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Sample records for medicine iom recommendations

  1. Changing national guidelines is not enough: The impact of 1990 IOM recommendations on gestational weight gain among U.S. women

    PubMed Central

    Hamad, Rita; Cohen, Alison K.; Rehkopf, David H.

    2016-01-01

    Background and Objectives Gestational weight gain (GWG) is associated with both long- and short-term maternal and child health outcomes, particularly obesity. Targeting maternal nutrition through policies is a potentially powerful pathway to influence these outcomes. Yet prior research has often failed to evaluate national policies and guidelines that address maternal and child health. In 1990, the U.S. Institute of Medicine (IOM) released guidelines recommending different GWG thresholds based on women’s pre-pregnancy body mass index (BMI), with the goal of improving infant birth weight. In this study, we employ quasi-experimental methods to examine whether the release of the IOM guidelines led to changes in GWG among a diverse and nationally representative sample of women. Methods Our sample included female participants of the National Longitudinal Survey of Youth who self-reported GWG for pregnancies during 1979–2000 (N = 7,442 pregnancies to 4,173 women). We compared GWG before and after the guidelines were released using difference-in-differences (DID) and regression discontinuity (RD) analyses. Results In DID analyses we found no reduction in GWG among overweight/obese women relative to normal/underweight women. Meanwhile, RD analyses demonstrated no changes in GWG by pre-pregnancy BMI for either overweight/obese or normal/underweight women. Results were similar for women regardless of educational attainment, race, or parity. Conclusions The findings suggest that national guidelines had no effect on weight gain among pregnant women. These results have implications for the implementation of policies targeting maternal and child health via dietary behaviors. PMID:27200502

  2. Review of institute of medicine and national research council recommendations for one health initiative.

    PubMed

    Rubin, Carol; Myers, Tanya; Stokes, William; Dunham, Bernadette; Harris, Stic; Lautner, Beth; Annelli, Joseph

    2013-12-01

    Human health is inextricably linked to the health of animals and the viability of ecosystems; this is a concept commonly known as One Health. Over the last 2 decades, the Institute of Medicine (IOM) and the National Research Council (NRC) have published consensus reports and workshop summaries addressing a variety of threats to animal, human, and ecosystem health. We reviewed a selection of these publications and identified recommendations from NRC and IOM/NRC consensus reports and from opinions expressed in workshop summaries that are relevant to implementation of the One Health paradigm shift. We grouped these recommendations and opinions into thematic categories to determine if sufficient attention has been given to various aspects of One Health. We conclude that although One Health themes have been included throughout numerous IOM and NRC publications, identified gaps remain that may warrant targeted studies related to the One Health approach.

  3. Children in school cafeterias select foods containing more saturated fat and energy than the Institute of Medicine recommendations.

    PubMed

    Martin, Corby K; Thomson, Jessica L; LeBlanc, Monique M; Stewart, Tiffany M; Newton, Robert L; Han, Hongmei; Sample, Alicia; Champagne, Catherine M; Williamson, Donald A

    2010-09-01

    In this study, we examined if children's food selection met the School Meals Initiative (SMI) standards and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2049 4th-6th grade students was measured objectively at lunch over 3 d with digital photography in 33 schools. The percent of children whose food selection met the SMI standards and IOM recommendations for energy (kJ), fat and saturated fat, calcium, iron, and vitamin A and C were calculated. The SMI standards provide lower limits for most nutrients; the IOM provides a range of values, including an upper limit for energy. Seventy-seven percent of children's energy selection met the SMI lower limit, but only 16% of children met the IOM's recommended range and 74% of children exceeded the upper limit. More than 70% of children exceeded the SMI and IOM's saturated fat recommendations. Children selected (mean +/- SD) 3168 +/- 621 kJ, discarded 882 +/- 581 kJ, and consumed 2286 +/- 716 kJ. Children were less likely to discard fat than carbohydrate, resulting in proportionally more fat being consumed. Most children met SMI and IOM recommendations for protein, calcium, iron, and vitamin A. With few exceptions, energy selection was similar among groups of children, but plate waste differed (P < 0.001), resulting in greater energy intake among boys compared with girls, Caucasians compared with African Americans, and heavier compared with lighter children. Children's selection was high in saturated fat and, based on IOM criteria, included excess energy.

  4. Children in school cafeterias select foods containing more saturated fat and energy than the institute of medicine recommends.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this study, we examined if children’s food selections met the School Meals Initiative (SMI) standards, and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2,049 4th-6th grade students were meas...

  5. Children in school cafeterias select foods containing more saturated fat and energy than the Institute of Medicine recommendations.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this study, we examined if children’s food selection met the School Meals Initiative (SMI) standards, and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2,049 4th-6th grade students were measu...

  6. Middle-school students' school lunch consumption does not meet the new Institute of Medicine's National School Lunch Program recommendations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to compare the school lunch consumption of Texas middle-school students with the 2009 Institute of Medicine's (IOM) school meal report recommendations. These new lunch menu patterns increase fruit to one serving and vegetables to two servings, with 50 percent wholegra...

  7. Weight gain in pregnancy and application of the 2009 IOM guidelines: toward a uniform approach

    PubMed Central

    Gilmore, L. Anne; Redman, Leanne M.

    2014-01-01

    Objective There is an urgent need to adopt standardized nomenclature as it relates to GWG, a more uniform approach to calculate it, and hence quantifying adherence to the 2009 Institute of Medicine (IOM) guidelines. Results This perspective highlights the varying methods used to estimate GWG and discuss the advantages and limitations of each. While these calculations could be argued to have a minimal impact on data at the population level, on the patient level, incorrectly estimating weight at conception can result in misclassification of preconception body mass index (BMI) and assignment of the IOM guidelines which inherently affect the prospective management of weight gain (and potential outcomes) during the current pregnancy. Conclusions We recommend that preconception BMI and total GWG be determined objectively and total GWG be adjusted for length of gestation before assessing adherence to the IOM GWG guidelines. PMID:25521748

  8. Is the Physician Shortage Real? Implications for the Recommendations of the Institute of Medicine Committee on the Governance and Financing of Graduate Medical Education.

    PubMed

    Salsberg, Edward S

    2015-09-01

    In July 2014, the Institute of Medicine (IOM) Committee on the Governance and Financing of Graduate Medical Education released its report calling for a major overhaul of the financing of graduate medical education (GME). Several national organizations with an interest in GME faulted the report on the basis that the IOM Committee recommendations would worsen physician shortages. However, this conclusion is based on two questionable assumptions: first, that the nation is already facing a general physician shortage; and second, that the IOM Committee recommendations would make shortages worse. The author argues that although some communities and specialties do face shortages, currently and in the future a general national physician shortage is unlikely. Reasons cited include changes in the delivery system with an increased focus on efficiency and effectiveness; the increased use of interprofessional teams facilitated by the increasing supply of nurse practitioners, physician assistants and other health professionals; and technological advances.The author concludes that the IOM Committee recommendations would support an increase in GME positions in locations and specialties where there is a documented need, in effect removing the current cap on Medicare-funded GME positions. Given the current fiscal environment, the approach recommended by the IOM Committee--steady funding levels but improved targeting to meet documented needs--may be the best strategy for maintaining GME funds and meeting the nation's physician workforce needs.

  9. What the IOM Report on Graduate Medical Education Means for Physician Assistants.

    PubMed

    Cawley, James F

    2015-06-01

    Graduate medical education (GME) is funded by taxpayers through Medicare subsidies that pay for physician residency training, primarily to teaching hospitals. The Institute of Medicine (IOM) recently conducted a study of US GME and issued a series of recommendations for future policy reform. This commentary examines the major elements of proposed reforms for GME and offers analysis of those that may pertain specifically to physician assistant education now and in the future.

  10. Present at the Creation: Perspectives on the IOM Report.

    ERIC Educational Resources Information Center

    Gershen, Jay A.

    1996-01-01

    This article reviews the background of the 1995 report of the Institute of Medicine (IOM) on the status and needs of dental education in the United States, notes the report's value as a database and information resource, urges its use by dental schools as a stimulus for considering options, and stresses the need for funding to stimulate…

  11. Dietary sodium: where science and policy conflict: impact of the 2013 IOM Report on Sodium Intake in Populations.

    PubMed

    Graudal, Niels

    2015-02-01

    The 2013 Institute of Medicine (IOM) report "Sodium Intake in Populations: Assessment of Evidence" did not support the current recommendations of the IOM and the American Heart Association (AHA) to reduce daily dietary sodium intake to below 2,300 mg. The report concluded that the population-based health outcome evidence was not sufficient to define a safe upper intake level for sodium. Recent studies have extended this conclusion to show that a sodium intake below 2,300 mg/day is associated with increased mortality. In spite of this increasing body of evidence, the AHA, Centers for Disease Control (CDC), other public health advisory bodies, and major medical journals have continued to support the current policy of reducing dietary sodium.

  12. Evaluation of IOM personal sampler at different flow rates.

    PubMed

    Zhou, Yue; Cheng, Yung-Sung

    2010-02-01

    The Institute of Occupational Medicine (IOM) personal sampler is usually operated at a flow rate of 2.0 L/min, the rate at which it was designed and calibrated, for sampling the inhalable mass fraction of airborne particles in occupational environments. In an environment of low aerosol concentrations only small amounts of material are collected, and that may not be sufficient for analysis. Recently, a new sampling pump with a flow rate up to 15 L/min became available for personal samplers, with the potential of operating at higher flow rates. The flow rate of a Leland Legacy sampling pump, which operates at high flow rates, was evaluated and calibrated, and its maximum flow was found to be 10.6 L/min. IOM samplers were placed on a mannequin, and sampling was conducted in a large aerosol wind tunnel at wind speeds of 0.56 and 2.22 m/s. Monodisperse aerosols of oleic acid tagged with sodium fluorescein in the size range of 2 to 100 microm were used in the test. The IOM samplers were operated at flow rates of 2.0 and 10.6 L/min. Results showed that the IOM samplers mounted in the front of the mannequin had a higher sampling efficiency than those mounted at the side and back, regardless of the wind speed and flow rate. For the wind speed of 0.56 m/s, the direction-averaged (the average value of all orientations facing the wind direction) sampling efficiency of the samplers operated at 2.0 L/min was slightly higher than that of 10.6 L/min. For the wind speed of 2.22 m/s, the sampling efficiencies at both flow rates were similar for particles < 60 microm. The results also show that the IOM's sampling efficiency at these two different flow rates follows the inhalable mass curve for particles in the size range of 2 to 20 microm. The test results indicate that the IOM sampler can be used at higher flow rates.

  13. From Recommendations to Reality: Educators Respond.

    ERIC Educational Resources Information Center

    Tedesco, Lisa A.

    1996-01-01

    This paper responds to the 1995 report of the Institute of Medicine concerning the present status and future needs of dental education in the United States. It describes the effort of the American Association of Dental Schools to systematically survey professional responses the IOM Report's recommendations. Among nine themes identified are…

  14. Veterinary medicine books recommended for academic libraries

    PubMed Central

    Crawley-Low, Jill

    2004-01-01

    This bibliography of in-print veterinary medical books published in English may be used as an acquisitions or evaluation tool for developing the monograph component of new veterinary medicine collections or existing science, technology, and medicine collections where veterinary medicine is in the scope of the collection. The bibliography is divided into 34 categories and consists of bibliographic information for 419 titles. The appendix contains an author/editor index. Prices for all entries are in US dollars, except where another currency is noted. The total cost of all books in the bibliography is $43,602.13 (US). PMID:15494763

  15. Veterinary medicine books recommended for academic libraries.

    PubMed

    Crawley-Low, Jill

    2004-10-01

    This bibliography of in-print veterinary medical books published in English may be used as an acquisitions or evaluation tool for developing the monograph component of new veterinary medicine collections or existing science, technology, and medicine collections where veterinary medicine is in the scope of the collection. The bibliography is divided into 34 categories and consists of bibliographic information for 419 titles. The appendix contains an author/editor index. Prices for all entries are in US dollars, except where another currency is noted. The total cost of all books in the bibliography is $43,602.13 (US).

  16. The University of Florida College of Dentistry Response to the IOM Report on Dental Education.

    ERIC Educational Resources Information Center

    Catalanotto, Frank A.; Heft, Marc W.

    1996-01-01

    This response of the University of Florida College of Dentistry to the Institute of Medicine's 1995 report concerning the present status and future needs of dental education stresses implications of eroding state funding for higher education. It notes use of the IOM report in the university's reorganization of the predoctoral curriculum as well as…

  17. Organizational technologies for transforming care: measures and strategies for pursuit of IOM quality aims.

    PubMed

    Gamm, Larry; Kash, Bita; Bolin, Jane

    2007-01-01

    Progress on the Institute of Medicine's (IOM's) 6 aims to bridge the "quality chasm" requires both measurement and the concerting of multiple organizational technologies. The basic thesis of this article is that rapid progress on the IOM's multiple aims calls for transformative change within and among healthcare organizations. The promise of a number of types of transformative approaches is closely linked to their ability to simultaneously build upon several organizational technologies: clinical, social, information, and administrative technologies. To encourage and advance such efforts, this article identifies illustrative measures of attainment of the IOM's 6 aims or targeted areas for improvement that reflect the contributions of the 4 organizational technologies. It discusses examples of relationships between the IOM aims and the organizational technologies considered. Finally, the article offers illustrations of the interplay of these organizational technologies and IOM aims-across an array of organizational innovations with transformative potential. Included among such innovations are information technology in the form of electronic medical records, computer-based physician order entry, and patient health records; organization-wide patient-centered cultural change such as Studer's Hardwiring Excellence; Six Sigma and Toyota Production Management/LEAN; major clinical technology change, for example, minimally invasive cardiac surgery and broader treatment innovations such as disease management.

  18. Tobacco Company Efforts to Influence the Food and Drug Administration-Commissioned Institute of Medicine Report Clearing the Smoke: An Analysis of Documents Released through Litigation

    PubMed Central

    Tan, Crystal E.; Kyriss, Thomas; Glantz, Stanton A.

    2013-01-01

    Background Spurred by the creation of potential modified risk tobacco products, the US Food and Drug Administration (FDA) commissioned the Institute of Medicine (IOM) to assess the science base for tobacco “harm reduction,” leading to the 2001 IOM report Clearing the Smoke. The objective of this study was to determine how the tobacco industry organized to try to influence the IOM committee that prepared the report. Methods and Findings We analyzed previously secret tobacco industry documents in the University of California, San Francisco Legacy Tobacco Documents Library, and IOM public access files. (A limitation of this method includes the fact that the tobacco companies have withheld some possibly relevant documents.) Tobacco companies considered the IOM report to have high-stakes regulatory implications. They developed and implemented strategies with consulting and legal firms to access the IOM proceedings. When the IOM study staff invited the companies to provide information on exposure and disease markers, clinical trial design for safety and efficacy, and implications for initiation and cessation, tobacco company lawyers, consultants, and in-house regulatory staff shaped presentations from company scientists. Although the available evidence does not permit drawing cause-and-effect conclusions, and the IOM may have come to the same conclusions without the influence of the tobacco industry, the companies were pleased with the final report, particularly the recommendations for a tiered claims system (with separate tiers for exposure and risk, which they believed would ease the process of qualifying for a claim) and license to sell products comparable to existing conventional cigarettes (“substantial equivalence”) without prior regulatory approval. Some principles from the IOM report, including elements of the substantial equivalence recommendation, appear in the 2009 Family Smoking Prevention and Tobacco Control Act. Conclusions Tobacco companies

  19. Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis

    PubMed Central

    Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping

    2015-01-01

    Background Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. Objective To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. Methods All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association. TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. Results A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Conclusions Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. PMID:26041487

  20. Toward clinical genomics in everyday medicine: perspectives and recommendations

    PubMed Central

    Delaney, Susan K.; Hultner, Michael L.; Jacob, Howard J.; Ledbetter, David H.; McCarthy, Jeanette J.; Ball, Michael; Beckman, Kenneth B.; Belmont, John W.; Bloss, Cinnamon S.; Christman, Michael F.; Cosgrove, Andy; Damiani, Stephen A.; Danis, Timothy; Delledonne, Massimo; Dougherty, Michael J.; Dudley, Joel T.; Faucett, W. Andrew; Friedman, Jennifer R.; Haase, David H.; Hays, Tom S.; Heilsberg, Stu; Huber, Jeff; Kaminsky, Leah; Ledbetter, Nikki; Lee, Warren H.; Levin, Elissa; Libiger, Ondrej; Linderman, Michael; Love, Richard L.; Magnus, David C.; Martland, AnneMarie; McClure, Susan L.; Megill, Scott E.; Messier, Helen; Nussbaum, Robert L.; Palaniappan, Latha; Patay, Bradley A.; Popovich, Bradley W.; Quackenbush, John; Savant, Mark J.; Su, Michael M.; Terry, Sharon F.; Tucker, Steven; Wong, William T.; Green, Robert C.

