. The aim of this study was to determine students’ expectations of the ideal educational environment. Methods: This was a qualitative study with content analysis approach. Using a theoretical sampling method, we selected eight students from Health School of Hormozgan University of Medical Sciences, studying health education, public health, environmental health, occupational health and medical entomology. To collect data, semi-structured interviews were used and continued until reaching data saturation. Qualitative content analysis was used to analyze the data. Results: Students' expectations of the ideal educational environment emerged in four main themes including school atmosphere, teaching, human aspects (with three subthemes including teachers, students, and school staff) and non-human aspects (with two subthemes including educational equipment and physical environment). Conclusion: Educational environment is a multidimensional issue and to achieve an ideal educational environment, educational planners should meet the students' expectations of the school atmosphere, teaching, teachers, students, school staff, educational equipment and physical environment. PMID:25512939
Future Directions in Medical Physics
NASA Astrophysics Data System (ADS)
Jeraj, Robert
Medical Physics is a highly interdisciplinary field at the intersection between physics and medicine and biology. Medical Physics is aiming at development of novel applications of physical processes and techniques in various areas of medicine and biology. Medical Physics had and continues to have profound impact by developing improved imaging and treatment technologies, and helping to advance our understanding of the complexity of the disease. The general trend in medicine towards personalized therapy, and emphasis on accelerated translational research is having a profound impact on medical physics as well. In the traditional stronghold for medical physicists - radiation therapy - the new reality is shaping in the form of biologically conformal and combination therapies, as well as advanced particle therapy approaches, such as proton and ion therapies. Rapid increase in faster and more informative multi-modality medical imaging is bringing a wealth of information that is being complemented with data obtained from genomic profiling and other biomarkers. Novel data analysis and data mining approaches are proving grounds for employment of various artificial intelligence methods that will help further improving clinical decision making for optimization of various therapies as well as better understanding of the disease properties and disease evolution, ultimately leading to improved clinical outcomes.
77 FR 51039 - Merchant Mariner Medical Advisory Committee
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-23
... the physical qualifications of operators of commercial vessels; medical examiner education; and..., medical standards and guidelines for physical qualifications of operators of commercial vessels, medical examiner education, and medical research. The meeting will be open to the public. DATES: MMMAC will meet on...
Ribeiro, F; Oliveira, N L; Silva, G; Campos, L; Miranda, F; Teixeira, M; Alves, A J; Oliveira, J
2017-03-01
To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infarction. Subanalysis of two randomised, prospective controlled trials. Outpatient clinic of a secondary hospital. Fifty consecutive patients randomised to the exercise group {n=25; 23 males; mean age 54 [standard deviation (SD) 9] years} or the control group [n=25; 20 males; mean age 58 (SD 9) years]. The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up. The control group received usual medical care and follow-up. The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day, assessed by accelerometer over 7 consecutive days. Secondary outcome measures were cardiorespiratory fitness, body mass, and resting blood pressure and heart rate. Moderate-to-vigorous physical activity levels increased significantly in the exercise group [43.2 (SD 36.3) to 53.5 (SD 31.9) minutes/day, P=0.030], and remained unchanged in the control group [40.8 (SD 26.2) to 36.8 (SD 26.5) minutes/day, P=0.241] from baseline to the end of the programme. Cardiorespiratory fitness increased significantly in the exercise group (mean difference 2.8; 95% of the difference 1.3 to 4.4ml/kg/minute, P=0.001) after the 8-week programme. In patients under optimal medication following myocardial infarction, participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits. Future studies are needed to determine whether the increase in physical activity is maintained in the long term. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Long-term care physical environments--effect on medication errors.
Mahmood, Atiya; Chaudhury, Habib; Gaumont, Alana; Rust, Tiana
2012-01-01
Few studies examine physical environmental factors and their effects on staff health, effectiveness, work errors and job satisfaction. To address this gap, this study aims to examine environmental features and their role in medication and nursing errors in long-term care facilities. A mixed methodological strategy was used. Data were collected via focus groups, observing medication preparation and administration, and a nursing staff survey in four facilities. The paper reveals that, during the medication preparation phase, physical design, such as medication room layout, is a major source of potential errors. During medication administration, social environment is more likely to contribute to errors. Interruptions, noise and staff shortages were particular problems. The survey's relatively small sample size needs to be considered when interpreting the findings. Also, actual error data could not be included as existing records were incomplete. The study offers several relatively low-cost recommendations to help staff reduce medication errors. Physical environmental factors are important when addressing measures to reduce errors. The findings of this study underscore the fact that the physical environment's influence on the possibility of medication errors is often neglected. This study contributes to the scarce empirical literature examining the relationship between physical design and patient safety.
Valenza, Marie Carmen; Castro-Martín, Eduardo; Valenza, Gerad; Guirao-Piñeiro, Miguel; De-la-Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César
2012-02-01
The curricula of all health professionals have an important foundation of human anatomy. A comparison of the anatomy retention between students from different curricula has not been studied. Our aim was to examine the knowledge competency of third-year physical therapy and medical students in carpal bone anatomy. The testing was conducted on the third-year medical and physical therapy students at Universidad de Granada. Students were given 5 minutes to answer the carpal bone test, a test which requires the identification of the carpal bones in an illustration of the bony skeleton of carpal region. Differences in the distribution of the responses between groups were analyzed using the χ(2) test. One hundred thirty-four (n = 134) tests were analyzed (n = 54 [41%] physical therapy students, n = 80 [59%] medical students). Only 39 students correctly identified all of the carpal bones (42.6% physical therapy, 20% medical, P < .001). Physical therapy students correctly identified a greater number (P < .001) of carpal bones (mean ± SD, 5.8 ± 2.2) than medical students (mean ± SD, 3.1 ± 2.9). The capitate was the most frequently identified bone in both physical therapy (96%) and medical (46%) students (P < .001). The hamate bone was the least frequently identified bone by medical students (n = 29, or 36.3%), whereas the trapezoid bone was the least frequently identified bone by physical therapy students (n = 35, or 64.8%). There are few studies investigating anatomical knowledge levels between disciplines. This study found that physical therapy students exhibited better retention of anatomy of the carpal bones than medical students. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.
Reißhauer, A; Liebl, M E
2012-07-01
Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.
Fruth, Stacie J; Wiley, Steve
2016-09-01
Emergency department (ED) use in the United States is expected to rapidly increase. Nearly half of all ED visits are classified as semiurgent or nonurgent, and many fall into the musculoskeletal category. Despite growing international evidence that patients are appropriately and safely managed by ED physical therapists in a time-efficient manner, physical therapist practice in EDs is not widely understood or utilized in the United States. To date, no studies have reported the impressions of ED physicians about this practice. The purposes of this study were: (1) to assess ED physicians' impressions of ED physical therapist practice 2 years after practice was initiated and (2) to determine whether physicians' impressions changed 7 years later. All ED staff physicians and medical residents at a level I trauma hospital were invited to complete a survey in 2004 and 2011. In both years, a majority of physicians reported favorable impressions of ED physical therapist practice. Physical therapists were valued for educating patients about safety and injury prevention, providing appropriate gait training, assisting with disposition planning, and providing interventions as alternatives to pain medication. Many physicians supported standing physical therapist orders for certain musculoskeletal conditions. The most common concern was the additional time that patients spend in the ED for a physical therapist consult. The results of this study may not reflect the impressions of physicians in all EDs that employ physical therapists. Emergency department physicians reported favorable impressions of ED physical therapist practice 2 years and 9 years following its implementation in this hospital. This study showed that ED physicians support standing physical therapist orders for certain musculoskeletal conditions, which suggests that direct triage to ED physical therapists for these conditions could be considered. © 2016 American Physical Therapy Association.
Stubbs, Brendon; Vancampfort, Davy; Mänty, Minna; Svärd, Anna; Rahkonen, Ossi; Lahti, Jouni
2017-01-01
This study aimed to examine the bidirectional relationship between psychotropic medication use and changes in leisure-time physical activity (LTPA) among a population cohort study. Phase 1 data were collected by mail surveys in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland, and phase 2 follow up survey was conducted in 2007. Based on self-report, the respondents were classified as inactive and active (≥14.75 MET-hours/week) at the phases 1 and 2. Hazard ratios (HR) were calculated for subsequent (2007-10) psychotropic medication purchasing according to changes in physical activity (phases 1-2). Odds ratios (OR) for physical inactivity at phase 2 were calculated according to the amount of psychotropic medication between phases 1-2. Overall, 5361 respondents were included (mean age 50 years, 80% women). Compared with the persistently active, the persistently inactive, those decreasing and adopting LTPA had an increased risk for psychotropic medication. Only the persistently inactive remained at increased risk for psychotropic medication use, following the adjustment for prior psychotropic medication use. Compared with those having no medication, the risk for physical inactivity increased as the psychotropic medication increased. Our data suggest that physical activity has an important role in maintaining wellbeing and reducing psychotropic medication usage. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Medical physics practice and training in Ghana.
Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw
2016-06-01
Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
78 FR 52779 - Merchant Mariner Medical Advisory Committee
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-26
..., medical standards and guidelines for physical qualifications of operators of commercial vessels, medical examiner education, and medical research. The meeting will be open to the public. DATES: MEDMAC will meet...' documents; (b) medical standards and guidelines for the physical qualifications of operators of commercial...
A Scoping Review of Physical Rehabilitation in Long-Term Care: Interventions, Outcomes, Tools.
McArthur, Caitlin; Gibbs, Jenna C; Patel, Ruchit; Papaioannou, Alexandra; Neves, Paula; Killingbeck, Jaimie; Hirdes, John; Milligan, James; Berg, Katherine; Giangregorio, Lora
2017-12-01
Residents in long-term care (LTC) often require physical rehabilitation (PR) to maintain/improve physical function. This scoping review described the breadth of literature regarding PR in LTC to date, synthesizing PR interventions that have been evaluated, outcomes used, and tools for determining service eligibility. A structured search, conducted in six licensed databases and grey literature, identified 381 articles for inclusion. Most interventions were delivered and evaluated at the resident level and typically were multicomponent exercise programs. Performance-based measures, activities of daily living, and mood were the most frequently reported outcomes. A key knowledge gap was PR in relation to goals, such as quality of life. Future studies should reflect medically complex residents who live in LTC, and length of residents' stay should be differentiated. Intervention studies should also explore realistic delivery methods; moreover, tool development for determining service eligibility is necessary to ensure equality in rehabilitative care across the LTC sector.
Jadczak, Agathe Daria; Tam, Khai Loon; Yu, Solomon; Visvanathan, Renuka
2017-09-01
To determine the effects of a 4.5-week geriatric medicine course on fifth year medical students' perception of the importance of and their competence in prescribing exercise to older people. The modified Exercise and Physical Activity Competence Questionnaire was administered to 81 students before and after the course. Scores ranged from 0 to 6. One open-ended question about perceived barriers to exercise prescription was asked. Students' perceptions of the importance of designing an exercise prescription (P = 0.038), determining the training heart rate (P = 0.021), determining the body mass index (P > 0.001), referring an older person to an exercise program (P > 0.001) and identifying age-related limitations (P = 0.029) improved significantly after the course. Students' self-perceived competence improved significantly across all items (P > 0.001). Barriers to exercise prescription included lack of: knowledge (57%), patient compliance (39%) and time (33%). A geriatric medicine course contributes to improved senior medical students' perceptions of importance of and their competence in prescribing exercise to older people. © 2017 AJA Inc.
42 CFR 416.52 - Conditions for coverage-Patient admission, assessment and discharge.
Code of Federal Regulations, 2014 CFR
2014-10-01
... completion of the most recently documented medical history and physical assessment, including documentation of any allergies to drugs and biologicals. (3) The patient's medical history and physical assessment... have a comprehensive medical history and physical assessment completed by a physician (as defined in...
42 CFR 416.52 - Conditions for coverage-Patient admission, assessment and discharge.
Code of Federal Regulations, 2012 CFR
2012-10-01
... completion of the most recently documented medical history and physical assessment, including documentation of any allergies to drugs and biologicals. (3) The patient's medical history and physical assessment... have a comprehensive medical history and physical assessment completed by a physician (as defined in...
42 CFR 416.52 - Conditions for coverage-Patient admission, assessment and discharge.
Code of Federal Regulations, 2013 CFR
2013-10-01
... completion of the most recently documented medical history and physical assessment, including documentation of any allergies to drugs and biologicals. (3) The patient's medical history and physical assessment... have a comprehensive medical history and physical assessment completed by a physician (as defined in...
Seibert, J Anthony; Clements, Jessica B; Halvorsen, Per H; Herman, Michael G; Martin, Melissa C; Palta, Jatinder; Pfeiffer, Douglas E; Pizzutiello, Robert J; Schueler, Beth A; Shepard, S Jeff; Fairobrent, Lynne A
2015-05-08
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.
Weaver, Amy L; Hernandez, Susan; Olson, Daiwai M
2017-01-01
This study was intended to determine whether positioning emergency department (ED) physicians, physician assistants, and nurse practitioners at the same workstations as registered nurses (RNs) improved communication and teamwork. Historically in this organization, providers and staff had separate physical locations (workstations). Construction of a new ED provided the opportunity to redesign the physical layout and to study whether a new design improved the perception of communication and teamwork among medical providers. A prospective, self-administered presurvey-postsurvey using the TeamSTEPPS Teamwork Perceptions Questionnaire (TPQ) was completed at 2 medical centers with the same staff premove and postmove but different ED designs. The presurvey was conducted while the staff were at the older facility with a more linear floor design and separated nurse and physician stations. The postsurvey was conducted 3 months after employees and physicians were relocated to a new hospital with a pod design and communal workstations in the ED. Forty-six staff members completed both the presurvey and the postsurvey. There was a statistically significant improvement in the total TPQ scores (P = .0009) and 4 of the 5 components of the TPQ: team structure (P = .0283), situation monitoring (P = .0006), mutual support (P < .0001), and communication (P < .0001). There was no change in the leadership component (P = .4519). Adopting a more communal physical layout was associated with improved overall TPQ scores and most of the TPQ components. The lack of change in the leadership component was explained by the lack of change in leadership structure. The physical placement of medical providers and RNs in an ED is important and can increase the perception of communication and teamwork and thereby improve patient outcomes.
Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P
2018-01-01
Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P < .01). Post hoc analyses revealed that differences in group performance were due to the shoulder group's higher scores on palpation of the biceps tendon (t = -2.8; df = 25; P = .01), a soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.
Correlates of impaired function in older women.
Ensrud, K E; Nevitt, M C; Yunis, C; Cauley, J A; Seeley, D G; Fox, K M; Cummings, S R
1994-05-01
To determine the factors associated with impaired function in older women. Cross-sectional analysis of baseline data collected for a multicenter, prospective study of risk factors for osteoporotic fractures. Four clinical centers in Portland, Oregon, Minneapolis, Minnesota, Baltimore, Maryland, and the Monongahela Valley, Pennsylvania. A total of 9,704 ambulatory, non-black women, aged 65 years and older, recruited from population-based listings. Independent variables, including demographic and historical information (medical conditions, health habits, and medications) and physiologic measures (anthropometry, blood pressure, mental status, vision, and neuromuscular performance) were obtained from a baseline questionnaire, interview, and examination. Measurement of function was assessed by self-reported ability to perform six physical and instrumental activities of daily living (ADL) and impaired function (dependent variable) was defined as difficulty performing three or more physical and instrumental ADLs. In order of decreasing strength of association, hip fracture, osteoarthritis, parkinsonism, slower walking speed, lower hip abduction force, back pain, greater Quetelet index, osteoporosis, former alcohol use, stroke, never drinking alcohol, lower mental status, use of anxiolytics and/or sleeping medications, inability to hold the tandem position, postural dizziness, cataracts, greater waist to hip ratio, lower physical activity in the past year, greater lifetime cigarette consumption, and lower grip strength were independently associated with impaired function in multivariate analyses. Age, low educational level, diabetes, current heavy alcohol use, postural hypotension, depth perception, and contrast sensitivity were not independent predictors. A combination of neuromuscular performance measures, including decreased muscle strength and impaired balance and gait, appeared to account for the effect of age on disability. A combination of many factors, including medical conditions, health habits such as obesity, smoking, alcohol abstinence, and physical inactivity, and direct measures of neuromuscular performance are associated with impaired function in older women.
Amin, Tarek Tawfik; Mohamed Abdelmoaty, Alshaimaa; Fouad Abd El Badei, Alaa; Obaid, Hamzah Ahmed; Mohamed, Esraa Mowafy; abosheab, Alaa; Abdulkarim, Ali; Abdelsadek, Omar
2017-01-01
Background: Physical inactivity is accountable for a sizable proportion of breast and colorectal cancers and other non-communicable diseases. The higher the individual’s awareness about the protective role of physical activity (PA) in reducing chronic disease, the greater the adoption of PA will be. Objectives: To determine the level of leisure-time physical activity (LTPA) and awareness towards the role of LTPA in cancer prevention among a sample of Medical students at Cairo University, Egypt. Subjects and Methods: A cross-sectional study, with multistage sampling (a total of 519 students from second to six year students) and a self administered questionnaire covering the study objectives. Results: A significant decrease in the actual?? level of LTPA was noted with students’ year of enrollment at the medical school. However, their knowledge about roles of PA in preventing coronary heart, elevated blood pressure, and elevated cholesterol exceeded 80%, with steady increase in relation to the year of enrolment from the second to 6th years. Their knowledge about PA preventive influence for cancer was low irrespective of the year enrolment (32.2% for prevention of colon and 16.2% for breast cancers). The main sources of knowledge about the role of PA in cancer prevention were the internet and media (77%). Conclusion: The students demonstrated a decline in their LTPA coupled with poor knowledge about the role of LTPA in cancer prevention. Revision of the current curricula should be considered with inclusion of more information on the role of LTPA in cancer prevention to facilitate better awareness of medical students and through them their future patients. Creative Commons Attribution License
Evolving models for medical physics education and training: a global perspective.
Sprawls, P
2008-01-01
There is a significant need for high-quality medical physics education and training in all countries to support effective and safe use of modern medical technology for both diagnostic and treatment purposes. This is, and will continue to be, achieved using appropriate technology to increase both the effectiveness and efficiency of educational activities everywhere in the world. While the applications of technology to education and training are relatively new, the successful applications are based on theories and principles of the learning process developed by two pioneers in the field, Robert Gagne and Edgar Dale.The work of Gagne defines the different levels of learning that can occur and is used to show the types and levels of learning that are required for the application of physics and engineering principles to achieve appropriate diagnostic and therapeutic results from modern technology. The learning outcomes are determined by the effectiveness of the learning activity or experience. The extensive work of Dale as formulated in his Cone of Experience relates the effectiveness to the efficiency of educational activities. A major challenge in education is the development and conduction of learning activities (classroom discussions, laboratory and applied experiences, individual study, etc) that provide an optimum balance between effectiveness and efficiency. New and evolving models of the educational process use technology as the infrastructure to support education that is both more effective and efficient.The goal is to use technology to enhance human performance for both learners (students) and learning facilitators (teachers). A major contribution to global education is the trend in the development of shared educational resources. Two models of programs to support this effort with open and free shared resources are Physical Principles of Medical Imaging Online (http://www.sprawls.org/resources) and AAPM Continuing Education Courses (http://www.aapm.org/international).
Evolving models for medical physics education and training: a global perspective
Sprawls, P
2008-01-01
There is a significant need for high-quality medical physics education and training in all countries to support effective and safe use of modern medical technology for both diagnostic and treatment purposes. This is, and will continue to be, achieved using appropriate technology to increase both the effectiveness and efficiency of educational activities everywhere in the world. While the applications of technology to education and training are relatively new, the successful applications are based on theories and principles of the learning process developed by two pioneers in the field, Robert Gagne and Edgar Dale. The work of Gagne defines the different levels of learning that can occur and is used to show the types and levels of learning that are required for the application of physics and engineering principles to achieve appropriate diagnostic and therapeutic results from modern technology. The learning outcomes are determined by the effectiveness of the learning activity or experience. The extensive work of Dale as formulated in his Cone of Experience relates the effectiveness to the efficiency of educational activities. A major challenge in education is the development and conduction of learning activities (classroom discussions, laboratory and applied experiences, individual study, etc) that provide an optimum balance between effectiveness and efficiency. New and evolving models of the educational process use technology as the infrastructure to support education that is both more effective and efficient. The goal is to use technology to enhance human performance for both learners (students) and learning facilitators (teachers). A major contribution to global education is the trend in the development of shared educational resources. Two models of programs to support this effort with open and free shared resources are Physical Principles of Medical Imaging Online (http://www.sprawls.org/resources) and AAPM Continuing Education Courses (http://www.aapm.org/international). PMID:21614309
Dinh, Vi Am; Frederick, Jon; Bartos, Rebekah; Shankel, Tamara M; Werner, Leonard
2015-01-01
Increasing emphasis has been placed on point-of-care ultrasound in medical school. The overall effects of ultrasound curriculum implementation on the traditional physical examination skills of medical students are still unknown. We studied the effects on the Objective Standardized Clinical Examination (OSCE) scores of year 1 medical students before and after ultrasound curriculum implementation. An ultrasound curriculum was incorporated into the physical diagnosis course for year 1 medical students in the 2012-2013 academic year. We performed a prospective observational study comparing traditional OSCE scores of year 1 medical students exposed to the ultrasound curriculum (post-ultrasound) versus historic year 1 medical student controls (pre-ultrasound) with no ultrasound exposure. Questionnaire data were also obtained from year 1 medical students and physical diagnosis faculty to assess attitudes toward ultrasound implementation. The final overall OSCE scores were graded with a 5-point Likert-type scale from unsatisfactory to outstanding. There was a significant increase in outstanding scores in the post-ultrasound compared to the pre-ultrasound group (27.0% versus 10.9%; P< .001). The post-ultrasound group had significantly (P< .05) increased first-time pass rates on blood pressure measurements, the abdominal examination, and professionalism. Student and physical diagnosis faculty questionnaire data showed an overall positive response, with most agreeing or strongly agreeing that ultrasound should be included in the future year 1 medical student curriculum. Ultrasound implementation into a physical diagnosis curriculum for year 1 medical students is feasible and may improve their overall traditional physical examination skills. © 2015 by the American Institute of Ultrasound in Medicine.
WE-E-19A-01: Globalization of Medical Physics
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rehani, M; Meghzifene, A; Tsapaki, V
Following successful 2012–2013 International Professional Symposiums as a part of Annual AAPM meetings, representatives of AAPM and International Organization of Medical Physics (IOMP) suggested to make this tradiational Symposium a permanent part of Annual AAPM meetings in future. Following the tradition, this session includes presentations of representatives of AAPM, IOMP, European Federation of Medical Physics (EFOMP), International Atomic Energy Agency (IAEA) and International Center for Theoretical Physics (ICTP). The speakers will cover various aspects of International collaboration such as educational, professional, and scientific issues, as well as help to developing countries. With further developments of medicine and technology and increasedmore » communication with our colleagues overseas, Medical Physics becomes more and more global profession. Use of the same technology, significant progress in medical physics research and developing practical regulations worldwide makes it increasingly useful to organize global collaboration of medical physicists. Several international organizations are tasked to promote such collaboration and provide help to developing countries. Not all AAPM members are fully aware of these international efforts. It is very useful for medical physicists to know about success of our profession in other countries. Different schools present different approaches to the same problem, which allows to find the best solution. By communicating with colleagues overseas, one can learn more than from just reading scientific publications. At this session the attendees will receive a glimpse of International Medical Physics activities. Learning Objectives: Understand the globalization of Medical Physics profession and advantages of collaboration with foreign colleagues. See what role AAPM is playing in establishing contacts with colleagues overseas. Understand the role of IOMP and main directions of its activity. Learn about IAEA and how it helps developing countries. Learn about activity of EFOMP and how can help the global development of Medical Physics. Find out about ICTP and its educational programs.« less
Caruana, Carmel J; Tsapaki, Virginia; Damilakis, John; Brambilla, Marco; Martín, Guadalupe Martín; Dimov, Asen; Bosmans, Hilde; Egan, Gillian; Bacher, Klaus; McClean, Brendan
2018-04-01
On 5 December 2013 the European Council promulgated Directive 2013/59/EURATOM. This Directive is important for Medical Physicists and Medical Physics Experts as it puts the profession on solid foundations and describes it more comprehensively. Much commentary regarding the role and competences has been developed in the context of the European Commission project "European Guidelines on the Medical Physics Expert" published as Radiation Protection Report RP174. The guidelines elaborate on the role and responsibilities under 2013/59/EURATOM in terms of a mission statement and competence profile in the specialty areas of Medical Physics relating to medical radiological services, namely Diagnostic and Interventional Radiology, Radiation Oncology and Nuclear Medicine. The present policy statement summarises the provisions of Directive 2013/59/EURATOM regarding the role and competences, reiterates the results of the European Guidelines on the Medical Physics Expert document relating to role and competences of the profession and provides additional commentary regarding further issues arising following the publication of the RP174 guidelines. Copyright © 2018. Published by Elsevier Ltd.
Aksakal, Fatma Nur Baran; Karaşahin, Emine Füsun; Dikmen, Asiye Uğraş; Avci, Emine; Ozkan, Seçil
2015-01-01
The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.
A journey into medical physics as viewed by a physicist
NASA Astrophysics Data System (ADS)
Gueye, Paul
2007-03-01
The world of physics is usually linked to a large variety of subjects spanning from astrophysics, nuclear/high energy physics, materials and optical sciences, plasma physics etc. Lesser is known about the exciting world of medical physics that includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. These physicists are typically based in hospital departments of radiation oncology or radiology, and provide technical support for patient diagnosis and treatment in a clinical environment. This talk will focus on providing a bridge between selected areas of physics and their medical applications. The journey will first start from our understanding of high energy beam production and transport beamlines for external beam treatment of diseases (e.g., electron, gamma, X-ray and proton machines) as they relate to accelerator physics. We will then embrace the world of nuclear/high energy physics where detectors development provide a unique tool for understanding low energy beam distribution emitted from radioactive sources used in Brachytherapy treatment modality. Because the ultimate goal of radiation based therapy is its killing power on tumor cells, the next topic will be microdosimetry where responses of biological systems can be studied via electromagnetic systems. Finally, the impact on the imaging world will be embraced using tools heavily used in plasma physics, fluid mechanics and Monte Carlo simulations. These various scientific areas provide unique opportunities for faculty and students at universities, as well as for staff from research centers and laboratories to contribute in this field. We will conclude with the educational training related to medical physics programs.
42 CFR 416.52 - Conditions for coverage-Patient admission, assessment and discharge.
Code of Federal Regulations, 2011 CFR
2011-10-01
... recently documented medical history and physical assessment, including documentation of any allergies to drugs and biologicals. (3) The patient's medical history and physical assessment must be placed in the... comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of...
42 CFR 416.52 - Conditions for coverage-Patient admission, assessment and discharge.
Code of Federal Regulations, 2010 CFR
2010-10-01
... recently documented medical history and physical assessment, including documentation of any allergies to drugs and biologicals. (3) The patient's medical history and physical assessment must be placed in the... comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of...
The functional IME: A linkage of expertise across the disability continuum.
Clifton, David W
2006-01-01
Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.
Moving towards an understanding of disability in older US stroke survivors
Brenner, Allison B.; Burke, James F.; Skolarus, Lesli E.
2017-01-01
Objectives We test a comprehensive model of disability in older stroke survivors, and determine the relative contribution of neighborhood, economic, psychological and medical factors to disability. Methods The sample consisted of 728 stroke survivors from the National Health and Aging Trends Study (NHATS), who were 65 years and older living in community settings or residential care. Confirmatory factor analysis and structural equation modeling were used to test relationships between neighborhood, socioeconomic, psychological and medical factors and disability. Results Economic and medical context were associated with disability directly and indirectly through physical impairment. Neighborhood context was associated with disability, but was only marginally statistically significant (p=0.05). The effect of economic and neighborhood factors was small compared to that of medical factors. Discussion Neighborhood and economic factors account for a portion of the variance in disability among older stroke survivors beyond that of medical factors. PMID:27605555
Sleep: a marker of physical and mental health in the elderly.
Reid, Kathryn J; Martinovich, Zoran; Finkel, Sanford; Statsinger, Judy; Golden, Robyn; Harter, Kathryne; Zee, Phyllis C
2006-10-01
The objective of this study was to determine the occurrence and recognition of common sleep-related problems and their relationship to health-related quality-of-life measures in the elderly. A total of 1,503 participants with a mean age of 75.5 (+/- 6.8, range: 62-100) years from 11 primary care sites serving primarily elderly patients were interviewed. Subjects completed a five-item sleep questionnaire and the SF-12. A Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) score was calculated. A systematic medical chart review was conducted to determine whether sleep problems were identified by the healthcare providers. A total of 68.9% of patients reported at least one sleep complaint and 40% had two or more. Participants most commonly endorsed (45%) that they had "difficulty falling asleep, staying asleep, or being able to sleep." The number and type of sleep problems endorsed was associated with both physical and mental health quality-of-life status. Excessive daytime sleepiness was the best predictor of poor mental and physical health-related quality of life. Even when all five sleep questions were endorsed, a sleep complaint was only reported in the chart 19.2% of the time. When elicited, sleep complaints predicted the general physical and mental health-related quality-of-life status in elderly populations with comorbid medical and mental illnesses. Yet, questions regarding sleep are not an integral component of most clinical evaluations. Given the growing evidence of a relationship between sleep and health, identification of sleep disorders could lead to improved management of common age-related chronic illnesses and quality of life of elderly patients.
Preventable Medical Errors Driven Modeling of Medical Best Practice Guidance Systems.