    2016-01-01

    ABSTRACT Precision or personalized medicine through clinical genome and exome sequencing has been described by some as a revolution that could transform healthcare delivery, yet it is currently used in only a small fraction of patients, principally for the diagnosis of suspected Mendelian conditions and for targeting cancer treatments. Given the burden of illness in our society, it is of interest to ask how clinical genome and exome sequencing can be constructively integrated more broadly into the routine practice of medicine for the betterment of public health. In November 2014, 46 experts from academia, industry, policy and patient advocacy gathered in a conference sponsored by Illumina, Inc. to discuss this question, share viewpoints and propose recommendations. This perspective summarizes that work and identifies some of the obstacles and opportunities that must be considered in translating advances in genomics more widely into the practice of medicine. PMID:26810587

  1. Toward clinical genomics in everyday medicine: perspectives and recommendations.

    PubMed

    Delaney, Susan K; Hultner, Michael L; Jacob, Howard J; Ledbetter, David H; McCarthy, Jeanette J; Ball, Michael; Beckman, Kenneth B; Belmont, John W; Bloss, Cinnamon S; Christman, Michael F; Cosgrove, Andy; Damiani, Stephen A; Danis, Timothy; Delledonne, Massimo; Dougherty, Michael J; Dudley, Joel T; Faucett, W Andrew; Friedman, Jennifer R; Haase, David H; Hays, Tom S; Heilsberg, Stu; Huber, Jeff; Kaminsky, Leah; Ledbetter, Nikki; Lee, Warren H; Levin, Elissa; Libiger, Ondrej; Linderman, Michael; Love, Richard L; Magnus, David C; Martland, AnneMarie; McClure, Susan L; Megill, Scott E; Messier, Helen; Nussbaum, Robert L; Palaniappan, Latha; Patay, Bradley A; Popovich, Bradley W; Quackenbush, John; Savant, Mark J; Su, Michael M; Terry, Sharon F; Tucker, Steven; Wong, William T; Green, Robert C

    2016-01-01

    Precision or personalized medicine through clinical genome and exome sequencing has been described by some as a revolution that could transform healthcare delivery, yet it is currently used in only a small fraction of patients, principally for the diagnosis of suspected Mendelian conditions and for targeting cancer treatments. Given the burden of illness in our society, it is of interest to ask how clinical genome and exome sequencing can be constructively integrated more broadly into the routine practice of medicine for the betterment of public health. In November 2014, 46 experts from academia, industry, policy and patient advocacy gathered in a conference sponsored by Illumina, Inc. to discuss this question, share viewpoints and propose recommendations. This perspective summarizes that work and identifies some of the obstacles and opportunities that must be considered in translating advances in genomics more widely into the practice of medicine.

  2. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    PubMed

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    should not be left unsupervised to care for critically ill patients. In settings in which the acuity is high, physicians who have completed residency should provide direct supervision for resident physicians. Supervising physicians should always be physically in the hospital for supervision of resident physicians who care for critically ill patientsThe ACGME should explicitly define "good" supervision by specialty and by year of training. Explicit requirements for intensity and level of training for supervision of specific clinical scenarios should be providedCenters for Medicare and Medicaid Services (CMS) should use graduate medical education funding to provide incentives to programs with proven, effective levels of supervision. Although this action would require federal legislation, reimbursement rules would help to ensure that hospitals pay attention to the importance of good supervision and require it from their training programs. RESIDENT PHYSICIAN WORK HOURS: Although the IOM "Sleep, supervision and safety" report provides a comprehensive review and discussion of all aspects of graduate medical education training, the report's focal point is its recommendations regarding the hours that resident physicians are currently required to work. A considerable body of scientific evidence, much of it cited by the Institute of Medicine report, describes deteriorating performance in fatigued humans, as well as specific studies on resident physician fatigue and preventable medical errors. The question before this conference was what work redesign and cultural changes are needed to reform work hours as recommended by the Institute of Medicine's evidence-based report? Extensive scientific data demonstrate that shifts exceeding 12-16 hours without sleep are unsafe. Several principles should be followed in efforts to reduce consecutive hours below this level and achieve safer work schedules. The recommendations are: Limit resident physician work hours to 12-16 hour maximum shifts

  3. Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

    PubMed

    Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

    2008-08-01

    The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

  4. Calling in the feds. IOM's new report says government must take lead in quality, but can Congress, hospitals find the money and support?

    PubMed

    Tieman, Jeff

    2002-11-04

    A new report by the Institute of Medicine calls for the federal government to "take the lead" in healthcare quality. Janet Corrigan, director of the IOM's Board of Health Care Services, and other members of the IOM say only the nation's largest provider and payer has what it takes to build a safer environment for patients. Can Congress come up with the money and support necessary to sustain such an undertaking?

  5. 78 FR 39741 - Announcement of Agency Decision: Recommendations on the Use of Chimpanzees in NIH-Supported Research

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ...This notice announces the responses to public comments and decisions of the National Institutes of Health (NIH) regarding the use of chimpanzees in research. In February 2012, the NIH charged a working group of the Council of Councils, a federal advisory committee, to provide advice on implementing recommendations made by the Institute of Medicine (IOM) Committee on the Use of Chimpanzees in......

  6. Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable.

    PubMed

    David, Sean P; Johnson, Samuel G; Berger, Adam C; Feero, W Gregory; Terry, Sharon F; Green, Larry A; Phillips, Robert L; Ginsburg, Geoffrey S

    2015-01-01

    Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system.

  7. Ensuring quality cancer care: a follow-up review of the Institute of Medicine's 10 recommendations for improving the quality of cancer care in America.

    PubMed

    Spinks, Tracy; Albright, Heidi W; Feeley, Thomas W; Walters, Ron; Burke, Thomas W; Aloia, Thomas; Bruera, Eduardo; Buzdar, Aman; Foxhall, Lewis; Hui, David; Summers, Barbara; Rodriguez, Alma; Dubois, Raymond; Shine, Kenneth I

    2012-05-15

    Responding to growing concerns regarding the safety, quality, and efficacy of cancer care in the United States, the Institute of Medicine (IOM) of the National Academy of Sciences commissioned a comprehensive review of cancer care delivery in the US health care system in the late 1990s. The National Cancer Policy Board (NCPB), a 20-member board with broad representation, performed this review. In its review, the NCPB focused on the state of cancer care delivery at that time, its shortcomings, and ways to measure and improve the quality of cancer care. The NCPB described an ideal cancer care system in which patients would have equitable access to coordinated, guideline-based care and novel therapies throughout the course of their disease. In 1999, the IOM published the results of this review in its influential report, Ensuring Quality Cancer Care. The report outlined 10 recommendations, which, when implemented, would: 1) improve the quality of cancer care, 2) increase the current understanding of quality cancer care, and 3) reduce or eliminate access barriers to quality cancer care. Despite the fervor generated by this report, there are lingering doubts regarding the safety and quality of cancer care in the United States today. Increased awareness of medical errors and barriers to quality care, coupled with escalating health care costs, has prompted national efforts to reform the health care system. These efforts by health care providers and policymakers should bridge the gap between the ideal state described in Ensuring Quality Cancer Care and the current state of cancer care in the United States.

  8. The Institute of Medicine's Report on "Research Training in Psychiatry Residency: Strategies for Reform"--Background, Results, and Follow Up

    ERIC Educational Resources Information Center

    Yager, Joel; Greden, John; Abrams, Michael; Riba, Michelle

    2004-01-01

    Objective: The National Institute of Mental Health (NIMH) determined that declines in the psychiatrist-researcher workforce are harming public needs and that significant steps are necessary to alter current trends. Method: The NIMH commissioned the Institute of Medicine (IOM) to examine the undersupply and recommend solutions. The NIMH…

  9. The Cease Smoking Today (CS2day) initiative: a guide to pursue the 2010 IOM report vision for CPD.

    PubMed

    Cervero, Ronald M; Moore, Donald E

    2011-01-01

    This article reviews the articles in this supplement that describe a smoking cessation project, Cease Smoking Today (CS2day) that demonstrated successful outcomes: physician adoption of a smoking cessation guideline and an increase in smoking quit rates. The authors examine how the activities of the CS2day project compared to the principles and characteristics of the vision for a future system of continuing professional development that was described in the 2010 Institute of Medicine (IOM) report, Redesigning Continuing Education in the Health Professions. While it did not meet all the characteristics of the IOM's vision, the CS2day Initiative met enough of them for the authors to suggest that the momentum that the IOM report generated has been sustained. The authors point out two strengths and two weaknesses that further strategic and organizational efforts should consider. The two strengths were the collaborative nature of the project and an approach to continuous outcomes assessment that was based on competencies derived from a practice guideline. The authors also suggested that future similar efforts should place more emphasis on instructional design and developing a program theory to guide program operations and educational development. The authors encouraged members of the CME profession to consider the accomplishments of the CS2day project as they are planning to move their CME programs toward the vision described in the IOM Report.

  10. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

    PubMed Central

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    services. Resident physicians should not be left unsupervised to care for critically ill patients. In settings in which the acuity is high, physicians who have completed residency should provide direct supervision for resident physicians. Supervising physicians should always be physically in the hospital for supervision of resident physicians who care for critically ill patientsThe ACGME should explicitly define “good” supervision by specialty and by year of training. Explicit requirements for intensity and level of training for supervision of specific clinical scenarios should be providedCenters for Medicare and Medicaid Services (CMS) should use graduate medical education funding to provide incentives to programs with proven, effective levels of supervision. Although this action would require federal legislation, reimbursement rules would help to ensure that hospitals pay attention to the importance of good supervision and require it from their training programs Resident physician work hours Although the IOM “Sleep, supervision and safety” report provides a comprehensive review and discussion of all aspects of graduate medical education training, the report’s focal point is its recommendations regarding the hours that resident physicians are currently required to work. A considerable body of scientific evidence, much of it cited by the Institute of Medicine report, describes deteriorating performance in fatigued humans, as well as specific studies on resident physician fatigue and preventable medical errors. The question before this conference was what work redesign and cultural changes are needed to reform work hours as recommended by the Institute of Medicine’s evidence-based report? Extensive scientific data demonstrate that shifts exceeding 12–16 hours without sleep are unsafe. Several principles should be followed in efforts to reduce consecutive hours below this level and achieve safer work schedules. The recommendations are: Limit resident physician

  11. Regulatory agencies' recommendations for medicine information leaflets: Are they in line with research findings?

    PubMed

    Young, Amber; Tordoff, June; Smith, Alesha

    2017-03-04

    The design of medicine information leaflets can determine whether a leaflet will be read or discarded by patients. It may also influence patients' ability to understand the information about their medicines within the leaflet. Researchers compared regulatory agencies' recommendations for medicine information leaflet design from New Zealand, the United Kingdom, Europe, and the United States against recommended good design principles to determine the appropriateness, comprehensiveness, and consistency of their recommendations. Recommendations for medicine information leaflets varied between the regulatory agencies. There were some inconsistencies between the recommendations and some gaps were identified. There was little regulatory guidance given to creators of medicine information leaflets in New Zealand compared to other countries, and this could lead to manufacturer-produced information leaflets of a poorer quality. Up-to-date and enforceable guidance for creators of medicine information leaflets should be provided in all countries to ensure they are of an appropriate standard.

  12. Essential medicines for cancer: WHO recommendations and national priorities

    PubMed Central

    Robertson, Jane; Barr, Ronald; Shulman, Lawrence N; Forte, Gilles B

    2016-01-01

    Abstract Objective To examine, for essential anti-cancer medicines, the alignment of national lists of essential medicines and national reimbursable medicines lists with the World Health Organization’s (WHO’s) Model Lists. Methods National medicine lists for 135 countries with per-capita gross national incomes below 25 000 United States dollars in 2015 were compared with WHO’s 2013 and 2015 Model Lists of Essential Medicines. Correlations between numbers of anti-cancer medicines included in national lists and gross national income (GNI), government health expenditure and number of physicians per 1000 population were evaluated. Findings Of the 25 anti-cancer medicines on the 2013 Model List and the 16 added via the 2015 revision of the Model List, 0–25 (median: 17) and 0–15 (median: 3) appeared in national lists, respectively. There was considerable variability in these numbers within and between World Bank income groups. Of the 16 new medicines included in the 2015 Model List, for example, 0–10 (median: 1) and 2–15 (median: 10) were included in the national lists of low-income and high-income countries, respectively. The numbers of these new medicines included in national lists were significantly correlated (P ≤ 0.0001) with per-capita GNI (r = 0.45), per-capita annual government health expenditure (r = 0.33) and number of physicians per 1000 population (r = 0.48). Twenty-one countries (16%) included the targeted anti-cancer medicines imatinib, rituximab and trastuzumab in their national lists. Conclusion Substantial numbers of anti-cancer medicines are included in national lists of low- and middle-income countries but the availability, affordability, accessibility and administration feasibility of these medicines, at country-level, need assessment. PMID:27843163

  13. Reflections on market access for personalized medicine: recommendations for Europe.

    PubMed

    Payne, Katherine; Annemans, Lieven

    2013-01-01

    This article aims to provide an overview of the current literature focusing on the reimbursement of personalized medicine across the European Union. The article starts by describing types of perspectives that are possible (general public, patient, payer, provider, service commissioner, and policymaker). The description of perspectives also explains the importance of understanding the different possible decision criteria and processes from the various perspectives by taking into account budget constraints. The article then focuses on an example of personalized medicine, namely, the use of companion diagnostic-medicine combinations, to describe the role of reimbursement/payer agencies across the European Union to control the introduction and coverage of such companion diagnostic-medicine technologies. The article touches on the strategic challenges and the use of economic evidence to introduce personalized medicine from a health policy perspective. The article also draws on empirical studies that have explored patients' and clinicians' views of examples of personalized medicine to illustrate the challenges for developing patient-centered and timely health care services.

  14. [Intratumoral administration of biological preparations--recommendation for integrative medicine].

    PubMed

    Ebina, T

    2001-10-01

    The antitumor effect of biological preparations was examined in a double grafted tumor system. PSK is a hot water extract of cultured mycelia from Coliolus versicolor. Its protein content is about 38% and the main glycoside portion of PSK is beta-D-glucan. Lentinan is purified from fruit bodies of Lentinus edodes and is a beta-1, 3-glucan. Cepharanthin is an extract from the root of Stephania cepharantha HAYATA, consisting of 4 kinds of biscoclaurine alkaloids. TAHEEBO tea is a hot water extract of Tabebuia avellanedae, the active ingredient of which is naphthoquinones. If protein-bound polysaccharides were to be used in Western medicine, these polysaccharides would be purified, but purified beta-glucan loses its beneficial effects. Similarly, when raw Cepharanthin is purified to isolate its active ingredient (an alkaloid cepharanthine), its anti-tumor effect is weakened. Clear IAP induction was observed in serum of mice treated with extracts of Coliolus versicolor and Stephania cepharantha. However, IAP induction was not observed in the serum of mice treated with purified beta-glucan or purified alkaloid. This suggests that macrophages may recognize extracts but not purified substances. In Western medicine, purified substances with known chemical structures are recognized as drugs, but overdoses of these drugs are toxic to the body, thus adverse reactions are always an issue. In Chinese medicine, mixtures containing several crude drugs are recognized as drugs, whose active ingredients are not identified. In integrative medicine, drugs are extracts that contain active ingredients with known structures and functions. We propose a Japanese version of integrative medicine which is neither Western nor Chinese.

  15. Implementing the Association of Teachers of Preventive Medicine's Recommendations into the Undergraduate Medical School Curriculum.

    ERIC Educational Resources Information Center

    Altekruse, Joan; And Others

    1991-01-01

    Ideas for integrating preventive medicine into the undergraduate medical curriculum include options for curricula in quantitative skills, clinical preventive medicine, primary care rotation, community health services, and independent continuing education. Recommendations are based on a guide assessing the effectiveness of 169 types of preventive…

  16. Analysis of the Italian generic medicines retail market: recommendations to enhance long-term sustainability.

    PubMed

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2015-02-01

    Italy is among the European countries with the lowest uptake of generic medicines. This paper provides a perspective on the Italian generic medicines retail market. Fast market entrance of generic medicines in Italy is hindered by several factors: the existence of Complementary Protection Certificates in the past, the large market for copies and multiple cases of patent linkage. Prices of generic medicines in Italy are low compared to other European countries. To contain pharmaceutical expenditure, pharmaceutical companies are currently forced to pay back in case of overspending, which disproportionally penalizes small and fast growing companies, to which most generic companies belong to. Current demand-side policies do not successfully stimulate the use of generic medicines. The current market environment surrounding the Italian generic medicines retail market (i.e., low prices, low volumes) threatens its long-term sustainability. Recommendations to enhance the long-term sustainability of the Italian generic medicines retail market round off this perspective paper.

  17. Nuclear medicine survey recommendations for a changing regulatory environment.

    PubMed

    Vernig, P G; Schumacher, T A

    2001-11-01

    The revision of 10 CFR 35 approved on 23 September 2000 and due for implementation in 2001, reduces the number of required radiation and contamination surveys to one ambient radiation survey each day when an administration requiring a written directive is used. This paper compares the current requirements in 10 CFR 35; the single, remaining, specific requirement in the revised part 35; the Nuclear Regulatory Commission's guidance in the proposed NUREG SR1556 and the general requirement for surveys to demonstrate compliance with 10 CFR 20. We also make recommendations on what periodic surveys are prudent.

  18. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships.

    PubMed

    Finnoff, Jonathan T; Berkoff, David; Brennan, Fred; DiFiori, John; Hall, Mederic M; Harmon, Kimberly; Lavallee, Mark; Martin, Sean; Smith, Jay; Stovak, Mark

    2015-02-01

    The American Medical Society for Sports Medicine (AMSSM) developed a musculoskeletal ultrasound curriculum for sports medicine fellowships in 2010. As the use of diagnostic and interventional ultrasound in sports medicine has evolved, it became clear that the curriculum needed to be updated. Furthermore, the name 'musculoskeletal ultrasound' was changed to 'sports ultrasound' (SPORTS US) to reflect the broad range of diagnostic and interventional applications of ultrasound in sports medicine. This document was created to outline the core competencies of SPORTS US and to provide sports medicine fellowship directors and others interested in SPORTS US education with a guide to create a SPORTS US curriculum. By completing this SPORTS US curriculum, sports medicine fellows and physicians can attain proficiency in the core competencies of SPORTS US required for the practice of sports medicine.

  19. Consensus-based recommendations for case report in Chinese medicine (CARC).

    PubMed

    Fu, Shu-Fei; Cheng, Chung-Wah; Zhang, Li; Zhong, Linda Li-Dan; Kun, Wai; Lin, Jia; Zhang, Bo-Li; Wang, Yong-Yan; Shang, Hong-Cai; Bian, Zhao-Xiang

    2016-01-01

    Case reports are valuable clinical evidence in traditional Chinese medicine (TCM). However, the general reporting quality is suboptimal. A working group comprising 20 members was set up to develop systematic recommendations on case report in Chinese medicine (CARC). The working group (CARC group) developed a primary checklist based on reviewing the general reporting quality of case reports in TCM and thorough internal discussion. Two-round consensus process had been carried out among clinical experts, evidence-based medicine methodologists, medical journal editors and clinical practitioners with designated questionnaire embedded with the primary checklist. In total, 118 participants from 17 provinces of China and Korea completed the questionnaires. Their feedback was analyzed and discussed by the CARC group. The checklist was amended accordingly, and the final version, comprising 16-item, is presented here. Under the framework of CARC recommendations, the reporting quality of case reports in TCM can be improved.

  20. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships.

    PubMed

    Finnoff, Jonathan T; Berkoff, David; Brennan, Fred; DiFiori, John; Hall, Mederic M; Harmon, Kimberly; Lavallee, Mark; Martin, Sean; Smith, Jay; Stovak, Mark

    2015-01-01

    The following sports ultrasound (SPORTS US) curriculum is a revision of the curriculum developed by the American Medical Society for Sports Medicine (AMSSM) in 2010. Several changes have been made to the curriculum with the primary aim of providing a pathway by which a sports medicine fellow can obtain sufficient SPORTS US training to become proficient in the core competencies of SPORTS US. The core competencies of SPORTS US are outlined in the learning objectives section of this document. The term "SPORTS US" was purposefully chosen rather than "musculoskeletal ultrasound" (MSK US) because it was recognized by the panel that the evolving field of SPORTS US encompasses non-MSK applications of ultrasound such as the FAST examination (focused assessment with sonography for trauma). Although the SPORTS US core competencies in this curriculum are all MSK in nature, they represent the minimum SPORTS US knowledge a sports medicine fellow should acquire during fellowship. However, additional training in more advanced MSK and non-MSK applications of ultrasound can be provided at the fellowship director's discretion. Completion of this SPORTS US curriculum fulfills the American Institute of Ultrasound in Medicine's (AIUM) requirements to perform an MSK US examination and the prerequisites for the American Registry for Diagnostic Medical Sonography's (ARDMS) MSK sonography certification examination.

  1. The suitability of the IOM foam sampler for bioaerosol sampling in Occupational Environments.

    PubMed

    Haatainen, Susanna; Laitinen, Juha; Linnainmaa, Markku; Reponen, Tiina; Kalliokoski, Pentti

    2010-01-01

    Concurrent samples were collected with Andersen and IOM foam samplers to determine whether if the IOM foam sampler can be applied to collect culturable microorganisms. Two different kinds of aerosols were studied: peat dust in a power plant and mist from coolant fluid aerosolized during grinding of blades and rollers in a paper mill. In the power plant, the concentrations of fungi were 2-3 times higher in the IOM samples than in the Andersen samples. However, more fungal genera were identified in the latter case. The methods yielded similar concentrations of bacteria and actinobacteria in the power plant. On the other hand, the performance of the IOM foam sampler was very poor in the paper mill, where stress-sensitive gram-negative bacteria dominated; low concentration of bacteria was detected in only one IOM sample even though the concentration of bacteria often exceeded even the upper detection limit in the Andersen impactor samples. It could be concluded that the IOM foam sampler performs quite well for collecting inhalable fungi and actinobacteria. However, the Andersen sampler provides better information on fungal genera and concentrations of gram-negative bacteria. Personal sampling with the IOM foam sampler provided an important benefit in the power plant, where the concentration ratio of personal to stationary samples was much higher for bacteria than for inhalable or respirable dust.

  2. The Italian Society of Physical and Rehabilitation Medicine (SIMFER) recommendations for neck pain.

    PubMed

    Monticone, Marco; Iovine, Roberto; de Sena, Giampaolo; Rovere, Giancarlo; Uliano, Domenico; Arioli, Giovanni; Bonaiuti, Donatella; Brugnoni, Guido; Ceravolo, Gabriella; Cerri, Cesare; Dalla Toffola, Elena; Fiore, Pietro; Foti, Calogero

    2013-01-01

    The paper represents the Italian Society of Physical " and Rehabilitation Medicine (SIMFER) recommendations to Neck Pain. We searched the principal scientific databases for papers concerning the main approaches to NP, including international guidelines, clinical trials of high methodological value and systematic reviews without any temporal limits. The recommendations were graded on the basis of the National Plan for Guidelines of the Italian Istituto Superiore di Sanità, which includes the level of evidence and strength of the recommendation. The principal sections of the recommendations deal with the Evaluation and Therapy for Neck Pain. The first describes the main evidence concerning the evaluation of patients with NP with or without limb involvement and/or headache: medical history, physical examination, neurological examination, laboratory tests, electrodiagnostics, diagnostic imaging and self-administered questionnaires. The second describes the best evidence synthesis concernig the therapy for Neck Pain: education, exercise, medical therapy, manual therapy, traction, physical therapy, acupuncture, orthoses, multimodal treatment, behavioural treatment.

  3. Reflections on the Institute of Medicine's systemic exertion intolerance disease.

    PubMed

    Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; McManimen, Stephanie; Furst, Jacob

    2015-01-01

    The Institute of Medicine (IOM) in the United States has recently proposed that the term systemic exertion intolerance disease (SEID) replace chronic fatigue syndrome. In addition, the IOM proposed a new case definition for SEID, which includes substantial reductions or impairments in the ability to engage in pre‑illness activities, unrefreshing sleep, postexertional malaise, and either cognitive impairment or orthostatic intolerance. Unfortunately, these recommendations for a name change were not vetted with patient and professional audiences, and the new criteria were not evaluated with data sets of patients and controls. A recent poll suggests that the majority of patients reject this new name. In addition, studies have found that prevalence rates will dramatically increase with the new criteria, particularly due to the ambiguity revolving around exclusionary illnesses. Findings suggest that the new criteria select more patients who have less impairment and fewer symptoms than several other criteria. The implications of these findings are discussed in the current review.

  4. Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

    PubMed

    Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

    2015-12-01

    Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Use of medicines recommended for secondary prevention of acute coronary syndrome

    PubMed Central

    Gaedke, Mari Ângela; da Costa, Juvenal Soares Dias; Manenti, Euler Roberto Fernandes; Henn, Ruth Liane; Paniz, Vera Maria Vieira; Nunes, Marcelo Felipe; da Motta, Monique Adriane; Olinto, Maria Teresa Anselmo

    2015-01-01

    ABSTRACT OBJECTIVE : To analyze if the demographic and socioeconomic variables, as well as percutaneous coronary intervention are associated with the use of medicines for secondary prevention of acute coronary syndrome. METHODS : In this cohort study, we included 138 patients with acute coronary syndrome, aged 30 years or more and of both sexes. The data were collected at the time of hospital discharge, and after six and twelve months. The outcome of the study was the simultaneous use of medicines recommended for secondary prevention of acute coronary syndrome: platelet antiaggregant, beta-blockers, statins and angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker. The independent variables were: sex, age, education in years of attending, monthly income in tertiles and percutaneous coronary intervention. We described the prevalence of use of each group of medicines with their 95% confidence intervals, as well as the simultaneous use of the four medicines, in all analyzed periods. In the crude analysis, we verified the outcome with the independent variables for each period through the Chi-square test. The adjusted analysis was carried out using Poisson Regression. RESULTS : More than a third of patients (36.2%; 95%CI 28.2;44.3) had the four medicines prescribed at the same time, at the moment of discharge. We did not observe any differences in the prevalence of use in comparison with the two follow-up periods. The most prescribed class of medicines during discharge was platelet antiaggregant (91.3%). In the crude analysis, the demographic and socioeconomic variables were not associated to the outcome in any of the three periods. CONCLUSIONS : The prevalence of simultaneous use of medicines at discharge and in the follow-ups pointed to the under-utilization of this therapy in clinical practice. Intervention strategies are needed to improve the quality of care given to patients that extend beyond the hospital discharge, a critical point of transition

  6. Recommendations

    ERIC Educational Resources Information Center

    Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

    2015-01-01

    In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

  7. Benefits, issues, and recommendations for personalized medicine in oncology in Canada.

    PubMed

    Butts, C; Kamel-Reid, S; Batist, G; Chia, S; Blanke, C; Moore, M; Sawyer, M B; Desjardins, C; Dubois, A; Pun, J; Bonter, K; Ashbury, F D

    2013-10-01

    would review research and provide recommendations on tests for funding or reimbursement, guidelines, service delivery models, laboratory quality assurance, education, and communication. More has to be known about the current state of personalized cancer medicine in Canada, and strategies have to be developed to inform and improve understanding and appropriate coordination and delivery. Our hope is that the perspectives emphasized in this paper will stimulate discussion and further research to create a more informed response.

  8. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine

    PubMed Central

    Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

    2016-01-01

    Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The recommendations are summarized here. A manuscript detailing the conference proceedings and the evidence supporting these recommendations will be published in the Journal of Clinical Sleep Medicine. Citation: Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med 2016;12(6):785–786. PMID:27250809

  9. IOM committee members respond to Endocrine Society vitamin D guideline

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In early 2011, a committee convened by the Institute of Medicine issued a report on the Dietary Reference Intakes for calcium and vitamin D. The Endocrine Society Task Force in July 2011 published a guideline for the evaluation, treatment, and prevention of vitamin D deficiency. Although these repor...

  10. USC's Response to the IOM Report on Dental Education.

    ERIC Educational Resources Information Center

    Landesman, Howard M.

    1996-01-01

    This response of the University of Southern California to the Institute of Medicine's 1995 report concerning the present status and future needs of dental education focuses on the report's influence in implementing a problem-based learning (PBL) option at USC. The PBL program's philosophy, goals, organization, faculty, admissions process, and…

  11. Sudden cardiac death in forensic medicine – Swiss recommendations for a multidisciplinary approach.

    PubMed

    Wilhelm, Matthias; Bolliger, Stephan A; Bartsch, Christine; Fokstuen, Siv; Gräni, Christoph; Martos, Viktor; Medeiros Domingo, Argelia; Osculati, Antonio; Rieubland, Claudine; Sabatasso, Sara; Saguner, Ardan M; Schyma, Christian; Tschui, Joelle; Wyler, Daniel; Bhuiyan, Zahurul A; Fellmann, Florence; Michaud, Katarzyna

    2015-01-01

    Sudden cardiac death (SCD) is by definition unexpected and cardiac in nature. The investigation is almost invariably performed by a forensic pathologist. Under these circumstances the role of the forensic pathologist is twofold: (1.) to determine rapidly and efficiently the cause and manner of death and (2.) to initiate a multidisciplinary process in order to prevent further deaths in existing family members. If the death is determined to be due to "natural" causes the district attorney in charge often refuses further examinations. However, additional examinations, i.e. extensive histopathological investigations and/or molecular genetic analyses, are necessary in many cases to clarify the cause of death. The Swiss Society of Legal Medicine created a multidisciplinary working group together with clinical and molecular geneticists and cardiologists in the hope of harmonising the approach to investigate SCD. The aim of this paper is to close the gap between the Swiss recommendations for routine forensic post-mortem cardiac examination and clinical recommendations for genetic testing of inherited cardiac diseases; this is in order to optimise the diagnostic procedures and preventive measures for living family members. The key points of the recommendations are (1.) the forensic autopsy procedure for all SCD victims under 40 years of age, (2.) the collection and storage of adequate samples for genetic testing, (3.) communication with the families, and (4.) a multidisciplinary approach including cardiogenetic counselling.

  12. Recommendations for Exploration Space Medicine from the Apollo Medical Operations Project

    NASA Technical Reports Server (NTRS)

    Scheuring, R. a.; Davis, J. R.; Duncan, J. M.; Polk, J. D.; Jones, J. A.; Gillis, D. B.

    2007-01-01

    Introduction: A study was requested in December, 2005 by the Space Medicine Division at the NASA-Johnson Space Center (JSC) to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The objective was to use this new information to develop medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), Lunar Habitat, and Advanced Extravehicular Activity (EVA) suits that are currently being developed within the exploration architecture. Methods: Available resources pertaining to medical operations on the Apollo 7 through 17 missions were reviewed. Ten categories of hardware, systems, or crew factors were identified in the background research, generating 655 data records in a database. A review of the records resulted in 280 questions that were then posed to surviving Apollo crewmembers by mail, face-to-face meetings, or online interaction. Response analysis to these questions formed the basis of recommendations to items in each of the categories. Results: Thirteen of 22 surviving Apollo astronauts (59%) participated in the project. Approximately 236 pages of responses to the questions were captured, resulting in 107 recommendations offered for medical consideration in the design of future vehicles and EVA suits based on the Apollo experience. Discussion: The goals of this project included: 1) Develop or modify medical requirements for new vehicles; 2) create a centralized database for future access; and 3) take this new knowledge and educate the various directorates at NASA-JSC who are participating in the exploration effort. To date, the Apollo Medical Operations recommendations are being incorporated into the exploration mission architecture at various levels and a centralized database has been developed. The Apollo crewmembers input has proved to be an invaluable resource, prompting ongoing collaboration as the requirements for the future exploration missions continue

  13. A field comparison of the IOM inhalable aerosol sampler and a modified 37-mm cassette.

    PubMed

    Clinkenbeard, R E; England, E C; Johnson, D L; Esmen, N A; Hall, T A

    2002-09-01

    This research focused on comparing a modified 37-mm (Mod37) sampling cassette with an IOM inhalable dust sampler. Paired IOM and Mod37 breathing-zone air samples were collected for workers engaged in corrosion control maintenance operations on several types of aircraft at several U.S. Air Force bases in the United States. Sampled operations included hand and power sanding, blow-down and wipe-down to remove dust, and spray finishing. The cassettes' interior surfaces were swabbed and the swabs combined with the filters for chromium analysis by NIOSH Method 7300. This approach utilized total chromium as a sensitive surrogate indicator of total aspirated mass. The influences of work location, work type, sample duration, and sampler type on measured concentration were evaluated using analysis of variance techniques. Only work type (process) was found to be a statistically significant predictor of measured concentration. The relationship between IOM- and Mod37-measured values for paired samples was evaluated by work type using linear regression techniques. Linear regressions showed that the modified 37-mm cassette over-samples aerosol by 35 percent compared to the IOM when a wide range of aerosol concentrations and compositions for divergent work tasks in multiple field locations are sampled. Interpretation of these results in light of previous results involving filter-only Mod37 analyses suggests that while the Mod37 has a higher aspiration efficiency than the IOM, substantial Mod37 wall losses result in underestimation of exposure when only the 37-mm filter is analyzed rather than filters plus wall swabs.

  14. Obstetric outcomes in normal weight and obese women in relation to gestational weight gain: comparison between Institute of Medicine guidelines and Cedergren criteria.

    PubMed

    Potti, Sushma; Sliwinski, Christopher S; Jain, Neetu J; Dandolu, Vani

    2010-05-01

    We compared obstetric outcomes based on gestational weight gain in normal-weight and obese women using traditional Institute of Medicine (IOM) guidelines and newly recommended Cedergren criteria. Using the New Jersey Pregnancy Risk Assessment Monitoring System (PRAMS) database and electronic birth records, perinatal outcomes were analyzed to estimate the independent effects of prepregnancy body mass index (BMI) and gestational weight gain by IOM versus Cedergren criteria. Of 9125 subjects in PRAMS database from 2002 to 2006, 53.7% had normal BMI, 12.3% were overweight, 18.2% were obese, and the rest were underweight. Among normal-weight mothers, when compared with the IOM guidelines, macrosomia (6.45% versus 4.27%) and cesarean delivery rates (30.42% versus 29.83%) were lower using Cedergren criteria but the rates of preterm delivery (5.06% versus 9.44%), low birth weight (0.38% versus 2.42%), and neonatal intensive care unit (NICU) admissions (7.02% versus 10.86%) were higher with the Cedergren criteria. Similarly, among obese patients, when compared with IOM guidelines, macrosomia (10.79% versus 5.47%) and cesarean delivery rates (43.95% versus 40.71%) were lower using Cedergren criteria but the rates of preterm delivery (6.83% versus 8.32%), low birth weight (0.87% versus 1.88%), and NICU admissions (8.92% versus 13.78%) were higher with the Cedergren criteria. Based on our results, ideal gestational weight gain is presumably somewhere between the IOM and Cedergren's guidelines.