Ou, Andrew Y-Z; Jiang, Yu; Wu, Po-Liang; Sha, Lui; Berlin, Richard B
2017-01-01
In a medical environment such as Intensive Care Unit, there are many possible reasons to cause errors, and one important reason is the effect of human intellectual tasks. When designing an interactive healthcare system such as medical Cyber-Physical-Human Systems (CPHSystems), it is important to consider whether the system design can mitigate the errors caused by these tasks or not. In this paper, we first introduce five categories of generic intellectual tasks of humans, where tasks among each category may lead to potential medical errors. Then, we present an integrated modeling framework to model a medical CPHSystem and use UPPAAL as the foundation to integrate and verify the whole medical CPHSystem design models. With a verified and comprehensive model capturing the human intellectual tasks effects, we can design a more accurate and acceptable system. We use a cardiac arrest resuscitation guidance and navigation system (CAR-GNSystem) for such medical CPHSystem modeling. Experimental results show that the CPHSystem models help determine system design flaws and can mitigate the potential medical errors caused by the human intellectual tasks.
Predicting low back pain outcome following rehabilitation for low back pain.
Roberts, Andrew J; Dew, Angela; Bridger, Robert; Etherington, John; Kilminster, Shaun
2015-01-01
Psychosocial factors are known to play a key role in determining the progress of back pain patients. However, it is not known whether these factors are applicable to military personnel, who tend to be fitter than the general population. The aim was to identify physical and psychological predictors in a prospective study of the outcome of back pain rehabilitation over 6 months and a longer follow-up time of between 15 and 32 months. Two hundred and fifty military personnel reporting for a residential rehabilitation programme completed a battery of physical and psychological tests. The physical tests included 800 m run time and the Biering-Sorensen test. The psychological/psychosocial measures included items on fear avoidance, self efficacy, anxiety and depression and occupational psychosocial factors such as job satisfaction. Self efficacy and 800 m run time predicted self-reported functional ability at 6 months and medical discharge/return to full fitness at 15–32 months. Patients with 800 m run times of more than 3 minutes 31 seconds had a four times greater chance of medical discharge from the Armed forces. Eight hundred metre run time and self-efficacy were independent predictors of both self-reported functional ability at 6 months and return to full fitness/medical discharge at 15–32 months. Self-efficacy also predicted 40% of the variance in the intensity of back pain and 10% of other non-back pain. Rehabilitation should include greater emphasis on physical fitness and on improving self-efficacy.
Clinical manifestations of Waardenburg syndrome in a male adolescent in Mali, West Africa.
Imperato, Pascal James; Imperato, Gavin H
2015-02-01
Waardenburg syndrome (WS) is a genetic disorder of which there are four distinct types. These four types are differentiated by the physical defects which they produce. Presented here is the case of a 13-year-old boy with WS Type I who was observed and physically assessed in Mali, West Africa in 1969. His physical findings included a bright blue coloring to the irises of the eyes, profound sensorineural deafness, mutism, dystopia canthorum (lateral displacement of the inner canthi of the eyes), broad nasal root, bushy eyebrows, and scaphoid deformities of the supraorbital portions of the frontal bone. Because family members were not available for interviews or physical examinations, it was not possible to determine if this patient was suffering from a congenital form of the disorder or from a spontaneous mutation. Given the patient's then location in a remote rural area of Mali where electricity was absent, it was not possible to perform additional diagnostic tests. The patient described here is the first with WS in Mali, West Africa to have been medically observed and evaluated and later documented in the medical literature. A second case of the syndrome in Mali was described in the medical literature in 2011 in an 18-month-old infant who did not have sensorineural hearing loss, but who did have a bilateral cleft lip. An historical overview of WS is presented along with details concerning the characteristics of the four types of the disorder.
WE-D-204-00: Session in Memory of Franca Kuchnir: Excellence in Medical Physics Residency Education
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less
AAPM-RSS Medical Physics Practice Guideline 9.a. for SRS-SBRT.
Halvorsen, Per H; Cirino, Eileen; Das, Indra J; Garrett, Jeffrey A; Yang, Jun; Yin, Fang-Fang; Fairobent, Lynne A
2017-09-01
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. Approved by AAPM Professional Council 3-31-2017 and Executive Committee 4-4-2017. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
Gress, Dustin A; Dickinson, Renee L; Erwin, William D; Jordan, David W; Kobistek, Robert J; Stevens, Donna M; Supanich, Mark P; Wang, Jia; Fairobent, Lynne A
2017-07-01
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: •Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. •Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
ERIC Educational Resources Information Center
Gogstad, Anders C.
Physical disability from disease or injury often results in a permanent state of social insufficiency, especially when the disability is reinforced by individual or environmental factors. In a study of almost 700 persons treated at a Norwegian rehabilitation center, regression analysis was used to compare those who benefited from the program with…
26 CFR 7.105-1 - Questions and answers relating to exclusions of certain disability income payments.
Code of Federal Regulations, 2011 CFR
2011-04-01
... engage in any substantial gainful activity by reason of any medically determinable physical or mental... exemption for age and the credit for the elderly? A-9: No. For purposes of the disability income exclusion... substantial gainful activity referred to is not limited to the activity, or a comparable activity, in which...
78 FR 21134 - Merchant Mariner Medical Advisory Committee; Vacancy
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-09
... standards and guidelines for the physical qualifications of operators of commercial vessels; medical examiner education; and medical research. DATES: Applicants must send a cover letter describing their... merchant mariners' documents; medical standards and guidelines for the physical qualifications of operators...
Round, W H; Ng, K H; Healy, B; Rodriguez, L; Thayalan, K; Tang, F; Fukuda, S; Srivastava, R; Krisanachinda, A; Shiau, A C; Deng, X; Han, Y
2011-09-01
AFOMP recognizes that clinical medical physicists should demonstrate that they are competent to practice their profession by obtaining appropriate education, training and supervised experience in the specialties of medical physics in which they practice, as well as having a basic knowledge of other specialties. To help its member countries to achieve this, AFOMP has developed this policy to provide guidance when developing medical physicist education and training programs. The policy is compatible with the standards being promoted by the International Organization for Medical Physics and the International Medical Physics Certification Board.
Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir
2013-01-01
We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
The medical physics specialization system in Poland.
Bulski, Wojciech; Kukołowicz, Paweł; Skrzyński, Witold
2016-07-01
This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization. The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
New Concepts and Fermilab Facilities for Antimatter Research
NASA Astrophysics Data System (ADS)
Jackson, Gerald
2008-04-01
There has long been significant interest in continuing antimatter research at the Fermi National Accelerator Laboratory. Beam kinetic energies ranging from 10 GeV all the way down to the eV scale and below are of interest. There are three physics missions currently being developed: the continuation of charmonium physics utilizing an internal target; atomic physics with in-flight generated antihydrogen atoms; and deceleration to thermal energies and paasage of antiprotons through a grating system to determine their gravitation acceleration. Non-physics missions include the study of medical applications, tests of deep-space propulsion concepts, low-risk testing of nuclear fuel elements, and active interrogation for smuggled nuclear materials in support of homeland security. This paper reviews recent beam physics and accelerator technology innovations in the development of methods and new Fermilab facilities for the above missions.
Geleijns, Jacob; Breatnach, Eamann; Cantera, Alfonso Calzado; Damilakis, John; Dendy, Philip; Evans, Anthony; Faulkner, Keith; Padovani, Renato; Van Der Putten, Wil; Schad, Lothar; Wirestam, Ronnie; Eudaldo, Teresa
2012-06-01
Some years ago it was decided that a European curriculum should be developed for medical physicists professionally engaged in the support of clinical diagnostic imaging departments. With this in mind, EFOMP (European Federation of Organisations for Medical Physics) in association with ESR (European Society of Radiology) nominated an expert working group. This curriculum is now to hand. The curriculum is intended to promote best patient care in radiology departments through the harmonization of education and training of medical physicists to a high standard in diagnostic radiology. It is recommended that a medical physicist working in a radiology department should have an advanced level of professional expertise in X-ray imaging, and additionally, depending on local availability, should acquire knowledge and competencies in overseeing ultrasound imaging, nuclear medicine, and MRI technology. By demonstrating training to a standardized curriculum, medical physicists throughout Europe will enhance their mobility, while maintaining local high standards of medical physics expertise. This document also provides the basis for improved implementation of articles in the European medical exposure directives related to the medical physics expert. The curriculum is divided into three main sections: The first deals with general competencies in the principles of medical physics. The second section describes specific knowledge and skills required for a medical physicist (medical physics expert) to operate clinically in a department of diagnostic radiology. The final section outlines research skills that are also considered to be necessary and appropriate competencies in a career as medical physicist.
Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi
2016-01-01
Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Method. Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Results. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Conclusion. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program. PMID:27239339
BOOK REVIEW Handbook of Physics in Medicine and Biology Handbook of Physics in Medicine and Biology
NASA Astrophysics Data System (ADS)
Tabakov, Slavik
2010-11-01
This is a multi-author handbook (66 authors) aiming to describe various applications of physics to medicine and biology, from anatomy and physiology to medical equipment. This unusual reference book has 44 chapters organized in seven sections: 1. Anatomical physics; 2. Physics of perception; 3. Biomechanics; 4. Electrical physics; 5. Diagnostic physics; 6. Physics of accessory medicine; 7. Physics of bioengineering. Each chapter has separate page numbering, which is inconvenient but understandable with the number of authors. Similarly there is some variation in the emphasis of chapters: for some the emphasis is more technical and for others clinical. Each chapter has a separate list of references. The handbook includes hundreds of diagrams, images and tables, making it a useful tool for both medical physicists/engineers and other medical/biology specialists. The first section (about 40 pages) includes five chapters on physics of the cell membrane; protein signaling; cell biology and biophysics of the cell membrane; cellular thermodynamics; action potential transmission and volume conduction. The physics of these is well explained and illustrated with clear diagrams and formulae, so it could be a suitable reference for physicists/engineers. The chapters on cellular thermodynamics and action potential transmission have a very good balance of technical/clinical content. The second section (about 85 pages) includes six chapters on medical decision making; senses; somatic senses: touch and pain; hearing; vision; electroreception. Again these are well illustrated and a suitable reference for physicists/engineers. The chapter on hearing stands out with good balance and treatment of material, but some other chapters contain less physics and are close to typical physiological explanations. One could query the inclusion of the chapter on medical decision making, which also needs more detail. The third section (about 80 pages) includes eight chapters on biomechanics; artificial muscle; cardiovascular system; control of cardiac output and arterial blood pressure regulation; fluid dynamics of the cardiovascular system; fluid dynamics; modeling and simulation of the cardiovascular system to determine work using bond graphs; anatomy and physics of respiration. The diagrams and data in this section could be used as reference material, but some chapters (such as that on the cardiovascular system) again take the form of physiological explanations. The best chapters in this section are on fluid dynamics and modeling. The fourth section (about 30 pages) includes two chapters on electrodes and recording of bioelectrical signals: theory and practice. Both chapters deal with electrodes and are well written and illustrated reference materials. This section could have been larger but the equipment associated with bioelectrical signals (such as ECG and EEG) is described in the next section. The fifth section (about 210 pages) includes 19 chapters on medical sensing and imaging; electrocardiogram: electrical information retrieval and diagnostics from the beating heart; electroencephalography: basic concepts and brain applications; bioelectric impedance analysis; x-ray and computed tomography; confocal microscopy; magnetic resonance imaging; positron emission tomography; in vivo fluorescence imaging and spectroscopy; optical coherence tomography; ultrasonic imaging; near-field imaging; atomic force microscopy; scanning ion conductance microscopy; quantitative thermographic imaging; intracoronary thermography; schlieren imaging: optical techniques to visualize thermal interactions with biological tissues; helium ion microscopy; electron microscopy: SEM/TEM. This is by far the largest section covering various methods and medical equipment and the variation in emphasis/quality is more prominent. The chapters on ECG and EEG are again more physiological with less physics, but the chapter on bioelectric impedance analysis is a good interdisciplinary article. The imaging chapters also vary in style and quality: while those on MRI and ultrasound provide a suitable introduction to the methods, the chapters on x-ray and PET need more detail. However this section includes some methods/equipment rarely featured in medical physics/engineering books (such as OCT or HIM). From this point of view the last eight chapters in the section will be a very useful reference for various specialists. The sixth section (about 30 pages) includes three chapters on lab-on-a-chip; the biophysics of DNA microarrays; nuclear medicine. While the first two could provide an interesting reference, the chapter on nuclear medicine needs much more detail. The last (seventh) section (15 pages) has only one chapter on biophysics of regenerative medicine, which is a good introduction, emphasizing biochemical factors important for improving/replacing tissues or tissue structures. The book ends with an index covering about 1400 terms. The handbook will be useful for the preparation of teaching materials and for undergraduate students, but should be complemented with more detailed/specific reference materials such as the Encyclopedia of Medical Devices and Instrumentation, the Encyclopedia of Medical Physics Emitel, or others. Parts of the handbook would be less suitable for more demanding readers (such as trainee medical physicists or radiologists, for example). In conclusion, the Handbook of Physics in Medicine and Biology includes materials that are rarely combined together, which strengthens its interdisciplinary approach and makes it an additional reference for a departmental library.
Physical Therapy for Chronic Low Back Pain in North Carolina: Overuse, Underuse, or Misuse?
Carey, Timothy S.; Holmes, George M.
2011-01-01
Background There are limited population-based studies of determinants of physical therapy use for chronic low back pain (LBP) and of the types of treatments received by individuals who see a physical therapist. Objective The purposes of this study were: (1) to identify determinants of physical therapy use for chronic LBP, (2) to describe physical therapy treatments for chronic LBP, and (3) to compare use of treatments with current best evidence on care for this condition. Design This study was a cross-sectional, population-based telephone survey of North Carolinians. Methods Five hundred eighty-eight individuals with chronic LBP who had sought care in the previous year were surveyed on their health and health care use. Bivariate and multivariable analyses were conducted to identify predisposing, enabling, and need characteristics associated with physical therapy use. Descriptive analyses were conducted to determine the use of physical treatments for individuals who saw a physical therapist. Use of treatments was compared with evidence from systematic reviews. Results Of our sample, 29.7% had seen a physical therapist in the previous year, with a mean of 15.6 visits. In multivariable analyses, receiving workers' compensation, seeing physician specialists, and higher Medical Outcomes Study 12-Item Short-Form Health Survey questionnaire (SF-12) physical component scores were positively associated with physical therapy use. Having no health insurance was negatively associated with physical therapy use. Exercise was the most frequent treatment received (75% of sample), and traction was the least frequent treatment received (7%). Some effective treatments were underutilized, whereas some ineffective treatments were overutilized. Limitations Only one state was examined, and findings were based on patient report. Conclusions Fewer than one third of individuals with chronic LBP saw a physical therapist. Health-related and non–health-related factors were associated with physical therapy use. Individuals who saw a physical therapist did not always receive evidence-based treatments. There are potential opportunities for improving access to and quality of physical therapy for chronic LBP. PMID:21330449
MO-FG-BRB-02: Debater [medical physics education
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hazle, J.
Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusionmore » of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.« less
MO-FG-BRB-00: AAPM Presidential Debate [medical physics education
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusionmore » of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.« less
MO-FG-BRB-04: Debater [Medical physics education
DOE Office of Scientific and Technical Information (OSTI.GOV)
Seibert, J.
Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusionmore » of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.« less
MO-FG-BRB-01: Debater [medical physics education
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bayouth, J.
Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusionmore » of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.« less
MO-FG-BRB-03: Debater [medical physics education
DOE Office of Scientific and Technical Information (OSTI.GOV)
Herman, M.
Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusionmore » of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.« less
Medical health physics: a review.
Vetter, Richard J
2004-05-01
Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.
Medical health physics: a review.
Vetter, Richard J
2005-06-01
Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.
Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H
2013-11-04
The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.
Physical Activity Patterns of Acute Stroke Patients Managed in a Rehabilitation Focused Stroke Unit
2013-01-01
Background. Comprehensive stroke unit care, incorporating acute care and rehabilitation, may promote early physical activity after stroke. However, previous information regarding physical activity specific to the acute phase of stroke and the comprehensive stroke unit setting is limited to one stroke unit. This study describes the physical activity undertaken by patients within 14 days after stroke admitted to a comprehensive stroke unit. Methods. This study was a prospective observational study. Behavioural mapping was used to determine the proportion of the day spent in different activities. Therapist reports were used to determine the amount of formal therapy received on the day of observation. The timing of commencement of activity out of bed was obtained from the medical records. Results. On average, patients spent 45% (SD 25) of the day in some form of physical activity and received 58 (SD 34) minutes per day of physiotherapy and occupational therapy combined. Mean time to first mobilisation out of bed was 46 (SD 32) hours post-stroke. Conclusions. This study suggests that commencement of physical activity occurs earlier and physical activity is at a higher level early after stroke in this comprehensive stroke unit, when compared to studies of other acute stroke models of care. PMID:24024192
An evolving perspective on physical activity counselling by medical professionals.
McPhail, Steven; Schippers, Mandy
2012-04-23
Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals and subsequent engagement in comprehensive community support programs to increase physical activity levels of inactive patients. Additionally, future clinical trials of physical activity interventions should be evaluated in the context of a broader framework of outcomes to inform a systematic consideration of broad strengths and weaknesses regarding not only efficacy but cost-effectiveness and likelihood of successful translation of interventions to clinical contexts.
Teaching empathy to undergraduate medical students using a temporary tattoo simulating psoriasis.
Latham, Lesley; MacDonald, Aimee; Kimball, Alexa B; Langley, Richard G
2012-07-01
Psoriasis has a profound negative effect on quality of life that is often underappreciated by health care professionals and the public. We sought to assess the perception of the burden of psoriasis relative to other medical conditions in first-year medical students, and to determine if wearing a temporary tattoo simulating psoriasis during a teaching exercise would change their perceptions. Participants completed a questionnaire assessing their perception of the impact of psoriasis and other common medical conditions (visual analog scale). Participants then wore a temporary tattoo of a psoriatic lesion for 24 hours and completed the same questionnaire after this exercise. Of 91 students approached, 61 completed the study. At baseline, psoriasis (mean = 23.6) and eczema (mean = 23.3) were perceived as having the lowest physical burden of diseases queried (P < .0001), whereas the mental impact of psoriasis was scored comparably with arthritis, heart disease, and diabetes (mean = 45.1-56.7), but lower than cancer (mean = 82.2) and depression (mean = 93.8). After the exercise, the perception of the impact of eczema (physical: mean = 37.3, P < .0001; mental: mean = 66.6, P = .0005) and psoriasis (physical: mean = 37.8, P = .0014; mental: mean = 68.6, P = .0293) was significantly increased. The exercise did not simulate the chronic nature of psoriasis or the scaling and pruritic characteristics of psoriatic lesions. The survey instrument used to assess empathy has not been previously validated and statistical analysis was limited by small sample size and the absence of a control group. Temporary tattoos are a novel and effective method of teaching medical students about the psychological burden of psoriasis. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
de los Santos, E. Fong; Evans, Suzanne; Ford, Eric C.; Gaiser, James E.; Hayden, Sandra E.; Huffman, Kristina E.; Johnson, Jennifer L.; Mechalakos, James G.; Stern, Robin L.; Terezakis, Stephanie; Thomadsen, Bruce R.; Pronovost, Peter J.; Fairobent, Lynne A.
2015-01-01
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. PMID:26103502
Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A
2015-05-08
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.
Das, Indra J.; Feygelman, Vladimir; Fraass, Benedick A.; Kry, Stephen F.; Marshall, Ingrid R.; Mihailidis, Dimitris N.; Ouhib, Zoubir; Ritter, Timothy; Snyder, Michael G.; Fairobent, Lynne
2015-01-01
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. PMID:26699330
Smilowitz, Jennifer B; Das, Indra J; Feygelman, Vladimir; Fraass, Benedick A; Kry, Stephen F; Marshall, Ingrid R; Mihailidis, Dimitris N; Ouhib, Zoubir; Ritter, Timothy; Snyder, Michael G; Fairobent, Lynne
2015-09-08
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines:• Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.• Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.
Caruana, C J; Christofides, S; Hartmann, G H
2014-09-01
In 2010, EFOMP issued Policy Statement No. 12: "The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations" to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework - the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update. Copyright © 2014. Published by Elsevier Ltd.
MO-D-16A-01: International Day of Medical Physics
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cheung, K; Damilakis, J
International Organization for Medical Physics (IOMP) which represents medical physicists in more than 80 countries decided to celebrate 7th November, birth date of the Polish and naturalized-French physicist Marie Sklodowska-Curie, as International Day of Medical Physics (IDMP). The main purpose of the initiative is to raise the visibility and awareness of medical physicist in the global community, to introduce ourselves to the general public, and bring a message to the community that a group of health professionals, the medical physicists are there to help the patients and other health professionals. First celebration was done in 2013 and now IDMP willmore » be celebrated every year. The theme of IDMP will be different each year. The theme for 2013 was ‘Radiation exposure from medical procedures, ask the Medical Physicist’. The inaugural event was celebrated in 23 countries and the amount of attention gained was remarkable. Main IDMP events were held in Poland, birthplace of Marie Curie, and France, workplace of Marie Curie. This year IOMP celebrates the 2nd IDMP and theme will be ‘Looking into the body-Advancement in Imaging through Medical Physics’ to draw attention to the profound contributions Medical Physics has made to the use of ionizing and non-ionizing radiation for the imaging of human body. A number of countries have informed about events that they are going to organize on IDMP. This gives wide attention to medical physics globally. AAPM is a major and important member of IOMP. It is hoped that AAPM will join in organizing activities. Learning Objectives: To learn about International Day of Medical Physics To become familiar with how first IDMP was celebrated in 2013 and learning achieved To understand on future plans for IDMPs.« less
Physics and the revised Medical College Admission Test
NASA Astrophysics Data System (ADS)
Hilborn, Robert C.
2014-05-01
Physics has played an important role in the preparation of future physicians and other health professionals for more than 100 years. Almost all pre-health students take a year of college-level physics as part of their preparation for medical, dental, and pharmacy school. In particular, the widely-used Medical College Admission Test (MCAT) contains a significant number of questions that require physics knowledge and skills. This paper describes the changes in the MCAT to be implemented in 2015, the role of physics in the revised MCAT, and implications for introductory physics courses for the life sciences.
The role, responsibilities and status of the clinical medical physicist in AFOMP.
Ng, K H; Cheung, K Y; Hu, Y M; Inamura, K; Kim, H J; Krisanachinda, A; Leung, J; Pradhan, A S; Round, H; van Doomo, T; Wong, T J; Yi, B Y
2009-12-01
This document is the first of a series of policy statements being issued by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP). The document was developed by the AFOMP Professional Development Committee (PDC) and was endorsed for official release by AFOMP Council in 2006. The main purpose of the document was to give guidance to AFOMP member organizations on the role and responsibilities of clinical medical physicists. A definition of clinical medical physicist has also been provided. This document discusses the following topics: professional aspects of education and training; responsibilities of the clinical medical physicist; status and organization of the clinical medical physics service and the need for clinical medical physics service.
Obstructive sleep apnea and schizophrenia: A systematic review to inform clinical practice.
Myles, Hannah; Myles, Nicholas; Antic, Nick A; Adams, Robert; Chandratilleke, Madhu; Liu, Dennis; Mercer, Jeremy; Vakulin, Andrew; Vincent, Andrew; Wittert, Gary; Galletly, Cherrie
2016-01-01
Risk factors for obstructive sleep apnea (OSA) are common in people with schizophrenia. Identification and treatment of OSA may improve physical health in this population; however there are no guidelines to inform screening and management. Systematic review to determine, in people with schizophrenia and related disorders: the prevalence of OSA; the prevalence of OSA compared to general population controls; the physical and psychiatric correlates of OSA, associations between antipsychotic medications and OSA; the impact of treatment of OSA on psychiatric and physical health; and the diagnostic validity of OSA screening tools. Medline, EMBASE, ISI Web of Science and PsycINFO electronic databases. Cohort, case-control and cross-sectional studies and RCTs reporting on prevalence of OSA in subjects with schizophrenia and related disorders were reviewed. The prevalence of OSA varied between 1.6% and 52%. The prevalence of OSA was similar between people with schizophrenia and population controls in two studies. Diagnosis of OSA was associated with larger neck circumference, BMI>25, male sex and age>50years. There were no data on physical or psychiatric outcomes following treatment of OSA. The diagnostic utility of OSA screening tools had not been investigated. OSA may be prevalent and potentially under-recognized in people with schizophrenia. Further research is required to determine utility of OSA screening tools, the relationships between antipsychotic medications and OSA and any benefits of treating OSA. We propose a strategy for the identification of OSA in people with schizophrenia and related disorders. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Halvorsen, P; Shine, K; White, G
The United States' healthcare delivery model is undergoing significant change. Insurance and reimbursement models are rapidly evolving, federal allocations are shifting from specialty services to preventive and generalpractice services, and Accountable Care Organizations are gaining in prominence. One area of focus is on the perceived over-utilization of expensive services such as advanced imaging and, in some cases, radiation therapy. Reimbursement incentives are increasingly aimed at quality metrics, leading to an increased interest in the core concepts of High Reliability Organizations. With the shift in federal resources away from specialty services and the increasing prominence of Accountable Care Organizations, we willmore » likely be challenged to re-assess our traditional model for delivering medical physics services. Medical physicists have a unique combination of education and training in physics principles, radiation physics applications in medicine, human anatomy, as well as safety analysis and quality control methods. An effective medical physicist recognizes that to advance the institution's mission, the medical physicist must join other professional leaders within the institution to provide clear direction and perspective for the entire team. To do that, we must first recognize the macro changes in our healthcare delivery system and candidly assess how the medical physics practice model can evolve in a prudent way to support the institution's objectives while maintaining the traditionally high level of quality and safety. This year's Professional Council Symposium will explore the many facets of the changing healthcare system and its potential impact on medical physics. Dr. Shine will provide an overview of the developing healthcare delivery and reimbursement models, with a focus on how the physician community has adapted to the changing objectives. Mr. White will describe recent changes in the reimbursement patterns for both imaging and radiation therapy services, the underlying imperatives that will influence additional changes in the near-term future, and the broader changes in the medical physics workforce that may arise due to many (often conflicting) directives and incentives both internal and external to the profession. Maintaining the integrity of the medical physics profession and the high quality of medical physics services will require a shared understanding of the changing practice environment and a firm commitment to protecting the key priorities of clinical medical physics as the healthcare system transitions to a new and very different model. To be effective as medical physicists, we must learn how to provide leadership in our respective institutions. Learning Objectives: Understand the macro changes occurring in the US healthcare delivery system. Understand the likely near-term, and possible longer-term, impact on the medical physics profession. Understand some strategies for providing leadership during this period of significant change.« less
Study on elder abuse and neglect among patients in a medical college hospital, Bangalore, India.
Nisha, Catherin; Manjaly, Steve; Kiran, Pretesh; Mathew, Betsy; Kasturi, Arvind
2016-01-01
Elder abuse and neglect is a problem that occurs across all settings and all populations. Elder abuse has many forms, such as abandonment, emotional or psychological abuse, financial or material exploitation, neglect, physical abuse, and sexual abuse. We conducted this research to determine the prevalence of various types of abuse and neglect and their associated factors among elderly patients attending the urban and rural geriatric clinics at a medical college hospital in Bangalore, India. A total of 200 elderly patients participated in the study. The overall prevalence of elder abuse or neglect was 32 (16%), comprised of: verbal abuse in 25 (12.5%); neglect in 22 (11%); financial abuse in 17 (8.5%); and physical abuse in 3 (1.5%). Hence, many elderly patients had experienced multiple forms of abuse. There was statistically significant association between elder abuse and total financial dependence, lack of social support, and depression among the elderly patients.
Pompili, Maurizio; Innamorati, Marco; Lamis, Dorian A; Serafini, Gianluca; Ricci, Federica; Migliorati, Monica; Bellini, Samantha; Erbuto, Denise; Mazza, Marianna; Di Nicola, Marco; Janiri, Luigi; Gonda, Xenia; Rihmer, Zoltan; Amore, Mario; Girardi, Paolo; Martelletti, Paolo
2016-07-01
Objective Medication-overuse headache is often comorbid with emotional disturbances and disordered personality traits. The aim of the present study was to determine whether depression and insomnia complaints were associated with satisfaction and enjoyment with one's own life in medication-overuse headache patients, and whether insomnia complaints were able to explain part of the variance of Quality of Life explained by depression. Methods Participants were 187 consecutive adult outpatients admitted to the Regional Referral Headache Centre of the Sant'Andrea Hospital in Rome, Italy. Patients were administered the Quality of Life Enjoyment and Satisfaction Questionnaire, the Beck Depression Inventory - II, and the Athens Insomnia Scale. Results The Beck Depression Inventory was associated with all the dimensions of the Quality of Life Enjoyment and Satisfaction Questionnaire, with more severe depression being associated independently with lower satisfaction and enjoyment with one's own life. The Athens Insomnia Scale was independently and significantly associated only with physical health, such that patients with more insomnia complaints were 3.1 times ( p < 0.001) more likely to report lower physical health satisfaction. Conclusions Our findings confirmed that medication-overuse headache patients has a negative impact on quality of life and suggested that depression and insomnia were independently associated with satisfaction and enjoyment of life in medication-overuse headache patients. The early recognition and appropriate treatment of comorbid psychopathological symptoms are crucial to improve satisfaction and enjoyment of life in medication-overuse headache patients.