  15. AxIOM: Amphipod crustaceans from insular Posidonia oceanica seagrass meadows

    PubMed Central

    Heughebaert, André; Lepoint, Gilles

    2016-01-01

    Abstract Background The Neptune grass, Posidonia oceanica (L.) Delile, 1813, is the most widespread seagrass of the Mediterranean Sea. This foundation species forms large meadows that, through habitat and trophic services, act as biodiversity hotspots. In Neptune grass meadows, amphipod crustaceans are one of the dominant groups of vagile invertebrates, forming an abundant and diverse taxocenosis. They are key ecological components of the complex, pivotal, yet critically endangered Neptune grass ecosystems. Nevertheless, comprehensive qualitative and quantitative data about amphipod fauna found in Mediterranean Neptune grass meadows remain scarce, especially in insular locations. New information Here, we provide in-depth metadata about AxIOM, a sample-based dataset published on the GBIF portal. AxIOM is based on an extensive and spatially hierarchized sampling design with multiple years, seasons, day periods, and methods. Samples were taken along the coasts of Calvi Bay (Corsica, France) and of the Tavolara-Punta Coda Cavallo Marine Protected Area (Sardinia, Italy). In total, AxIOM contains 187 samples documenting occurrence (1775 records) and abundance (10720 specimens) of amphipod crustaceans belonging to 72 species spanning 29 families. The dataset is available at http://ipt.biodiversity.be/resource?r=axiom. PMID:27660521

  16. [Theory of toxic classification of traditional Chinese medicine and recommendations for revision of China pharmacopeia (volume 1)].

    PubMed

    Zhao, Junning; Ye, Zuguang

    2012-08-01

    Toxic classification of traditional Chinese medicine, as a contribution of traditional Chinese medicine (TCM) to the recognition of medicinal toxicity and rational use of medicinal materials by Chinese people, is now a great issue related to safe medication, sustainable development and internationalization of Chinese medicine. In this article, the origination and development of toxic classification theory was summarized and analyzed. Because toxic classification is an urgent issue related to TCM industrialization, modernization and internationalization, this article made a systematic analysis on the nature and connotation of toxic classification as well as risk control for TCM industry due to the medicinal toxicity. Based on the toxic studies, this article made some recommendations on toxic classification of Chinese medicinal materials for the revision of China Pharmacopeia (volume 1). From the aspect of scientific research, a new technical guideline for research on toxic classification of Chinese medicine should be formulated based on new biological toxicity test technology such as Microtox and ADME/Tox, because the present classification of acute toxicity of mice/rats can not met the modern development of Chinese medicine any more. The evaluation system and technical SOP of TCM toxic classification should also be established, and they should well balance TCM features, superiority and international requirements. From the aspect of medicine management, list of toxic medicines and their risk classification should be further improved by competent government according to scientific research. In China Pharmacopeia (volume I), such descriptions of strong toxicity, toxicity or mild toxicity should be abandoned when describing medicine nature and flavor. This revision might help promote TCM sustainable development and internationalization, and enhance the competitive capacity of Chinese medicine in both domestic and international market. However, description of strong

  17. Environmental risk assessment of medicinal products for human use according to European Commission recommendations.

    PubMed

    Huschek, Gerd; Hansen, Peter D; Maurer, Hans H; Krengel, Dietmar; Kayser, Anja

    2004-06-01

    Presented here, based on new recommendations of the European Commission, is an environmental risk assessment (ERA) of a selected group of pharmaceuticals for Phase I, environmental exposure assessment, and Phase II Tier A, initial environmental fate and effect analysis. This pharmaceutical group is composed of the 111 highest-selling human drug substances that have annual sales in Germany of more than 5,000 kg. The data required for this ERA came from analyzing: (1) sales annually (in kg or IU) of the 2671 active pharmaceutical drug substances (2001) on the German market in all medicinal products sold by pharmacies (with and without prescriptions) and used in hospitals in 1996-2001; (2) the use pattern of drug substances as categorized according to Anatomical Therapeutic Chemical (ATC) classification indexes ATC3 and ATC7; (3) data for excretion, toxicity, and metabolites of the 111 selected human drug substances; (4) the physicochemical properties of these substances; and (5) the degradability of selected drug substances in sewage treatment plants (STPs) by using a validated and accredited liquid chromatography-electrospray ionization tandem mass spectrometry method. A correction factor for the pharmaceutical therapeutic (PT) activity of metabolites, the PT(Index) (excretion rate/100) for drug substances and PT active metabolites was established to refine the predicted environmental concentration (PEC(SURFACEWATER)). A refinement of the PEC(SURFACEWATER) was carried out with the market penetration factor of the human drug substances in Germany. In addition, for effect analysis the predicted no-effects concentration (PNEC) was calculated using assessment factors. The estimated PEC results were validated with the exposure results of effluents of the STPs. All results on ERA of drug substances have been documented in a Microsoft Access 2000 database.

  18. Consistency of Nutrition Recommendations for Foods Marketed to Children in the United States, 2009–2010

    PubMed Central

    Quilliam, Elizabeth Taylor; Paek, Hye-Jin; Kim, Sookyong; Venkatesh, Sumathi; Plasencia, Julie; Lee, Mira; Rifon, Nora J.

    2013-01-01

    Introduction Food marketing has emerged as an environmental factor that shapes children’s dietary behaviors. “Advergames,” or free online games designed to promote branded products, are an example of evolving food marketing tactics aimed at children. Our primary objective was to classify foods marketed to children (aged 2–11 y) in advergames as those meeting or not meeting nutrition recommendations of the US Department of Agriculture (USDA), Food & Drug Administration (FDA), Center for Science in the Public Interest (CSPI), and the Institute of Medicine (IOM). We document the consistency of classification of those foods across agency guidelines and offer policy recommendations. Methods We used comScore Media Builder Metrix to identify 143 websites that marketed foods (n = 439) to children aged 2 to 11 years through advergames. Foods were classified on the basis of each of the 4 agency criteria. Food nutrient labels provided information on serving size, calories, micronutrients, and macronutrients. Results The websites advertised 254 meals, 101 snacks, and 84 beverages. Proportions of meals and snacks meeting USDA and FDA recommendations were similarly low, with the exception of saturated fat in meals and sodium content in snacks. Inconsistency in recommendations was evidenced by only a small proportion of meals and fewer snacks meeting the recommendations of all the agencies per their guidelines. Beverage recommendations were also inconsistent across the 3 agencies that provide recommendations (USDA, IOM, and CSPI). Most (65%–95%) beverages advertised in advergames did not meet some of these recommendations. Conclusion Our findings indicate that a large number of foods with low nutritional value are being marketed to children via advergames. A standardized system of food marketing guidance is needed to better inform the public about healthfulness of foods advertised to children. PMID:24070037

  19. Guidelines for pharmacoeconomic studies. Recommendations from the panel on cost effectiveness in health and medicine. Panel on cost Effectiveness in Health and Medicine.

    PubMed

    Siegel, J E; Torrance, G W; Russell, L B; Luce, B R; Weinstein, M C; Gold, M R

    1997-02-01

    This article reports the recommendations of the Panel on Cost Effectiveness in Health and Medicine, sponsored by the US Public Health Service, on standardised methods for conducting cost-effectiveness analyses. Although not expressly directed at analyses of pharmaceutical agents, the Panel's recommendations are relevant to pharmacoeconomic studies. The Panel outlines a 'Reference Case' set of methodological practices to improve quality and comparability of analyses. Designed for studies that inform resource-allocation decisions, the Reference Case includes recommendations for study framing and scope, components of the numerator and denominator of cost-effectiveness ratios, discounting, handling uncertainty and reporting. The Reference Case analysis is conducted from the societal perspective, and includes all effects of interventions on resource use and health. Resource use includes 'time' resources, such as for caregiving or undergoing an intervention. The quality-adjusted life-year (QALY) is the common measure of health effect across Reference Case studies. Although the Panel does not endorse a measure for obtaining quality-of-life weights, several recommendations address the QALY. The Panel recommends a 3% discount rate for costs and health effects. Pharmacoeconomic studies have burgeoned in recent years. The Reference Case analysis will improve study quality and usability, and permit comparison of pharmaceuticals with other health interventions.

  20. Chirality of meteoritic free and IOM-derived monocarboxylic acids and implications for prebiotic organic synthesis

    NASA Astrophysics Data System (ADS)

    Aponte, José C.; Tarozo, Rafael; Alexandre, Marcelo R.; Alexander, Conel M. O.'D.; Charnley, Steven B.; Hallmann, Christian; Summons, Roger E.; Huang, Yongsong

    2014-04-01

    The origin of homochirality and its role in the development of life on Earth are among the most intriguing questions in science. It has been suggested that carbonaceous chondrites seeded primitive Earth with the initial organic compounds necessary for the origin of life. One of the strongest pieces of evidence supporting this theory is that certain amino acids in carbonaceous chondrites display a significant L-enantiomeric excess (ee), similar to those use by terrestrial life. Analyses of ee in meteoritic molecules other than amino acids would shed more light on the origins of homochirality. In this study we investigated the stereochemistry of two groups of compounds: (1) free monocarboxylic acids (MCAs) from CM2 meteorites LON 94101 and Murchison; and (2) the aliphatic side chains present in the insoluble organic matter (IOM) and extracted in the form of monocarboxylic acids (MCAs) from EET 87770 (CR2) and Orgueil (CI1). Contrary to the well-known ee observed for amino acids in meteorites, we found that meteoritic branched free and IOM-derived MCAs with 5-8 carbon atoms are essentially racemic. The racemic nature of these compounds is used to discuss the possible influence of ultraviolet circularly polarized light (UVCPL) and aqueous alterations on the parent body on chirality observed in in carbonaceous chondrites.

  1. Recommendations for teaching upon sensitive topics in forensic and legal medicine in the context of medical education pedagogy.

    PubMed

    Kennedy, Kieran M; Scriver, Stacey

    2016-11-01

    Undergraduate medical curricula typically include forensic and legal medicine topics that are of a highly sensitive nature. Examples include suicide, child abuse, domestic and sexual violence. It is likely that some students will have direct or indirect experience of these issues which are prevalent in society. Those students are vulnerable to vicarious harm from partaking in their medical education. Even students with no direct or indirect experience of these issues may be vulnerable to vicarious trauma, particularly students who are especially empathetic to cases presented. Despite these risks, instruction relating to these topics is necessary to ensure the competencies of graduating doctors to respond appropriately to cases they encounter during their professional careers. However, risk can be minimised by a well-designed and thoughtfully delivered educational programme. We provide recommendations for the successful inclusion of sensitive forensic and legal medicine topics in undergraduate medical curricula.

  2. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This article summarizes the new 2011 report on dietary requirements for calcium and vitamin D from the Institute of Medicine (IOM). An IOM Committee, charged with determining the population needs for these nutrients in North America, conducted a comprehensive review of the evidence for both skeletal...

  3. Recommendations for Nuclear Medicine Technologists Drawn from an Analysis of Errors Reported in Australian Radiation Incident Registers.

    PubMed

    Kearney, Nicole; Denham, Gary

    2016-12-01

    When a radiation incident occurs in nuclear medicine in Australia, the incident is reported to the relevant state or territory authority, which performs an investigation and sends its findings to the Australian Radiation Protection and Nuclear Safety Agency. The agency then includes these data in its Australian Radiation Incident Register and makes them available to the public as an annual summary report on its website. The aim of this study was to analyze the radiation incidents included in these annual reports and in the publically available state and territory registers, identify any recurring themes, and make recommendations to minimize future incidents.

  4. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    PubMed

    Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

    2016-10-15

    Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.

  5. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

    PubMed Central

    Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

    2016-01-01

    Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard – fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline – second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing. PMID:27812301

  6. Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    PubMed

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana; Maradin, Miljenka

    2015-01-01

    Capillary blood sampling is a medical procedure aimed at assisting in patient diagnosis, management and treatment, and is increasingly used worldwide, in part because of the increasing availability of point-of-care testing. It is also frequently used to obtain small blood volumes for laboratory testing because it minimizes pain. The capillary blood sampling procedure can influence the quality of the sample as well as the accuracy of test results, highlighting the need for immediate, widespread standardization. A recent nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia has shown that capillary sampling procedures are not standardized and that only a small proportion of Croatian laboratories comply with guidelines from the Clinical Laboratory Standards Institute (CLSI) or the World Health Organization (WHO). The aim of this document is to provide recommendations for capillary blood sampling. This document has been produced by the Working Group for Capillary Blood Sampling within the Croatian Society of Medical Biochemistry and Laboratory Medicine. Our recommendations are based on existing available standards and recommendations (WHO Best Practices in Phlebotomy, CLSI GP42-A6 and CLSI C46-A2), which have been modified based on local logistical, cultural, legal and regulatory requirements. We hope that these recommendations will be a useful contribution to the standardization of capillary blood sampling in Croatia.

  7. 4Ps medicine of the fatty liver: the research model of predictive, preventive, personalized and participatory medicine-recommendations for facing obesity, fatty liver and fibrosis epidemics.

    PubMed

    Trovato, Francesca Maria; Catalano, Daniela; Musumeci, Giuseppe; Trovato, Guglielmo M

    2014-01-01

    Relationship between adipose tissue and fatty liver, and its possible evolution in fibrosis, is supported by clinical and research experience. Given the multifactorial pathogenesis of non-alcoholic fatty liver disease (NAFLD), treatments for various contributory risk factors have been proposed; however, there is no single validated therapy or drug association recommended for all cases which can stand alone. Mechanisms, diagnostics, prevention and treatment of obesity, fatty liver and insulin resistance are displayed along with recommendations and position points. Evidences and practice can get sustainable and cost-benefit valuable outcomes by participatory interventions. These recommendations can be enhanced by comprehensive research projects, addressed to societal issues and innovation, market appeal and industry development, cultural acceptance and sustainability. The basis of participatory medicine is a greater widespread awareness of a condition which is both a disease and an easy documented and inclusive clue for associated diseases and unhealthy lifestyle. This model is suitable for addressing prevention and useful for monitoring improvement, worsening and adherence with non-invasive imaging tools which allow targeted approaches. The latter include health psychology and nutritional and physical exercise prescription expertise disseminated by continuous medical education but, more important, by concrete curricula for training undergraduate and postgraduate students. It is possible and recommended to do it by early formal teaching of ultrasound imaging procedures and of practical lifestyle intervention strategies, including approaches aimed to healthier fashion suggestions. Guidelines and requirements of research project funding calls should be addressed also to NAFLD and allied conditions and should encompass the goal of training by research and the inclusion of participatory medicine topics. A deeper awareness of ethics of competences in health professionals

  8. The orientation-averaged aspiration efficiency of IOM-like personal aerosol samplers mounted on bluff bodies.

    PubMed

    Paik, Samuel Y; Vincent, James H

    2004-01-01

    This paper describes two sets of experiments that were intended to characterize the orientation-averaged aspiration efficiencies of IOM samplers mounted on rotating bluff bodies. IOM samplers were mounted on simplified, three-dimensional rectangular bluff bodies that were rotated horizontally at a constant rate. Orientation-averaged aspiration efficiencies (A360) were measured as a function of Stokes' number (St), velocity ratio (R) and dimension ratio (r). Aspiration efficiency (A) is the efficiency with which particles are transported from the ambient air into the body of a sampler, and A360 is A averaged over all orientations to the wind. St is a dimensionless variable that represents particle inertia, R is the ratio of the air velocity in the freestream and that at the plane of the sampler's entry orifice, and r is the ratio of the sampler's orifice diameter and the bluff body's width. The first set of experiments were instrumental in establishing a hierarchy of effects on orientation-averaged A. It was clear that compared to r, St had a much larger influence on A. It was also clear, however, that the effects of St were overpowered by the effects of R in many cases. As concluded in previous studies, R and St were considered the most important factors in determining A, even for A360. The second set of experiments investigated A360 of IOM samplers for a much wider range of r than examined in previous research. Two important observations were made from the experimental results. One was that the A360 of IOM samplers, as a function of St, did not change for an r-range of 0.066-0.4. This meant that an IOM sampler mounted on a near life-size mannequin would measure the same aerosol concentration as one not mounted on anything. The second observation was that the aspiration efficiency curve of the IOM sampler was close to the inhalability curve. This gave further evidence that the bluff body did not play a major role in influencing A360, as the IOM samplers, in these

  9. Field comparison of three inhalable samplers (IOM, PGP-GSP 3.5 and Button) for welding fumes.

    PubMed

    Zugasti, Agurtzane; Montes, Natividad; Rojo, José M; Quintana, M José

    2012-02-01

    Inhalable sampler efficiency depends on the aerodynamic size of the airborne particles to be sampled and the wind speed. The aim of this study was to compare the behaviour of three personal inhalable samplers for welding fumes generated by Manual Metal Arc (MMA) and Metal Active Gas (MAG) processes. The selected samplers were the ones available in Spain when the study began: IOM, PGP-GSP 3.5 (GSP) and Button. Sampling was carried out in a welding training center that provided a homogeneous workplace environment. The static sampling assembly used allowed the placement of 12 samplers and 2 cascade impactors simultaneously. 183 samples were collected throughout 2009 and 2010. The range of welding fumes' mass concentrations was from 2 mg m(-3) to 5 mg m(-3). The pooled variation coefficients for the three inhalable samplers were less than or equal to 3.0%. Welding particle size distribution was characterized by a bimodal log-normal distribution, with MMADs of 0.7 μm and 8.2 μm. For these welding aerosols, the Button and the GSP samplers showed a similar performance (P = 0.598). The mean mass concentration ratio was 1.00 ± 0.01. The IOM sampler showed a different performance (P < 0.001). The mean mass concentration ratios were 0.90 ± 0.01 for Button/IOM and 0.92 ± 0.02 for GSP/IOM. This information is useful to consider the measurements accomplished by the IOM, GSP or Button samplers together, in order to assess the exposure at workplaces over time or to study exposure levels in a specific industrial activity, as welding operations.

  10. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    PubMed Central

    Stoneking, LR; Waterbrook, AL; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, KH; Adamas-Rappaport, W

    2016-01-01

    Background After emergency department (ED) discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit. Objectives To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency. Methods Our ED has two Emergency Medicine Residency Programs, University Campus (UC) and South Campus (SC). SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions. Results Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters – 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters – 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians

  11. Recommendations for protecting National Library of Medicine Computing and Networking Resources

    SciTech Connect

    Feingold, R.

    1994-11-01

    Protecting Information Technology (IT) involves a number of interrelated factors. These include mission, available resources, technologies, existing policies and procedures, internal culture, contemporary threats, and strategic enterprise direction. In the face of this formidable list, a structured approach provides cost effective actions that allow the organization to manage its risks. We face fundamental challenges that will persist for at least the next several years. It is difficult if not impossible to precisely quantify risk. IT threats and vulnerabilities change rapidly and continually. Limited organizational resources combined with mission restraints-such as availability and connectivity requirements-will insure that most systems will not be absolutely secure (if such security were even possible). In short, there is no technical (or administrative) {open_quotes}silver bullet.{close_quotes} Protection is employing a stratified series of recommendations, matching protection levels against information sensitivities. Adaptive and flexible risk management is the key to effective protection of IT resources. The cost of the protection must be kept less than the expected loss, and one must take into account that an adversary will not expend more to attack a resource than the value of its compromise to that adversary. Notwithstanding the difficulty if not impossibility to precisely quantify risk, the aforementioned allows us to avoid the trap of choosing a course of action simply because {open_quotes}it`s safer{close_quotes} or ignoring an area because no one had explored its potential risk. Recommendations for protecting IT resources begins with discussing contemporary threats and vulnerabilities, and then procedures from general to specific preventive measures. From a risk management perspective, it is imperative to understand that today, the vast majority of threats are against UNIX hosts connected to the Internet.

  12. Physical therapy in critically ill adult patients: recommendations from the Brazilian Association of Intensive Care Medicine Department of Physical Therapy.

    PubMed

    França, Eduardo Ériko Tenório de; Ferrari, Francimar; Fernandes, Patrícia; Cavalcanti, Renata; Duarte, Antonio; Martinez, Bruno Prata; Aquim, Esperidião Elias; Damasceno, Marta Cristina Paulete

    2012-03-01

    Complications from immobility in intensive care unit patients contribute to functional decline, increased healthcare costs, reduced quality of life and higher post-discharge mortality. Physical therapy focuses on promoting recovery and preserving function, and it may minimize the impact of these complications. A group of Brazilian Association of Intensive Care Medicine physical therapy experts developed this document that contains minimal physical therapy recommendations appropriate to the Brazilian real-world clinical situation. Prevention and treatment of atelectasis, procedures related to the removal of secretions and treatment of conditions related to physical deconditioning and functional decline are discussed. Equally important is the consideration that prescribing and executing activities, mobilizations and exercises are roles of the physical therapist, whose diagnosis should precede any intervention.

  13. Performance evaluation of three computed radiography systems using methods recommended in American Association of Physicists in Medicine Report 93.

    PubMed

    Muhogora, Wilbroad; Padovani, Renato; Bonutti, Faustino; Msaki, Peter; Kazema, R

    2011-07-01

    The performances of three clinical computed radiography (CR) systems, (Agfa CR 75 (with CRMD 4.0 image plates), Kodak CR 850 (with Kodak GP plates) and Kodak CR 850A (with Kodak GP plates)) were evaluated using six tests recommended in American Association of Physicists in Medicine Report 93. The results indicated variable performances with majority being within acceptable limits. The variations were mainly attributed to differences in detector formulations, plate readers' characteristics, and aging effects. The differences of the mean low contrast scores between the imaging systems for three observers were statistically significant for Agfa and Kodak CR 850A (P=0.009) and for Kodak CR systems (P=0.006) probably because of the differences in ages. However, the differences were not statistically significant between Agfa and Kodak CR 850 (P=0.284) suggesting similar perceived image quality. The study demonstrates the need to implement quality control program regularly.

  14. US Military Dietary Protein Recommendations: A Simple But Often Confused Topic.

    PubMed

    Pasiakos, Stefan M; Sepowitz, John J; Deuster, Patricia A

    2015-01-01

    Military recommendations for dietary protein are based on the recommended dietary allowance (RDA) of 0.8 g of protein per kilogram of body mass (BM) established by the Food and Nutrition Board, Institute of Medicine (IOM) of the National Academies. The RDA is likely adequate for most military personnel, particularly when activity levels are low and energy intake is sufficient to maintain a healthy body weight. However, military recommendations account for periods of increased metabolic demand during training and real-world operations, especially those that produce an energy deficit. Under those conditions, protein requirements are higher (1.5-2.0 g/kg BM) in an attempt to attenuate the unavoidable loss of muscle mass that occurs during prolonged or repeated exposure to energy deficits. Whole foods are recommended as the primary method to consume more protein, although there are likely operational scenarios where whole foods are not available and consuming supplemental protein at effective, not excessive, doses (20-25 g or 0.25-0.3 g/kg BM per meal) is recommended. Despite these evidence-based, condition-specific recommendations, the necessity of protein supplements and the requirements and rationale for consuming higher-protein diets are often misunderstood, resulting in an overconsumption of dietary protein and unsubstantiated health-related concerns. This review will provide the basis of the US military dietary protein requirements and highlight common misconceptions associated with the amount and safety of protein in military diets.

  15. Lowering Salt in Your Diet

    MedlinePlus

    ... the Institute of Medicine (IOM) report, "Strategies to Reduce Sodium Intake in the United States," which was released ... IOM committee reviewed and recommended various ways to reduce sodium intake. The strategies recommended included actions by FDA ...

  16. Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. Participants: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. Evidence: The ...

  17. The Institute of Medicine, the Food and Drug Administration, and the calcium conundrum.

    PubMed

    Neupane, Shristi; Knohl, Stephen J

    2014-08-01

    In the present article we aim to bring forward the apparent disconnect between two US government-sponsored entities - the Institute of Medicine (IOM) and the Food and Drug Administration (FDA) - regarding the safe upper limit of Ca intake. In light of the 2011 US Congress-appointed IOM report indicating an upper limit of elemental Ca intake of 2000-2500 mg/d in adults (based on age group), it is perplexing that the FDA has not yet required a change on the labelling of over-the-counter Ca-containing antacids, some of which indicate an upper limit of elemental Ca intake of 2800-3000 mg/d. Even more concerning is that Ca intake is rarely from supplementation in isolation. National Health and Nutrition Examination Survey (NHANES) data from 2003-2006 indicate that mean dietary Ca intakes for males ranged from 871 to 1266 mg/d and for females from 748 to 968 mg/d depending on the age group. The estimated total Ca (diet + supplements) intake exceeded the upper limit in 5 % of the population older than 50 years. Furthermore, NHANES data from 1999-2000 indicate that when Ca is taken as part of an antacid preparation, patients often fail to report this as Ca intake. Thus, individuals taking the maximum allowable dose of supplemental Ca as antacids are at high risk for complications associated with excess Ca intake. Our hope is that by describing Ca homeostasis and highlighting the risks and dangers of Ca overload, the FDA will align its recommendation with the IOM and solve the current Ca conundrum in the USA for the sake of patient safety.

  18. [Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (ÖGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013].

    PubMed

    Singler, K; Stuck, A E; Masud, T; Goeldlin, A; Roller, R E

    2014-11-01

    Sound knowledge in the care and management of geriatric patients is essential for doctors in almost all medical subspecialties. Therefore, it is important that pregraduate medical education adequately covers the field of geriatric medicine. However, in most medical faculties in Europe today, learning objectives in geriatric medicine are often substandard or not even explicitly addressed. As a first step to encourage undergraduate teaching in geriatric medicine, the European Union of Medical Specialists -Geriatric Medicine Section (UEMS-GMS) recently developed a catalogue of learning goals using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end of their studies.In order to ease the implementation of this new, competence-based curriculum among the medical faculties in universities teaching in the German language, the authors translated the published English language curriculum into German and adapted it according to medical language and terms used at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties adapt their curricula for undergraduate teaching based on this catalogue.

  19. The experiences of implementing generic medicine policy in eight countries: A review and recommendations for a successful promotion of generic medicine use

    PubMed Central

    Hassali, Mohamed Azmi; Alrasheedy, Alian A.; McLachlan, Andrew; Nguyen, Tuan Anh; AL-Tamimi, Saleh Karamah; Ibrahim, Mohamed Izham Mohamed; Aljadhey, Hisham

    2013-01-01

    Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price. Thus, while providing the same therapeutic outcomes, generic medicines lead to substantial savings for healthcare systems. Therefore, the quality use of generic medicines is promoted in many countries. In this paper, we reviewed the role of generic medicines in healthcare systems and the experiences of promoting the use of generic medicines in eight selected countries, namely the United States (US), the United Kingdom (UK), Sweden, Finland, Australia, Japan, Malaysia and Thailand. The review showed that there are different main policies adopted to promote generic medicines such as generic substitution in the US, generic prescribing in the UK and mandatory generic substitution in Sweden and Finland. To effectively and successfully implement the main policy, different complementary policies and initiatives were necessarily introduced. Barriers to generic medicine use varied between countries from negative perceptions about generic medicines to lack of a coherent generic medicine policy, while facilitators included availability of information about generic medicines to both healthcare professionals and patients, brand interchangeability guidelines, regulations that support generic substitution by pharmacists, and incentives to both healthcare professionals and patients. PMID:25561861

  20. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576

  1. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159

  2. Challenges and recommendations for placebo controls in randomized trials in physical and rehabilitation medicine: a report of the international placebo symposium working group.

    PubMed

    Fregni, Felipe; Imamura, Marta; Chien, Hsin Fen; Lew, Henry L; Boggio, Paulo; Kaptchuk, Ted J; Riberto, Marcelo; Hsing, Wu Tu; Battistella, Linamara Rizzo; Furlan, Andrea

    2010-02-01

    Compared with other specialties, the field of physical and rehabilitation medicine has not received the deserved recognition from clinicians and researchers in the scientific community. One of the reasons is the lack of sound evidence to support the traditional physical and rehabilitation medicine treatments. The best way to change this disadvantage is through a well conducted clinical research, such as standard placebo- or sham-controlled randomized clinical trials. Therefore, having placebo groups in clinical trials is essential to improve the level of evidence-based practice in physical and rehabilitation medicine that ultimately translates to better clinical care. To address the challenges for the use of placebo in physical and rehabilitation medicine and randomized clinical trials and to create useful recommendations, we convened a working group during the inaugural International Symposium in Placebo (February 2009, in Sao Paulo, Brazil) in which the following topics were discussed: (1) current status of randomized clinical trials in physical and rehabilitation medicine, (2) challenges for the use of placebo in physical and rehabilitation medicine, (3) bioethics, (4) use of placebo in acupuncture trials and for the treatment of low-back pain, (5) mechanisms of placebo, and (6) insights from other specialties. The current article represents the consensus report from the working group.

  3. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

    PubMed

    Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

    2015-08-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

  4. Pre-graduate and post-graduate education in personalized medicine in the Czech Republic: statistics, analysis and recommendations.

    PubMed

    Polivka, Jiri; Polivka, Jiri; Karlikova, Marie; Topolcan, Ondrej

    2014-01-01

    The main goal of personalized medicine is the individualized approach to the patient's treatment. It could be achieved only by the integration of the complexity of novel findings in diverse "omics" disciplines, new methods of medical imaging, as well as implementation of reliable biomarkers into the medical care. The implementation of personalized medicine into clinical practice is dependent on the adaptation of pre-graduate and post-graduate medical education to these principles. The situation in the education of personalized medicine in the Czech Republic is analyzed together with novel educational tools that are currently established in our country. The EPMA representatives in the Czech Republic in cooperation with the working group of professionals at the Faculty of Medicine in Pilsen, Charles University in Prague have implemented the survey of personalized medicine awareness among students of Faculty of Medicine in Pilsen-the "Personalized Medicine Questionnaire". The results showed lacking knowledge of personalized medicine principles and students' will of education in this domain. Therefore, several educational activities addressed particularly to medical students and young physicians were realized at our facility with very positive evaluation. These educational activities (conferences, workshops, seminars, e-learning and special courses in personalized medicine (PM)) will be a part of pre-graduate and post-graduate medical education, will be extended to other medical faculties in our country. The "Summer School of Personalized Medicine in Plzen 2015" will be organized at the Faculty of Medicine and Faculty Hospital in Pilsen as the first event on this topic in the Czech Republic.

  5. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    PubMed

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate.

  6. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  7. Medicinal plants recommended by the world health organization: DNA barcode identification associated with chemical analyses guarantees their quality.

    PubMed

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; Dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines.

  8. The Record-Setting Flood of 2014 in Kelantan: Challenges and Recommendations from an Emergency Medicine Perspective and Why the Medical Campus Stood Dry

    PubMed Central

    BAHARUDDIN, Kamarul Aryffin; ABDULL WAHAB, Shaik Farid; NIK AB RAHMAN, Nik Hisamuddin; NIK MOHAMAD, Nik Arif; TUAN KAMAUZAMAN, Tuan Hairulnizam; MD NOH, Abu Yazid; ABDUL MAJOD, Mohd Roslani

    2015-01-01

    Floods are considered an annual natural disaster in Kelantan. However, the record-setting flood of 2014 was a ‘tsunami-like disaster’. Hospital Universiti Sains Malaysia was the only fully functioning hospital in the state and had to receive and manage cases from the hospitals and clinics throughout Kelantan. The experiences, challenges, and recommendations resulting from this disaster are highlighted from an emergency medicine perspective so that future disaster preparedness is truly a preparation. The history of how the health campus was constructed with the collaboration of Perunding Alam Bina and Perkins and Willis of Chicago is elaborated. PMID:26023289

  9. [Diagnosis and treatment of imported eosinophilia in travellers and immigrants: Recommendations of the Spanish Society of Tropical Medicine and International Health (SEMTSI)].

    PubMed

    Salas-Coronas, J; Ramírez-Olivencia, G; Pérez-Arellano, J L; Belhassen-García, M; Carranza-Rodríguez, C; García-Rodríguez, M; Villar-Garcia, J; Treviño-Maruri, B; Serre-Delcor, N; López-Vélez, R; Norman, F; Gómez-Junyent, J; Soriano-Pérez, M J; Rojo-Marcos, G; Rodríguez de Las Parras, E; Lago-Núñez, M M; Muro, A; Muñoz, J

    2017-02-01

    According to published data, prevalence of imported eosinophilia among travellers and immigrants is set between 8% and 28.5%. Etiological diagnosis is often troublesome, and depending on the depth of the study and on the population analyzed, a parasitic cause is identified in 17% to 75.9% of the individuals. Among the difficulties encountered to compare studies are the heterogeneity of the studied populations, the type of data collection (prospective/retrospective) and different diagnostic protocols. In this document the recommendations of the expert group of the Spanish Society of Tropical Medicine and International Health (SEMTSI) for the diagnosis and treatment of imported eosinophilia are detailed.

  10. Toward competency-based curricula in patient-centered spiritual care: recommended competencies for family medicine resident education.

    PubMed

    Anandarajah, Gowri; Craigie, Frederic; Hatch, Robert; Kliewer, Stephen; Marchand, Lucille; King, Dana; Hobbs, Richard; Daaleman, Timothy P

    2010-12-01

    Spiritual care is increasingly recognized as an important component of medical care. Although many primary care residency programs incorporate spiritual care into their curricula, there are currently no consensus guidelines regarding core competencies necessary for primary care training. In 2006, the Society of Teachers of Family Medicine's Interest Group on Spirituality undertook a three-year initiative to address this need. The project leader assembled a diverse panel of eight educators with dual expertise in (1) spirituality and health and (2) family medicine. The multidisciplinary panel members represented different geographic regions and diverse faith traditions and were nationally recognized senior faculty. They underwent three rounds of a modified Delphi technique to achieve initial consensus regarding spiritual care competencies (SCCs) tailored for family medicine residency training, followed by an iterative process of external validation, feedback, and consensus modifications of the SCCs. Panel members identified six knowledge, nine skills, and four attitude core SCCs for use in training and linked these to competencies of the Accreditation Council for Graduate Medical Education. They identified three global competencies for use in promotion and graduation criteria. Defining core competencies in spiritual care clarifies training goals and provides the basis for robust curricula evaluation. Given the breadth of family medicine, these competencies may be adaptable to other primary care fields, to medical and surgical specialties, and to medical student education. Effective training in this area may enhance physicians' ability to attend to the physical, mental, and spiritual needs of patients and better maintain sustainable healing relationships.