Vialu, Carlo; Doyle, Maura
2017-10-01
The Individuals with Disabilities Education Act (IDEA) includes physical therapy (PT) as a related service that may be provided to help students with disabilities benefit from their education. However, the IDEA does not provide specific guidance for the provision of school-based PT, resulting in variations in practice across the United States. The authors examined 22 state and local education agency guidelines available online to find commonalities related to the determination of a student's need for PT. Seven commonalities found: educational benefit, team decision, need for PT expertise, establishment of Individualized Education Program (IEP) goal before determining need for PT, distinction between medical and educational PT, the student's disability adversely affects education, and the student's potential for improvement. These commonalities are discussed in relation to current PT and special education literature. This article suggests applying these commonalities as procedural requirements and questions for discussion during an IEP team meeting.
Brief histories of medical physics in Asia-Oceania.
Round, W H; Jafari, S; Kron, T; Azhari, H A; Chhom, S; Hu, Y; Mauldon, G F; Cheung, K Y; Kuppusamy, T; Pawiro, S A; Lubis, L E; Soejoko, D S; Haryanto, F; Endo, M; Han, Y; Suh, T S; Ng, K H; Luvsan-Ish, A; Maung, S O; Chaurasia, P P; Jafri, S M A; Farrukh, S; Peralta, A; Toh, H J; Sarasanandarajah, S; Shiau, A C; Krisanachinda, A; Suriyapee, S; Vinijsorn, S; Nguyen, T C
2015-09-01
The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.
Low, David; Vlasschaert, Meghan; Novak, Kerri; Chee, Alex; Ma, Irene W Y
2014-11-01
The frequency at which housestaff need to assess volume status on medical inpatients is unknown. In this brief report, we invited 39 housestaff, over 13 randomly selected dates, to complete a 25-item survey. Participants (n = 31, 79%) logged a total of 455 hours, reporting 197 pages or telephone requests received regarding medical inpatients. Of these, 41 pages (21%) required a volume status assessment. Participants reported their volume status assessment competency to be moderate (median score = 3, interquartile range = 3 to 4, where 1 = not competent to perform independently and 6 = above average competence). In 9 of the 41 assessments (22%), at least 1 barrier was reported in determining volume status. The most commonly reported barriers were conflicting physical examination findings (n = 8, 20%) and suboptimal patient examination (n = 5, 12%). Over 20% of pages regarding admitted medical patients required volume status assessments by medical housestaff. Despite moderate self-reported competence in the ability to assess volume status, barriers such as conflicting physical examination findings and suboptimal patient examinations were present in up to 20% of assessments. Therefore, we urge educators to consider incorporating bedside ultrasound training for volume status into the internal medicine curriculum. © 2014 Society of Hospital Medicine.
DOE Office of Scientific and Technical Information (OSTI.GOV)
McEwen, M; Rogers, D; Johns, P
Purpose: To build a world-class medical physics educational program that capitalizes on expertise distributed over several clinical, government, and academic centres. Few if any of these centres would have the critical mass to solely resource a program. Methods: In order to enable an academic program, stakeholders from five institutions made a proposal to Carleton University for a) a research network with defined membership requirements and a process for accepting new members, and b) a graduate specialization (MSc and PhD) in medical physics. Both proposals were accepted and the program has grown steadily. Our courses are taught by medical physicists frommore » across the collaboration. Our students have access to physicists in: clinical radiotherapy (the Ottawa Cancer Centre treats 4500 new patients/y), radiology, cardiology and nuclear medicine, Canada’s primary standards dosimetry laboratory, radiobiology, and university-based medical physics research. Our graduate courses emphasize the foundational physics plus applied aspects of imaging, radiotherapy, and radiobiology. Active researchers in the city-wide volunteer-run network are appointed as adjunct professors by Physics, giving them access to national funding competitions and partial student funding through teaching assistantships while opening up facilities in their institutions for student thesis research. Results: The medical physics network has grown to ∼40 members from eight institutions and includes five full-time faculty in Physics and 17 adjunct research professors. The graduate student population is ∼20. Our graduates have proceeded to a spectrum of careers. Our alumni list includes a CCPM Past-President, the current COMP President, many clinical physicists, and the heads of at least three major clinical medical physics departments. Our PhD was Ontario’s first CAMPEP-accredited program. Conclusion: A self-governing volunteer network is the foundational element that enables an MSc/PhD medical physics program in a city with multiple physicist employers. It enriches graduate education with an unusually broad range of expertise.« less
A new method for teaching physical examination to junior medical students.
Sayma, Meelad; Williams, Hywel Rhys
2016-01-01
Teaching effective physical examination is a key component in the education of medical students. Preclinical medical students often have insufficient clinical knowledge to apply to physical examination recall, which may hinder their learning when taught through certain understanding-based models. This pilot project aimed to develop a method to teach physical examination to preclinical medical students using "core clinical cases", overcoming the need for "rote" learning. This project was developed utilizing three cycles of planning, action, and reflection. Thematic analysis of feedback was used to improve this model, and ensure it met student expectations. A model core clinical case developed in this project is described, with gout as the basis for a "foot and ankle" examination. Key limitations and difficulties encountered on implementation of this pilot are discussed for future users, including the difficulty encountered in "content overload". This approach aims to teach junior medical students physical examination through understanding, using a simulated patient environment. Robust research is now required to demonstrate efficacy and repeatability in the physical examination of other systems.
Reimbursement versus effort in medical physics practice in radiation oncology
Herman, Michael G.; Mills, Michael D.; Gillin, Michael T.
2003-01-01
The changes in health care reimbursement have the potential to affect the availability of quality medical physicist service in patient care. A survey was conducted by the AAPM Professional Council and the ACMP to collect cost information for special medical physics consultation, CPT4‐77370 and continuing medical physics, CPT4‐77336. The data collected from the survey was compared to current reimbursement schemes for a number of special procedures. Under varying reimbursement schemes, the costs of the medical physics services provided cannot be recaptured by the institution. It remains important for medical physicists to assess our utilization of resources and allocation to each of the services we provide and to understand the implications of policy changes at the federal and local levels. PACS number(s): 87.90.+y, 87.53.–j PMID:12777154
History of childhood trauma and disruptive behaviors in the medical setting.
Sansone, Randy A; Farukhi, Shahzad; Wiederman, Michael W
2012-03-01
In this study, we examined relationships between five types of childhood trauma and 17 disruptive behaviors in the medical setting. Using a cross-sectional consecutive sample of 394 internal medicine outpatients, we surveyed participants about five types of childhood trauma (i.e. witnessing of violence, physical neglect, emotional abuse, physical abuse, and sexual abuse) and 17 disruptive behaviors in the medical setting (e.g., yelling, cursing, threatening medical personnel). Initial correlations indicated relationships between four of the five forms of childhood trauma and the number of different disruptive behaviors endorsed. However, using multiple regression analysis, only witnessing violence and physical abuse remained independent predictors of disruptive behaviors in the medical setting. Individuals with childhood histories of witnessing violence and/or physical abuse are at-risk for perpetrating various disruptive behaviors in the medical setting.
Brummel, N E; Girard, T D; Ely, E W; Pandharipande, P P; Morandi, A; Hughes, C G; Graves, A J; Shintani, A; Murphy, E; Work, B; Pun, B T; Boehm, L; Gill, T M; Dittus, R S; Jackson, J C
2014-03-01
Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem-solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3 months, we also assessed cognitive, functional, and health-related quality of life outcomes. Data are presented as median (interquartile range) or frequency (%). Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% (92-100%) of study days beginning 1.0 (1.0-1.0) day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients, and 42/43 (98%) of cognitive plus physical therapy patients on 17% (10-26%), 67% (46-87%), and 75% (59-88%) of study days, respectively. Cognitive, functional, and health-related quality of life outcomes did not differ between groups at 3-month follow-up. This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment, and benefits of cognitive therapy in the critically ill is needed.
Brummel, N.E.; Girard, T.D.; Ely, E.W.; Pandharipande, P.P.; Morandi, A.; Hughes, C.G.; Graves, A.J.; Shintani, A.K.; Murphy, E.; Work, B.; Pun, B.T.; Boehm, L.; Gill, T.M.; Dittus, R.S.; Jackson, J.C.
2013-01-01
PURPOSE Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. METHODS We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3-months, we also assessed cognitive, functional and health-related quality of life outcomes. Data are presented as median [interquartile range] or frequency (%). RESULTS Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% [92–100%] of study days beginning 1.0 [1.0–1.0] day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients and 42/43 (98%) of cognitive plus physical therapy patients on 17% [10–26%], 67% [46–87%] and 75% [59–88%] of study days, respectively. Cognitive, functional and health-related quality of life outcomes did not differ between groups at 3-month follow-up. CONCLUSIONS This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment and benefits of cognitive therapy in the critically ill is needed. PMID:24257969
Soma, Yuki; Tsunoda, Kenji; Kitano, Naruki; Jindo, Takashi; Tsuji, Taishi; Saghazadeh, Mahshid; Okura, Tomohiro
2017-03-01
To explore the relationships between the built environment and older adults' physical function. The present cross-sectional study carried out in 2010-2012 used data drawn from 509 community-dwelling older adults aged 65-86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed up & go and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants' neighborhoods. After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P < 0.05). A lower number of daily life-related destinations was related to poor performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Similarly, the number of community centers was related to walking speed in both sexes. The number of medical and recreational facilities was also related to some physical performance in both sexes. A lower land use mix score, calculated by principal component analysis, was related to lower performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. The present study suggests that, although there are some sex differences, low population density, land use mix, and fewer daily life-related destinations, community centers, medical facilities and recreational facilities are negative determinants of physical function. Geriatr Gerontol Int 2017; 17: 382-390. © 2016 Japan Geriatrics Society.
The utility of outpatient commitment: acute medical care access and protecting health.
Segal, Steven P; Hayes, Stephania L; Rimes, Lachlan
2018-06-01
This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585 severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis. Mental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality.
Bishop, Julie Y; Awan, Hisham M; Rowley, David M; Nagel, Rollin W
2013-01-01
Despite a renewed emphasis among educators, musculoskeletal education is still lacking in medical school and residency training programs. We created a musculoskeletal multiple-choice physical examination decision-making test to assess competency and physical examination knowledge of our trainees. We developed a 20-question test in musculoskeletal physical examination decision-making test with content that most medical students and orthopedic residents should know. All questions were reviewed by ratings of US orthopedic chairmen. It was administered to postgraduate year 2 to 5 orthopedic residents and 2 groups of medical students: 1 group immediately after their 3-week musculoskeletal course and the other 1 year after the musculoskeletal course completion. We hypothesized that residents would score highest, medical students 1 year post-musculoskeletal training lowest, and students immediately post-musculoskeletal training midrange. We administered an established cognitive knowledge test to compare student knowledge base as we expected the scores to correlate. Academic medical center in the Midwestern United States. Orthopedic residents, chairmen, and medical students. Fifty-four orthopedic chairmen (54 of 110 or 49%) responded to our survey, rating a mean overall question importance of 7.12 (0 = Not Important; 5 = Important; 10 = Very Important). Mean physical examination decision-making scores were 89% for residents, 77% for immediate post-musculoskeletal trained medical students, and 59% 1 year post-musculoskeletal trained medical students (F = 42.07, p<0.001). The physical examination decision-making test was found to be internally consistent (Kuder-Richardson Formula 20 = 0.69). The musculoskeletal cognitive knowledge test was 78% for immediate post-musculoskeletal trained students and 71% for the 1 year post-musculoskeletal trained students. The student physical examination and cognitive knowledge scores were correlated (r = 0.54, p<0.001), but were not significantly different for either class. The physical examination decision-making test was found to be internally consistent in exposing the deficiencies of musculoskeletal education skills of our medical students and differentiated between ability levels in musculoskeletal physical examination decision-making (residents vs recently instructed musculoskeletal students vs 1 year post-musculoskeletal instruction). Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Postdoctoral Opportunities in Medical Physics
NASA Astrophysics Data System (ADS)
Hogstrom, Kenneth
2006-04-01
The medical physicist is a professional who specializes in the application of the concepts and methods of physics to the diagnosis and treatment of human disease. Medical physicists identify their primary discipline to be radiation therapy (78%), medical imaging (16%), nuclear medicine (3%), or radiation safety (2%). They state their primary responsibility to be clinical (78%), academic (9%), research (4%), etc. Correspondingly, medical physicists reveal their primarily employment to be a private hospital (42%), university hospital (32%), physicist's service group (9%), physician's service group (9%), industry (5%), and government (3%). The most frequent job of medical physicists is clinical radiation therapy physicist, whose clinical duties include: equipment acquisition, facility design, commissioning, machine maintenance, calibration and quality assurance, patient treatment planning, patient dose calculation, management of patient procedures, development of new technology, radiation safety, and regulatory compliance. The number of medical physicists in the United States can be estimated by the number of members of the American Association of Physicists in Medicine (AAPM), which has increased 5.5% annually since 1969, currently being 5,000. New positions plus retirements create a current need >300 new medical physicists per year, which exceeds supply. This is supported by the steady growth in average salaries, being 100,000 for PhDs entering the field and reaching 180,000. Graduate programs alone cannot meet demand, and physicists entering the field through postdoctoral training in medical physics remain important. Details of postdoctoral research programs and medical physics residency programs will provide direction to physics PhD graduates interested in medical physics. [The AAPM, its annual Professional Information Report, and its Public Education Committee are acknowledged for information contributing to this presentation.
Jönsson, Bo-Anders
2005-09-01
Learning activities and course design in the new context of e-learning, such as in web-based courses involves a change both for teachers and students. The paper discusses factors important for e-learning to be successful. The development of an online course in medical physics and technology for high school teachers of physics, details of the course, and experience gained in connection with it are described. The course syllabus includes basics of radiation physics, imaging techniques using ionizing or non-ionizing radiation, and external and internal radiation therapy. The course has a highly didactic approach. The final task is for participants to design a course of their own centered on some topic of medical physics on the basis of the knowledge they have acquired. The aim of the course is to help the teachers integrate medical physics into their own teaching. This is seen as enhancing the interest of high school students in later studying physics, medical physics or some other branch of science at the university level, and as increasing the knowledge that they and people generally have of science. It is suggested that the basic approach taken can also have applicability to the training of medical, nursing or engineering students, and be used for continuing professional development in various areas.
Physical Examination for the Academic Psychiatrist: Primer and Common Clinical Scenarios.
Azzam, Pierre N; Gopalan, Priya; Brown, Jennifer R; Aquino, Patrick R
2016-04-01
As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).
NASA Astrophysics Data System (ADS)
Blado, Gardo Garnet
2000-09-01
The present paper discusses the physics portion of the Medical College Admission Test (MCAT). Various methods of incorporating "MCAT-type" questions in introductory physics courses to help pre-medical students prepare for the MCAT, are carefully examined.
The present status of medical physics education and training in Europe: an EFOMP survey.
Eudaldo, T; Olsen, K
2008-03-01
The aim of this work is to present the results of an EFOMP's survey on the status of Education and Training of Medical Physics in Europe. This survey has been undertaken by EFOMP in 2005, to update the document "Policy Statement No. 1", which represents the starting point of the EFOMP recommendations on Education and Training in Medical Physics. Ultimate results have been collected at the end of 2006. To perform the survey, a questionnaire was sent to 34 National Member Organisations (NMOs) for Medical Physics, to collect information on the present state of education and training in each European country. Twenty-five countries participated in the enquiry and responded to it. The most outstanding results are as follows: In all countries, the basic requirement to enter the Medical Physics education is a university degree. The length of this university education ranges from 2 to 5 years. Concerning the Post-graduate education in Medical Physics: A nationally approved educational programme is in operation in 16 of the 25 countries. Postgraduate education takes place essentially within 3 different approaches and the total length of Medical Physics education and training ranges from 2 1/2 years to 9 years. In 14 countries, it is mandatory to hold a diploma or license to work as a Medical Physicist. It allows working in all areas of competence (the most mentioned were Radiotherapy, Nuclear Medicine, Diagnostic Radiology and Radiation Protection) in 14 countries, whereas in 4 countries it allows to work only in 1 or 2 areas. Seventeen countries have a register for Medical Physicists. A formal CPD (Continuing Professional Development) programme is in operation in 13 countries.
Parker, Brent C; Duhon, John; Yang, Claus C; Wu, H Terry; Hogstrom, Kenneth R; Gibbons, John P
2014-03-06
In 2009, Mary Bird Perkins Cancer Center (MBPCC) established a Radiation Oncology Physics Residency Program to provide opportunities for medical physics residency training to MS and PhD graduates of the CAMPEP-accredited Louisiana State University (LSU)-MBPCC Medical Physics Graduate Program. The LSU-MBPCC Program graduates approximately six students yearly, which equates to a need for up to twelve residency positions in a two-year program. To address this need for residency positions, MBPCC has expanded its Program by developing a Consortium consisting of partnerships with medical physics groups located at other nearby clinical institutions. The consortium model offers the residents exposure to a broader range of procedures, technology, and faculty than available at the individual institutions. The Consortium institutions have shown a great deal of support from their medical physics groups and administrations in developing these partnerships. Details of these partnerships are specified within affiliation agreements between MBPCC and each participating institution. All partner sites began resident training in 2011. The Consortium is a network of for-profit, nonprofit, academic, community, and private entities. We feel that these types of collaborative endeavors will be required nationally to reach the number of residency positions needed to meet the 2014 ABR certification requirements and to maintain graduate medical physics training programs.
Physical activity is related to quality of life in older adults.
Acree, Luke S; Longfors, Jessica; Fjeldstad, Anette S; Fjeldstad, Cecilie; Schank, Bob; Nickel, Kevin J; Montgomery, Polly S; Gardner, Andrew W
2006-06-30
Physical activity is associated with health-related quality of life (HRQL) in clinical populations, but less is known whether this relationship exists in older men and women who are healthy. Thus, this study determined if physical activity was related to HRQL in apparently healthy, older subjects. Measures were obtained from 112 male and female volunteers (70 +/- 8 years, mean +/- SD) recruited from media advertisements and flyers around the Norman, Oklahoma area. Data was collected using a medical history questionnaire, HRQL from the Medical Outcomes Survey short form-36 questionnaire, and physical activity level from the Johnson Space Center physical activity scale. Subjects were separated into either a higher physically active group (n = 62) or a lower physically active group (n = 50) according to the physical activity scale. The HRQL scores in all eight domains were significantly higher (p < 0.05) in the group reporting higher physical activity. Additionally, the more active group had fewer females (44% vs. 72%, p = 0.033), and lower prevalence of hypertension (39% vs. 60%, p = 0.041) than the low active group. After adjusting for gender and hypertension, the more active group had higher values in the following five HRQL domains: physical function (82 +/- 20 vs. 68 +/- 21, p = 0.029), role-physical (83 +/- 34 vs. 61 +/- 36, p = 0.022), bodily pain (83 +/- 22 vs. 66 +/- 23, p = 0.001), vitality (74 +/- 15 vs. 59 +/- 16, p = 0.001), and social functioning (92 +/- 18 vs. 83 +/- 19, p = 0.040). General health, role-emotional, and mental health were not significantly different (p > 0.05) between the two groups. Healthy older adults who regularly participated in physical activity of at least moderate intensity for more than one hour per week had higher HRQL measures in both physical and mental domains than those who were less physically active. Therefore, incorporating more physical activity into the lifestyles of sedentary or slightly active older individuals may improve their HRQL.
Sazlina, Shariff-Ghazali; Browning, Colette Joy; Yasin, Shajahan
2012-01-01
Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care. A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals. This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).
Programmed Multiphasic Health Testing
NASA Technical Reports Server (NTRS)
Hershberg, P. I.
1970-01-01
Multiphase health screening procedures are advocated for detection and prevention of disease at an early stage through risk factor analysis. The use of an automated medical history questionnaire together with scheduled physical examination data provides a scanning input for computer printout. This system makes it possible to process laboratory results from 1,000 to 2,000 patients for biochemical determinations on an economically feasible base.
Calvert, Eric; Chambers, Gordon Keith; Regan, William; Hawkins, Robert H; Leith, Jordan M
2009-05-01
The diagnosis of a superior labrum anterior posterior (SLAP) lesion through physical examination has been widely reported in the literature. Most of these studies report high sensitivities and specificities, and claim to be accurate, valid, and reliable. The purpose of this study was to critically evaluate these studies to determine if there was sufficient evidence to support the use of the SLAP physical examination tests as valid and reliable diagnostic test procedures. Strict epidemiologic methodology was used to obtain and collate all relevant articles. Sackett's guidelines were applied to all articles. Confidence intervals and likelihood ratios were determined. Fifteen of 29 relevant studies met the criteria for inclusion. Only one article met all of Sackett's critical appraisal criteria. Confidence intervals for both the positive and negative likelihood ratios contained the value 1. The current literature being used as a resource for teaching in medical schools and continuing education lacks the validity necessary to be useful. There are no good physical examination tests that exist for effectively diagnosing a SLAP lesion.
Physics and medicine: a historical perspective.
Keevil, Stephen F
2012-04-21
Nowadays, the term medical physics usually refers to the work of physicists employed in hospitals, who are concerned mainly with medical applications of radiation, diagnostic imaging, and clinical measurement. This involvement in clinical work began barely 100 years ago, but the relation between physics and medicine has a much longer history. In this report, I have traced this history from the earliest recorded period, when physical agents such as heat and light began to be used to diagnose and treat disease. Later, great polymaths such as Leonardo da Vinci and Alhazen used physical principles to begin the quest to understand the function of the body. After the scientific revolution in the 17th century, early medical physicists developed a purely mechanistic approach to physiology, whereas others applied ideas derived from physics in an effort to comprehend the nature of life itself. These early investigations led directly to the development of specialties such as electrophysiology, biomechanics, and ophthalmology. Physics-based medical technology developed rapidly during the 19th century, but it was the revolutionary discoveries about radiation and radioactivity at the end of the century that ushered in a new era of radiation-based medical diagnosis and treatment, thereby giving rise to the modern medical physics profession. Subsequent developments in imaging in particular have revolutionised the practice of medicine. We now stand on the brink of a new revolution in post-genomic personalised medicine, with physics-based techniques again at the forefront. As before, these techniques are often the unpredictable fruits of earlier investment in basic physics research. Copyright © 2012 Elsevier Ltd. All rights reserved.
Objective Structured Clinical Examination as an Assessment Tool for Clinical Skills in Dermatology.
Saceda-Corralo, D; Fonda-Pascual, P; Moreno-Arrones, Ó M; Alegre-Sánchez, A; Hermosa-Gelbard, Á; Jiménez-Gómez, N; Vañó-Galván, S; Jaén-Olasolo, P
2017-04-01
Objective Structured Clinical Evaluation (OSCE) is an excellent method to evaluate student's abilities, but there are no previous reports implementing it in dermatology. To determine the feasibility of implementation of a dermatology OSCE in the medical school. Five stations with standardized patients and image-based assessment were designed. A specific checklist was elaborated in each station with different items which evaluated one competency and were classified into five groups (medical history, physical examination, technical skills, case management and prevention). A total of 28 students were tested. Twenty-five of them (83.3%) passed the exam globally. Concerning each group of items tested: medical interrogation had a mean score of 71.0; physical examination had a mean score of 63.0; management had a mean score of 58.0; and prevention had a mean score of 58.0 points. The highest results were obtained in interpersonal skills items with 91.8 points. Testing a small sample of voluntary students may hinder generalization of our study. OSCE is an useful tool for assessing clinical skills in dermatology and it is possible to carry it out. Our experience enhances that medical school curriculum needs to establish OSCE as an assessment tool in dermatology. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab,more » Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
Low energy ion beam induced changes in ETFE polymer
NASA Astrophysics Data System (ADS)
Parada, M. A.; Delalez, N.; de Almeida, A.; Muntele, C.; Muntele, I.; Ila, D.
2006-01-01
Low energy ion beam bombardment of ethylenetetrafluoroethylene (ETFE) modifies the physical and chemical properties of the polymer surface in ways that enhance or compromise applications in the technological and medical physics fields. When a material is exposed to ionizing radiation, its changes depends on the type, energy and intensity of the applied radiation. In order to determine the nature of the induced radiation changes, ETFE films were bombarded with fluences from 1012 up to 1015 ions/cm2 of keV N and protons. The emission of gaseous species during the bombardments was monitored with a residual gas analyser (RGA). The bombarded films were analysed with optical absorption photospectrometry (OAP), Fourier transform infrared (FTIR) and micro-Raman spectrometries that determine the chemical nature of the structural changes caused by ions bombardment.
Medical physics: some recollections in diagnostic X-ray imaging and therapeutic radiology.
Gray, J E; Orton, C G
2000-12-01
Medical physics has changed dramatically since 1895. There was a period of slow evolutionary change during the first 70 years after Roentgen's discovery of x rays. With the advent of the computer, however, both diagnostic and therapeutic radiology have undergone rapid growth and changes. Technologic advances such as computed tomography and magnetic resonance imaging in diagnostic imaging and three-dimensional treatment planning systems, stereotactic radiosurgery, and intensity modulated radiation therapy in radiation oncology have resulted in substantial changes in medical physics. These advances have improved diagnostic imaging and radiation therapy while expanding the need for better educated and experienced medical physics staff.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
SU-A-BRA-04: Incorporating Active Learning Into Medical Physics Education
DOE Office of Scientific and Technical Information (OSTI.GOV)
Burmeister, J.
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
The prevalence of obesity among clinical students in a Malaysian medical school.
Boo, N Y; Chia, G J Q; Wong, L C; Chew, R M; Chong, W; Loo, R C N
2010-02-01
This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities. This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake. The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors. Obesity remains a common problem among medical students in their clinical years.
Abdulghani, Hamza M; AlKanhal, Abdulaziz A; Mahmoud, Ebrahim S; Ponnamperuma, Gominda G; Alfaris, Eiad A
2011-10-01
Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. All the medical students from year one to year five levels from the College of Medicine, King Saud University, were enrolled in the study. The study was conducted using Kessler10 psychological distress (K10) inventory, which measures the level of stress according to none, mild, moderate, and severe categories. The prevalence of stress was measured and compared with the five study variables, such as gender, academic year, academic grades, regularity to course attendance, and perceived physical problems. The response rate among the study subjects was 87% (n=892). The total prevalence of stress was 63%, and the prevalence of severe stress was 25%. The prevalence of stress was higher (p<0.5) among females (75.7%) than among males (57%) (odds ratio=2.3, chi2=27.2, p<0.0001). The stress significantly decreased as the year of study increased, except for the final year. The study variables, including being female (p<0.0001), year of study (p<0.001), and presence of perceived physical problems (p<0.0001), were found as independent significant risk factors for the outcome variables of stress. Students' grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress levels. Preventive mental health services, therefore, could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrence.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sprawls, P
Purpose: To enhance the understanding of medical physics concepts and develop higher levels of learning relating to invisible physics phenomena such as radiation. To provide medical physics educators in all countries of the world with understanding of knowledge structures in the human brain, the different levels of learning, and the types of knowledge required for higher level functions such as problem solving, creative innovations, and applied clinical applications. To provide medical physics educators with an open access resource (tool) that they can use in their teaching activities to enrich and elevate the level of learning for their students, residents, etc.more » with respect to the invisible realm of medical physics. Methods: An experienced clinical medical physicist and educator has created and provided with open access three complementary web-based resources to achieve the purposes described above. One is a module focusing on the medical physics learning process with respect to mental knowledge structures, how they relate to outcomes and applications, and learning activities that are required to develop the required knowledge structures. The second is an extensive set of visuals that educators can use in their activities (classes, small group discussions, etc.) to visualize the invisible. The third is an interactive online simulation where learners can adjust factors and visually observe changes in x-radiation.These resources are available online at www.BLINDED FOR REVIEW . Results: Medical physics education, especially for non-physicists, is becoming much more interesting and useful especially with respect to invisible radiation. The global impact is that medical imaging professionals can be more effective in optimizing x-ray imaging procedures and risk management when they have knowledge levels that enhance problem solving, innovation, and creativity. Conclusion: Medical physics educators in all institutions can be much more effective and efficient in the sharing of their knowledge and experience when enhanced with high-quality visuals.« less
Can basic life support personnel safely determine that advanced life support is not needed?
Cone, D C; Wydro, G C
2001-01-01
To determine whether firefighter/emergency medical technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered emergency medical services (EMS) system can safely determine when advanced life support (ALS) is not needed. This was a prospective, observational study conducted in two academic emergency departments (EDs) receiving patients from a large urban fire-based EMS system. Runs were studied to which ALS and BLS ambulances were simultaneously dispatched, with the patient transported by the BLS unit. Prospectively established criteria for potential need for ALS were used to determine whether the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes (admission rate, length of stay, mortality) were examined. In the system studied, BLS crews may cancel responding ALS units at their discretion; there are no protocols or medical criteria for cancellation. A convenience sample of 69 cases was collected. In 52 cases (75%), the BLS providers indicated that they cancelled the responding ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39 had potentially serious chief complaints, nine had abnormal vital signs, and ten had physical exam findings that warranted ALS. Forty-five (87%) received an intervention immediately upon ED arrival that could have been provided in the field by an ALS unit, and 16 (31%) were admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days). One patient died. Firefighter/EMT-Bs, working without protocols or medical criteria, cannot always safely determine which patients may require ALS intervention.
Statins and physical activity in older men: the osteoporotic fractures in men study.