  11. From Systems Understanding to Personalized Medicine: Lessons and Recommendations Based on a Multidisciplinary and Translational Analysis of COPD.

    PubMed

    Roca, Josep; Cano, Isaac; Gomez-Cabrero, David; Tegnér, Jesper

    2016-01-01

    Systems medicine, using and adapting methods and approaches as developed within systems biology, promises to be essential in ongoing efforts of realizing and implementing personalized medicine in clinical practice and research. Here we review and critically assess these opportunities and challenges using our work on COPD as a case study. We find that there are significant unresolved biomedical challenges in how to unravel complex multifactorial components in disease initiation and progression producing different clinical phenotypes. Yet, while such a systems understanding of COPD is necessary, there are other auxiliary challenges that need to be addressed in concert with a systems analysis of COPD. These include information and communication technology (ICT)-related issues such as data harmonization, systematic handling of knowledge, computational modeling, and importantly their translation and support of clinical practice. For example, clinical decision-support systems need a seamless integration with new models and knowledge as systems analysis of COPD continues to develop. Our experience with clinical implementation of systems medicine targeting COPD highlights the need for a change of management including design of appropriate business models and adoption of ICT providing and supporting organizational interoperability among professional teams across healthcare tiers, working around the patient. In conclusion, in our hands the scope and efforts of systems medicine need to concurrently consider these aspects of clinical implementation, which inherently drives the selection of the most relevant and urgent issues and methods that need further development in a systems analysis of disease.

  12. The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

    PubMed

    Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

    2012-01-01

    The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.

  13. [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery. Joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].

    PubMed

    2011-09-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest-x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate and publish recommendations on the preoperative evaluation of adult patients prior to elective, non-cardiac and non-lung resection surgery. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  14. Medicinal Plants Recommended by the World Health Organization: DNA Barcode Identification Associated with Chemical Analyses Guarantees Their Quality

    PubMed Central

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines. PMID:25978064

  15. Child Care Provider Adherence to Infant and Toddler Feeding Recommendations: Findings from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) Study

    PubMed Central

    Davison, Kirsten K.; Hesketh, Kathryn; Taveras, Elsie M.; Gillman, Matthew W.; Benjamin Neelon, Sara E.

    2015-01-01

    Abstract Background: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity. Methods: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation. Results: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2–21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7–6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8–6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09–0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51–32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34–9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05–25.06) or fast foods (OR, 11.56; 95% CI, 3.20–41.80). Conclusions: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods. PMID:25918873

  16. Not so fast: IOM report warns of danger in rushing IT training, as providers, vendors push for keeping safety reporting voluntary.

    PubMed

    Daly, Rich

    2011-11-14

    Hospitals need to be vigilant in giving staff adequate training in using health IT, according to an IOM report. One hospital that's fully implemented an EHR can attest to the importance of engaging physicians in the process. "When needed, we were relentless in going after them to receive the training," says Denni McColm, of Citizens Memorial Healthcare, Bolivar, Mo..

  17. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment.

    PubMed

    Mathieu, Daniel; Marroni, Alessandro; Kot, Jacek

    2017-03-01

    The tenth European Consensus Conference on Hyperbaric Medicine took place in April 2016, attended by a large delegation of experts from Europe and elsewhere. The focus of the meeting was the revision of the European Committee on Hyperbaric Medicine (ECHM) list of accepted indications for hyperbaric oxygen treatment (HBOT), based on a thorough review of the best available research and evidence-based medicine (EBM). For this scope, the modified GRADE system for evidence analysis, together with the DELPHI system for consensus evaluation, were adopted. The indications for HBOT, including those promulgated by the ECHM previously, were analysed by selected experts, based on an extensive review of the literature and of the available EBM studies. The indications were divided as follows: Type 1, where HBOT is strongly indicated as a primary treatment method, as it is supported by sufficiently strong evidence; Type 2, where HBOT is suggested as it is supported by acceptable levels of evidence; Type 3, where HBOT can be considered as a possible/optional measure, but it is not yet supported by sufficiently strong evidence. For each type, three levels of evidence were considered: A, when the number of randomised controlled trials (RCTs) is considered sufficient; B, when there are some RCTs in favour of the indication and there is ample expert consensus; C, when the conditions do not allow for proper RCTs but there is ample and international expert consensus. For the first time, the conference also issued 'negative' recommendations for those conditions where there is Type 1 evidence that HBOT is not indicated. The conference also gave consensus-agreed recommendations for the standard of practice of HBOT.

  18. Is rest after concussion "the best medicine?": recommendations for activity resumption following concussion in athletes, civilians, and military service members.

    PubMed

    Silverberg, Noah D; Iverson, Grant L

    2013-01-01

    Practice guidelines universally recommend an initial period of rest for people who sustain a sports-related concussion or mild traumatic brain injury (MTBI) in daily life or military service. This practice is difficult to reconcile with the compelling evidence that other health conditions can be worsened by inactivity and improved by early mobilization and exercise. We review the scientific basis for the recommendation to rest after MTBI, the challenges and potential unintended negative consequences of implementing it, and how patient management could be improved by refining it. The best available evidence suggests that complete rest exceeding 3 days is probably not helpful, gradual resumption of preinjury activities should begin as soon as tolerated (with the exception of activities that have a high MTBI exposure risk), and supervised exercise may benefit patients with persistent symptoms.

  19. 76 FR 45825 - Center for Devices and Radiological Health 510(k) Clearance Process; Institute of Medicine Report...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... HUMAN SERVICES Food and Drug Administration Center for Devices and Radiological Health 510(k) Clearance Process; Institute of Medicine Report: ``Medical Devices and the Public's Health, The FDA 510(k) Clearance... Medicine (IOM) report entitled: ``Medical Devices and the Public's Health, The FDA 510(k) Clearance...

  20. Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making

    PubMed Central

    Brandeau, Margaret L.; McCoy, Jessica H.; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M.

    2013-01-01

    Purpose Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. We examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. Methods We reviewed a spectrum of published disaster response models addressing public health or healthcare delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. We developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. Results We propose six recommendations for model construction and reporting, inspired by the most exemplary models: Health sector disaster response models should address real-world problems; be designed for maximum usability by response planners; strike the appropriate balance between simplicity and complexity; include appropriate outcomes, which extend beyond those considered in traditional cost-effectiveness analyses; and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. Conclusions Quantitative models are critical tools for planning effective health sector responses to disasters. The recommendations we propose can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response. PMID:19605887

  1. An overview of the health care system in Georgia: expert recommendations in the context of predictive, preventive and personalised medicine

    PubMed Central

    2013-01-01

    The main aim of this paper is to present the current statistics and situation of health care system in Georgia; the changes in the transition period within the society and the health care system. Also presented are the efforts from the Government and the Ministry of Labour, Health and Social Affairs of Georgia in the way of numerous initiatives and action in order to improve quality care of patients and sustain the health care system. This paper described the institutional framework, process, content and implementation of health and health care policies in Georgia in the context of predictive, preventive and personalised medicine. PMID:23442219

  2. Fluid management in traumatic shock: a practical approach for mountain rescue. Official recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    PubMed

    Sumann, Günther; Paal, Peter; Mair, Peter; Ellerton, John; Dahlberg, Tore; Zen-Ruffinen, Gregoire; Zafren, Ken; Brugger, Hermann

    2009-01-01

    Sumann, Günther, Peter Paal, Peter Mair, John Ellerton, Tore Dahlberg, Gregoire Zen-Ruffinen, Ken Zafren, and Hermann Brugger. Fluid management in traumatic shock: a practical approach for mountain rescue. High Alt. Med. Biol. 10:71-75, 2009.-The management of severe injuries leading to traumatic shock in mountains and remote areas is a great challenge for emergency physicians and rescuers. Traumatic brain injury may further aggravate outcome. A mountain rescue mission may face severe limitations from the terrain and required rescue technique. The mission may be characterized by a prolonged prehospital care time, where urban traumatic shock protocols may not apply. Yet optimal treatment is of utmost importance. The aim of this study is to establish scientifically supported recommendations for fluid management that are feasible for the physician or paramedic attending such an emergency. A nonsystematic literature search was performed; the results and recommendations were discussed among the authors and accepted by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Diagnostic and therapeutic strategies are discussed, as well as limitations on therapy in mountain rescue. An algorithm for fluid resuscitation, derived from the recommendations, is presented in Fig. 1. Focused on the key criterion of traumatic brain injury, different levels of blood pressure are presented as a goal of therapy, and the practical means for achieving these are given.

  3. Medical standards for mountain rescue operations using helicopters: official consensus recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    PubMed

    Tomazin, Iztok; Ellerton, John; Reisten, Oliver; Soteras, Inigo; Avbelj, Miha

    2011-01-01

    The purpose of this article is to establish medical recommendations for safe and effective Helicopter Emergency Medical Systems (HEMS) in countries with a dedicated mountain rescue service. A nonsystematic search was undertaken and a consensus among members of International Commission for Mountain Emergency Medicine (ICAR Medcom) was reached. For the severely injured or ill patient, survival depends on approach time and quality of medical treatment by high-level providers. Helicopters can provide significant shortening of the times involved in mountain rescue. Safety is of utmost importance and everything possible should be done to minimize risk. Even in the mountainous environment, the patient should be reached as quickly as possible (optimally<20 min) and provided with on-site and en-route medical treatment according to international standards. The HEMS unit should be integrated into the Emergency Medical System of the region. All dispatchers should be aware of the specific problems encountered in mountainous areas. The nearest qualified HEMS team to the incident site, regardless of administrative boundaries, should be dispatched. The 'air rescue optimal crew' concept with its flexibility and adaptability of crewmembers ensures that all HEMS tasks can be performed. The helicopter and all equipment should be appropriate for the conditions and specific for mountain related emergencies. These recommendations, agreed by ICAR Medcom, establish recommendations for safe and effective HEMS in mountain rescue.

  4. ExCEL in Social Work: Excellence in Cancer Education & Leadership An Oncology Social Work Response to the 2008 Institute of Medicine Report

    PubMed Central

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A.; Ferrell, Betty

    2014-01-01

    ExCEL in Social Work : Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program’s curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers - the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers. PMID:25146345

  5. ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report.

    PubMed

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty

    2015-09-01

    ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.

  6. A Strategic Vision for NSF Investments in Antarctic and Southern Ocean Research: Recommendations of a New Study from the National Academes of Sciences, Engineering, and Medicine.

    NASA Astrophysics Data System (ADS)

    Weller, R. A.; Bell, R. E.; Geller, L.

    2015-12-01

    A Committee convened by the National Academies of Sciences, Engineering, and Medicine carried out a study (at the request of NSF's Division of Polar Programs) to develop a strategic vision for the coming decade of NSF's investments in Antarctic and Southern Ocean research. The study was informed by extensive efforts to gather ideas from researchers across the United States. This presentation will provide an overview of the Committee's recommendations—regarding an overall strategic framework for a robust U.S. Antarctic program, regarding the specific areas of research recommended as highest priority for NSF support, and regarding the types of infrastructure, logistical support, data management, and other critical foundations for enabling and adding lasting value to the proposed research .

  7. [Diagnosis and treatment of imported malaria in Spain: Recommendations from the Malaria Working Group of the Spanish Society of Tropical Medicine and International Health (SEMTSI)].

    PubMed

    Muñoz, Jose; Rojo-Marcos, Gerardo; Ramírez-Olivencia, Germán; Salas-Coronas, Joaquín; Treviño, Begoña; Perez Arellano, José Luis; Torrús, Diego; Muñoz Vilches, Maria Jose; Ramos, Jose Manuel; Alegría, Iñaki; López-Vélez, Rogelio; Aldasoro, Edelweiss; Perez-Molina, Jose Antonio; Rubio, Jose Miguel; Bassat, Quique

    2015-01-01

    Malaria is a common parasitic disease diagnosed in the returned traveler. Mortality in travelers with imported malaria is around 2-3%, and one of the main factors associated with poor prognosis is the delay in the diagnosis and treatment. Imported malaria cases usually present with fever, headache and myalgia, but other symptoms may appear. The diagnosis should be performed as soon as possible, using thick smear or rapid diagnostic tests, and a blood smear. Treatment should be initiated urgently. In cases of severe malaria, the use of intravenous artemisinins has proved to be superior to intravenous quinine. This document reviews the recommendations of the expert group of the Spanish Society of Tropical Medicine and International Health (SEMTSI) for the diagnosis and treatment of imported malaria in Spain.

  8. The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a list of recommendations and additional conclusions: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.

    PubMed

    Le Roux, Peter; Menon, David K; Citerio, Giuseppe; Vespa, Paul; Bader, Mary Kay; Brophy, Gretchen; Diringer, Michael N; Stocchetti, Nino; Videtta, Walter; Armonda, Rocco; Badjatia, Neeraj; Bösel, Julian; Chesnut, Randall; Chou, Sherry; Claassen, Jan; Czosnyka, Marek; De Georgia, Michael; Figaji, Anthony; Fugate, Jennifer; Helbok, Raimund; Horowitz, David; Hutchinson, Peter; Kumar, Monisha; McNett, Molly; Miller, Chad; Naidech, Andrew; Oddo, Mauro; Olson, DaiWai; O'Phelan, Kristine; Provencio, J Javier; Puppo, Corinna; Riker, Richard; Roberson, Claudia; Schmidt, Michael; Taccone, Fabio

    2014-12-01

    Careful patient monitoring using a variety of techniques including clinical and laboratory evaluation, bedside physiological monitoring with continuous or non-continuous techniques and imaging is fundamental to the care of patients who require neurocritical care. How best to perform and use bedside monitoring is still being elucidated. To create a basic platform for care and a foundation for further research the Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to develop recommendations about physiologic bedside monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews as a background to the recommendations. In this article, we highlight the recommendations and provide additional conclusions as an aid to the reader and to facilitate bedside care.

  9. A survey of emergency medical services in mountain areas of Europe and North America: official recommendations of the International Commission for Mountain Emergency Medicine (ICAR Medcom).

    PubMed

    Brugger, Hermann; Elsensohn, Fidel; Syme, Dave; Sumann, Günther; Falk, Markus

    2005-01-01

    Survey of on-site treatment of patients in mountain areas of 14 countries in Europe and North America (nonresponder rate 33%) to compare emergency medical services. Around 37,535 ground rescuers and 747 helicopters are ready for evacuation of casualties and patients in mountain areas. And 1316 physicians and 50,967 paramedics take part in ground and air mountain rescue operations. In Europe, 63.2% of helicopters have a physician on board, 17.8% are staffed with a paramedic, and 19% have no medically trained personnel on board. In North America, 31.6% (p < 0.001) of helicopters are staffed with a doctor, 59.3% (p < 0.001) with a paramedic, and 9.1% (p < 0.001) have no medical personnel. The percentage of on-site treatment according to the recommendations of the International Liaison Committee on Resuscitation (ILCOR) or International Commission for Alpine Rescue (ICAR) varies among all countries (p < 0.001) and is positively related to the percentage of physician-staffed helicopters (r = 0.76, p < 0.001). Paramedics in 90.9% countries are obliged to be medically trained, but physicians only need to have a standardized training in emergency medicine in 50% (p < 0.042). On-site treatment according to ILCOR or ICAR recommendations is performed more often in countries where physicians are regularly involved in mountain rescue operations. However, no conclusions can be drawn from the data as to the efficiency of treatment. The data show a lack of medical education in specific, mountain rescue-related problems. Physicians involved should undergo suitable training.

  10. [Policy recommendations based on SWOT analysis for agricultural industrialization of traditional Chinese medicinal materials--a case study of uncariae ramulus cum uncis from Jianhe county in Guizhou province].

    PubMed

    Hu, Yong; Huo, Ke-Yi; Xiang, Hua

    2013-09-01

    This thesis reviews the historical background of agricultural industrialization, and analyzes the major theories of agricultural industrialization. It also utilizes SWOT analysis method to discuss the industrialization of traditional Chinese medicinal materials in Jianhe county, and finally it puts forward the recommendations for its further development.

  11. Immobilization and splinting in mountain rescue. Official Recommendations of the International Commission for Mountain Emergency Medicine, ICAR MEDCOM, Intended for Mountain Rescue First Responders, Physicians, and Rescue Organizations.