Lee, David S H; Markwardt, Sheila; Goeres, Leah; Lee, Christine G; Eckstrom, Elizabeth; Williams, Craig; Fu, Rongwei; Orwoll, Eric; Cawthon, Peggy M; Stefanick, Marcia L; Mackey, Dawn; Bauer, Douglas C; Nielson, Carrie M
2014-08-01
Muscle pain, fatigue, and weakness are common adverse effects of statin medications and may decrease physical activity in older men. To determine whether statin use is associated with physical activity, longitudinally and cross-sectionally. Men participating in the Osteoporotic Fractures in Men Study (N = 5994), a multicenter prospective cohort study of community-living men 65 years and older, enrolled between March 2000 and April 2002. Follow-up was conducted through 2009. Statin use as determined by an inventory of medications (taken within the last 30 days). In cross-sectional analyses (n = 4137), statin use categories were users and nonusers. In longitudinal analyses (n = 3039), categories were prevalent users (baseline use and throughout the study), new users (initiated use during the study), and nonusers (never used). Self-reported physical activity at baseline and 2 follow-up visits using the Physical Activity Scale for the Elderly (PASE). At the third visit, an accelerometer measured metabolic equivalents (METs [kilocalories per kilogram per hour]) and minutes of moderate activity (METs ≥3.0), vigorous activity (METs ≥6.0), and sedentary behavior (METs ≤1.5). At baseline, 989 men (24%) were users and 3148 (76%) were nonusers. The adjusted difference in baseline PASE between users and nonusers was -5.8 points (95% CI, -10.9 to -0.7 points). A total of 3039 men met the inclusion criteria for longitudinal analysis: 727 (24%) prevalent users, 845 (28%) new users, and 1467 (48%) nonusers. PASE score declined by a mean (95% CI) of 2.5 (2.0 to 3.0) points per year for nonusers and 2.8 (2.1 to 3.5) points per year for prevalent users, a nonstatistical difference (0.3 [-0.5 to 1.0] points). For new users, annual PASE score declined at a faster rate than nonusers (difference of 0.9 [95% CI, 0.1 to 1.7] points). A total of 3071 men had adequate accelerometry data, 1542 (50%) were statin users. Statin users expended less METs (0.03 [95% CI, 0.02-0.04] METs less) and engaged in less moderate physical activity (5.4 [95% CI, 1.9-8.8] fewer minutes per day), less vigorous activity (0.6 [95% CI, 0.1-1.1] fewer minutes per day), and more sedentary behavior (7.6 [95% CI, 2.6-12.4] greater minutes per day). Statin use was associated with modestly lower physical activity among community-living men, even after accounting for medical history and other potentially confounding factors. The clinical significance of these findings deserves further investigation.
Geraets, Stijn E W; Meuffels, Duncan E; van Meer, Belle L; Breedveldt Boer, Hans P; Bierma-Zeinstra, Sita M A; Reijman, Max
2015-04-01
Well-designed validity studies on the clinical diagnosis of anterior cruciate ligament (ACL) injury are scarce. Our purpose is to assess the diagnostic value of ACL-specific medical history assessment and physical examination between primary and secondary care medical specialists. Medical history assessment and physical examination were performed by both an orthopaedic surgeon and a primary care physician, both blinded to all clinical information, in a secondary care population. A knee arthroscopy was used as reference standard. A total of 60 participants were divided into an index group with an arthroscopically proven complete ACL rupture and a control group with an arthroscopically proven intact ACL. The orthopaedic surgeon recognized 94 % of the participants with an ACL rupture through a positive medical history combined with a positive physical examination; of the participants with an intact ACL, 16 % were misclassified by the orthopaedic surgeon. The primary care physician recognized 62 % of the participants with an ACL rupture and misclassified 23 % of the participants with an intact ACL. Physical examination appeared to have no additional value for the primary care physician. Combined medical history and physical examination have strong diagnostic value in ACL rupture diagnostics performed by an orthopaedic surgeon, whereas for the primary care physician, only medical history appeared to be of value. For current practice, this could mean that only orthopaedic surgeons can perform an ACL physical examination with accuracy. III.
Medical error and related factors during internship and residency.
Ahmadipour, Habibeh; Nahid, Mortazavi
2015-01-01
It is difficult to determine the real incidence of medical errors due to the lack of a precise definition of errors, as well as the failure to report them under certain circumstances. We carried out a cross- sectional study in Kerman University of Medical Sciences, Iran in 2013. The participants were selected through the census method. The data were collected using a self-administered questionnaire, which consisted of questions on the participants' demographic data and questions on the medical errors committed. The data were analysed by SPSS 19. It was found that 270 participants had committed medical errors. There was no significant difference in the frequency of errors committed by interns and residents. In the case of residents, the most common error was misdiagnosis and in that of interns, errors related to history-taking and physical examination. Considering that medical errors are common in the clinical setting, the education system should train interns and residents to prevent the occurrence of errors. In addition, the system should develop a positive attitude among them so that they can deal better with medical errors.
Kouvonen, Anne; Mänty, Minna; Lallukka, Tea; Pietiläinen, Olli; Lahelma, Eero; Rahkonen, Ossi
2017-07-12
To investigate whether changes in psychosocial and physical working conditions are associated with subsequent psychotropic medication in ageing employees. Data were from the Helsinki Health Study, a cohort study of Finnish municipal employees, aged 40-60 years at phase 1 (2000-2002). Changes in psychosocial and physical working conditions were measured between phase 1 and phase 2 (2007). Survey data were longitudinally linked to data on prescribed, reimbursed psychotropic medication purchases (Anatomical Therapeutic Chemical) obtained from the registers of the Social Insurance Institution of Finland between the phase 2 survey and December 2013 (N=3587; 80% women). Outcomes were any psychotropic medication; antidepressants (N06A); anxiolytics (N05B); and sedatives and hypnotics (N05C). Cox regression analyses were performed. During the follow-up, 28% of the participants were prescribed psychotropic medication. Repeated exposures to low job control, high job demands and high physical work load were associated with an increased risk of subsequent antidepressant and anxiolytic medication. Increased and repeated exposure to high physical work load, increased job control and repeated high job demands were associated with subsequent sedative and hypnotic medication. Age and sex-adjusted HR varied from 1.18 to 1.66. Improvement in job control was associated with a lower risk of anxiolytic, but with a higher risk of sedatives and hypnotic medication. Decreased physical work load was associated with a lower risk of antidepressant and anxiolytic medications. Improvement in working conditions could lower the risk of mental ill-health indicated by psychotropic medication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Medical Evaluation of Suspected Child Sexual Abuse: 2011 Update
ERIC Educational Resources Information Center
Adams, Joyce A.
2011-01-01
The medical evaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The…
An evolving perspective on physical activity counselling by medical professionals
2012-01-01
Background Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Discussion Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. Summary It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals and subsequent engagement in comprehensive community support programs to increase physical activity levels of inactive patients. Additionally, future clinical trials of physical activity interventions should be evaluated in the context of a broader framework of outcomes to inform a systematic consideration of broad strengths and weaknesses regarding not only efficacy but cost-effectiveness and likelihood of successful translation of interventions to clinical contexts. PMID:22524484
The association between physical symptoms and depression among medical students in Bahrain.
Abdelaziz, Ammar M Y; Alotaibi, Khalid T; Alhurayyis, Jarah H; Alqahtani, Turky A; Alghamlas, Aamer M; Algahtani, Haifa M; Jahrami, Haitham A
2017-12-15
To examine the association between depression and physical symptoms among medical students in Bahrain. The present study employed a cross-sectional design. A total of 160 students were recruited, 41.3% were male and 58.8% female, using a convenience sampling approach. Participants completed the validated Patients Health Questionnaires (PHQs) in which they provided information about demographics, physical symptoms, and depression. Results were considered significant if p <0.05. Nearly nineteen percent of the participants have moderate to severe depression, and 42.2% has moderate to severe physical symptoms. Participants reported different physical symptoms, sleep problems, 40%; lethargy, 31.9%; and headaches, 23.8%. The results of the logistic regression showed that there was a significant association between age and gender (χ 2 (3) = 32.28, p < 0.001). Sleep and gastrointestinal symptoms were the most associated with depression, respectively (χ 2 (3) =49.77, p<0.001) and (χ 2 (3) =49.77, p< 0.05). The association between depression and physical symptoms are considerably high among medical students in Bahrain. Medical educators should take such symptoms seriously among medical students as it may have serious consequences on the mental health of medical students. In practice, adequate awareness initiatives should be organized and provided for medical students to help them overcome their challenges they face. Additionally, incorporating screening self-screening strategies in the medical curriculum can be beneficial for early detections of mental health problems. The Implications and limitations of the study are discussed.
Strength, mobility and falling in women referred to a geriatric outpatient clinic.
Janssen, Hennie C J P; Samson, Monique M; Meeuwsen, Ingrid B A E; Duursma, Sijmen A; Verhaar, Harald J J
2004-04-01
Mobility impairment and falling have a multifactorial etiology in frail older people. Muscle weakness is one of the risk factors and is accessible to intervention. The aim of this study was to determine the most important contributors of mobility and indicators of fall occurrence in women referred to a geriatric outpatient clinic. Mobility was assessed using the Timed 'Get-Up-and-Go' test (TGUG) and the modified Coopertest (COOP). Falling was assessed retrospectively and isometric knee extension force was measured using fixed dynamometry. Habitual physical activity was quantified using a questionnaire for the elderly. Height, weight, medical conditions and current medication were recorded. Isometric knee extension strength and habitual physical activity, which consisted predominantly of household work, were independent variables of performance on TGUG and COOP and together explained 57% of the variance in TGUG (r=0.75, p<0.001), and 64% of that in COOP, (r=0.80, p<0.001). Age, total number of medical conditions, and presence of cardiovascular disease were not significant in the model. Women in the lowest tertile of knee extension strength had a significantly higher probability of falling (0.75, 95% CI 0.56-0.91) compared with women in the highest tertile (0.27, 95% CI 0.14-0.50). Knee extension strength remains a strong determinant of mobility and fall occurrence in women referred to a geriatric outpatient clinic. Performing light to moderate household work remains independently associated with functional mobility.
Basavaraj, K H; Navya, M A; Rashmi, R
2010-07-01
Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected persons. Existing data suggest that physical manifestations, antiretroviral therapy, psychological well-being, social support systems, coping strategies, spiritual well-being, and psychiatric comorbidities are important predictors of QOL in this population. Consequently, the impact of HIV infection on the dimensions of QOL, including physical and emotional well-being, social support systems, and life roles, has emerged as a key issue for persons infected with HIV.
Basavaraj, K. H.; Navya, M. A.; Rashmi, R.
2010-01-01
Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected persons. Existing data suggest that physical manifestations, antiretroviral therapy, psychological well-being, social support systems, coping strategies, spiritual well-being, and psychiatric comorbidities are important predictors of QOL in this population. Consequently, the impact of HIV infection on the dimensions of QOL, including physical and emotional well-being, social support systems, and life roles, has emerged as a key issue for persons infected with HIV. PMID:21716787
A report on student abuse during medical training.
Maida, Ana Margarita; Vásquez, Alicia; Herskovic, Viviana; Calderón, José Luis; Jacard, Marcela; Pereira, Ana; Widdel, Lars
2003-09-01
The purpose of this study was to determine the incidence, and the consequences, of abusive situations as perceived by students during the course of their medical training. A descriptive study was carried out surveying the entire 2000 fifth-year class of 181 in the Medical School of the University of Chile. The questionnaire was answered by 144 students. Results showed that 91.7% of the students who responded had suffered at least one episode of abuse while enrolled in medical school. The main offenders were teachers and peers. Verbal abuse was the most common (85.4%), followed by psychological (79.9%), sexual(26.4%) and physical (23.6%) abuse. Students reported that abuse had effects on their mental health, social life and the image they had of physicians; 17% considered dropping out of school as a consequence of this experience. Efforts should be addressed to prompt educators to reflect on their role.
[Medical and legal considerations in whiplash injury].
Castillo-Chávez, Miguel Angel
2013-01-01
Whiplash injury usually occurs in people who suffered an automobile accident, but also occurs as a result of physical assault and other mechanisms. Diagnosis and initial management of the patient by the emergency physician or orthopedist, and prescribing indications, are taken into account by two forensic intervention specialists. One of these is the medical officer, who, through analysis of the injury mechanism, establishes a cause-effect relationship and concludes whether the accident suffered by a worker it is related to work or not, determines how long the worker will remain disabled and if the injury caused permanent disability under Federal Labor Law. The medical examiner by injury classification assists the Public Ministry so that it can frame the crime of injury to the Criminal Code of Federal District. For these reasons a review of medical information about the mechanism of injury, diagnosis, treatment and healing time was performed to help both specialists to standardize their approach in their daily activities.
A new method for teaching physical examination to junior medical students
Sayma, Meelad; Williams, Hywel Rhys
2016-01-01
Introduction Teaching effective physical examination is a key component in the education of medical students. Preclinical medical students often have insufficient clinical knowledge to apply to physical examination recall, which may hinder their learning when taught through certain understanding-based models. This pilot project aimed to develop a method to teach physical examination to preclinical medical students using “core clinical cases”, overcoming the need for “rote” learning. Methods This project was developed utilizing three cycles of planning, action, and reflection. Thematic analysis of feedback was used to improve this model, and ensure it met student expectations. Results and discussion A model core clinical case developed in this project is described, with gout as the basis for a “foot and ankle” examination. Key limitations and difficulties encountered on implementation of this pilot are discussed for future users, including the difficulty encountered in “content overload”. Conclusion This approach aims to teach junior medical students physical examination through understanding, using a simulated patient environment. Robust research is now required to demonstrate efficacy and repeatability in the physical examination of other systems. PMID:26937208
The physical basis and future of radiation therapy.
Bortfeld, T; Jeraj, R
2011-06-01
The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more compact and cheaper technologies. Bigger challenges lie ahead of physicists in radiation therapy beyond the dose localisation problem, for example in the areas of biological target definition, improved modelling for normal tissues and tumours, advanced multicriteria and robust optimisation, and continuous incorporation of advanced technologies such as molecular imaging. The success of physics in radiation therapy has been based on the continued "fuelling" of the field with new discoveries and inventions from physics research. A key to the success has been the application of the rigorous scientific method. In spite of the importance of physics research for radiation therapy, too few physicists are currently involved in cutting-edge research. The increased emphasis on more "professionalism" in medical physics will tip the situation even more off balance. To prevent this from happening, we argue that medical physics needs more research positions, and more and better academic programmes. Only with more emphasis on medical physics research will the future of radiation therapy and other physics-related medical specialties look as bright as the past, and medical physics will maintain a status as one of the most exciting fields of applied physics.
The physical basis and future of radiation therapy
Bortfeld, T; Jeraj, R
2011-01-01
The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more compact and cheaper technologies. Bigger challenges lie ahead of physicists in radiation therapy beyond the dose localisation problem, for example in the areas of biological target definition, improved modelling for normal tissues and tumours, advanced multicriteria and robust optimisation, and continuous incorporation of advanced technologies such as molecular imaging. The success of physics in radiation therapy has been based on the continued “fuelling” of the field with new discoveries and inventions from physics research. A key to the success has been the application of the rigorous scientific method. In spite of the importance of physics research for radiation therapy, too few physicists are currently involved in cutting-edge research. The increased emphasis on more “professionalism” in medical physics will tip the situation even more off balance. To prevent this from happening, we argue that medical physics needs more research positions, and more and better academic programmes. Only with more emphasis on medical physics research will the future of radiation therapy and other physics-related medical specialties look as bright as the past, and medical physics will maintain a status as one of the most exciting fields of applied physics. PMID:21606068
Altschuler, Eric L; Cruz, Eduardo; Salim, Sara Z; Jani, Jay B; Stitik, Todd P; Foye, Patrick M; DeLisa, Joel A
2014-01-01
The aim of this study was to evaluate the efficacy of a checklist as part of a physical medicine clerkship to teach medical students physical examination maneuvers. This is a prospective study performed on fourth year medical students enrolled in a 2-wk mandatory clerkship of the Department of Physical Medicine and Rehabilitation. At the start and end of the rotation, the participating students were tested by performing 20 physical examination maneuvers on an investigator who was both the standardized patient and the evaluator. At the end of the rotation, the students also completed a survey. Data were analyzed using the Bernoulli trial model, with the percentage of students who performed the maneuver correctly on the pretest as the a priori probability. A full Bonferroni correction was applied. The authors enrolled 141 of the 176 fourth year medical students; 121 completed testing. At prerotation, approximately 35% of the physical examination maneuvers were performed correctly; at postrotation, 82%. For 19 of 20 maneuvers, the improvement was statistically significant at P < 0.01. The survey results indicated that the students felt that they had limited exposure to musculoskeletal examination skills at prerotation, that this rotation helped them achieve competency in performing the maneuvers, and that this would improve their future patient care irrespective of field of choice. Considering the high prevalence of musculoskeletal disorders and the anticipated rise in the future, the authors strongly recommend teaching musculoskeletal physical examination maneuvers in medical school, which can be accomplished via a mandatory physical medicine and rehabilitation rotation. The authors conclude that checklists as part of this rotation can effectively help in teaching physical examination skills to medical students.
Taylor, A H; Fox, K R; Hillsdon, M; Anokye, N; Campbell, J L; Foster, C; Green, C; Moxham, T; Mutrie, N; Searle, J; Trueman, P; Taylor, R S
2011-01-01
Objective To assess the impact of exercise referral schemes on physical activity and health outcomes. Design Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference −0.82, −1.28 to −0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses.Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings. Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis. PMID:22058134
Parker, Brent C.; Duhon, John; Yang, Claus C.; Wu, H. Terry; Hogstrom, Kenneth R.
2014-01-01
In 2009, Mary Bird Perkins Cancer Center (MBPCC) established a Radiation Oncology Physics Residency Program to provide opportunities for medical physics residency training to MS and PhD graduates of the CAMPEP‐accredited Louisiana State University (LSU)‐MBPCC Medical Physics Graduate Program. The LSU‐MBPCC Program graduates approximately six students yearly, which equates to a need for up to twelve residency positions in a two‐year program. To address this need for residency positions, MBPCC has expanded its Program by developing a Consortium consisting of partnerships with medical physics groups located at other nearby clinical institutions. The consortium model offers the residents exposure to a broader range of procedures, technology, and faculty than available at the individual institutions. The Consortium institutions have shown a great deal of support from their medical physics groups and administrations in developing these partnerships. Details of these partnerships are specified within affiliation agreements between MBPCC and each participating institution. All partner sites began resident training in 2011. The Consortium is a network of for‐profit, nonprofit, academic, community, and private entities. We feel that these types of collaborative endeavors will be required nationally to reach the number of residency positions needed to meet the 2014 ABR certification requirements and to maintain graduate medical physics training programs. PACS numbers: 01.40.Fk, 01.40.gb PMID:24710434
WE-D-204-04: Learning the Ropes: Clinical Immersion in the First Month of Residency
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dieterich, S.
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Parker, W.
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less
WE-D-204-02: Errors and Process Improvements in Radiation Therapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fontenla, D.
2016-06-15
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less
WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hendrickson, K.
2016-06-15
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less
ERIC Educational Resources Information Center
Wells, P. N. T.
1983-01-01
Careers in medical physics are discussed. Considers types of hospital departments and responsibilities in same for medical physicists and the education/training needed to enter the field. Indicates that the field is not large and that opportunities to enter it are keenly contested. (JN)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Naqvi, S.
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
Benchmarking the Physical Therapist Academic Environment to Understand the Student Experience.
Shields, Richard K; Dudley-Javoroski, Shauna; Sass, Kelly J; Becker, Marcie
2018-04-19
Identifying excellence in physical therapist academic environments is complicated by the lack of nationally available benchmarking data. The objective of this study was to compare a physical therapist academic environment to another health care profession (medicine) academic environment using the Association of American Medical Colleges Graduation Questionnaire (GQ) survey. The design consisted of longitudinal benchmarking. Between 2009 and 2017, the GQ was administered to graduates of a physical therapist education program (Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa [PTRS]). Their ratings of the educational environment were compared to nationwide data for a peer health care profession (medicine) educational environment. Benchmarking to the GQ capitalizes on a large, psychometrically validated database of academic domains that may be broadly applicable to health care education. The GQ captures critical information about the student experience (eg, faculty professionalism, burnout, student mistreatment) that can be used to characterize the educational environment. This study hypothesized that the ratings provided by 9 consecutive cohorts of PTRS students (n = 316) would reveal educational environment differences from academic medical education. PTRS students reported significantly higher ratings of the educational emotional climate and student-faculty interactions than medical students. PTRS and medical students did not differ on ratings of empathy and tolerance for ambiguity. PTRS students reported significantly lower ratings of burnout than medical students. PTRS students descriptively reported observing greater faculty professionalism and experiencing less mistreatment than medical students. The generalizability of these findings to other physical therapist education environments has not been established. Selected elements of the GQ survey revealed differences in the educational environments experienced by physical therapist students and medical students. All physical therapist academic programs should adopt a universal method to benchmark the educational environment to understand the student experience.
Shiyanbola, Olayinka O; Farris, Karen B; Chrischilles, Elizabeth
2013-01-01
Concern belief in medication is a construct that may characterize patients' attitude toward managing medicines, and this could change with time. Understanding the factors that would impact a change in concern beliefs would be helpful in interventions that could reframe patients' perceptions about their medicines. To examine if patient concern beliefs in medications change over time, assess the characteristics of individuals whose beliefs change, and determine what factors might impact a change in patient beliefs. Secondary data analysis using 2 longitudinal studies. The first study was an Internet-based survey of Medicare enrollees pre-post Medicare Part D. The second study was a randomized controlled trial evaluating a medication management intervention among adults with physical limitations. Respondents were classified as those whose beliefs remained stable and those whose beliefs increased and decreased over 2 separate periods. Chi-square analysis examined significant differences across the groups. Multiple linear regressions examined factors that influence changes in patient beliefs. Among older adults, there were differences in perceived health status (χ(2)=26.05, P=.001), number of pharmacies used (χ(2)=17.41, P=.008), and number of medicines used after the start of Medicare Part D. There were no significant differences among adults with physical limitations. Among older adults, having an increased number of medicines over time and reporting a self-reported adverse effect to a physician were positively associated with an increase in concern beliefs in medication. Having an increase in adherence was associated with a decrease in concern beliefs over time. Concern beliefs in medications may contribute independent information about individuals' response to drug programs and policies. Outcomes of medication use may influence patient anxieties about medicines. The instability of patient concerns in medications that occurs with prescription drug coverage changes, and the emergence of adverse outcomes of medication use may provide insight into the development of individualized interventions. Copyright © 2013 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Shields, Richard K.; Pizzimenti, Marc A.; Dudley-Javoroski, Shauna; Schwinn, Debra A.
2015-01-01
The purpose of this report is to describe student satisfaction with a near-peer interprofessional education (IPE) session for physical therapy and medical students. Ten senior physical therapy students worked in peer-groups to develop a musculoskeletal anatomy demonstration for first-semester medical students. Together with their classmates, they…
ERIC Educational Resources Information Center
Rees, Charlotte E.; Wearn, Andy M.; Vnuk, Anna K.; Sato, Toshio J.
2009-01-01
Although studies have begun to shed light on medical students' attitudes towards peer physical examination (PPE), they have been conducted at single sites, and have generally not examined changes in medical students' attitudes over time. Employing both cross-sectional and longitudinal designs, the current study examines medical students' attitudes…
Using web-based video to enhance physical examination skills in medical students.
Orientale, Eugene; Kosowicz, Lynn; Alerte, Anton; Pfeiffer, Carol; Harrington, Karen; Palley, Jane; Brown, Stacey; Sapieha-Yanchak, Teresa
2008-01-01
Physical examination (PE) skills among U.S. medical students have been shown to be deficient. This study examines the effect of a Web-based physical examination curriculum on first-year medical student PE skills. Web-based video clips, consisting of instruction in 77 elements of the physical examination, were created using Microsoft Windows Moviemaker software. Medical students' PE skills were evaluated by standardized patients before and after implementation of the Internet-based video. Following implementation of this curriculum, there was a higher level of competency (from 87% in 2002-2003 to 91% in 2004-2005), and poor performances on standardized patient PE exams substantially diminished (from a 14%-22%failure rate in 2002-2003, to 4% in 2004-2005. A significant improvement in first-year medical student performance on the adult PE occurred after implementing Web-based instructional video.
Environmental health program in NASA
NASA Technical Reports Server (NTRS)
Marrazzo, R. M.
1969-01-01
The NASA policy on environmental health uses medical and environmental concepts to: (1) Determine the health status of employees; (2) prevent illness and promote good health among employees; and (3) identify and control factors that affect the health of personnel and quality of environment. Evaluation and control of physical, chemical, radiological and biological factors surrounding personnel and which represent physiological and psychological stresses and impairment are considered.
Students with Shunts: Program Considerations.
ERIC Educational Resources Information Center
French, Ron; And Others
1997-01-01
Examines how the medical condition of hydrocephalus can affect physical education students and physical education programs, and stresses the need to provide physical educators with information on students' medical conditions. Describes hydrocephalus and its treatment with ventricular peritoneal shunts, and offers suggestions on modifying…
Report on the American Association of Medical Physics Undergraduate Fellowship Programs
Avery, Stephen; Gueye, Paul; Sandison, George A.
2013-01-01
The American Association of Physicists in Medicine (AAPM) sponsors two summer undergraduate research programs to attract top performing undergraduate students into graduate studies in medical physics: the Summer Undergraduate Fellowship Program (SUFP) and the Minority Undergraduate Summer Experience (MUSE). Undergraduate research experience (URE) is an effective tool to encourage students to pursue graduate degrees. The SUFP and MUSE are the only medical physics URE programs. From 2001 to 2012, 148 fellowships have been awarded and a total of $608,000 has been dispersed to fellows. This paper reports on the history, participation, and status of the programs. A review of surveys of past fellows is presented. Overall, the fellows and mentors are very satisfied with the program. The efficacy of the programs is assessed by four metrics: entry into a medical physics graduate program, board certification, publications, and AAPM involvement. Sixty‐five percent of past fellow respondents decided to pursue a graduate degree in medical physics as a result of their participation in the program. Seventy percent of respondents are currently involved in some educational or professional aspect of medical physics. Suggestions for future enhancements to better track and maintain contact with past fellows, expand funding sources, and potentially combine the programs are presented. PACS number: 01.10.Hx PMID:23318397
Teaching medical physics to general audiences.
Amador, S
1994-01-01
By judiciously selecting topics and reading materials, one can teach a full semester course on medical physics appropriate for college students not majoring in the natural sciences. This interdisciplinary field offers an opportunity to teach a great deal of basic physics at the freshman level in the context of explaining modern medical technologies such as ultrasound imaging, laser surgery, and positron emission tomography. This article describes one such course which combines lectures, outside visitors, varied readings, and laboratories to convey a select subset of physical principles and quantitative problem-solving skills. These resources are also valuable for enriching the standard freshman physics sequence for premedical students. PMID:8075355
University education for the physically disabled
Gunn, Alexander D. G.
1977-01-01
Two per thousand of the student population are physically handicapped. The facilities for the care of physically disabled students were surveyed at the 34 universities that have full-time medical officers and primary medical teams. It was found that communication before arrival about special medical and nursing needs of the student is insufficient, that there is inadequate liaison within the universities between the admissions office and the medical unit, and a lack of published statements by the universities about the admission of the physically disabled. In contrast, the facilities available for the handicapped student are considerable, the academic success rate high, the range of serious disability being successfully coped with is extensive, and there is a need for more encouragement in the community for the physically disabled to undertake, where intellectually capable, a university education. ImagesFigure 1.Figure 2.Figure 3. PMID:140240
Gazzaniga, David; Brenton, Ashley; Meshkin, Brian
2017-02-24
Precision medicine is a promising technology in patient care that combines genetic analysis with clinical data, such as health, behavioral, functional, environment, and lifestyle information. Here we present the case of a 54-year old woman who, following an accident, had uncontrolled chronic pain and was subsequently labeled a drug seeker. A 54-year-old white woman who was experiencing severe calf pain was referred for treatment. Her pain was insufficiently controlled immediately following knee arthroplasty with multiple opioid medications, as well as non-opioids. Precision medicine testing was ordered for her so that we could assess her pain sensitivity objectively to determine if the pill seeker designation was correct and to determine the best medications for her. Based on the Proove profiles, we determined that she had moderately low pain sensitivity, which means that clinically she may underreport pain and may have decreased medication needs. This result suggested that her continued reporting of unresolved pain was probably due to a condition unresolved by her right knee arthroplasty. In addition, she was found to be at low risk of opioid addiction, based on the Proove Opioid Risk Profile. Taken together, along with the high levels of pain she described, we determined that her pain was not properly controlled and that the designation of pill seeker was incorrect. The next step was to determine which medications and which doses would result in the most favorable outcomes for our patient. To determine this, we used the results of the Proove Opioid Response, Proove Drug Metabolism, and Proove Non-Opioid Profiles to guide her treatment. We reduced her pain medications to a single opioid, Vicodin (acetaminophen and hydrocodone), which also eliminated the adverse side effects she experienced. Precision medicine offers an important health care decision tool which can reduce emotional and physical costs to patients and may reduce the economic health care burden of unnecessary surgeries and ineffective medication. The information provided by these profiles can be used clinically to guide treatment decisions and evaluate patient pain.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-06
...The Department of Energy (DOE or Department) proposes to revise the regulation governing the standards for medical, physical performance, training, and access authorizations for protective force (PF) personnel employed by contractors providing security services to the Department. The existing version of this regulation was promulgated in 1993 and substantial portions of the regulation date to the mid- 1980s. Since 1993 DOE policy has placed greater reliance upon technology, vehicular response, and increased firepower and, correspondingly, has reduced its reliance upon the ability of PF personnel to perform the running tasks required in the current regulation. Furthermore, this shift in emphasis has placed a greater premium upon the retention of mature, tactically experienced, and technically sophisticated personnel, particularly since these personnel represent a considerable investment by DOE in security background investigations and training. The proposed revisions bring DOE PF medical and physical readiness requirements in line with these tactical and organizational priorities. The proposed revisions reduce the exposure of the PF population to injuries related to physical readiness testing. They would create a PF readiness classification designed specifically to encourage the retention of experienced personnel. The revisions would further ensure that PF personnel would be evaluated on a case-by-case basis on their ability to perform the essential functions of their positions without posing a direct threat to themselves or site personnel, the facility, or the general public. The proposed revisions would further ensure that reasonable accommodations would be considered before a determination is made that an individual cannot perform the essential functions of a particular position. The proposed rule also would provide for new medical review processes for PF personnel disqualified from medical certification. The proposed rule would ensure that DOE PF medical and physical readiness requirements would be compliant with the Americans with Disabilities Act (ADA) of 1990, as amended by the Americans with Disabilities Amendment Act of 2009 (ADAAA), the Privacy Act and DOE implementing regulations, and changes in DOE policy regarding PF operations made since the publication of the last version of this rule. In addition, the proposed rule would promote operational efficiency through greater emphasis on aligning training with mission-essential tasks and the increased use of simulation technologies. Finally, the proposed revision would update the regulation to reflect organizational changes in the Office of Health, Safety and Security and the creation of the National Nuclear Security Administration (NNSA).
Haring, Catharina M; van der Meer, Jos W M; Postma, Cornelis T
2013-09-01
Performance of a focused physical examination will induce a high cognitive load for medical students in the early phase of the clinical clerkships. To come to a workable and clinically applicable standard physical examination for medical students to be used in every new patient in the daily clinical practice of internal medicine. A questionnaire held among physicians that supervise students during the clerkship of internal medicine in one Dutch training region. Of the complete list of physical examination 55 items were considered to be an integral part of the standard general physical examination for medical students. Most emphasized were elements of the physical examination aimed at general parameters, thorax and abdomen, vascular status, lymph nodes, spinal column, skin and some parts of the neurological examination. The standard physical examinations performed by supervisors themselves contain fewer items than they expected from the students. The expectations a supervisor has towards the student correlates with the frequency with which they apply the various components in their own physical examination. This study provides us with a 'core' physical examination for medical students that can be applied in the early phase of the clinical clerkships.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Montemayor, V.
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Howell, R.
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Montemayor, V.
Vic Montemayor - No one has been more passionate about improving the quality and effectiveness of the teaching of Medical Physics than Bill Hendee. It was in August of 2008 that the first AAPM Workshop on Becoming a Better Teacher of Medical Physics was held, organized and run by Bill Hendee. This was followed up in July of 2010 with a summer school on the same topic, again organized by Bill. There has been continued interest in alternate approaches to teaching medical physics since those initial gatherings. The momentum established by these workshops is made clear each year in themore » annual Innovation in Medical Physics Education session, which highlights work being done in all forms of medical physics education, from one-on-one residencies or classroom presentations to large-scale program revisions and on-line resources for international audiences. This symposium, presented on behalf of the Education Council, highlights the work of three finalists from past Innovation in Education sessions. Each will be presenting their approaches to and innovations in teaching medical physics. It is hoped that audience members interested in trying something new in their teaching of medical physics will find some of these ideas and approaches readily applicable to their own classrooms. Rebecca Howell - The presentation will discuss ways to maximize classroom learning, i.e., increasing the amount of material covered while also enhancing students’ understanding of the broader implications of the course topics. Specifically, the presentation will focus on two teaching methodologies, project based learning and flip learning. These teaching methods will be illustrated using an example of graduate medical physics course where both are used in conjunction with traditional lectures. Additionally, the presentation will focus on our experience implementing these methods including challenges that were overcome. Jay Burmeister - My presentation will discuss the incorporation of active learning techniques into a traditional medical physics classroom course. I will describe these techniques and how they were implemented as well as student performance before and after implementation. Student feedback indicated that these course changes improved their ability to actively assimilate the course content, thus improving their understanding of the material. Shahid Naqvi - My talk will focus on ways to help students visualize crucial concepts that lie at the core of radiation physics. Although particle tracks generated by Monte Carlo simulations have served as an indispensable visualization tool, students often struggle to resolve the underlying physics from a simultaneous jumble of tracks. We can clarify the physics by “coding” the tracks, e.g., by coloring the tracks according to their “starting” or “crossing” regions. The regionally-coded tracks when overlaid with dose distributions help the students see the elusive connection between dose, kerma and electronic disequilibrium. Tracks coded according to local energy or energy-loss rate can illustrate the need for stopping power corrections in electron beams and explain the Bragg peak in a proton beam. Coding tracks according to parent interaction type and order can clarify the often misunderstood distinction between primary and scatter dose. The students can thus see the “whole” simultaneously with the “sum of the parts,” which enhances their physical insight and creates a sustainable foundation for further learning. After the presentations the speakers and moderator will be open to questions and discussion with the audience members. Learning Objectives: Be able to explain Project-Based Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain Flipped Learning and how can it be incorporated into a Medical Physics classroom. Be able to explain active-learning strategies for the teaching of Medical Physics. Be able to explain how Monte Carlo simulations can be used to deepen a student’s understanding of radiation physics and dosimetry.« less
Chronic low back pain patients around the world: cross-cultural similarities and differences.
Sanders, S H; Brena, S F; Spier, C J; Beltrutti, D; McConnell, H; Quintero, O
1992-12-01
The current study sought to determine whether there were any significant cross-cultural differences in medical-physical findings, or in psychosocial, behavioral, vocational, and avocational functioning, for chronic low back pain patients. Partially double-blind controlled comparison of six different culture groups. Subjects were selected from primarily ambulatory care facilities specializing in treating chronic pain patients. PATIENTS-SUBJECTS: Subjects consisted of 63 chronic low back pain patients and 63 healthy controls. Low back pain patients were randomly selected from six different culture groups (American, Japanese, Mexican, Colombian, Italian, and New Zealander). Ten to 11 were gathered per culture from a pool of patients treated at various pain treatment programs. Likewise, 10 or 11 control group subjects were obtained from each culture from a pool of healthy support staff. The Sickness Impact Profile and the Medical Examination and Diagnostic Information Coding System were used as primary outcome measures. Findings showed that (a) low back pain subjects across all cultures had significantly more medical-physical findings and more impairment on psychosocial, behavioral, vocational, and avocational measures than controls did; (b) Mexican and New Zealander low back pain subjects had significantly fewer physical findings than other low back pain groups did; (c) the American, New Zealander, and Italian low back pain patients reported significantly more impairment in psychosocial, recreational, and/or work areas, with the Americans the most dysfunctional; and (d) findings were not a function of working class, age, sex, pain intensity, pain duration, previous surgeries, or differences in medical-physical findings. It was concluded that there were important cross-cultural differences in chronic low back pain patients' self-perceived level of dysfunction, with the American patients clearly the most dysfunctional. Possible explanations included cross-cultural differences in social expectation; attention; legal-administrative requirements; financial gains; attitudes-expectations about usage, type, and availability of health care; and self-perceived ability and willingness to cope.
Žeželj, Sandra Pavičić; Tomljanović, Ana; Jovanović, Gordana Kenđel; Krešić, Greta; Peloza, Olga Cvijanović; Dragaš-Zubalj, Nataša; Prokurica, Iva Pavlinić
2018-05-23
The aim of this study was to determine the prevalence of usage and the knowledge and attitudes towards dietary supplements among medical sciences and nonmedical sciences students from Croatia. The study was conducted based on a questionnaire about dietary supplement usage, knowledge and attitudes. The prevalence of dietary supplement use, among 910 university students was 30.5%. The most-used dietary supplements were vitamins (18.0% in medical sciences students and 9.8% in non-medical sciences students). For all students, the internet (66.1%) was the most common source of information, followed by healthcare professionals (33.2%). The most common reason for taking dietary supplements was to maintain good health (26.4%). Use of the internet rather than health professionals as a trusted information source should be revised among this young population. Supplement intake was significantly associated with body mass index (BMI) ( p = 0.016) and physical activity ( p = 0.050). Students with normal BMI (61.5%) and the most physically active students (37.7%) took significantly more dietary supplements. Results of this study could help medicine faculties to improve their curriculum and support the development of public health messages aimed at wise and safe use of dietary supplements.
Lyndon, Mataroria P; Henning, Marcus A; Alyami, Hussain; Krishna, Sanjeev; Yu, Tzu-Chieh; Hill, Andrew G
2017-01-01
The purpose of this study was to determine the impact of a revised curriculum on medical student academic motivation, burnout, and quality of life. This cross-sectional comparative study involved 2 medical school cohorts of second year and fourth year medical students at The University of Auckland: a cohort under a traditional curriculum (n = 437) and a cohort under a revised curriculum (n = 446). Participants completed self-reported questionnaires measuring academic motivation, burnout, and quality of life. Two multivariate analyses of covariance (MANCOVAs) were conducted. The response rate was 48%. No statistically significant differences were found between curriculum cohorts for mean scores of academic motivation, personal burnout, and quality of life. However, differences were found when comparing preclinical medical students and students in their clinical years of training. In comparison with Year 2 medical students, the MANCOVA for Year 4 students showed a significant main effect for the revised curriculum with respect to both physical and environmental quality of life. A revised medical curriculum had a differential effect on quality of life for Year 4 students in the latter years of medical school who are based in a clinical learning environment.
Del Guerra, Alberto; Bardies, Manuel; Belcari, Nicola; Caruana, Carmel J; Christofides, Stelios; Erba, Paola; Gori, Cesare; Lassmann, Michael; Lonsdale, Markus Nowak; Sattler, Bernhard; Waddington, Wendy
2013-03-01
To provide a guideline curriculum covering theoretical and practical aspects of education and training for Medical Physicists in Nuclear Medicine within Europe. National training programmes of Medical Physics, Radiation Physics and Nuclear Medicine physics from a range of European countries and from North America were reviewed and elements of best practice identified. An independent panel of experts was used to achieve consensus regarding the content of the curriculum. Guidelines have been developed for the specialist theoretical knowledge and practical experience required to practice as a Medical Physicist in Nuclear Medicine in Europe. It is assumed that the precondition for the beginning of the training is a good initial degree in Medical Physics at master level (or equivalent). The Learning Outcomes are categorised using the Knowledge, Skill and Competence approach along the lines recommended by the European Qualifications Framework. The minimum level expected in each topic in the theoretical knowledge and practical experience sections is intended to bring trainees up to the requirements expected of a Medical Physicist entering the field of Nuclear Medicine. This new joint EANM/EFOMP European guideline curriculum is a further step to harmonise specialist training of Medical Physicists in Nuclear Medicine within Europe. It provides a common framework for national Medical Physics societies to develop or benchmark their own curricula. The responsibility for the implementation and accreditation of these standards and guidelines resides within national training and regulatory bodies. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
42 CFR 493.1449 - Standard; Technical supervisor qualifications.
Code of Federal Regulations, 2010 CFR
2010-10-01
... earned doctoral degree in a chemical, physical, biological or clinical laboratory science from an... chemical, physical, biological or clinical laboratory science or medical technology from an accredited..., physical, or biological science or medical technology from an accredited institution; and (ii) Have at...
42 CFR 493.1449 - Standard; Technical supervisor qualifications.
Code of Federal Regulations, 2012 CFR
2012-10-01
... earned doctoral degree in a chemical, physical, biological or clinical laboratory science from an... chemical, physical, biological or clinical laboratory science or medical technology from an accredited..., physical, or biological science or medical technology from an accredited institution; and (ii) Have at...
42 CFR 493.1449 - Standard; Technical supervisor qualifications.
Code of Federal Regulations, 2014 CFR
2014-10-01
... earned doctoral degree in a chemical, physical, biological or clinical laboratory science from an... chemical, physical, biological or clinical laboratory science or medical technology from an accredited..., physical, or biological science or medical technology from an accredited institution; and (ii) Have at...
42 CFR 493.1449 - Standard; Technical supervisor qualifications.
Code of Federal Regulations, 2013 CFR
2013-10-01
... earned doctoral degree in a chemical, physical, biological or clinical laboratory science from an... chemical, physical, biological or clinical laboratory science or medical technology from an accredited..., physical, or biological science or medical technology from an accredited institution; and (ii) Have at...
Christofides, Stelios; Isidoro, Jorge; Pesznyak, Csilla; Bumbure, Lada; Cremers, Florian; Schmidt, Werner F O
2016-01-01
This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration. The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1"Recommended Guidelines on National Registration Schemes for Medical Physicists"). Copyright © 2016. Published by Elsevier Ltd.
Nindl, Bradley C; Williams, Thomas J; Deuster, Patricia A; Butler, Nikki L; Jones, Bruce H
2013-01-01
With downsizing of the military services and significant budget cuts, it will be more important than ever to optimize the health and performance of individual service members. Musculoskeletal injuries (MSIs) represent a major threat to the health and fitness of Soldiers and other service members that degrade our nation's ability to project military power. This affects both financial (such as the economic burden from medical, healthcare, and disability costs) and human manpower resources (Soldiers medically unable to optimally perform their duties and to deploy). For example, in 2012, MSIs represented the leading cause of medical care visits across the military services resulting in almost 2,200,000 medical encounters. They also result in more disability discharges than any other health condition. Nonbattle injuries (NBIs) have caused more medical evacuations (34%) from recent theaters of operation than any other cause including combat injuries. Physical training and sports are the main cause of these NBIs. The majority (56%) of these injuries are the direct result of physical training. Higher levels of physical fitness protect against such injuries; however, more physical training to improve fitness also causes higher injury rates. Thus, military physical training programs must balance the need for fitness with the risks of injuries. The Army has launched several initiatives that may potentially improve military physical readiness and reduce injuries. These include the US Army Training and Doctrine Command's Baseline Soldier Physical Readiness Requirements and Gender Neutral Physical Performance Standards studies, as well as the reimplementation of the Master Fitness Trainer program and the Army Medical Command's Soldier Medical Readiness and Performance Triad Campaigns. It is imperative for military leaders to understand that military physical readiness can be enhanced at the same time that MSIs are prevented. A strategic paradigm shift in the military's approach to physical readiness policies is needed to avoid further degradation of warfighting capability in an era of austerity. We believe this can be best accomplished through leveraging scientific, evidence-based best practices by Army senior leadership which supports, prioritizes, and implements innovative, synchronized, and integrated human performance optimization/injury prevention policy changes.
Loponen, Tiina; Lallukka, Tea; Holstila, Ansku; Lahti, Jouni
2015-10-03
Physical activity level and overweight have shown associations with mental health problems but it is not known whether the risk of mental health problems due to overweight varies by physical activity. We examined joint association of physical activity and overweight with subsequent psychotropic medication among 40-60-year-old employees. The questionnaire survey data were derived from Helsinki Health Study baseline postal questionnaires in 2000-02 among employees of the City of Helsinki aged 40-60 years (n = 8960, response rate 67%). Baseline survey data were linked with prospective register data on prescribed psychotropic medication (ATC-codes N05 and N06, except N06D) among those with written consent (74%) for such linkage. The analyses included 6169 responders (78% women, corresponding to the target population). We divided participants into six groups according to their baseline self-reported body mass index and leisure-time physical activity using physically highly active normal-weight participants as a reference group. We used Cox regression analysis adjusted for age, gender, psychotropic medication prior to baseline, and socioeconomic position, marital status, working conditions, limiting long-standing illness, alcohol use, and smoking. At baseline, 49% were overweight and 23% were physically inactive. After adjusting for age and gender, inactive normal-weight (hazard ratio (HR) 1.3, 95% CI 1.1-1.5), moderately active overweight (HR 1.3, 95% CI 1.1-1.5) and inactive overweight (HR 1.4, 95% CI 1.2-1.6) had higher risk for any psychotropic medication compared with group of highly active normal-weight. After adjusting for prior medication, only the inactive overweight group had higher risk (HR 1.4, 95% CI 1.2-1.6). Other covariates made but a minor contribution to the examined associations. For antidepressants the associations were somewhat stronger than for sedatives. Both normal-weight and physical activity help prevent psychotropic medication but physical activity dominates the association over normal-weight.
Uchida, Toshiko; Achike, Francis I; Blood, Angela D; Boyle, Mary; Farnan, Jeanne M; Gowda, Deepthiman; Hojsak, Joanne; Ovitsh, Robin K; Park, Yoon Soo; Silvestri, Ronald
2018-05-01
To examine resources used in teaching the physical exam to preclerkship students at U.S. medical schools. The Directors of Clinical Skills Courses developed a 49-question survey addressing resources and pedagogical methods employed in preclerkship physical exam curricula. The survey was sent to all 141 Liaison Committee on Medical Education-accredited medical schools in October 2015. Results were averaged across schools, and data were weighted by class size. Results from 106 medical schools (75% response rate) identified a median of 59 hours devoted to teaching the physical exam. Thirty-eight percent of time spent teaching the physical exam involved the use of standardized patients, 30% used peer-to-peer practice, and 25% involved examining actual patients. Approximately half of practice time with actual patients was observed by faculty. At 48% of schools (51), less than 15% of practice time was with actual patients, and at 20% of schools (21) faculty never observed students practicing with actual patients. Forty-eight percent of schools (51) did not provide compensation for their outpatient clinical preceptors. There is wide variation in the resources used to teach the physical examination to preclerkship medical students. At some schools, the amount of faculty observation of students examining actual patients may not be enough for students to achieve competency. A significant percentage of faculty teaching the physical exam remain uncompensated for their effort. Improving faculty compensation and increasing use of senior students as teachers might allow for greater observation and feedback and improved physical exam skills among students.
10 CFR 72.32 - Emergency Plan.
Code of Federal Regulations, 2013 CFR
2013-01-01
... emergencies. Radiological/Health Physics, Medical, and Fire drills shall be conducted annually. Semiannual... onsite exercises to test response to simulated emergencies. Radiological/Health Physics, Medical, and...
10 CFR 72.32 - Emergency Plan.
Code of Federal Regulations, 2014 CFR
2014-01-01
... emergencies. Radiological/Health Physics, Medical, and Fire drills shall be conducted annually. Semiannual... onsite exercises to test response to simulated emergencies. Radiological/Health Physics, Medical, and...
10 CFR 72.32 - Emergency Plan.
Code of Federal Regulations, 2011 CFR
2011-01-01
... emergencies. Radiological/Health Physics, Medical, and Fire drills shall be conducted annually. Semiannual... onsite exercises to test response to simulated emergencies. Radiological/Health Physics, Medical, and...
10 CFR 72.32 - Emergency Plan.
Code of Federal Regulations, 2012 CFR
2012-01-01
... emergencies. Radiological/Health Physics, Medical, and Fire drills shall be conducted annually. Semiannual... onsite exercises to test response to simulated emergencies. Radiological/Health Physics, Medical, and...
Body composition and physical fitness in a cohort of US military medical students.
Mitchell, Sarah D; Eide, Richard; Olsen, Cara H; Stephens, Mark B
2008-01-01
Medical school requires that students balance academic schedules with other lifestyle demands, including nutrition, physical fitness, and wellness. We retrospectively reviewed trends in body composition and physical fitness of a cohort of military medical students attending the Uniformed Services University. Although students were able to maintain muscular endurance and body composition, cardiorespiratory endurance, as measured by a timed 1.5-mile run, declined significantly over a 2-yr period.
Review of online educational resources for medical physicists.
Prisciandaro, Joann I
2013-11-04
Medical physicists are often involved in the didactic training of graduate students, residents (both physics and physicians), and technologists. As part of continuing medical education, we are also involved in maintenance of certification projects to assist in the education of our peers. As such, it is imperative that we remain current concerning available educational resources. Medical physics journals offer book reviews, allowing us an opportunity to learn about newly published books in the field. A similar means of communication is not currently available for online educational resources. This information is conveyed through informal means. This review presents a summary of online resources available to the medical physics community that may be useful for educational purposes.
Student-patient communication during physical examination.
Cleland, Jennifer; de la Croix, Anne; Cotton, Philip; Coull, Sharon; Skelton, John
2013-04-01
Communication during the physical examination has been understudied. Explicit, evidence-based guidance is not available as to the most effective content or process of communication while performing physical examination, or indeed how to teach this to medical students. The objective of this exploratory study was to explore how medical students communicate with patients when performing a physical examination in the absence of formal teaching on how to communicate in this situation. We recorded 15 senior UK medical students as they performed physical examinations with real patients in general practice situations. The transcriptions were analysed for linguistic functions to identify the use of different categories of utterances. Student utterances fell into four categories: minimising language; using positive evaluative language; repeating the patient; and stating intentions or explanations and requesting consent. Students would often preface an explanation or action by phrases showing 'togetherness', by using 'we' rather than 'you'. They also used linguistic 'hedges' to minimise the impact of an utterance. Senior medical students speak very little during the physical examination. When they do, they use a taxonomy of utterances that reflects those reported in doctor-patient interactions. Identifying how medical students communicate when carrying out the physical examination is the first step in planning how to best teach specific communication skills. Further work is needed to identify how best to explore communication during physical examination, and how this is taught and learned. © Blackwell Publishing Ltd 2013.
Staitieh, Bashar S; Saghafi, Ramin; Kempker, Jordan A; Schulman, David A
2016-04-01
Hypothesis-driven physical examination emphasizes the role of bedside examination in the refinement of differential diagnoses and improves diagnostic acumen. This approach has not yet been investigated as a tool to improve the ability of higher-level trainees to teach medical students. To assess the effect of teaching hypothesis-driven physical diagnosis to pulmonary fellows on their ability to improve the pulmonary examination skills of first-year medical students. Fellows and students were assessed on teaching and diagnostic skills by self-rating on a Likert scale. One group of fellows received the hypothesis-driven teaching curriculum (the "intervention" group) and another received instruction on head-to-toe examination. Both groups subsequently taught physical diagnosis to a group of first-year medical students. An oral examination was administered to all students after completion of the course. Fellows were comfortable teaching physical diagnosis to students. Students in both groups reported a lack of comfort with the pulmonary examination at the beginning of the course and improvement in their comfort by the end. Students trained by intervention group fellows outperformed students trained by control group fellows in the interpretation of physical findings (P < 0.05). Teaching hypothesis-driven physical examination to higher-level trainees who teach medical students improves the ability of students to interpret physical findings. This benefit should be confirmed using validated testing tools.
Jackson, James C.; Girard, Timothy D.; Pandharipande, Pratik P.; Schiro, Elena; Work, Brittany; Pun, Brenda T.; Boehm, Leanne; Gill, Thomas M.; Ely, E. Wesley
2012-01-01
Background In the coming years, the number of survivors of critical illness is expected to increase. These survivors frequently develop newly acquired physical and cognitive impairments. Long-term cognitive impairment is common following critical illness and has dramatic effects on patients' abilities to function autonomously. Neuromuscular weakness affects similar proportions of patients and leads to equally profound life alterations. As knowledge of these short-term and long-term consequences of critical illness has come to light, interventions to prevent and rehabilitate these devastating consequences have been sought. Physical rehabilitation has been shown to improve functional outcomes in people who are critically ill, but subsequent studies of physical rehabilitation after hospital discharge have not. Post-hospital discharge cognitive rehabilitation is feasible in survivors of critical illness and is commonly used in people with other forms of acquired brain injury. The feasibility of early cognitive therapy in people who are critically ill remains unknown. Objective The purpose of this novel protocol trial will be to determine the feasibility of early and sustained cognitive rehabilitation paired with physical rehabilitation in patients who are critically ill from medical and surgical intensive care units. Design This is a randomized controlled trial. Setting The setting for this trial will be medical and surgical intensive care units of a large tertiary care referral center. Patients The participants will be patients who are critically ill with respiratory failure or shock. Intervention Patients will be randomized to groups receiving usual care, physical rehabilitation, or cognitive rehabilitation plus physical rehabilitation. Twice-daily cognitive rehabilitation sessions will be performed with patients who are noncomatose and will consist of orientation, memory, and attention exercises (eg, forward and reverse digit spans, matrix puzzles, letter-number sequences, pattern recognition). Daily physical rehabilitation sessions will advance patients from passive range of motion exercises through ambulation. Patients with cognitive or physical impairment at discharge will undergo a 12-week, in-home cognitive rehabilitation program. Measurements A battery of neurocognitive and functional outcomes will be measured 3 and 12 months after hospital discharge. Conclusions If feasible, these interventions will lay the groundwork for a larger, multicenter trial to determine their efficacy. PMID:22577067
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mahesh, M; Borras, C; Frey, G
This workshop is jointly organized by the AAPM, the Spanish (SEFM) and the Russian (AMPR) Medical Physics Societies, as part of formal educational exchange agreements signed by the AAPM with each one of these two societies.With the rapid technological advances in radiation therapy both for treatment and imaging, it is challenging how physics is taught to medical physicists practicing in radiation therapy. The main Objectives: of this workshop is to bring forth current status, challenges and issues related to education of radiation therapy physicists here in the US, Spain and Russia. Medical physicists from each one of these countries willmore » present educational requirements of international recommendations and directives and analyze their impact on national legislations. Current and future educational models and plans for harmonization will be described. The role of universities, professional societies and examination boards, such as the American Board of Radiology, will be discussed. Minimum standards will be agreed upon. Learning Objectives: Review medical physics educational models supported by AAPM, SEFM, and AMPR. Discuss the role of governmental and non-governmental organizations in elaborating and adopting medical physics syllabi. Debate minimum educational standards for medical physics education based on country-specific resources.« less
A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.
Schein, Oliver D; Pronovost, Peter J
2017-07-01
Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.
Lack of access to medical care during Hurricane Sandy and mental health symptoms.
Ruskin, Julia; Rasul, Rehana; Schneider, Samantha; Bevilacqua, Kristin; Taioli, Emanuela; Schwartz, Rebecca M
2018-06-01
Destruction caused by natural disasters compromises medical providers' and hospitals' abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013-2/25/2015) and Project Restoration (6/5/2014-8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77-4.16]), as well as depression (AOR = 1.94, CI = [1.29-2.92]) and anxiety (AOR = 1.61, CI = [1.08-2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health.
Behbod, Behrooz; Parker, Erin M; Jones, Erin A; Bayleyegn, Tesfaye; Guarisco, John; Morrison, Melissa; McIntyre, Mary G; Knight, Monica; Eichold, Bert; Yip, Fuyuen
2014-01-01
In 2008, a lightning strike caused a leak of tert-butyl mercaptan from its storage tank at the Gulf South Natural Gas Pumping Station in Prichard, Alabama. On July 27, 2012, the Alabama Department of Public Health requested Centers for Disease Control and Prevention epidemiologic assistance investigating possible health effects resulting from airborne exposure to mercaptan from a contaminated groundwater spring, identified in January 2012. To assess the self-reported health effects in the community, to determine the scope of the reported medical services received, and to develop recommendations for prevention and response to future incidents. In September 2012, we performed a representative random sampling design survey of households, comparing reported exposures and health effects among residents living in 2 circular zones located within 1 and 2 miles from the contaminated source. Eight Mile community, Prichard, Alabama. We selected 204 adult residents of each household (≥ 18 years) to speak for all household members. Self-reported mercaptan odor exposure, physical and mental health outcomes, and medical-seeking practices, comparing residents in the 1- and 2-mile zones. In the past 6 months, 97.9% of respondents in the 1-mile zone and 77.6% in the 2-mile zone reported mercaptan odors. Odor severity was greater in the 1-mile zone, in which significantly more subjects reported exposures aggravating their physical and mental health including shortness of breath, eye irritations, and agitated behavior. Overall, 36.5% sought medical care for odor-related symptoms. Long-term odorous mercaptan exposures were reportedly associated with physical and psychological health complaints. Communication messages should include strategies to minimize exposures and advise those with cardiorespiratory conditions to have medications readily available. Health care practitioners should be provided information on mercaptan health effects and approaches to prevent exacerbating existing chronic diseases.
Mai, Trinh; Woo, Michael Y; Boles, Kim; Jetty, Prasad
2018-05-16
To determine the test characteristics of point-of-care ultrasonography performed by a medical student versus physical examination by vascular surgeons compared to a gold standard reference scan for the detection of abdominal aortic aneurysms. We conducted a prospective, observer-blinded study recruiting patients from an outpatient vascular surgery clinic. Participants were screened for abdominal aortic aneurysms by standardized physical examination by a blinded vascular surgeon, followed by a point-of-care ultrasound examination by a blinded medical student. The student underwent prior training by a vascular sonographer and emergency physician on 60 patients (16 were supervised). Ultrasonography was used to visualize and measure the proximal, mid, and distal aortic diameters. The maximal aortic diameter was noted and compared to measurements obtained by the reference scan (CT scan or vascular sonographer-performed ultrasound). Reference scans were completed within 3 months of the recruitment visit. A total of 57 patients were enrolled over a 5-month period between October 2015 and March 2016. Mean age of recruited patients was 71 years and 61% were male. Mean body mass index was 27.9 ± 4.3 and mean waist-hip ratio was 0.96 ± 0.10. Sixteen abdominal aortic aneurysms were detected by the reference scan, with an average maximal aortic diameter of 44.9 mm. Physical examination by a vascular surgeon detected 11 of 16 abdominal aortic aneurysms with 2 false positives (sensitivity and specificity of 66.7% (95% CI 38.4-88.2) and 94.4% (95% CI 81.3-99.3), respectively). Point-of-care ultrasound detected 15 of 16 abdominal aortic aneurysms (sensitivity and specificity of 93.3% (95% CI 68.1-99.8) and 100% (95% CI 88.4-100), respectively). Seven of the 64 point-of-care ultrasound scans were indeterminate (>1 cm of the aorta was not visualized). Average time to conduct the physical examination was 35 seconds vs. 4.0 minutes for point-of-care ultrasonography. There was a strong linear correlation (R2=0.95) between maximal aortic diameter measured by point-of-care ultrasonography vs referencescan with a mean absolute difference of 2.6 mm. Point-of-care ultrasonography performed by a medical student is highly accurate and more effective in detecting abdominal aortic aneurysms when compared to physical examination by vascular surgeons. The introduction of point-of-care ultrasound training at the medical student level, and its wide-scale implementation as an extension to physical examination, may lead to improved detection of abdominal aortic aneurysms. Copyright © 2018. Published by Elsevier Inc.