    PubMed

    Ellerton, John; Tomazin, Iztok; Brugger, Hermann; Paal, Peter

    2009-01-01

    Immobilization and splinting of fractures are essential to reduce morbidity and mortality in mountain rescue. Therefore, members of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) debated the results of a literature review carried out by the authors. Focusing on common immobilization and splinting techniques relevant to mountain rescue, a consensus document was formulated. Pain relief of appropriate speed of onset and strength should be available on scene. Spinal immobilization is recommended for all casualties that have sustained head or spine injury. The preferred method is a vacuum mattress with an appropriately sized rigid cervical collar. In such casualties, only those in an unsafe environment or with time-critical injuries should be evacuated before spinal immobilization is performed. In some casualties, the cervical spine may be cleared and a cervical collar may be omitted. In the presence of hemodynamic instability and where there is a suspicion of a fractured pelvis, an external compression splint should be applied. Splinting of a femoral shaft fracture is important to limit pain and life-threatening blood loss. If time allows, extremity fractures should be adequately splinted and, if the practitioner is skilled, a displaced fracture or joint dislocation should be reduced on scene with the use of appropriate analgesia.

  12. Critical assessment of high-circulation print newspaper coverage of the Institute of Medicine report Dietary Reference Intakes for Calcium and Vitamin D

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this article is to evaluate high-circulation US and Canadian newspaper coverage of the Institute of Medicine (IOM) report Dietary Reference Intakes for Calcium and Vitamin D and assess pre-report and post-report reporter-specific vitamin D-related coverage. Two independent reviewers...

  13. Health-related quality of life (HR-QOL) and regulatory issues. An assessment of the European Agency for the Evaluation of Medicinal Products (EMEA) recommendations on the use of HR-QOL measures in drug approval.

    PubMed

    Apolone, G; De Carli, G; Brunetti, M; Garattini, S

    2001-01-01

    Interest in measuring qualitative aspects of life that are most closely related to health and healthcare has increased in recent years. Methods of describing patients' subjective health status now incorporate standardised measures, and several psychometric measures are available. Despite the thousands of empirical and conceptual papers in the medical and pharmacological literature on health-related quality of life (HR-QOL), the value of such measures in the regulatory process is still being debated. We conducted an assessment to understand and document the position of the European Agency for the Evaluation of Medicinal Products (EMEA) on the use of HR-QOL measures in studies conducted for regulatory purposes. Official documents produced and circulated by the EMEA containing recommendations on trial design, conduct and analysis for sponsors and scientific experts were independently reviewed by authors to document the position of the Agency on the specific topic of HR-QOL. All documents found in the Agency website on 30 September 1999 were identified and then assessed to: (i) identify diseases or drugs for which formal HR-QOL assessment is recommended; (ii) identify measures and methods recommended; and (iii) evaluate the reliability of recommendations across documents. Of the 189 documents retrieved, none focused directly on health-related quality of life. A few explicit recommendations were identified for 13 specific drugs or conditions. These recommendations were mostly general and vague, and used nonstandard terminology. In addition, terminology and recommendations were not consistent across documents and, in at least one case, were in contrast with the US Food and Drug Administration (FDA) guidelines. EMEA guidelines incorporating quality-of-life outcomes are welcomed but it is obvious that more detailed guidance is required. Closer collaboration between the EMEA and the FDA is also recommended. Experts from different disciplines should be involved in the

  14. Recommendations of the German Society for Medical Education and the German Association of Medical Faculties regarding university-specific assessments during the study of human, dental and veterinary medicine.

    PubMed

    Jünger, Jana; Just, Ingo

    2014-01-01

    The practice of assessing student performance in human, dental and veterinary medicine at universities in German-speaking countries has undergone significant changes in the past decade. Turning the focus to practical requirements regarding medical practice during undergraduate study away from an often theory-dominated curriculum, the academic scrutiny of the basics of teaching medical knowledge and skills, and amendments to legislation, all require ongoing adjustments to curricula and the ways in which assessments are done during undergraduate medical education. To establish quality standards, the Gesellschaft für medizinische Ausbildung (GMA German Society for Medical Education) reached a consensus in 2008 on recommendations for administering medical school-specific exams which have now been updated and approved by the GMA assessments committee, together with the Medizinischer Fakultätentag (MFT German Association of Medical Faculties), as recommendations for the administration of high-quality assessments.

  15. Ten years after the IOM report: Engaging residents in quality and patient safety by creating a House Staff Quality Council.

    PubMed

    Fleischut, Peter M; Evans, Adam S; Nugent, William C; Faggiani, Susan L; Lazar, Eliot J; Liebowitz, Richard S; Forese, Laura L; Kerr, Gregory E

    2011-01-01

    Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

  16. A Multicenter Study of the Family Educational Rights and Privacy Act and the Standardized Letter of Recommendation: Impact on Emergency Medicine Residency Applicant and Faculty Behaviors

    PubMed Central

    Diab, Jessica; Riley, Stephanie; Downes, Andrew; Gaeta, Theodore; Hern, H. Gene; Hwang, Eric; Kass, Lawrence; Kelly, Michael; Luber, Samuel D.; Martel, Marc; Minns, Alicia; Patterson, Leigh; Pazderka, Philip; Sayan, Osman; Thurman, Jason; Vallee, Phyllis; Overton, David

    2014-01-01

    Background Residency applicants have the right to see letters of recommendation written on their behalf. It is not known whether applicants are affected by waiving this right. Objectives Our multicenter study assessed how frequently residency applicants waived their FERPA rights to view their letters of recommendation, and whether this affected the ratings they were given by faculty. Methods We reviewed all ERAS-submitted letters of recommendation to 14 ACGME-accredited programs in 2006–2007. We collected ERAS ID, program name, FERPA declaration, standardized letter of recommendation (SLOR) use, and SLOR Global Assessment ranking. The percentage of applicants who waived their FERPA rights was determined. Chi-square tests of independence assessed whether applicants' decision to waive their FERPA rights was associated with their SLOR Global Assessment. Results We examined 1776 applications containing 6424 letters of recommendations. Of 2736 letters that specified a Global Assessment, 2550 (93%) applicants waived their FERPA rights, while 186 did not. Of the applicants who chose not to waive their rights, 45.6% received a ranking of Outstanding, 35.5% Excellent, 18.3% Very Good, and 1.6% Good. Of applicants who waived their FERPA rights, 35.1% received a ranking of Outstanding, 49.6% Excellent, 13.7% Very Good, and 1.6% Good. Applicants who did not waive their FERPA rights were more likely to receive an Outstanding Assessment (P  =  .003). Conclusions The majority (93%) of residency applicants waived their FERPA rights. Those who did not waive their rights had a statistically higher chance of receiving an Outstanding Assessment than those who did. PMID:24949134

  17. Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: a position paper of the Society for Adolescent Health and Medicine.

    PubMed

    2013-04-01

    Adolescent health care providers frequently care for patients who identify as lesbian, gay, bisexual, or transgendered (LGBT), or who may be struggling with or questioning their sexual orientation or gender identity. Whereas these youth have the same health concerns as their non-LGBT peers, LGBT teens may face additional challenges because of the complexity of the coming-out process, as well as societal discrimination and bias against sexual and gender minorities. The Society for Adolescent Health and Medicine encourages adolescent providers and researchers to incorporate the impact of these developmental processes (and understand the impacts of concurrent potential discrimination) when caring for LGBT adolescents. The Society for Adolescent Health and Medicine also encourages providers to help positively influence policy related to LGBT adolescents in schools, the foster care system, and the juvenile justice system, and within the family structure. Consistent with other medical organizations, the Society for Adolescent Health and Medicine rejects the mistaken notion that LGBT orientations are mental disorders, and opposes the use of any type of reparative therapy for LGBT adolescents.

  18. A blueprint for maternal and child health primary care physician education in medical genetics and genomic medicine: recommendations of the United States secretary for health and human services advisory committee on heritable disorders in newborns and children.

    PubMed

    Kemper, Alex R; Trotter, Tracy L; Lloyd-Puryear, Michele A; Kyler, Penny; Feero, W Gregory; Howell, R Rodney

    2010-02-01

    Primary health care providers will play an increasingly important role in delivering genetics-related services for women and children along the reproductive continuum. However, most primary health care providers have received little training in genetics or medical genomics to incorporate such services into routine care. A workshop was convened by the National Institutes of Health, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration to identify practical strategies to educate primary care physicians involved in maternal and child health. These included developing a targeted curriculum for residency training programs, incorporating assessments of genetics and genomic medicine into the initial board certification process and the process for maintenance of certification, providing continuing medical education opportunities at national meetings, establishing an Internet-based repository of recommendations for primary care providers, and forming a learning collaborative to link primary care providers and specialists to evaluate strategies to improve care. Workgroup members underscored the importance of assessing the impact of these interventions on the process and outcomes of health care delivery. The recommendations from this workshop were presented to the United States Secretary for Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children Subcommittee on Education and Training. The Subcommittee reviewed the report and put forth recommendations to the Committee, which were adopted by the Committee in September 2009.

  19. Functional fitting of interstitial brachytherapy dosimetry data recommended by the AAPM Radiation Therapy Committee Task Group 43. American Association of Physicists in Medicine.

    PubMed

    Furhang, E E; Anderson, L L

    1999-02-01

    This work was undertaken to expedite implementation of the AAPM Task Group 43 recommendations, which call for significant modifications in the way dose is calculated for interstitial sources of 192Ir, 125I, and 103Pd as well as significant changes in the dose rate constant for 125I sources. The TG43 recommendations include a new formalism for dose calculation at points defined by the radial distance, r, from the source center and the angle, theta, that such a radius makes with the source axis. For each source type, values are tabulated for the radial dose function, the anisotropy function, and the anisotropy factor. The TG43 report includes fitting functions for the radial dose function in the form of polynomials, which are poorly behaved outside the range of fitted data. No functions are offered for the anisotropy function data or the anisotropy factor data, both of which could profit from some smoothing by such functions. We have found a double exponential fit to the radial dose function that not only approximates the data adequately but also appropriately approaches zero for very large distances. The anisotropy function is conveniently fit with a form of type 1 - f(r,theta)cos(theta)e(cr), which is exactly 1 at theta=90 degrees and approaches 1 for large r (for c<0), where f(r,theta) is a selected polynomial in the two variables. The form chosen for the anisotropy factor was 1 - (a+br)e(cr), which appropriately approaches 1 for large r (and c<0). Functional fits of these types are expected to facilitate implementation of TG43 recommendations, in that they may be either incorporated into dose algorithms or used to generate lookup tables of either the x, y or the r, theta format.

  20. Recommendations for standards in transthoracic two-dimensional echocardiography in the dog and cat. Echocardiography Committee of the Specialty of Cardiology, American College of Veterinary Internal Medicine.

    PubMed

    Thomas, W P; Gaber, C E; Jacobs, G J; Kaplan, P M; Lombard, C W; Moise, N S; Moses, B L

    1993-01-01

    Recommendations are presented for standardized imaging planes and display conventions for two-dimensional echocardiography in the dog and cat. Three transducer locations ("windows") provide access to consistent imaging planes: the right parasternal location, the left caudal (apical) parasternal location, and the left cranial parasternal location. Recommendations for image display orientations are very similar to those for comparable human cardiac images, with the heart base or cranial aspect of the heart displayed to the examiner's right on the video display. From the right parasternal location, standard views include a long-axis four-chamber view and a long-axis left ventricular outflow view, and short-axis views at the levels of the left ventricular apex, papillary muscles, chordae tendineae, mitral valve, aortic valve, and pulmonary arteries. From the left caudal (apical) location, standard views include long-axis two-chamber and four-chamber views. From the left cranial parasternal location, standard views include a long-axis view of the left ventricular outflow tract and ascending aorta (with variations to image the right atrium and tricuspid valve, and the pulmonary valve and pulmonary artery), and a short-axis view of the aortic root encircled by the right heart. These images are presented by means of idealized line drawings. Adoption of these standards should facilitate consistent performance, recording, teaching, and communicating results of studies obtained by two-dimensional echocardiography.

  1. Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) Clinical Practice Recommendations: National Academy of Sciences' Institute of Medicine Burn Pits Workshop.

    PubMed

    Szema, Anthony; Mirsaidi, Niely; Patel, Bhumika; Viens, Laura; Forsyth, Edward; Li, Jonathan; Dang, Sophia; Dukes, Brittany; Giraldo, Jheison; Kim, Preston; Burns, Matthew

    2015-12-14

    High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical symptoms among soldiers post-deployment to the Middle East. Subsequent to initiation of the Burnpits360.org website, the Department of Veterans Affairs started the Airborne Hazards and Open Burn Pit registry. This paper: (a) analyzes the latest 38 patients in the Burnpits360.org registry, validated by DD214 Forms; (b) compares strengths and weaknesses of both registries as outlined at the National Academy of Sciences Institute of Medicine Burn Pits Workshop; (c) further characterizes the spectrum of disease in IAW-LI; (d) describes the risk factors of affected populations; (e) summarizes current practices regarding management of the condition; and (f) defines future research objectives.

  2. Eye problems in mountain and remote areas: prevention and onsite treatment--official recommendations of the International Commission for Mountain Emergency Medicine ICAR MEDCOM.

    PubMed

    Ellerton, John A; Zuljan, Igor; Agazzi, Giancelso; Boyd, Jeffrey J

    2009-01-01

    Although eyes are not frequently injured in the mountains, they are exposed to many adverse factors from the environment. This article, intended for first responders, paramedics, physicians, and mountaineers, is the consensus opinion of the International Commission for Mountain Emergency Medicine (ICAR-MEDCOM). Its aim is to give practical advice on the management of eye problems in mountainous and remote areas. Snow blindness and minor injuries, such as conjunctival and corneal foreign bodies, could immobilize a person and put him or her at risk of other injuries. Blunt or penetrating trauma can result in the loss of sight in the eye; this may be preventable if the injury is managed properly. In almost all cases of severe eye trauma, protecting the eye and arranging an immediate evacuation are necessary. The most common eye problems, however, are due to ultraviolet light and high altitude. People wearing contact lenses and with previous history of eye diseases are more vulnerable. Any sight-threatening eye problem or unexplained visual loss at high altitude necessitates descent. Wearing appropriate eye protection, such as sunglasses with sidepieces and goggles with polarized or photochromic lenses, could prevent most of the common eye problems in mountaineering.

  3. Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for {sup 90}Y microsphere brachytherapy in the treatment of hepatic malignancies

    SciTech Connect

    Dezarn, William A.; Cessna, Jeffery T.; DeWerd, Larry A.; and others

    2011-08-15

    Yttrium-90 microsphere brachytherapy of the liver exploits the distinctive features of the liver anatomy to treat liver malignancies with beta radiation and is gaining more wide spread clinical use. This report provides a general overview of microsphere liver brachytherapy and assists the treatment team in creating local treatment practices to provide safe and efficient patient treatment. Suggestions for future improvements are incorporated with the basic rationale for the therapy and currently used procedures. Imaging modalities utilized and their respective quality assurance are discussed. General as well as vendor specific delivery procedures are reviewed. The current dosimetry models are reviewed and suggestions for dosimetry advancement are made. Beta activity standards are reviewed and vendor implementation strategies are discussed. Radioactive material licensing and radiation safety are discussed given the unique requirements of microsphere brachytherapy. A general, team-based quality assurance program is reviewed to provide guidance for the creation of the local procedures. Finally, recommendations are given on how to deliver the current state of the art treatments and directions for future improvements in the therapy.

  4. Standardizing terms, definitions and concepts for describing and interpreting unwanted immunogenicity of biopharmaceuticals: recommendations of the Innovative Medicines Initiative ABIRISK consortium.

    PubMed

    Rup, B; Pallardy, M; Sikkema, D; Albert, T; Allez, M; Broet, P; Carini, C; Creeke, P; Davidson, J; De Vries, N; Finco, D; Fogdell-Hahn, A; Havrdova, E; Hincelin-Mery, A; C Holland, M; H Jensen, P E; Jury, E C; Kirby, H; Kramer, D; Lacroix-Desmazes, S; Legrand, J; Maggi, E; Maillère, B; Mariette, X; Mauri, C; Mikol, V; Mulleman, D; Oldenburg, J; Paintaud, G; R Pedersen, C; Ruperto, N; Seitz, R; Spindeldreher, S; Deisenhammer, F

    2015-09-01

    Biopharmaceuticals (BPs) represent a rapidly growing class of approved and investigational drug therapies that is contributing significantly to advancing treatment in multiple disease areas, including inflammatory and autoimmune diseases, genetic deficiencies and cancer. Unfortunately, unwanted immunogenic responses to BPs, in particular those affecting clinical safety or efficacy, remain among the most common negative effects associated with this important class of drugs. To manage and reduce risk of unwanted immunogenicity, diverse communities of clinicians, pharmaceutical industry and academic scientists are involved in: interpretation and management of clinical and biological outcomes of BP immunogenicity, improvement of methods for describing, predicting and mitigating immunogenicity risk and elucidation of underlying causes. Collaboration and alignment of efforts across these communities is made difficult due to lack of agreement on concepts, practices and standardized terms and definitions related to immunogenicity. The Innovative Medicines Initiative (IMI; www.imi-europe.org), ABIRISK consortium [Anti-Biopharmaceutical (BP) Immunization Prediction and Clinical Relevance to Reduce the Risk; www.abirisk.eu] was formed by leading clinicians, academic scientists and EFPIA (European Federation of Pharmaceutical Industries and Associations) members to elucidate underlying causes, improve methods for immunogenicity prediction and mitigation and establish common definitions around terms and concepts related to immunogenicity. These efforts are expected to facilitate broader collaborations and lead to new guidelines for managing immunogenicity. To support alignment, an overview of concepts behind the set of key terms and definitions adopted to date by ABIRISK is provided herein along with a link to access and download the ABIRISK terms and definitions and provide comments (http://www.abirisk.eu/index_t_and_d.asp).