Barakat-Haddad, Caroline; Siddiqua, Ayesha
2018-01-02
The patterns of over-the-counter medication (OTC) usage among adolescents living in the United Arab Emirates (UAE) remains largely understudied. The objectives of this study are: (1) to determine the profile of OTC use among UAE adolescents; and (2) to determine the biological or physical, psychological or behavioural, and social predictors of OTC use among the UAE adolescent population. Using a cross-sectional study design, data were collected on the prevalence of OTC use for a sample of 6363 adolescents. Overall, 51% of participants in this study reported OTC use. The most common form of OTC used was acetaminophen. Significant predictors of OTC use were: nationality (UAE, GCC, Arab / Middle East, Arab / Africa, Western, other); needed health care but did not receive it; sex (female); age (15-18 years); any medical diagnosis; unconventional drug use; spending more than 5 hours using TV and computer daily; and using prescription medicines. Thus, there is a need to develop public health policies and strategies that promote appropriate use of OTC in the population.
Determinism and mass-media portrayals of genetics.
Condit, C M; Ofulue, N; Sheedy, K M
1998-01-01
Scholars have expressed concern that the introduction of substantial coverage of "medical genetics" in the mass media during the past 2 decades represents an increase in biological determinism in public discourse. To test this contention, we analyzed the contents of a randomly selected, structured sample of American public newspapers (n=250) and magazines (n=722) published during 1919-95. Three coders, using three measures, all with intercoder reliability >85%, were employed. Results indicate that the introduction of the discourse of medical genetics is correlated with both a statistically significant decrease in the degree to which articles attribute human characteristics to genetic causes (P<.001) and a statistically significant increase in the differentiation of attributions to genetic and other causes among various conditions or outcomes (P<. 016). There has been no statistically significant change in the relative proportions of physical phenomena attributed to genetic causes, but there has been a statistically significant decrease in the number of articles assigning genetic causes to mental (P<.002) and behavioral (P<.000) characteristics. These results suggest that the current discourse of medical genetics is not accurately described as more biologically deterministic than its antecedents. PMID:9529342
Workshop summary. Biomedical and Space-Related Research with Heavy Ions at the BEVALAC
NASA Technical Reports Server (NTRS)
Schimmerling, W.; Curtis, S. B.
1989-01-01
The authors provide an overview of papers presented at a workshop on Biomedical and Space-Related Research with Heavy Ions at the BEVALAC at Lawrence Berkeley Laboratory. Goals of the meeting were to determine the critical experiments using heavy ions as probes in radiation physics, radiation chemistry, macromolecular and cellular biology, evolution science, basic neurophysiology, and medical therapies; how beam lines and facilities at Lawrence Berkeley Laboratory can be improved for these experiments; and implications in priorities and funding for national policy. Workshop topics included physics and facilities, cellular and molecular biology, tissue radiobiology, and the future of heavy ion research.
Clough, S; Shehabi, Z; Morgan, C
2016-02-12
Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.
WE-AB-213-01: AAPM Projects and Collaborations in Africa
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shulman, A.
AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such asmore » Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
WE-AB-213-03: Challenges and Opportunities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Borras, C.
AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such asmore » Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pipman, Y.
AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such asmore » Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
Medical cyber-physical systems: A survey.
Dey, Nilanjan; Ashour, Amira S; Shi, Fuqian; Fong, Simon James; Tavares, João Manuel R S
2018-03-10
Medical cyber-physical systems (MCPS) are healthcare critical integration of a network of medical devices. These systems are progressively used in hospitals to achieve a continuous high-quality healthcare. The MCPS design faces numerous challenges, including inoperability, security/privacy, and high assurance in the system software. In the current work, the infrastructure of the cyber-physical systems (CPS) are reviewed and discussed. This article enriched the researches of the networked Medical Device (MD) systems to increase the efficiency and safety of the healthcare. It also can assist the specialists of medical device to overcome crucial issues related to medical devices, and the challenges facing the design of the medical device's network. The concept of the social networking and its security along with the concept of the wireless sensor networks (WSNs) are addressed. Afterward, the CPS systems and platforms have been established, where more focus was directed toward CPS-based healthcare. The big data framework of CPSs is also included.
TU-C-18C-01: Medical Physics 1.0 to 2.0: Introduction and Panel Discussion
DOE Office of Scientific and Technical Information (OSTI.GOV)
Samei, E; Pfeiffer, D; Frey, G
2014-06-15
Medical Physics 2.0, a new frontier in clinical imaging physics: Diagnostic imaging has always been a technological highlight of modern medicine. Imaging systems, with their ever-expanding advancement in terms of technology and application, increasingly require skilled expertise to understand the delicacy of their operation, monitor their performance, design their effective use, and ensure their overall quality and safety, scientifically and in quantitative terms. Physicists can play a crucial role in that process. But that role has largely remained a severely untapped resource. Many imaging centers fail to appreciate this potential, with medical physics groups either nonexistent or highly understaffed andmore » their services poorly integrated into the patient care process. As a field, we have yet to define and enact how the clinical physicist can engage as an active, effective, and integral member of the clinical team, and how the services that she/he provides can be financially accounted for. Physicists do and will always contribute to research and development. However, their indispensible contribution to clinical imaging operations is something that has not been adequately established. That, in conjunction with new realities of healthcare practice, indicates a growing need to establish an updated approach to clinical medical imaging physics. This presentation aims to describe a vision as how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement addressing topics such as new non-classical challenges of new technologies, quantitative imaging, and operational optimization. The Medical Physics 2.0 paradigm extends clinical medical physics from isolated characterization of inherent properties of the equipment to effective use of the equipment and to retrospective evaluation of clinical performance. This is an existential transition of the field that speaks to the new paradigms of value-based and evidence-based medicine, comparative effectiveness, and meaningful use. The panel discussion that follows includes prominent practitioners, thinkers, and leaders that would lead the discussion on how Medical Physics 2.0 can be actualized. Topics of discussion will include the administrative, financial, regulatory, and accreditation requirements of the new paradigm, effective models of practice, and the steps that we need to take to make MP 2.0 a reality. Learning Objectives: To understand the new paradigm of clinical medical physics practice extending from traditional insular models of compliance towards teambased models of operational engagement. To understand how clinical physics can most effectively contribute to clinical care. Learn to identify strengths and weaknesses in studies designed to measure the effect of low doses of ionizing radiation To recognize the impediments to Medical Physics 2.0 paradigm.« less
WE-AB-213-02: Status of Medical Physics Collaborations, and Projects in Latin America
DOE Office of Scientific and Technical Information (OSTI.GOV)
Guzman, S.
AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such asmore » Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Meghzifene, A.
AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such asmore » Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.« less
Rothenbacher, Dietrich; Jaensch, Andrea; Mons, Ute; Hahmann, Harry; Becker, Thomas; Koenig, Wolfgang; Brenner, Hermann
2015-09-01
Symptoms of depression and anxiety contribute to determining prognosis of patients with coronary heart disease. We evaluated the association of the one-year course of symptoms of anxiety and depressive symptoms with fatal and non-fatal cardiovascular disease-events during 10-year follow-up and assessed the utilization of anti-depressant and psycholeptic medication. Prospective cohort study in coronary heart disease patients aged 30-70 years with stable coronary heart disease. Symptoms of anxiety and depression were evaluated at baseline and follow-up using the Hospital Anxiety and Depression Scale. Associations with fatal and non-fatal cardiovascular disease events were determined by a Cox-proportional hazards model. Nine hundred and ninety-six patients were included in this study. Of the 862 patients with a normal depression symptom score at baseline 10.3% had an increased score at one-year follow-up. Of those with an elevated symptom score at baseline, 62.7% still had an elevated score after one year. During follow-up (median 8.9 years) fatal and non-fatal cardiovascular disease events were observed in 152 patients. One year course of depressive symptoms was associated with cardiovascular disease events during follow-up (p-value for trend 0.029); for example, patients with an increase of depressive symptoms had a hazard ratio of 1.93 (95% confidence interval 1.08-3.34) compared with patients with a normal score at baseline as well as at one-year follow-up. However, if physical activity was considered as a covariate, the HRs attenuated and the association was no longer statistically significant. The utilization of anti-depressant medication in the overall population was low (overall 2%). The study supports a role of the one year course of symptoms of depression for long-term prognosis of patients with known coronary heart disease, which might be partly mediated by lack of physical activity. © The European Society of Cardiology 2014.
Developing and Assessing Curriculum on the Physics of Medical Instruments
ERIC Educational Resources Information Center
Christensen, Warren; Johnson, James K.; Van Ness, Grace R.; Mylott, Elliot; Dunlap, Justin C.; Anderson, Elizabeth A.; Widenhorn, Ralf
2013-01-01
Undergraduate educational settings often struggle to provide students with authentic biologically or medically relevant situations and problems that simultaneously improve their understanding of physics. Through exercises and laboratory activities developed in an elective Physics in Biomedicine course for upper-level biology or pre-health majors…
42 CFR 34.4 - Medical notifications.
Code of Federal Regulations, 2010 CFR
2010-10-01
... which the alien is incapable of normal physical activity; and the extent to which the condition is... physical activity, and the extent to which the condition is remediable. The medical examiner shall indicate... have: (i) A communicable disease of public health significance; (ii)(A) A physical or mental disorder...
Multiscale solvers and systematic upscaling in computational physics
NASA Astrophysics Data System (ADS)
Brandt, A.
2005-07-01
Multiscale algorithms can overcome the scale-born bottlenecks that plague most computations in physics. These algorithms employ separate processing at each scale of the physical space, combined with interscale iterative interactions, in ways which use finer scales very sparingly. Having been developed first and well known as multigrid solvers for partial differential equations, highly efficient multiscale techniques have more recently been developed for many other types of computational tasks, including: inverse PDE problems; highly indefinite (e.g., standing wave) equations; Dirac equations in disordered gauge fields; fast computation and updating of large determinants (as needed in QCD); fast integral transforms; integral equations; astrophysics; molecular dynamics of macromolecules and fluids; many-atom electronic structures; global and discrete-state optimization; practical graph problems; image segmentation and recognition; tomography (medical imaging); fast Monte-Carlo sampling in statistical physics; and general, systematic methods of upscaling (accurate numerical derivation of large-scale equations from microscopic laws).
Roohpour, Nima; Wasikiewicz, Jaroslaw M.; Moshaverinia, Alireza; Paul, Deepen; Rehman, Ihtesham U.; Vadgama, Pankaj
2009-01-01
Polyurethane films have potential applications in medicine, especially for packaging implantable medical devices. Although polyether-urethanes have superior mechanical properties and are biocompatible, achieving water resistance is still a challenge. Polyether based polyurethanes with two different molecular weights (PTMO1000, PTMO2000) were prepared from 4,4’-diphenylmethane diisocyanate and poly(tetra-methylene oxide). Polymer films were introduced using different concentrations (0.5-10 wt %) of isopropyl myristate lipid (IPM) as a non-toxic modifying agent. The physical and mechanical properties of these polymers were characterised using physical and spectroscopy techniques (FTIR, Raman, DSC, DMA, tensile testing). Water contact angle and water uptake of the membranes as a function of IPM concentration was also determined accordingly. The FTIR and Raman data indicate that IPM is dispersed in polyurethane at ≤ 2wt% and thermal analysis confirmed this miscibility to be dependent on soft segment length. Modified polymers showed increased tensile strength and failure strain as well as reduced water uptake by up to 24% at 1-2 wt% IPM.
Hallbeck, M Susan; Koneczny, Sonja; Smith, Justine
2009-01-01
Controls for most technologies, including medical devices, are becoming increasingly complex, difficult to intuitively understand and don't necessarily follow population stereotypes. The resulting delays and errors are unacceptable when seconds can mean the difference between life and death. In this study participants were asked to "control" a system using a paper prototype (color photographs of controls) and then with a higher fidelity prototype of the same physical controls to determine performance differences among ethnicities and genders. No ethnic nor gender differences were found, and the comparison of paper versus higher fidelity prototypes also showed no significant differences. Thus, paper prototypes can be employed as an early device design usability tool to illustrate stereotype violations long before the first physical prototype. This will not only save money in the development and design processes, but also makes sure that even the most complex devices are intuitively understandable and operable for their basic functions.
GPU computing in medical physics: a review.
Pratx, Guillem; Xing, Lei
2011-05-01
The graphics processing unit (GPU) has emerged as a competitive platform for computing massively parallel problems. Many computing applications in medical physics can be formulated as data-parallel tasks that exploit the capabilities of the GPU for reducing processing times. The authors review the basic principles of GPU computing as well as the main performance optimization techniques, and survey existing applications in three areas of medical physics, namely image reconstruction, dose calculation and treatment plan optimization, and image processing.
2014-10-01
work under the guidance of an outstanding mentor team at Emory Winship Cancer Institute. I took three courses ( Medical Health Physics, Radiation...and Late Normal-Tissue Toxicity in Breast- Cancer Radiotherapy”, Medical Physics, 40(6):379, 2013. 5. Yang X, Liu T, Curran W and Torres M...Analysis for Normal-tissue Toxicity: A Prospective Ultrasound Study of Acute Toxicity in Breast- Cancer Radiotherapy", Medical Physics 41 (6), 482-482
Paunovich, E
1994-01-01
This pilot study was designed to assess the oral health status of homebound elderly and determine their dental care needs. Fifty-one subjects enrolled in a hospital-based home care program were recruited for this study. Subjects were visited in their homes by both a dentist and a physician. Care plans and medications were reviewed for each subject. Initial assessments to receive informed written consent were conducted by the physician. Oral health assessments by the dentist included comprehensive examinations for soft tissue pathology, periodontal health, caries, restoration, and tooth condition, as well as existing prosthesis assessment, plaque index, and grip strength. A Physical Self-Maintenance Scale was administered in order to determine the level of dependence of this population for their oral hygiene self-care. The oral health status of these homebound elderly was found to be poor, with 84% of the subjects requiring dental care.
Salute to the sun: a new dawn in yoga therapy for breast cancer.
Galliford, Melissa; Robinson, Stephanie; Bridge, Pete; Carmichael, MaryAnn
2017-09-01
Interest in the application of yoga for health benefits in western medicine is growing rapidly, with a significant rise in publications. The purpose of this systematic review is to determine whether the inclusion of yoga therapy to the treatment of breast cancer can improve the patient's physical and psychosocial quality of life (QoL). A search of peer reviewed journal articles published between January 2009 and July 2014 was conducted. Studies were included if they had more than 15 study participants, included interventions such as mindfulness-based stress reduction (MBSR) or yoga therapy with or without comparison groups and had stated physical or psychological outcomes. Screening identified 38 appropriate articles. The most reported psychosocial benefits of yoga therapy were anxiety, emotional and social functioning, stress, depression and global QoL. The most reported physical benefits of yoga therapy were improved salivary cortisol readings, sleep quality and lymphocyte apoptosis. Benefits in these areas were linked strongly with the yoga interventions, in addition to significant improvement in overall QoL. The evidence supports the use of yoga therapy to improve the physical and psychosocial QoL for breast cancer patients with a range of benefits relevant to radiation therapy. Future studies are recommended to confirm these benefits. Evidence-based recommendations for implementation of a yoga therapy programme have been derived and included within this review. Long-term follow-up is necessary with these programmes to assess the efficacy of the yoga intervention in terms of sustainability and patient outcomes. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.
Magnetic resonance of porous media (MRPM): a perspective.
Song, Yi-Qiao
2013-04-01
Porous media are ubiquitous in our environment and their application is extremely broad. The common connection between these diverse materials is the importance of the microstructure (μm to mm scale) in determining the physical, chemical and biological functions and properties. Magnetic resonance and its imaging modality have been essential for noninvasive characterization of these materials, in the development of catalysts, understanding cement hydration, fluid transport in rocks and soil, geological prospecting, and characterization of tissue properties for medical diagnosis. The past two decades have witnessed significant development of MRPM that couples advances in physics, chemistry and engineering with a broad range of applications. This article will summarize key advances in basic physics and methodology, examine their limitations and envision future R&D directions. Copyright © 2012 Elsevier Inc. All rights reserved.
The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture.
Sinaki, Mehrsheed
2007-08-01
Locomotion has always been a major criterion for human survival. Thus, it is no surprise that science supports the dependence of bone health on weight-bearing physical activities. The effect of physical activity on bone is site-specific. Determining how to perform osteogenic exercises, especially in individuals who have osteopenia or osteoporosis, without exceeding the biomechanical competence of bone always poses a dilemma and must occur under medical advice. This article presents the hypothesis that back exercises performed in a prone position, rather than a vertical position, may have a greater effect on decreasing the risk for vertebral fractures without resulting in compression fracture. The risk for vertebral fractures can be reduced through improvement in the horizontal trabecular connection of vertebral bodies.
Physical working principles of medical radar.
Aardal, Øyvind; Paichard, Yoann; Brovoll, Sverre; Berger, Tor; Lande, Tor Sverre; Hamran, Svein-Erik
2013-04-01
There has been research interest in using radar for contactless measurements of the human heartbeat for several years. While many systems have been demonstrated, not much attention have been given to the actual physical causes of why this work. The consensus seems to be that the radar senses small body movements correlated with heartbeats, but whether only the movements of the body surface or reflections from internal organs are also monitored have not been answered definitely. There has recently been proposed another theory that blood perfusion in the skin could be the main reason radars are able to detect heartbeats. In this paper, an experimental approach is given to determine the physical causes. The measurement results show that it is the body surface reflections that dominate radar measurements of human heartbeats.
Adding New Tools to the Black Bag—Introduction of Ultrasound into the Physical Diagnosis Course
Amponsah, David; Yang, James; Mendez, Jennifer; Bridge, Patrick; Hays, Gregory; Baliga, Sudhir; Crist, Karen; Brennan, Simone; Jackson, Matt; Dulchavsky, Scott
2010-01-01
INTRODUCTION Ultrasound, a versatile diagnostic modality that permits real-time visualization at the patient’s bedside, can be used as an adjunct in teaching physical diagnosis (PD). Aims: (1) to study the feasibility of incorporating ultrasound into PD courses and (2) determine whether learners can demonstrate image recognition and acquisition skills. PROGRAM DESCRIPTION Three hundred seven second-year medical students were introduced to cardiovascular and abdominal ultrasound scanning after training in the physical examination. This consisted of a demonstration of the ultrasound examination, followed by practice on standardized patients (SPs). Pre-post tests were administered to evaluate students’ knowledge and understanding of ultrasound. Students performed an ultrasound examination during the PD final examination. PROGRAM EVALUATION Pre-post test data revealed significant improvements in image recognition. On the final exam, the highest scores (98.4%) were obtained for the internal jugular vein and lowest scores (74.6%) on the Focused Assessment with Sonography for Trauma images. Eighty-nine percent of students’ surveyed felt ultrasound was a valuable tool for physicians. DISCUSSION An introductory ultrasound course is effective in improving medical students' acquisition and recognition of basic cardiovascular and abdominal ultrasound images. This innovative program demonstrates the feasibility of incorporating portable ultrasound as a learning tool during medical school. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1451-5) contains supplementary material, which is available to authorized users. PMID:20697974
Taylor, Silas; Shulruf, Boaz
2016-01-01
Peer physical examination (PPE), by which junior medical students learn physical examination skills before practicing on patients, is a widely implemented and accepted part of medical curricula. However, the ethical implications of PPE have been debated, since issues including student gender impact on its acceptability. Research has previously demonstrated the phenomenon of 'attitude-behavior inconsistency' showing that students' predictions about their participation in PPE differ from what they actually do in practice. This study asks whether gender and student self-ratings of outlook affect engagement in PPE. This study gathered data from students who had completed PPE with the objective of determining what factors have the greatest impact on the actual practice of PPE by students. Data were used to derive the number of opportunities students had to examine a peer, for various body parts. Respondent gender and self-ratings of outlook were recorded. Responses from 130 students were analysed: 74 female (57%) and 56 male (43%). Students have fewer opportunities to examine peers of the opposite gender; this is statistically significant for all body parts when male students examine female peers. Gender is the factor of overriding importance on whether these peer interactions actually occur, such that students have fewer opportunities to examine peers of the opposite gender, particularly male students examining female peers. Student outlook has little impact. We speculate that the more acceptable PPE is to participants, paradoxically, the more complicated these interactions become, possibly with implications for future practice.
Martin, Kathryn Remmes; Shreffler, Jack; Schoster, Britta; Callahan, Leigh F
2012-10-01
Prescription medication costs increase financial burden, often leading individuals to engage in intentional nonadherence. Little is known about what specific medication cost-coping strategies individuals with arthritis employ. The purposes of this study are (1) to identify characteristics of individuals with arthritis who self-report prescription medication cost-coping strategies and (2) to examine the association between medication cost-coping strategies and health status. Seven hundred twenty-nine people self-reporting arthritis and prescription medication use completed a telephone survey. Adjusted regression models examined medication cost-coping strategies and five health status outcomes. Participants reported engaging in cost-coping strategies due to medication costs. Those borrowing money had worse psychosocial health and greater disability; those with increasing credit card debt reported worse physical functioning, self-rated health, and greater helplessness. Medication underuse was associated with worse psychosocial health, greater disability, and depressive symptoms. Individuals with arthritis use multiple strategies to cope with medication costs, and these strategies are associated with adverse physical and psychosocial health status.
Depression in patients with chronic kidney disease on dialysis in Saudi Arabia.
Al Zaben, Faten; Khalifa, Doaa Ahmed; Sehlo, Mohammad Gamal; Al Shohaib, Saad; Shaheen, Faisul; Alhozali, Hanadi; Hariri, Alferdose Osama; Ahmad, Riyadh Ghazi; Kabli, Moayad Reda; Koenig, Harold G
2014-12-01
Patients with chronic kidney disease on hemodialysis experience considerable psychological stress due to physical and social changes brought on by illness, increasing the risk of depressive disorder (DD). We examined the prevalence of DD and depressive symptoms, identified treatments for depression, and determined baseline demographic, social/behavioral, physical, and psychological correlates. A convenience sample of 310 dialysis patients in Jeddah, Saudi Arabia, was screened for DD using the Structured Clinical Interview for Depression and for depressive symptoms using the Hamilton Depression Rating Scale (HDRS). Established measures of psychosocial and physical health characteristics were administered, along with questions about current and past treatments. Bivariate and multivariate analyses identified independent correlates of DD and symptoms. The prevalence of DD was 6.8 % (major depression 3.2 %, minor depression 3.6 %), and significant depressive symptoms were present in 24.2 % (HDRS 8 or higher). No patients with DD were being treated with antidepressant medication, whereas 28.6 % (6 of 21) were receiving counseling. Being a Saudi national, married, in counseling, or having a history of antidepressant were associated with DD in bivariate analyses. Correlates of depressive symptoms HDRS in multivariate analyses were Saudi nationality, marital status, stressful life events, poor physical functioning, cognitive impairment, overall severity of medical illness, and history of family psychiatric problems. The prevalence of DD and depressive symptoms is lower in Saudi dialysis patients than in the rest of the world, largely untreated, and is associated with a distinct set of demographic, psychosocial, and physical health characteristics.
Crespo-Salgado, Juan José; Delgado-Martín, José Luis; Blanco-Iglesias, Orlando; Aldecoa-Landesa, Susana
2015-03-01
The detection of physical inactivity in adults, using simple and useful tools is primary objective in both public health and in clinical settings, since this risk factor is one of the major causes of non-communicable disease in the world, and is very prevalent in developed societies such as in Spain. Two validated instruments are described that are simple and useful for detecting and/or monitoring physical inactivity in adults: (i)the international physical activity questionnaire in its short version, and (ii)the pedometer to measure the number of steps taken in a day. Increased levels of physical activity are important for the primary prevention of some chronic diseases (coronary heart disease, type2 diabetes, osteoporosis, colon cancer) and to improve the quality of life. Medical personnel must determine the motivation level and the availability of patients and their families to change their behavior towards physical activity. Moderate-intensity physical activities have hardly any contraindications and the risks are few. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.
Stability of physical assessment of older drivers over 1 year.
Smith, Andrew; Marshall, Shawn; Porter, Michelle; Ha, Linda; Bédard, Michel; Gélinas, Isabelle; Man-Son-Hing, Malcolm; Mazer, Barbara; Rapoport, Mark; Tuokko, Holly; Vrkljan, Brenda
2013-12-01
Older adults represent the fastest-growing population of drivers with a valid driver's licence. Also common in this age group are multiple chronic medical conditions that may have an effect on physical function and driving ability. Determining the reliability of physical measures used to assess older drivers' functional ability is important to identifying those who are safe to continue driving. Most previous reliability studies of clinical physical measures of health used test-retest intervals shorter than those between patient visits with a clinician. In the present study we examined a more clinically representative interval of 1 year to determine the stability of commonly used physical measures collected during the Candrive II prospective cohort study of older drivers. Reliability statistics indicate that the sequential finger-thumb opposition, rapid pace walk and the Pelli-Robson contrast sensitivity tests have adequate stability over 1 year. Poor stability was observed for the one-legged stance and Snellen visual acuity test. Several assessments with nominal data (Marottoli method [functional neck range of motion], whispered voice test, range of motion and strength testing) lacked sufficient variability to conduct reliability analyses; however, a lack of variability between test days suggests consistency over a 1-year time frame. Our results provide evidence that specific physical measures are stable in monitoring functional ability over the course of a year. Copyright © 2013 Elsevier Ltd. All rights reserved.
... includes physical therapy and if needed, pain medication. Orthopedic surgery may be needed to correct severe foot ... includes physical therapy and if needed, pain medication. Orthopedic surgery may be needed to correct severe foot ...
21 CFR 890.1850 - Diagnostic muscle stimulator.
Code of Federal Regulations, 2010 CFR
2010-04-01
...) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic... electromyograph machine to initiate muscle activity. It is intended for medical purposes, such as to diagnose...
Pan, Xiaochuan; Siewerdsen, Jeffrey; La Riviere, Patrick J; Kalender, Willi A
2008-08-01
The AAPM, through its members, meetings, and its flagship journal Medical Physics, has played an important role in the development and growth of x-ray tomography in the last 50 years. From a spate of early articles in the 1970s characterizing the first commercial computed tomography (CT) scanners through the "slice wars" of the 1990s and 2000s, the history of CT and related techniques such as tomosynthesis can readily be traced through the pages of Medical Physics and the annals of the AAPM and RSNA/AAPM Annual Meetings. In this article, the authors intend to give a brief review of the role of Medical Physics and the AAPM in CT and tomosynthesis imaging over the last few decades.
Review of online educational resources for medical physicists
2013-01-01
Medical physicists are often involved in the didactic training of graduate students, residents (both physics and physicians), and technologists. As part of continuing medical education, we are also involved in maintenance of certification projects to assist in the education of our peers. As such, it is imperative that we remain current concerning available educational resources. Medical physics journals offer book reviews, allowing us an opportunity to learn about newly published books in the field. A similar means of communication is not currently available for online educational resources. This information is conveyed through informal means. This review presents a summary of online resources available to the medical physics community that may be useful for educational purposes. PACS number: 87.10.‐e PMID:24257289
Ethical analysis of non-medical fetal ultrasound.
Leung, John Lai Yin; Pang, Samantha Mei Che
2009-09-01
Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed.
[Driver's licence: responsibility, ethics and deontology].
Lucas, P
1999-09-01
The new law enacted on march 23rd 1998 regarding driving-licence, which became effective on october 1st 1998, modifies the method for obtaining the different types of driving-licences. Its 6th annex enumerates a list of physical impairments and pathologies implying the denial, the limitation or the withdrawal of the driving-licence; it determines if a medical advice, and if the case which kind of medical advice, is required. This leads to new situations, for which no jurisprudence has been established to date, where not only the responsibility of the licence's applicant but also that of the examining physician could be suspected. The physicians are also confronted to ethical an deontological problems on which the medical authorities have not always given an opinion. This paper examines them in order to give some bases for reflexion and discussion.
Fetal evaluation for transport by ultrasound performed by air medical teams: A case series.
Polk, James D; Merlino, James I; Kovach, Betty L; Mancuso, Charlene; Fallon, William F
2004-01-01
The air medical team has limited options when evaluating the obstetrical patient and assessing fetal health during air transport to a high-risk obstetrical unit. Traditionally, physical examination and a Doppler stethoscope have been used to determine fetal heart rates and movement. However, with the advent of portable ultrasound technology, new information about the mother and child are available to the air medical crew. The Fetal Evaluation for Transport with Ultrasound (FETUS) is a screening examination that consists of an evaluation of the fetal heart rate, position, and movement and general condition of the placenta. The examination can be repeated in flight with no acoustic distortion from rotor noise. The additional information can be advantageous when transport decisions need to be made or when conditions do not allow Doppler stethoscope use.
IAEA support to medical physics in nuclear medicine.
Meghzifene, Ahmed; Sgouros, George
2013-05-01
Through its programmatic efforts and its publications, the International Atomic Energy Agency (IAEA) has helped define the role and responsibilities of the nuclear medicine physicist in the practice of nuclear medicine. This paper describes the initiatives that the IAEA has undertaken to support medical physics in nuclear medicine. In 1984, the IAEA provided guidance on how to ensure that the equipment used for detecting, imaging, and quantifying radioactivity is functioning properly (Technical Document [TECDOC]-137, "Quality Control of Nuclear Medicine Instruments"). An updated version of IAEA-TECDOC-137 was issued in 1991 as IAEA-TECDOC-602, and this included new chapters on scanner-computer systems and single-photon emission computed tomography systems. Nuclear medicine physics was introduced as a part of a project on radiation imaging and radioactivity measurements in the 2002-2003 IAEA biennium program in Dosimetry and Medical Radiation Physics. Ten years later, IAEA activities in this field have expanded to cover quality assurance (QA) and quality control (QC) of nuclear medicine equipment, education and clinical training, professional recognition of the role of medical physicists in nuclear medicine physics, and finally, the coordination of research and development activities in internal dosimetry. As a result of these activities, the IAEA has received numerous requests to support the development and implementation of QA or QC programs for radioactivity measurements in nuclear medicine in many Member States. During the last 5 years, support was provided to 20 Member States through the IAEA's technical cooperation programme. The IAEA has also supported education and clinical training of medical physicists. This type of support has been essential for the development and expansion of the Medical Physics profession, especially in low- and middle-income countries. The need for basic as well as specialized clinical training in medical physics was identified as a priority for healthcare providers in many countries. The IAEA's response to meet the increasing needs for training has been 2-folds. Through its regular program, a priority is given to the development of standardized syllabi and education and clinical training guides. Through its technical cooperation programme, support is given for setting up national medical physics education and clinical training programs in countries. In addition, fellowships are granted for professionals working in the field for specialized training, and workshops are organized at the national and regional level in specialized topics of nuclear medicine physics. So as to support on-the-job training, the IAEA has also setup a gamma camera laboratory in Seibersdorf, Austria. The laboratory is also equipped with QC tools and equipments, and radioisotopes are procured when training events are held. About 2-3 specialized courses are held every year for medical physicists at the IAEA gamma camera laboratory. In the area of research and development, the IAEA supports, through its coordinated research projects, new initiatives in quantitative nuclear medicine and internal dosimetry. The future of nuclear medicine is driven by advances in instrumentation, by the ever increasing availability of computing power and data storage, and by the development of new radiopharmaceuticals for molecular imaging and therapy. Future developments in nuclear medicine are partially driven by, and will influence, nuclear medicine physics and medical physics. To summarize, the IAEA has established a number of programs to support nuclear medicine physics and will continue to do so through its coordinated research activities, education and training in clinical medical physics, and through programs and meetings to promote standardization and harmonization of QA or QC procedures for imaging and treatment of patients. Copyright © 2013 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Palacio, C.; Jaramillo, D.; Correa, S.; Arroyave, M.
2017-06-01
Hydroxyapatite (HA) is a material widely used by the medical community due to its Ca/P ratio is comparable to the Ca/P ratio of bones and teeth, which promotes osteoinduction and osteoconduction processes when in contact with bone tissue, either as volume piece or coating. This work focuses on studying the quality of the commercial HA powder MKnano-#MKN-HXAP-S12 µm, after processing, to obtain sintered compact discs with suitable physical and chemical characteristics for implants applications. The HA powder was processed through calcination, grinding, pressing and sintering to evaluate the effect of such as procedures in the compacts dics quality. The raw powder was characterized by laser diffraction, SEM, XRF, XRD, TGA and DSC while the characteristics of the obtained compact discs were determined by dilatometry and XRD to identify the sintering temperature range, constituent phases, the amorphous content and the crystallinity degree, parameters that allow determining their suitability for implants applications. Although, it was not possible to obtain sintered compacts with the suitable chemical composition and without fractures, this work allowed to identify the parameters that determine the suitability of a HA powder to obtain sintered compacts for medical applications, as well as the characterization protocol that allows the evaluation of such parameters.
Behaviour and burnout in medical students.
Cecil, Jo; McHale, Calum; Hart, Jo; Laidlaw, Anita
2014-01-01
Background Burnout is prevalent in doctors and can impact on job dissatisfaction and patient care. In medical students, burnout is associated with poorer self-rated health; however, it is unclear what factors influence its development. This study investigated whether health behaviours predict burnout in medical students. Methods Medical students (n=356) at the Universities of St Andrews and Manchester completed an online questionnaire assessing: emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA), alcohol use, physical activity, diet, and smoking. Results Approximately 55% (54.8%) of students reported high levels of EE, 34% reported high levels of DP, and 46.6% reported low levels of PA. Linear regression analysis revealed that year of study, physical activity, and smoking status significantly predicted EE whilst gender, year of study, and institution significantly predicted DP. PA was significantly predicted by alcohol binge score, year of study, gender, and physical activity. Conclusions Burnout is present in undergraduate medical students in the United Kingdom, and health behaviours, particularly physical activity, predict components of burnout. Gender, year of study, and institution also appear to influence the prevalence of burnout. Encouraging medical students to make healthier lifestyle choices early in their medical training may reduce the likelihood of the development of burnout.
Behaviour and burnout in medical students
Cecil, Jo; McHale, Calum; Hart, Jo; Laidlaw, Anita
2014-01-01
Background Burnout is prevalent in doctors and can impact on job dissatisfaction and patient care. In medical students, burnout is associated with poorer self-rated health; however, it is unclear what factors influence its development. This study investigated whether health behaviours predict burnout in medical students. Methods Medical students (n=356) at the Universities of St Andrews and Manchester completed an online questionnaire assessing: emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA), alcohol use, physical activity, diet, and smoking. Results Approximately 55% (54.8%) of students reported high levels of EE, 34% reported high levels of DP, and 46.6% reported low levels of PA. Linear regression analysis revealed that year of study, physical activity, and smoking status significantly predicted EE whilst gender, year of study, and institution significantly predicted DP. PA was significantly predicted by alcohol binge score, year of study, gender, and physical activity. Conclusions Burnout is present in undergraduate medical students in the United Kingdom, and health behaviours, particularly physical activity, predict components of burnout. Gender, year of study, and institution also appear to influence the prevalence of burnout. Encouraging medical students to make healthier lifestyle choices early in their medical training may reduce the likelihood of the development of burnout. PMID:25160716
Behaviour and burnout in medical students.
Cecil, Jo; McHale, Calum; Hart, Jo; Laidlaw, Anita
2014-01-01
Burnout is prevalent in doctors and can impact on job dissatisfaction and patient care. In medical students, burnout is associated with poorer self-rated health; however, it is unclear what factors influence its development. This study investigated whether health behaviours predict burnout in medical students. Medical students (n=356) at the Universities of St Andrews and Manchester completed an online questionnaire assessing: emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA), alcohol use, physical activity, diet, and smoking. Approximately 55% (54.8%) of students reported high levels of EE, 34% reported high levels of DP, and 46.6% reported low levels of PA. Linear regression analysis revealed that year of study, physical activity, and smoking status significantly predicted EE whilst gender, year of study, and institution significantly predicted DP. PA was significantly predicted by alcohol binge score, year of study, gender, and physical activity. Burnout is present in undergraduate medical students in the United Kingdom, and health behaviours, particularly physical activity, predict components of burnout. Gender, year of study, and institution also appear to influence the prevalence of burnout. Encouraging medical students to make healthier lifestyle choices early in their medical training may reduce the likelihood of the development of burnout.
Carson, Paul L; Fenster, Aaron
2009-02-01
Ultrasound has been the greatest imaging modality worldwide for many years by equipment purchase value and by number of machines and examinations. It is becoming increasingly the front end imaging modality; serving often as an extension of the physician's fingers. We believe that at the other extreme, high-end systems will continue to compete with all other imaging modalities in imaging departments to be the method of choice for various applications, particularly where safety and cost are paramount. Therapeutic ultrasound, in addition to the physiotherapy practiced for many decades, is just coming into its own as a major tool in the long progression to less invasive interventional treatment. The physics of medical ultrasound has evolved over many fronts throughout its history. For this reason, a topical review, rather than a primarily chronological one is presented. A brief review of medical ultrasound imaging and therapy is presented, with an emphasis on the contributions of medical physicists, the American Association of Physicists in Medicine (AAPM) and its publications, particularly its journal Medical Physics. The AAPM and Medical Physics have contributed substantially to training of physicists and engineers, medical practitioners, technologists, and the public.
Saghafi, Ramin; Kempker, Jordan A.; Schulman, David A.
2016-01-01
Rationale: Hypothesis-driven physical examination emphasizes the role of bedside examination in the refinement of differential diagnoses and improves diagnostic acumen. This approach has not yet been investigated as a tool to improve the ability of higher-level trainees to teach medical students. Objectives: To assess the effect of teaching hypothesis-driven physical diagnosis to pulmonary fellows on their ability to improve the pulmonary examination skills of first-year medical students. Methods: Fellows and students were assessed on teaching and diagnostic skills by self-rating on a Likert scale. One group of fellows received the hypothesis-driven teaching curriculum (the “intervention” group) and another received instruction on head-to-toe examination. Both groups subsequently taught physical diagnosis to a group of first-year medical students. An oral examination was administered to all students after completion of the course. Measurements and Main Results: Fellows were comfortable teaching physical diagnosis to students. Students in both groups reported a lack of comfort with the pulmonary examination at the beginning of the course and improvement in their comfort by the end. Students trained by intervention group fellows outperformed students trained by control group fellows in the interpretation of physical findings (P < 0.05). Conclusions: Teaching hypothesis-driven physical examination to higher-level trainees who teach medical students improves the ability of students to interpret physical findings. This benefit should be confirmed using validated testing tools. PMID:26730644
Thirty year celebration of journal publications on radiation oncology medical physics.
Oliver, L D
2007-03-01
The Australasian Physical & Engineering Sciences in Medicine Journal (APESM) is an avenue for the profession to report scientific work in medicine; provide a facility for the publication of current work, new research and new techniques developed or reviewed; report on professional news from elsewhere and; publish the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) policies and protocols. The journal is a vital instrument within the ACPSEM organisation with a worldwide circulation. This review of APESM on medical physics in radiation oncology is meant to be a progress summary of work in that specialty. Even so, it has become a lengthy appraisal due to the many years involved. In considering publications related to medical physics in radiation oncology, this review has shown the progression of the College journal to an international journal. There is an increase in the number of papers contributed from Asia and other countries world wide for this discipline. Growth in the number of contributions should continue to rise. In order to provide some appreciation of where the present medical physics activity arose from, this article commences its discussion in 1959 and progresses towards the present, describing along the way, from radiation oncology papers published in APESM, the use of linear accelerators, brachytherapy, the medical physics workforce, the formation of the ACPSEM, and the more modern developments in radiotherapy such as 3-D treatment planning and IMRT.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-02
... the reported medical events, the VA National Health Physics Program (NHPP) conducted onsite... Radiology in 1989 and subsequent practice in the field of Medical Physics, Mr. Desobry's actions at the... medical physicist, but had been employed at the Capital Health System--Mercer Campus, in Trenton, New...
Medical Physicists and Health Physicists: Radiation Occupations
ERIC Educational Resources Information Center
LaPointe, Jeffrey
2011-01-01
Physics is the study of matter and energy and the ways in which the two interact. Some physicists use their expertise in physics to focus on radiation. These specialists, called medical physicists and health physicists, work to help people or protect the environment. Medical physicists work with physicians, assisting patients who need imaging…
Daniali, Seyde Shahrbanoo; Darani, Firooze Mostafavi; Eslami, Ahmad Ali; Mazaheri, Mohammad
2017-01-01
Background: The global epidemic of unhealthy lifestyle causes to increase chronic disease. It has been proven that psychological factors such as self-efficacy are responsible to success in the process of lifestyle change. Low self-efficacy is usually related to low level of physical activity and medication adherence. Objective of the study was to investigate the effects of self-efficacy, other physical symptoms on physical activity and medication adherence in patients with chronic illness in public health centers. Materials and Methods: A cross-sectional study was conducted on 483 patients with chronic diseases attended to governmental health care centers in Isfahan. Participants were chosen by systematic random sampling. Inclusion criteria were having a chronic illness at least 6-month ago while prescription of medication and willing to take part in the survey. The parts of Stanford Self-management Questionnaire were used. Data were analyzed by SPSS 18 software using the descriptive and analytic statistics. P < 0.05 was considered significant. Results: Mean age of participants was 54.8 (7.22) years. The half of participants had low self-efficacy and 87.2% had low physical activity. Nearly 80% of patients had a good medication adherence. There was a significant relationship between self-efficacy and physical activity (P = 0.336, β = 1.01, P < 0.001). Conclusion: Although chronic disease patients had a good medication adherence, other self-care behaviors such as physical activity has been neglected. It is seemed that concentration on psychological factors such as self-efficacy should be considered as a proximal factor to improve self-care. PMID:28603704
WE-E-218-01: Writing and Reviewing Papers in Medical Physics.
Hendee, W; Slattery, P; Rogers, D; Karellas, A
2012-06-01
There is an art to writing a scientific paper so that it communicates accurately, succinctly, and comprehensively. Developing this art comes with experience, and sharing that experience with younger physicists is an obligation of senior scientists, especially those with editorial responsibilities for the journal. In this workshop, the preparation of a scientific manuscript will be dissected so participants can appreciate how each part is developed and then assembled into a complete paper. Then the review process for the paper will be discussed, including how to examine a paper and write an insightful and constructive review. Finally, we will consider the challenge of accommodating the concerns and recommendations of a reviewer in preparing a revision of the paper. A second feature of the workshop will be a discussion of the process of electronic submission of a paper for consideration by Medical Physics. The web-based PeerX-Press engine for manuscript submission and management will be examined, with attention to special features such as epaps and line-referencing. Finally, new features of Medical Physics will be explained, such as Vision 20/20 manuscripts, Physics Letters and the standardized formatting of book reviews. 1. Improve the participants' abilities to write a scientific manuscript. 2. Understand the review process for Medical Physics manuscripts and how to participate in and benefit from it. 3. Appreciate the many features of the PeerX-Press electronic management process for Medical Physics manuscripts. 4. Develop a knowledge of new features of Medical Physics. © 2012 American Association of Physicists in Medicine.
Oviedo-Joekes, Eugenia; Marchand, Kirsten; Guh, Daphne; Marsh, David C; Brissette, Suzanne; Krausz, Michael; Anis, Aslam; Schechter, Martin T
2011-01-01
Opioid-dependent individuals with a history of abuse have exhibited worse mental and physical health compared to those without such a history; however, the evidence regarding the influence of abuse histories on addiction treatment outcomes are conflicting. In the present study, we identified history of physical or sexual abuse at treatment initiation in relation to drug use and health among long-term opioid-dependent individuals and we determined the relationship of abuse histories with treatment outcomes following substitution treatment. We analyzed data from a randomized controlled trial that compared the effectiveness of opioid-agonists in the treatment of chronic opioid dependence. The North American Opiate Medication Initiative (NAOMI) was conducted in Vancouver and Montreal (Canada) and provided oral methadone, injectable diacetylmorphine or injectable hydromorphone, the last two on a double blind basis, over 12 months. A total of 112 (44.6%) participants reported a history of physical or sexual abuse at baseline. Participants with an abuse history reported a significantly higher number of chronic medical problems, suicide attempts, and previous drug treatments and had poorer psychiatric, family and social relations, and quality of life status compared to those without abuse histories. No differences in current and past substance use were found between those with and without abuse histories. Following 12 months of treatment, the participants with abuse histories improved to a similar degree as those without a history of abuse in all of the European Addiction Severity Index sub-scales, with the exception of medical status. The findings suggest that individuals with abuse histories were able to achieve similar outcomes as those without abuse histories following treatment despite having poorer scores in physical and mental health, social status and quality of life at treatment initiation. These findings suggest that the substitution treatments as provided in this study can benefit the most vulnerable and access needs to be expanded to reach this population. Copyright © 2010 Elsevier Ltd. All rights reserved.
Factors Associated with Quality of Life among Hemodialysis Patients in Malaysia
Md. Yusop, Nor Baizura; Yoke Mun, Chan; Shariff, Zalilah Mohd; Beng Huat, Choo
2013-01-01
Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0–100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m2) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1±19.2, while the score for the mental and physical components were 45.0±8.6 and 39.6±8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life. PMID:24358336
Thomas, Anne Goldzier; Tran, Bonnie Robin; Cranston, Marcus; Brown, Malerato Cecilia; Kumar, Rajiv; Tlelai, Matsotetsi
2011-01-01
Overwhelming evidence, including three clinical trials, shows that male circumcision (MC) reduces the risk of HIV infection among men. However, data from recent Lesotho Demographic and Health Surveys do not demonstrate MC to be protective against HIV. These contradictory findings could partially be due to inaccurate self-reported MC status used to estimate MC prevalence. This study describes MC characteristics among men applying for Lesotho Defence Force recruitment and seeks to assess MC self-reported accuracy through comparison with physical-examination-based data. During Lesotho Defence Force applicant screening in 2009, 241 (77%) of 312 men, aged 18-25 y, consented to a self-administered demographic and MC characteristic survey and physician-performed genital examination. The extent of foreskin removal was graded on a scale of 1 (no evidence of MC) to 4 (complete MC). MC was self-reported by 27% (n = 64/239) of participants. Of the 64 men self-reporting being circumcised, physical exam showed that 23% had no evidence of circumcision, 27% had partial circumcision, and 50% had complete circumcision. Of the MCs reportedly performed by a medical provider, 3% were Grade 1 and 73% were Grade 4. Of the MCs reportedly performed by traditional circumcisers, 41% were Grade 1, while 28% were Grade 4. Among participants self-reporting being circumcised, the odds of MC status misclassification were seven times higher among those reportedly circumcised by initiation school personnel (odds ratio = 7.22; 95% CI = 2.29-22.75). Approximately 27% of participants self-reported being circumcised. However, only 50% of these men had complete MC as determined by a physical exam. Given this low MC self-report accuracy, countries scaling up voluntary medical MC (VMMC) should obtain physical-exam-based MC data to guide service delivery and cost estimates. HIV prevention messages promoting VMMC should provide comprehensive education regarding the definition of VMMC.
Health-related quality of life of students from a private medical school in Brazil.
Lins, Liliane; Carvalho, Fernando M; Menezes, Marta S; Porto-Silva, Larissa; Damasceno, Hannah
2015-11-08
To assess health-related quality of life (HRQOL) and to describe factors associated with its variation among undergraduate medical students at a Brazilian private medical school. A cross-sectional study in a sample (n=180) of medical students at a private medical school in Salvador, Brazil, stratified by year of medical course. Data about age, sex, year of course, physical activity, sleepiness, headaches, participation in a student loan program supported by the Brazilian government (FIES) and living arrangements were collected using a self-administered form. HRQOL was assessed by using a Brazilian Portuguese version of the SF-36 form. The eight domains of SF-36 and the Physical Component (PCS) and Mental Component (MCS) Summaries scales were calculated. The medical students showed poor HRQOL, mainly because of the mental component. Lower mean scores were found among those with FIES support, females, those suffering from sleepiness, headaches and lacking physical activity. No clear trend was observed in the variation of the SF-36 mean scores according to the year of medical school. However, students in the fifth year of the course had the highest HRQOL mean scores. Health-related quality of life of students at this private medical school was poor, mainly because of its mental component. Lower HRQOL was associated with FIES support, females, sleepiness, headaches and lack of regular physical activity. Higher scores were found among fifth year students.
Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C
2011-08-08
Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline. Copyright 2011, SLACK Incorporated.
Chan, M; Fontenot, J; Halvorsen, P
2012-06-01
The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management and review". 1. Understand the concept and scope of MPPG from the AAPM 2. Understand the benefits and process of the development of MPPG by the AAPM 3. Understand the goals and methodology of the Therapy MPPG Task Group #14. 4. Understand the strategic plans from Professional Council towards the AAPM initiatives. © 2012 American Association of Physicists in Medicine.
Opioid Crisis: No Easy Fix to Its Social and Economic Determinants
Beletsky, Leo; Ciccarone, Daniel
2018-01-01
The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness. Overreliance on opioid medications is emblematic of a health care system that incentivizes quick, simplistic answers to complex physical and mental health needs. In an analogous way, simplistic measures to cut access to opioids offer illusory solutions to this multidimensional societal challenge. We trace the crisis’ trajectory through the intertwined use of opioid analgesics, heroin, and fentanyl analogs, and we urge engaging the structural determinants lens to address this formidable public health emergency. A broad focus on suffering should guide both patient- and community-level interventions. PMID:29267060
Opioid Crisis: No Easy Fix to Its Social and Economic Determinants.
Dasgupta, Nabarun; Beletsky, Leo; Ciccarone, Daniel
2018-02-01
The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness. Overreliance on opioid medications is emblematic of a health care system that incentivizes quick, simplistic answers to complex physical and mental health needs. In an analogous way, simplistic measures to cut access to opioids offer illusory solutions to this multidimensional societal challenge. We trace the crisis' trajectory through the intertwined use of opioid analgesics, heroin, and fentanyl analogs, and we urge engaging the structural determinants lens to address this formidable public health emergency. A broad focus on suffering should guide both patient- and community-level interventions.
Neighborhoods and HIV: A Social Ecological Approach to Prevention and Care
Latkin, Carl A.; German, Danielle; Vlahov, David
2013-01-01
Neighborhood factors have been linked to HIV risk behaviors, HIV counseling and testing, and HIV medical care. However, the social–psychological mechanisms that connect neighborhood factors to HIV-related behaviors have not been fully determined. In this paper we review the research on neighborhood factors and HIV-related behaviors, approaches to measuring neighborhoods, and mechanism that may help to explain how the physical and social environment within neighborhoods may lead to HIV related behaviors. We then discuss organizational, geographic, and social network approaches to intervene in neighborhoods to reduce HIV transmission and facilitate HIV medical care with the goal of reducing morbidity and mortality and increasing social and psychological well-being. PMID:23688089
Prakash, Om; Gupta, L N; Singh, V B; Singhal, A K; Verma, K K
2007-11-01
Morbidity among elderly people has an important influence on their psychological well-being. Evaluation of the morbidity profile and its determinants, which have implications for management of medical problems of elderly people, are scarce in developing countries. Even the physicians' detection rate of mental distress in elderly populations is low in medical outpatient clinics. This could be due to the large caseloads and also, importantly, underestimation of psychological concerns of the elderly. The objective of this study was to study the psychiatric co-morbidity and life events among elderly medical outpatients. One hundred medically ill elderly (>60 years) patients attending the Geriatric Clinic at Bikaner (North India) constituted the study population. The physical diagnosis was made by a physician based on reported illness, clinical examination and medical records. Psychiatric diagnosis was made by detailed clinical psychiatric interview using ICD-10 guidelines. Life events were assessed by the Indian adaptation of Presumptive Stressful Life Events Scale. Hypertension was the most commonly reported physical diagnosis (50%), other specific medical illnesses were osteoarthritis (15%), diabetes (13%) and constipation (8%). The study found 18% subjects had depression and 11% had other mental disorders. Patients with mental disorders had suffered more recent stressful life events. Among life events, conflicts in family (16%); unemployment of self or children (9%) was reported by elderly psychiatric patients. Other reported life events in psychiatric diagnosed elderly were conflict in family (7%), illness of self (6%) or family members (5%) and death of family members (5%) or close relatives (4%). Mental disorders are common among medically ill elderly patients, but they are poorly recognized and treated. Assessment of the psychiatric morbidity will help in strengthening psycho-geriatric services and thus, improve the quality of life of the elderly. Copyright 2007 John Wiley & Sons, Ltd.
Teaching Physics to Premedical Students
NASA Astrophysics Data System (ADS)
Schantz, Hans
1997-04-01
The MCAT exam (taken by students seeking entry to medical school) is drastically different from the standard university course test. The MCAT emphasizes reading and analytic skills far more than quantitative analysis, even on the sections that test physics. I describe these differences, and outline an introductory physics curriculum focused to the special needs of pre-medical students.
Psychological well-being after spinal cord injury: perception of loss and meaning making.
deRoon-Cassini, Terri A; de St Aubin, Ed; Valvano, Abbey; Hastings, James; Horn, Patricia
2009-08-01
This study examined the influence of medical injury severity, perceived loss of physical functioning (conceptualized as physical resource loss), and global meaning making on psychological well-being among 79 veterans living with a spinal cord injury. Structured interviews were completed to assess perceived loss of physical abilities using the Conservation of Resources-Evaluation and SF-36 Health Survey, global meaning making (Purpose in Life scale), and psychological well-being (Sense of Well-Being Inventory). Medical injury severity was calculated from medical records. Medical injury severity was not related to psychological well-being, whereas perceived loss of physical functioning was inversely associated. Global meaning making was significantly related to and accounted for a large portion of the variance in psychological well-being. Results suggest that global meaning making partially mediates perceived loss of physical resources and psychological well-being. The perceived loss of physical abilities and the generation of meaning and purpose in life are important variables that relate to positive adaptation following spinal cord injury. Treatment implications related to factors that increase quality of life following spinal cord injury are discussed. (c) 2009 APA
Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience.
Rempell, Joshua S; Saldana, Fidencio; DiSalvo, Donald; Kumar, Navin; Stone, Michael B; Chan, Wilma; Luz, Jennifer; Noble, Vicki E; Liteplo, Andrew; Kimberly, Heidi; Kohler, Minna J
2016-11-01
Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey. All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum. POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school.
Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience
Rempell, Joshua S.; Saldana, Fidencio; DiSalvo, Donald; Kumar, Navin; Stone, Michael B.; Chan, Wilma; Luz, Jennifer; Noble, Vicki E.; Liteplo, Andrew; Kimberly, Heidi; Kohler, Minna J.
2016-01-01
Introduction Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. Methods This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey. Results All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum. Conclusion POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school. PMID:27833681
Binsch, Olaf; Banko, Katherine M; Veenstra, Bertil J; Valk, Pierre J L
2015-11-01
For infantry units of the Dutch Ministry of Defence, high attrition rates (varying from 42 to 68%) during initial training are a persisting problem. The reasons for this attrition are diverse. Having better insight into the causes of attrition is a prerequisite for implementing preventive measures. To achieve this, a monitoring assessment system was developed that integrated the effects of physical, mental, and organizational determinants on operational readiness. The aim of this study was to implement the monitoring tools and to establish the set of determinants that best predicted attrition during infantry training of new recruits. Eighty-five recruits were monitored over a 24-week infantry training course. Before the training, recruits were screened for medical, psychological, and physical wellness. During the monitoring phase, mental, physiological, and organizational indicants were obtained using an array of tools such as questionnaires, chest belt monitors (for heart rate, acceleration, and skin temperature measurements), and computerized tests (e.g., vigilance, long-term memory). Survival analyses were used to tease out the determinants of individual and grouped predictors of attrition. Nearly half the recruits (47%) failed the training. Attrition was predicted by both physiological and mental determinants. However, the organizational determinant "trainers' judgment" on the "recruits' military quality" dominated the physiological and mental determinants. It was concluded that the monitoring system was successfully implemented during infantry training, and that the survival analysis method emphasized on single effects and interactions between the different determinants. Based on the current findings, we recommend several steps to successfully implement a monitoring method in settings with high demands.
Future forum, Hobart, October 29, 2017: examining the role of medical physics in cancer research.
Ebert, Martin A; Hardcastle, Nicholas; Kron, Tomas
2018-06-25
This commentary reports on a forum held in October 2017 in Hobart, Tasmania, attended by 20 Australasian medical physicists, to consider the future role of medical physics, as well as non-medical physics and allied disciplines, in oncology research. Attendees identified important areas of oncology research which physicists can be contributing to, with these evaluated in the context of a set of "Provocative Questions" recently generated by the American Association of Physicists in Medicine. Primary perceived barriers to participation in research were identified, including a "lack of knowledge of cancer science", together with potential solutions. Mechanisms were considered for engagement with the broader scientific community, consumers, advocates and policy makers. In considering future opportunities in oncology research for medical physicists, it was noted that a professional need to focus on the safety and accuracy of current treatments applied to patients, encouraging risk-aversion, is somewhat in competition with the role of physical scientists in the exploration and discovery of new concepts and understandings.
Prisciandaro, Joann I; Willis, Charles E; Burmeister, Jay W; Clarke, Geoffrey D; Das, Rupak K; Esthappan, Jacqueline; Gerbi, Bruce J; Harkness, Beth A; Patton, James A; Peck, Donald J; Pizzutiello, Robert J; Sandison, George A; White, Sharon L; Wichman, Brian D; Ibbott, Geoffrey S; Both, Stefan
2014-05-08
There is a clear need for established standards for medical physics residency training. The complexity of techniques in imaging, nuclear medicine, and radiation oncology continues to increase with each passing year. It is therefore imperative that training requirements and competencies are routinely reviewed and updated to reflect the changing environment in hospitals and clinics across the country. In 2010, the AAPM Work Group on Periodic Review of Medical Physics Residency Training was formed and charged with updating AAPM Report Number 90. This work group includes AAPM members with extensive experience in clinical, professional, and educational aspects of medical physics. The resulting report, AAPM Report Number 249, concentrates on the clinical and professional knowledge needed to function independently as a practicing medical physicist in the areas of radiation oncology, imaging, and nuclear medicine, and constitutes a revision to AAPM Report Number 90. This manuscript presents an executive summary of AAPM Report Number 249.
Willis, Charles E.; Burmeister, Jay W.; Clarke, Geoffrey D.; Das, Rupak K.; Esthappan, Jacqueline; Gerbi, Bruce J.; Harkness, Beth A.; Patton, James A.; Peck, Donald J.; Pizzutiello, Robert J.; Sandison, George A.; White, Sharon L.; Wichman, Brian D.; Ibbott, Geoffrey S.; Both, Stefan
2014-01-01
There is a clear need for established standards for medical physics residency training. The complexity of techniques in imaging, nuclear medicine, and radiation oncology continues to increase with each passing year. It is therefore imperative that training requirements and competencies are routinely reviewed and updated to reflect the changing environment in hospitals and clinics across the country. In 2010, the AAPM Work Group on Periodic Review of Medical Physics Residency Training was formed and charged with updating AAPM Report Number 90. This work group includes AAPM members with extensive experience in clinical, professional, and educational aspects of medical physics. The resulting report, AAPM Report Number 249, concentrates on the clinical and professional knowledge needed to function independently as a practicing medical physicist in the areas of radiation oncology, imaging, and nuclear medicine, and constitutes a revision to AAPM Report Number 90. This manuscript presents an executive summary of AAPM Report Number 249. PACS number: 87.10.‐e PMID:24892354
Mejia, Christian R; Failoc-Rojas, Virgilio E; Cervantes, Carmen; Aspajo, Antonio J; Leandro, Jesus Galileo; Cordova-De La Cruz, Jhomar; Charri, Julio C; García-Auqui, Kevin E; Coronel-Chucos, Lelis Gabriela; Justo-Pinto, Luz Delia; Mamani-Apaza, Marisol Stefanie; Paz-Campos, Neil Arón; Correa, Ricardo
2017-01-01
Introduction Hypertension is a very common disease worldwide, and medication is needed to prevent its short-term and long-term complications. Our objective was to determine the characteristics and factors associated with antihypertensive medication use in patients attending Peruvian health facilities. Materials & Methods We performed a multicenter, cross-sectional study with secondary data. We obtained self-reported antihypertensive medication from patients attending health facilities in 10 departments of Peru. We looked for associations of the antihypertensive treatment according to sociopathological factors and obtained p values using generalized linear models. Results Of the 894 patients with hypertension, 61% (547) were women and 60% (503) were on antihypertensive treatment, of which 82% (389) had monotherapy and 52% (258) had recently taken their medication. Antihypertensive treatment was positively correlated with the patient's age (adjusted prevalence ratio [aPR]: 1.01; 95% confidence interval [CI]: 1.007 to 1.017; p value < 0.001), diabetes (aPR: 1.31; 95% CI: 1.11 to 1.55; p value = 0.001) and cardiovascular disease (aPR: 1.38; 95% CI: 1.26 to 1.51; p value < 0.001). Conversely, the frequency of antihypertensive treatment decreases with physical activity (aPR: 0.80; 95% CI: 0.70 to 0.92; p value = 0.001). Conclusion Patients who have comorbidities and advanced age are more likely to be on antihypertensive treatment. In contrast, patients with increased physical activity have a lower frequency of antihypertensive treatment. It is important to consider these factors for future preventive programs and to improve therapeutic compliance. PMID:28331773
Using a Multimedia Tool to Improve Cardiac Auscultation Knowledge and Skills
Stern, David T; Mangrulkar, Rajesh S; Gruppen, Larry D; Lang, Angela L; Grum, Cyril M; Judge, Richard D
2001-01-01
OBJECTIVE Today's medical school graduates have significant deficits in physical examination skills. Medical educators have been searching for methods to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining significant gains in cardiac auscultatory skills. DESIGN Controlled cohort study PARTICIPANTS All 168 third-year medical students at 1 medical school in an academic medical center. INTERVENTIONS Students were tested before and after exposure to 1 or more elements of the auscultation curriculum: teaching on ward/clinic rotations, CD-ROM comprehensive cases with follow-up seminars, and a CD-ROM 20-case miniseries. The primary outcome measures were student performance on a 10-item test of auscultation skill (listening and identifying heart sound characteristics) and a 30-item test of auscultation knowledge (factual questions about auscultation). A subset of students was tested for attenuation effects 9 or 12 months after the intervention. RESULTS Compared with the control group (1 month clinical rotation alone), students who were also exposed to the CD-ROM 20-case miniseries had significant improvements in auscultation skills scores (P < .05), but not knowledge. Additional months of clerkship, comprehensive CD-ROM cases, and follow-up seminars increased auscultation knowledge beyond the miniseries alone (P < .05), but did not further improve auscultation skills. Students' auscultation knowledge diminished one year after the intervention, but auscultation skills did not. CONCLUSION In addition to the standard curriculum of ward and conference teaching, portable multimedia tools may help improve quality of physical examination skills. PMID:11722691
Using a multimedia tool to improve cardiac auscultation knowledge and skills.
Stern, D T; Mangrulkar, R S; Gruppen, L D; Lang, A L; Grum, C M; Judge, R D
2001-11-01
Today's medical school graduates have significant deficits in physical examination skills. Medical educators have been searching for methods to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining significant gains in cardiac auscultatory skills. Controlled cohort study. All 168 third-year medical students at 1 medical school in an academic medical center. Students were tested before and after exposure to 1 or more elements of the auscultation curriculum: teaching on ward/clinic rotations, CD-ROM comprehensive cases with follow-up seminars, and a CD-ROM 20-case miniseries. The primary outcome measures were student performance on a 10-item test of auscultation skill (listening and identifying heart sound characteristics) and a 30-item test of auscultation knowledge (factual questions about auscultation). A subset of students was tested for attenuation effects 9 or 12 months after the intervention. Compared with the control group (1 month clinical rotation alone), students who were also exposed to the CD-ROM 20-case miniseries had significant improvements in auscultation skills scores (P < .05), but not knowledge. Additional months of clerkship, comprehensive CD-ROM cases, and follow-up seminars increased auscultation knowledge beyond the miniseries alone (P < .05), but did not further improve auscultation skills. Students' auscultation knowledge diminished one year after the intervention, but auscultation skills did not. In addition to the standard curriculum of ward and conference teaching, portable multimedia tools may help improve quality of physical examination skills.
Cerulli, Catherine; Cerulli, Jennifer; Santos, Elizabeth J; Lu, Najii; He, Hua; Kaukeinen, Kimberly; White, Anne Marie; Tu, Xin
To explore whether the health status of intimate partner violence (IPV) victims warrants pharmacies to be portals for public health promotion. Specific objectives included (1) identifying prevalence of IPV including domestic violence (DV) and sexual assault (SA) in a community sample, (2) describing characteristics and correlates of DV/SA between participants who reported and did not report DV/SA, and (3) exploring whether DV/SA status is related to mental health medication use. Cross sectional. Upstate New York during 2006. English- and Spanish-speaking respondents younger than 65 years of age answering four questions to assess DV/SA. Secondary analysis of a countywide random telephone survey, the 2006 Monroe County Adult Health Survey, which collects prevalence data on health behaviors and health status indicators. To determine whether those reporting DV/SA are at increased odds for mental health medication use, controlling for other sociodemographic- and health-related variables. The survey response rate was 30.3%, with 1,881 respondents meeting inclusion criteria. Those reporting DV/SA were almost twice as likely to use mental health medications. However, when controlling for other variables, only poor mental and physical health were significant in increasing the odds of mental health medication use. The analyses reported here suggest that DV/SA victims in a community sample use mental health medications. When controlling for other variables, survey respondents reported worse physical and mental health. If pharmacies are suitable portals for DV/SA outreach, curricula would need to provide the knowledge and skills needed to take an active role in this public health promotion.
Mejia, Christian R; Failoc-Rojas, Virgilio E; So, Edison; Cervantes, Carmen; Aspajo, Antonio J; Leandro, Jesus Galileo; Cordova-De La Cruz, Jhomar; Charri, Julio C; García-Auqui, Kevin E; Coronel-Chucos, Lelis Gabriela; Justo-Pinto, Luz Delia; Mamani-Apaza, Marisol Stefanie; Paz-Campos, Neil Arón; Correa, Ricardo
2017-02-03
Hypertension is a very common disease worldwide, and medication is needed to prevent its short-term and long-term complications. Our objective was to determine the characteristics and factors associated with antihypertensive medication use in patients attending Peruvian health facilities. We performed a multicenter, cross-sectional study with secondary data. We obtained self-reported antihypertensive medication from patients attending health facilities in 10 departments of Peru. We looked for associations of the antihypertensive treatment according to sociopathological factors and obtained p values using generalized linear models. Of the 894 patients with hypertension, 61% (547) were women and 60% (503) were on antihypertensive treatment, of which 82% (389) had monotherapy and 52% (258) had recently taken their medication. Antihypertensive treatment was positively correlated with the patient's age (adjusted prevalence ratio [aPR]: 1.01; 95% confidence interval [CI]: 1.007 to 1.017; p value < 0.001), diabetes (aPR: 1.31; 95% CI: 1.11 to 1.55; p value = 0.001) and cardiovascular disease (aPR: 1.38; 95% CI: 1.26 to 1.51; p value < 0.001). Conversely, the frequency of antihypertensive treatment decreases with physical activity (aPR: 0.80; 95% CI: 0.70 to 0.92; p value = 0.001). Patients who have comorbidities and advanced age are more likely to be on antihypertensive treatment. In contrast, patients with increased physical activity have a lower frequency of antihypertensive treatment. It is important to consider these factors for future preventive programs and to improve therapeutic compliance.
Medical Physics Undergraduate Degree Courses at University.
ERIC Educational Resources Information Center
Chadwick, Roy
1989-01-01
Described are the course, teaching/study, entry qualifications, and destination of graduates of four courses in medical physics from Exeter University, King's College London, University College London, and University College of Swansea. (YP)
21 CFR 890.3665 - Congenital hip dislocation abduction splint.
Code of Federal Regulations, 2010 CFR
2010-04-01
... SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890... abduction splint is a device intended for medical purposes to stabilize the hips of a young child with...
Application of nuclear physics in medical physics and nuclear medicine
NASA Astrophysics Data System (ADS)
Hoehr, Cornelia
2016-09-01
Nuclear physics has a long history of influencing and advancing medical fields. At TRIUMF we use the applications of nuclear physics to diagnose several diseases via medical isotopes and treat cancer by using proton beams. The Life Science division has a long history of producing Positron Emission Tomography (PET) isotopes but we are also investigating the production of SPECT and PET isotopes with a potential shortage for clinical operation or otherwise limited access to chemists, biologists and medical researchers. New targets are being developed, aided by a simulation platform investigating the processes inside a target under proton irradiation - nuclear, thermodynamic, and chemical. Simulations also aid in the development of new beam-shaping devices for TRIUMF's Proton Therapy facility, Canada's only proton therapy facility, as well as new treatment testing systems. Both promise improved treatment delivery for cancer patients.
Pan, Xiaochuan; Siewerdsen, Jeffrey; La Riviere, Patrick J.; Kalender, Willi A.
2008-01-01
The AAPM, through its members, meetings, and its flagship journal Medical Physics, has played an important role in the development and growth of x-ray tomography in the last 50 years. From a spate of early articles in the 1970s characterizing the first commercial computed tomography (CT) scanners through the “slice wars” of the 1990s and 2000s, the history of CT and related techniques such as tomosynthesis can readily be traced through the pages of Medical Physics and the annals of the AAPM and RSNA/AAPM Annual Meetings. In this article, the authors intend to give a brief review of the role of Medical Physics and the AAPM in CT and tomosynthesis imaging over the last few decades. PMID:18777932
WE-E-16A-01: Medical Physics Economics Update
DOE Office of Scientific and Technical Information (OSTI.GOV)
Goodwin, J; Dirksen, B; White, G
Radiology and Medical Physics reimbursement for Medicare services is constantly changing. In this presentation we will review the proposed reimbursement rules and levels for 2015 and compare them with those currently in effect for 2014. In addition, we will discuss the challenges that may lie ahead for the medical physics profession as the Centers for Medicare and Medicaid Services (CMS) moves away from a fee for service payment model and towards one of prospective payment. Learning Objectives: Understand the differences in the Medicare reimbursement systems for outpatient departments as opposed to physicians and free standing centers. Learn the proposed Medicaremore » rules for 2015 and how they may affect Radiology and Medical Physics revenues. Be aware of possible long term changes in reimbursement and how they may affect our employers, our pocket books and our profession.« less
Arnone, Anna; Sillanpaa, Jussi K; Yu, Yan; Mills, Michael D.
2015-01-01
The medical physics profession is undergoing significant changes. Starting in 2014, candidates registering for certification exams by the American Board of Radiology must have completed a CAMPEP‐accredited residency. This requirement, along with tightened state regulations, uncertainty in future reimbursement, and a stronger emphasis on board certification, have raised questions concerning the state of the medical physics workforce and its ability to adapt to changing requirements. In 2012, ASTRO conducted a workforce study of the comprehensive field of radiation oncology. This article reviews the findings of the medical physics section of the study, including age and gender distribution, educational background, workload, and primary work setting. We also report on job satisfaction, the perceived supply and demand of medical physicists, and the medical physicists' main concerns pertaining to patient safety and quality assurance. PACS number: 87.90 PMID:26103483
Albanese, Mark A; Farrell, Philip; Dottl, Susan L
2005-01-01
Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions. To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores. Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24). Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.
The medical home and integrated behavioral health: advancing the policy agenda.
Ader, Jeremy; Stille, Christopher J; Keller, David; Miller, Benjamin F; Barr, Michael S; Perrin, James M
2015-05-01
There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration. Copyright © 2015 by the American Academy of Pediatrics.
Molsted, Stig; Eidemak, Inge; Sorensen, Helle Tauby; Kristensen, Jens Halkjaer
2004-01-01
The number of chronic renal failure patients treated by hemodialysis (HD) is continuously increasing. Most patients have reduced physical capacity and have a high risk of cardiac and vascular diseases. The aim of this study was to determine the effects of 5 months physical exercise of HD patients' physical capacity, self-rated health and risk factors for cardiovascular disease. 33 HD patients were included in the study. HD for more than 3 months, age >18 years. Diabetes mellitus, symptomatic cardiovascular disease, musculoskeletal limitations, severe peripheral polyneuropathy, inability to speak Danish or English, dementia or other mental disorders. The patients were randomly assigned to an exercise group (EG, n = 22) or a control group (CG, n = 11). Prior to randomization, baseline testing was performed. The effects were measured by aerobic capacity, '2-min stair climbing', 'squat test', self-rated health (SF36), blood pressure and lipids. All tests were carried out by blinded testers. The intervention consisted of 1 h of physical exercise twice a week for 5 months. 20 patients completed the intervention. Attendance was 74% of all sessions. There were no dropouts caused by complications related to the intervention. The EG had a significant increase in aerobic capacity, 'squat test' and Physical Function and Physical Component Scale (SF36). No significant changes were observed in any of the parameters in the CG. Physical exercise twice a week for 5 months increases physical function and aerobic capacity in HD patients. An exercise program with only two exercise sessions per week seems easy to implement in clinical practice with high attendance among participants. Further investigation is needed to determine the effects on blood pressure and lipids. There were no medical complications related to the exercise program. Copyright 2004 S. Karger AG, Basel
[Discuss on effect of physical environmental factors on nature of Chinese materia medica].
Tang, Shihuan; Yang, Hongjun; Huang, Luqi
2010-01-01
Nature of Chinese materia medica is the nucleus in the theory of Chinese material medica, according to the recognition of Traditional Chinese Medicine, which is the character of the drug related on curative effect. Nature and efficacy of a drug is through the medical material, then, physical environment, including the temperature, humidity, atmospheric water, wind, topography, soil, micro-organism, and so on, influence the growth and development of the medical meterial. In this paper, we researched the explanation on nature of Chinese materia medica in the medical books of past dynasties, combined with the modem research, analyzed the relationship between generative reception and physical environmental factors, and discussed the effect of physical environmental factors on nature of Chinese materia medica. We indicated that the formation of Chinese materia medical nature is that the drug receptive the change of physical environmental factors, and resulted by the synthetic action of the factors, such as climate, soil, biology, topography, etc.
Lyndon, Mataroria P; Henning, Marcus A; Alyami, Hussain; Krishna, Sanjeev; Yu, Tzu-Chieh; Hill, Andrew G
2017-01-01
Objective: The purpose of this study was to determine the impact of a revised curriculum on medical student academic motivation, burnout, and quality of life. Methods: This cross-sectional comparative study involved 2 medical school cohorts of second year and fourth year medical students at The University of Auckland: a cohort under a traditional curriculum (n = 437) and a cohort under a revised curriculum (n = 446). Participants completed self-reported questionnaires measuring academic motivation, burnout, and quality of life. Two multivariate analyses of covariance (MANCOVAs) were conducted. Results: The response rate was 48%. No statistically significant differences were found between curriculum cohorts for mean scores of academic motivation, personal burnout, and quality of life. However, differences were found when comparing preclinical medical students and students in their clinical years of training. In comparison with Year 2 medical students, the MANCOVA for Year 4 students showed a significant main effect for the revised curriculum with respect to both physical and environmental quality of life. Conclusions: A revised medical curriculum had a differential effect on quality of life for Year 4 students in the latter years of medical school who are based in a clinical learning environment. PMID:29349339
Floor vibration evaluations for medical facilities
NASA Astrophysics Data System (ADS)
Himmel, Chad N.
2003-10-01
The structural floor design for new medical facilities is often selected early in the design phase and in renovation projects, the floor structure already exists. Because the floor structure can often have an influence on the location of vibration sensitive medical equipment and facilities, it is becoming necessary to identify the best locations for equipment and facilities early in the design process. Even though specific criteria for vibration-sensitive uses and equipment may not always be available early in the design phase, it should be possible to determine compatible floor structures for planned vibration-sensitive uses by comparing conceptual layouts with generic floor vibration criteria. Relatively simple evaluations of planned uses and generic criteria, combined with on-site vibration and noise measurements early in design phase, can significantly reduce future design problems and expense. Concepts of evaluation procedures and analyses will be presented in this paper. Generic floor vibration criteria and appropriate parameters to control resonant floor vibration and noise will be discussed for typical medical facilities and medical research facilities. Physical, economic, and logistical limitations that affect implementation will be discussed through case studies.
Manpower Management: No Tiered Readiness - Enabling The Nation’s Force in Readiness
2013-04-09
physically qualified (medical, dental , panorex) 2,D, D,H,Q Pregnancy (after determination by proper authority) N Postpartum (up to six...identifying surfaces and gaps are elemental to both the Marine Corps Planning Process and this study, and assist in the overall problem framing. Manning...of the Marine Corps on T/Os. To assist the deputy commandants in this task, each occupational field retains an occupational field sponsor. The
Niemiec, Christopher P.; Ryan, Richard M.; Deci, Edward L.; Williams, Geoffrey C.
2009-01-01
Objective To assess aspirations for physical health over 18 months. To examine whether maintained importance of aspirations for physical health mediated and/or moderated the effect of an intensive intervention on long-term tobacco abstinence. Methods Participants were randomly assigned to an intervention based on self-determination theory or to community care, and provided data at baseline and at 18 and 30 months post-randomization. Results Aspirations for physical health were better maintained over 18 months among participants in the intervention (mean change = .05), relative to community care (mean change = -.13), t = 2.66, p < .01. Maintained importance of aspirations for physical health partially mediated the treatment condition effects on seven-day point prevalence tobacco abstinence (z′ = 1.68, p < .01) and the longest number of days not smoking (z′ = 2.16, p < .01), and interacted with treatment condition to facilitate the longest number of days not smoking (β = .08, p < .05). Conclusion Maintained importance of aspirations for physical health facilitated tobacco abstinence. Practice implications Smokers may benefit from discussing aspirations for physical health within autonomy-supportive interventions. Patients may benefit from discussing aspirations during counseling about therapeutic lifestyle change and medication use. PMID:18838243
Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L; Williams, Geoffrey C
2009-02-01
To assess aspirations for physical health over 18 months. To examine whether maintained importance of aspirations for physical health mediated and/or moderated the effect of an intensive intervention on long-term tobacco abstinence. Participants were randomly assigned to an intervention based on self-determination theory or to community care, and provided data at baseline and at 18 and 30 months post-randomization. Aspirations for physical health were better maintained over 18 months among participants in the intervention (mean change=.05), relative to community care (mean change=-.13), t=2.66, p<.01. Maintained importance of aspirations for physical health partially mediated the treatment condition effects on seven-day point prevalence tobacco abstinence (z'=1.68, p<.01) and the longest number of days not smoking (z'=2.16, p<.01), and interacted with treatment condition to facilitate the longest number of days not smoking (beta=.08, p<.05). Maintained importance of aspirations for physical health facilitated tobacco abstinence. Smokers may benefit from discussing aspirations for physical health within autonomy-supportive interventions. Patients may benefit from discussing aspirations during counseling about therapeutic lifestyle change and medication use.
From Particle Physics to Medical Applications
NASA Astrophysics Data System (ADS)
Dosanjh, Manjit
2017-06-01
CERN is the world's largest particle physics research laboratory. Since it was established in 1954, it has made an outstanding contribution to our understanding of the fundamental particles and their interactions, and also to the technologies needed to analyse their properties and behaviour. The experimental challenges have pushed the performance of particle accelerators and detectors to the limits of our technical capabilities, and these groundbreaking technologies can also have a significant impact in applications beyond particle physics. In particular, the detectors developed for particle physics have led to improved techniques for medical imaging, while accelerator technologies lie at the heart of the irradiation methods that are widely used for treating cancer. Indeed, many important diagnostic and therapeutic techniques used by healthcare professionals are based either on basic physics principles or the technologies developed to carry out physics research. Ever since the discovery of x-rays by Roentgen in 1895, physics has been instrumental in the development of technologies in the biomedical domain, including the use of ionizing radiation for medical imaging and therapy. Some key examples that are explored in detail in this book include scanners based on positron emission tomography, as well as radiation therapy for cancer treatment. Even the collaborative model of particle physics is proving to be effective in catalysing multidisciplinary research for medical applications, ensuring that pioneering physics research is exploited for the benefit of all.
[Staffing in medical radiation physics in Germany--summary of a questionnaire].
Leetz, Hans-Karl; Eipper, Hermann Hans; Gfirtner, Hans; Schneider, Peter; Welker, Klaus
2003-01-01
To obtain an overview of the actual staffing levels in Medical Radiation Physics, a survey was carried out in 1999 by the task-group "Staffing requirements" of the Deutsche Gesellschaft für Medizinische Physik (DGMP; German Society of Medical Physics) among all DGMP members active in this field. The main components for equipment and activities are defined as in Report 8 and 10 of the DGMP for staffing requirements in Medical Radiation Physics. The survey focused on these main components. Of 322 forms sent out, 173 answers could be evaluated. From the answers regarding equipment and activities, theoretical staff requirements were calculated on the basis of this spot-check target and compared with the effective staffing levels documented in the survey. The spot-check data were then extrapolated to the whole Germany. The calculation revealed a deficit of 72% for the whole physics staff and of 58% for the number of physicists. Considering the age distribution of the DGMP members and the calculated staffing deficit, a training need was calculated of approximately 100 medical physicists per year in Germany, provided that the goal is set of cutting back the deficit in 10 years.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Morin, R
The Medical Physics community lost one of its prominent leaders in April, 2013 with the passing of Donald D. Tolbert, PhD. He received his Doctorate at the University of Kansas followed by post Doctoral training at Florida State University and the University of Wisconsin. He was Chief of Radiation Therapy Medical Physics at the University of Wisconsin Hospital for 7 years before relocating to Honolulu Hawaii, where he founded the consulting group Mid-Pacific Medical Physics. Don was a leader in both the AAPM and the ACR, chairing the Professional Council and the Commission on Medical Physics. He was active onmore » the AAPM Board of Directors and a member of the ACR Board of Chancellors. Dr. Tolbert's approach to the difficult problems of the times was admired and respected by colleagues in Medical Physics, Radiation Oncology, and Diagnostic Radiology. He always rose above the heated political rhetoric and led the discussion to higher ground. His wisdom was continually sought to solve complicated problems. Following retirement, he returned to homes in Kansas and Colorado, devoting his time to writing about coping with diabetes and providing support for Seniors in Beloit Kansas. Don is survived by his wife, Mattie, his 3 children and 5 grandchildren. He will be greatly missed.« less
Kim, JinShil; Shin, Mi-Seung; Hwang, Seon Young; Park, Eunok; Lim, Young-Hyo; Shim, Jae Lan; Kim, Sun Hwa; Kim, Yeon Hee; An, Minjeong
There is limited evidence on the degree of cognitive impairment and its association with physical functional capacity among patients with heart failure (HF) in Korea. In this study, we compared cognitive impairment between patients with HF and community-dwelling participants with non-HF medical conditions (medical participants) and its association with physical functional capacity. We conducted a cross-sectional comparative study and assessed the neuropsychological cognitive status (Seoul Neuropsychological Screening Battery) and physical functional capacity (Duke Activity Status Index) of patients with HF and medical participants using face-to-face interviews. One hundred and eighteen patients with HF (age, 65.45 ± 9.38 years; men, 57.6%; left ventricular ejection fraction, 34.93 ± 8.72%) and 83 medical participants (age, 66.02 ± 8.28 years; men, 47.0%) were included. Using seventh-percentile medical participant Z-scores as cutoffs, memory and executive function were worse in patients with HF than in medical participants: immediate (35.0% vs. 6.0%) and delayed recall memory (34.5% vs. 8.4%), and executive function (28.6% vs. 6.0%). Independent of age, sex, education, comorbidity, and HF status, executive function was a significant predictor of physical functional capacity (b = 1.82, p = .021). More patients with HF had impaired memory and executive function, which were associated with their physical functional capacities. Copyright © 2017 Elsevier Inc. All rights reserved.
Prevalence and Sources of Stress among Universiti Sains Malaysia Medical Students.
Yusoff, Muhamad Saiful Bahri; Abdul Rahim, Ahmad Fuad; Yaacob, Mohd Jamil
2010-01-01
Being in medical school has always been regarded as highly stressful. Excessive stress causes physical and mental health problems. Persistent stress can impair students' academic achievement and personal or professional development. The aim of this study is to explore the nature of stress among medical students by determining the prevalence, sources and pattern of stress and the factors affecting it. We chose a cross-sectional study design utilizing validated questionnaires, the 12 items General Health Questionnaire (GHQ-12) and Medical Student Stressor Questionnaire (MSSQ), to evaluate stress levels and stressors. School and ethical committee clearance were obtained prior to the study. Data were analysed using SPSS version 12. Of the medical students who were administered the questionnaire, 761 (72%) respondents participated in this study. The prevalence of stress among the medical students was 29.6%. The top 10 stressors were academic-related. Prevalence of stress for the first, second, third, fourth and fifth year students was 26.3%, 36.5 %, 31.4%, 35.3% and 21.9%, respectively. Year of study was the only significant factor affecting stress among medical students (P-value < 0.05). The prevalence of stress among medical students in USM is high. Academic-related problems were the major stressor among medical students. Year of study was the factor most significantly associated with medical students' stress. There was a bimodal pattern of the stress level throughout the year of study.
Exploring Oral Cancer Patients' Preference in Medical Decision Making and Quality of Life.
Cheng, Sun-Long; Liao, Hsien-Hua; Shueng, Pei-Wei; Lee, Hsi-Chieh; Cheewakriangkrai, Chalong; Chang, Chi-Chang
2017-01-01
Little is known about the clinical effects of shared medical decision making (SMDM) associated with quality of life about oral cancer? To understand patients who occurred potential cause of SMDM and extended to explore the interrelated components of quality of life for providing patients with potential adaptation of early assessment. All consenting patients completed the SMDM questionnaire and 36-Item Short Form (SF-36). Regression analyses were conducted to find predictors of quality of life among oral cancer patients. The proposed model predicted 57.4% of the variance in patients' SF-36 Mental Component scores. Patient mental component summary scores were associated with smoking habit (β=-0.3449, p=0.022), autonomy (β=-0.226, p=0.018) and Control preference (β=-0.388, p=0.007). The proposed model predicted 42.6% of the variance in patients' SF-36 Physical component scores. Patient physical component summary scores were associated with higher education (β=0.288, p=0.007), employment status (β=-0.225, p=0.033), involvement perceived (β=-0.606, p=0.011) and Risk communication (β=-0.558, p=0.019). Future research is necessary to determine whether oral cancer patients would benefit from early screening and intervention to address shared medical decision making.
Use of an appendicitis medical information sheet in the pediatric primary care system.
Oyachi, Noboru; Yagasaki, Hideaki; Suzuki, Takeyuki; Higashida, Kosuke; Komai, Takayuki; Hasuda, Norio; Takano, Kunio; Obana, Kazuko
2016-10-01
Accurate and prompt diagnosis is required for the primary evaluation of pediatric appendicitis. Among pediatricians and surgeons working in Yamanashi Prefecture, the pediatric appendicitis medical information (PAMI) sheet was edited in April 2011 to reflect the diagnostic results of the pediatric primary and emergency medical service and used as a referral document for surgical consultation to secondary hospitals. The PAMI sheet consisted of sections for history taking, symptoms, physical signs and laboratory findings without a scoring system. For 32 consecutive months starting in April 2011, 59 patients hospitalized for suspected appendicitis were retrospectively reviewed. In particular, a total of 17 referral patients evaluated with the PAMI sheet were assessed in order to evaluate the utility of the form. The pediatric surgeons were able to easily determine patient condition from the PAMI sheet. In total, 13 of 17 patients had appendicitis. According to the physical findings of the 17 studied patients, the judgment of right lower quadrant tenderness (κ = 0.63) and guarding (κ = 1.00) was consistent between the pediatric surgeons and primary attending pediatricians. The PAMI sheet aids in the collection of detailed history and objective data with a high level of accuracy, and provides useful referral diagnostic information to the secondary-level hospitals. © 2016 Japan Pediatric Society.
MCAT, LSAT and Physics Bachelor's. Focus On
ERIC Educational Resources Information Center
Statistical Research Center of the American Institute of Physics, 2013
2013-01-01
Physics majors pursue a wide variety of career paths, many of which are not what you might expect. Some pursue advanced training by applying to graduate schools, medical schools, or law schools. The Medical College Admissions Test (MCAT) and Law School Admission Test (LSAT) data in this report show that the physics majors who applied to either…