  5. Standardizing terms, definitions and concepts for describing and interpreting unwanted immunogenicity of biopharmaceuticals: recommendations of the Innovative Medicines Initiative ABIRISK consortium

    PubMed Central

    Rup, B; Pallardy, M; Sikkema, D; Albert, T; Allez, M; Broet, P; Carini, C; Creeke, P; Davidson, J; De Vries, N; Finco, D; Fogdell-Hahn, A; Havrdova, E; Hincelin-Mery, A; C Holland, M; H Jensen, P E; Jury, E C; Kirby, H; Kramer, D; Lacroix-Desmazes, S; Legrand, J; Maggi, E; Maillère, B; Mariette, X; Mauri, C; Mikol, V; Mulleman, D; Oldenburg, J; Paintaud, G; R Pedersen, C; Ruperto, N; Seitz, R; Spindeldreher, S; Deisenhammer, F

    2015-01-01

    Biopharmaceuticals (BPs) represent a rapidly growing class of approved and investigational drug therapies that is contributing significantly to advancing treatment in multiple disease areas, including inflammatory and autoimmune diseases, genetic deficiencies and cancer. Unfortunately, unwanted immunogenic responses to BPs, in particular those affecting clinical safety or efficacy, remain among the most common negative effects associated with this important class of drugs. To manage and reduce risk of unwanted immunogenicity, diverse communities of clinicians, pharmaceutical industry and academic scientists are involved in: interpretation and management of clinical and biological outcomes of BP immunogenicity, improvement of methods for describing, predicting and mitigating immunogenicity risk and elucidation of underlying causes. Collaboration and alignment of efforts across these communities is made difficult due to lack of agreement on concepts, practices and standardized terms and definitions related to immunogenicity. The Innovative Medicines Initiative (IMI; http://www.imi-europe.org), ABIRISK consortium [Anti-Biopharmaceutical (BP) Immunization Prediction and Clinical Relevance to Reduce the Risk; http://www.abirisk.eu] was formed by leading clinicians, academic scientists and EFPIA (European Federation of Pharmaceutical Industries and Associations) members to elucidate underlying causes, improve methods for immunogenicity prediction and mitigation and establish common definitions around terms and concepts related to immunogenicity. These efforts are expected to facilitate broader collaborations and lead to new guidelines for managing immunogenicity. To support alignment, an overview of concepts behind the set of key terms and definitions adopted to date by ABIRISK is provided herein along with a link to access and download the ABIRISK terms and definitions and provide comments (http://www.abirisk.eu/index_t_and_d.asp). PMID:25959571

  6. Regionalization and emergency care: the institute of medicine reports and a federal government update.

    PubMed

    Carr, Brendan G; Asplin, Brent R

    2010-12-01

    The 2010 Academic Emergency Medicine consensus conference on regionalization in emergency care began with an update on the Institute of Medicine (IOM) reports on the Future of Emergency Care. This was followed by two presentations from federal officials, focusing on regionalization from the perspective of the White House National Security Staff and the Emergency Care Coordination Center. This article summarizes the content of these presentations. It should be noted that this summary is the perspective of the authors and does not represent the official policy of the U.S. government.

  7. [Educational objectives in the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Techniques" under the 9th Revision of the Licensing Regulations for Doctors--consensus recommendations of the German Society for Rehabilitative Sciences and the German Society for Physical Medicine and Rehabilitation].

    PubMed

    Mau, W; Gülich, M; Gutenbrunner, C; Lampe, B; Morfeld, M; Schwarzkopf, S R; Smolenski, U C

    2004-12-01

    In October 2003 the 9 (th) revision of the Federal Medical Training Regulations (Approbationsordnung) came into effect. The new compulsory interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" offers the opportunity to teach all students in comprehensive concepts of Rehabilitation such as the International Classification of Functioning, Disability and Health (ICF) of the WHO and the new book 9 of the German Social Code (SGB 9), as well as Physical Medicine and Naturopathic Treatment. Since the content of this new subject has not been defined up to date a joint task force of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation was founded in order to recommend teaching standards. As part of these teaching standards educational objectives are introduced in this article. They should guide the persons in charge of teaching the subject in the medical faculties. In some areas the students should acquire profound abilities and skills in addition to knowledge. The medical faculties may focus on different educational targets according to their individual teaching profile.

  8. Travel medicine

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  9. Review of the Institute of Medicine Report: Long-term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan

    DTIC Science & Technology

    2012-01-01

    adopted the categories of association used for previous reports re- garding the fi rst Gulf War and health , and Agent Orange and health , based on...pit sites, and further investigation of possible long-term health effects . Strengths of the study included the ability to use com- prehensive...Veterans Af- fairs (VA) asked the Institute of Medicine (IOM)* to: Determine the long-term health effects from exposure to burn pits in Iraq and Afghanistan

  10. Assessing Weight Gain by the 2009 Institute of Medicine Guidelines and Perinatal Outcomes in Twin Pregnancy.

    PubMed

    Ozcan, Tulin; Bacak, Stephen J; Zozzaro-Smith, Paula; Li, Dongmei; Sagcan, Seyhan; Seligman, Neil; Glantz, Christopher J

    2016-07-23

    Objective The objective is to estimate the impact of maternal weight gain outside the 2009 Institute of Medicine recommendations on perinatal outcomes in twin pregnancies. Study Design Twin pregnancies with two live births between January 1, 2004 and December 31, 2014 delivered after 23 weeks Finger Lakes Region Perinatal Data System (FLRPDS) and Central New York Region Perinatal Data System were included. Women were classified into three groups using pre-pregnancy body mass index (BMI). Perinatal outcomes in women with low or excessive weekly maternal weight gain were assessed using normal weekly weight gain as the referent in each BMI group. Results Low weight gain increased the risk of preterm delivery, birth weight less than the 10th percentile for one or both twins and decreased risk of macrosomia across all BMI groups. There was a decreased risk of hypertensive disorders in women with normal pre-pregnancy weight and an increased risk of gestational diabetes with low weight gain in obese women. Excessive weight gain increased the risk of hypertensive disorders and macrosomia across all BMI groups and decreased the risk of birth weight less than 10th percentile one twin in normal pre-pregnancy BMI group. Conclusion Among twin pregnancies, low weight gain is associated with low birth weight and preterm delivery in all BMI groups and increased risk of gestational diabetes in obese women. Our study did not reveal any benefit from excessive weekly weight gain with potential harm of an increase in risk of hypertensive disorders of pregnancy. Normal weight gain per 2009 IOM guidelines should be encouraged to improve pregnancy outcome in all pre-pregnancy BMI groups.

  11. [Recommendations for the use of faecal microbiota transplantation "stool transplantation": consensus of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) in cooperation with the Austrian Society of Infectious Diseases and Tropical Medicine].

    PubMed

    Kump, P K; Krause, R; Steininger, C; Gröchenig, H P; Moschen, A; Madl, C; Novacek, G; Allerberger, F; Högenauer, C

    2014-12-01

    The intestinal microbiota has a pivotal role in the maintenance of health of the human organism, especially in the defense against pathogenic microorganisms. Alterations in the microbiota, also termed dysbiosis, seem to be involved in the pathogenesis of a variety of intestinal and extraintestinal diseases. Fecal microbiota transplantation (FMT), also known as stool transplantation, is a therapeutic procedure aiming at restoring an altered intestinal microbiota by administration of stool microorganisms from a healthy donor into the intestinal tract of a patient. FMT is most commonly used for recurrent forms of Clostridium difficile infections (CDI). There are currently many cohort studies in a large number of patients and a randomized controlled trial showing a dramatic effect of FMT for this indication. Therefore FMT is recommended by international medical societies for the treatment of recurrent CDI with high scientific evidence. Other potential indications are the treatment of fulminant CDI or the treatment of inflammatory bowel diseases. In the practical utilization of FMT there are currently several open questions regarding the screening of stool donors, the processing of stool and the mode of FMT application. Different modes of FMT application have been described, the application into the colon has to be preferred due to less reported side effects than the application into the upper gastrointestinal tract. So far only very few side effects due to FMT have been reported, nevertheless the use and risks of FMT are currently intensely debated in the medical community. This consensus report of the Austrian society of gastroenterology and hepatology (ÖGGH) in cooperation with the Austrian society of infectious diseases and tropical medicine provides instructions for physicians who want to use FMT which are based on the current medical literature.

  12. The future of nursing: domestic agenda, global implications.

    PubMed

    Shaffer, Franklin A; Davis, Catherine R; To Dutka, Julia; Richardson, Donna R

    2014-10-01

    The 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, challenges the nursing profession to take a key role in redesigning the health care system. Intended to shape the future of nursing in the United States, the IOM report has implications for nursing worldwide. While individual states and nursing organizations are developing initiatives to implement the IOM recommendations in the United States, there must be a concomitant effort to examine the ripple effect on global health and the nursing community. This article addresses four IOM recommendations that are directly relevant to internationally educated nurses who practice across borders: nurse residency programs, lifelong learning, leading change to advance health, and interprofessional health care workforce data. The article discusses the IOM recommendations through a global perspective and offers policy implications for legislators, health care organizations and nurse educators, regulators and administrators.

  13. [Sugar and diabetes: international recommendations].

    PubMed

    Sanz París, Alejandro; Boj Carceller, Diana; Melchor Lacleta, Isabel; Albero Gamboa, Ramón

    2013-07-01

    Nutrition in the diabetic patient is not just a mere nutrient but his treatment is based. In fact, international scientific societies have called "medical nutrition therapy" to give it the emphasis it deserves. Nutritional recommendations of scientific societies have been changing in recent years with evidence-based medicine. Regarding the consumption of sugar, most believe it does not affect metabolic control if it is replaced by other carbohydrates, but does not indicate a specific amount.

  14. Diabetes Medicines

    MedlinePlus

    ... Problems Diabetes & Sexual & Urologic Problems Insulin, Medicines, & Other Diabetes Treatments Taking insulin or other diabetes medicines is ... also available. What medicines might I take for diabetes? The medicine you take will vary by your ...

  15. Calling the shots: immunization finance policies and practices. Executive summary of the report of the Institute of Medicine.

    PubMed

    Guyer, B; Smith, D R; Chalk, R

    2000-10-01

    Federal, state, and private-sector investments in vaccine purchases and immunization programs are lagging behind emerging opportunities to reduce the risks of vaccine-preventable disease. Although federal assistance to the states for immunization programs and data collection efforts rapidly expanded in the early part of the 1990s, significant cutbacks have occurred in the last 5 years that have reduced the size of state grant awards by more than 50% from their highest point. During this same period, the vaccine delivery system for children and adults has become more complex and fragmented. This combination of new challenges and reduced resources has led to instability in the public health infrastructure that supports the U. S. immunization system. Many states have reduced the scale of their immunization programs and currently lack adequate strength in areas such as data collection among at-risk populations, strategic planning, program coordination, and assessment of immunization status in communities that are served by multiple health care providers. If unmet immunization needs are not identified and addressed, states will have difficulty in achieving the national goal of 90% coverage by the year 2010 for completion of the childhood immunization series for young children. Furthermore, state and national coverage rates, which reached record levels for vaccines in widespread use (79%, 1998), can be expected to decline and preventable disease outbreaks may occur as a result, particularly among persons who are vulnerable to vaccine-preventable disease because of their underimmunization status. The Institute of Medicine (IOM) Committee on Immunization Finance Policies and Practices has therefore concluded that a renewal and strengthening of the federal and state immunization partnership is necessary. The goal of this renewed partnership is to prevent infectious disease; to monitor, sustain, and improve vaccine coverage rates for child and adult populations within more

  16. Medicinal cannabis

    PubMed Central

    Murnion, Bridin

    2015-01-01

    Summary A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4. PMID:26843715

  17. Medicinal cannabis.

    PubMed

    Murnion, Bridin

    2015-12-01

    A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4.

  18. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  19. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  20. Heart failure - medicines

    MedlinePlus

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  1. [Social networks and medicine].

    PubMed

    Bastardot, F; Vollenweider, P; Marques-Vidal, P

    2015-11-04

    Social networks (social media or #SoMe) have entered medical practice within the last few years. These new media--like Twitter or Skype--enrich interactions among physicians (telemedicine), among physicians and patients (virtual consultations) and change the way of teaching medicine. They also entail new ethical, deontological and legal issues: the extension of the consultation area beyond the medical office and the access of information by third parties were recently debated. We develop here a review of some social networks with their characteristics, applications for medicine and limitations, and we offer some recommendations of good practice.

  2. Disparities and discrimination in health care coverage: a critique of the Institute of Medicine study.

    PubMed

    Epstein, Richard A

    2005-01-01

    The 2003 Institute of Medicine (IOM) study on Unequal Treatment takes the strong position that many of the current disparities in health care by race are attributable to forms of conscious and unconscious discrimination by health care providers. The study, however, is flawed by imprecise definitions of discrimination that fail to distinguish between differences in treatment due to breakdown in communications and differences in the treated population that are prompted by invidious motives of health care providers. It is doubtful that hidden forms of discrimination are prevalent in a profession whose professional norms are set so strongly against it. In addition, the IOM relies too uncritically on similar studies in unrelated fields to show the ostensible forms of discrimination. These errors have adverse social consequences. A false diagnosis of discrimination where none exists will send a false signal to members of racial minorities that may induce them to avoid receiving needed medical care and instead pursue costly and ineffective remedial devices that will take away funds better spent on providing direct health care.

  3. [Recommendations in neonatal resuscitation].

    PubMed

    2004-01-01

    The recommendations for neonatal resuscitation are not always based on sufficient scientific evidence and thus expert consensus based on current research, knowledge, and experience are useful for formulating practical protocols that are easy to follow. The latest recommendations, in 2000, modified previously published recommendations and are included in the present text.

  4. Procedures for establishing and maintaining consistent air-kerma strength standards for low-energy, photon-emitting brachytherapy sources: recommendations of the Calibration Laboratory Accreditation Subcommittee of the American Association of Physicists in Medicine.

    PubMed

    DeWerd, Larry A; Huq, M Saiful; Das, Indra J; Ibbott, Geoffrey S; Hanson, William F; Slowey, Thomas W; Williamson, Jeffrey F; Coursey, Bert M

    2004-03-01

    Low dose rate brachytherapy is being used extensively for the treatment of prostate cancer. As of September 2003, there are a total of thirteen 125I and seven 103Pd sources that have calibrations from the National Institute of Standards and Technology (NIST) and the Accredited Dosimetry Calibration Laboratories (ADCLs) of the American Association of Physicists in Medicine (AAPM). The dosimetry standards for these sources are traceable to the NIST wide-angle free-air chamber. Procedures have been developed by the AAPM Calibration Laboratory Accreditation Subcommittee to standardize quality assurance and calibration, and to maintain the dosimetric traceability of these sources to ensure accurate clinical dosimetry. A description of these procedures is provided to the clinical users for traceability purposes as well as to provide guidance to the manufacturers of brachytherapy sources and ADCLs with regard to these procedures.

  5. Herbal Medicine

    MedlinePlus

    ... for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  6. Diabetes Medicines

    MedlinePlus

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  7. [SPORT MEDICINE].

    PubMed

    Constantini, Naama; Mann, Gideon

    2016-06-01

    Sports Medicine is a relatively new subject in medicine and includes a variety of medical and paramedical fields. Although sports medicine is mistakenly thought to be mainly for sports professionals/athletes, it actually encompasses the entire population, including the active and non-active healthy populations, as well as the sick. Sports medicine also engages amateur sportsmen and strives to promote physical activity and quality of life in the general population. Hence, the field involves all ages from childhood to old age, aiming to preserve and support every person at every age. Sports medicine, which started developing in the 19th century, is today a specialty, primary or secondary, in many countries, while in others it is a fellowship or under the jurisdiction of local or sports authorities. In Israel, the field exists since the 1950's and is advanced. The Sports Medicine Society founded a 3-year course of continued education in sport medicine as part of the Tel-Aviv University Faculty of Medicine. Later on, a fellowship in general Sports Medicine and in Orthopedic Sports Medicine were developed within the Israel Medical Association. A year ago, Israel formally became a member of the global "Exercise is Medicine" foundation, and under this title promotes education for health care providers on exercise prescription. The understanding of the importance of physical activity and fitness as part of a healthy lifestyle is increasing in Israel, as well as the number of amateur athletes, and the profession of sports medicine takes a big part in this process.

  8. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  9. (Re)introducing medicinal cannabis.

    PubMed

    Mather, Laurence E; Rauwendaal, Evert R; Moxham-Hall, Vivienne L; Wodak, Alex D

    2013-12-16

    • After considering extensive scientific and medical evidence, a New South Wales Legislative Council multiparty committee recommended that medicinal cannabis should lawfully be made available for selected-use pharmacotherapy. • The evidence indicates that cannabis has genuine medicinal utility in patients with certain neuropathic conditions, with acceptable levels of risk from mostly mild side effects. • The potential medical benefits of cannabis pharmacotherapy have largely been overlooked, with research and society's attention, in most parts of the world, being directed towards the hazards of its recreational use. • The NSW Government has since dismissed the unanimous and compassionate recommendations of their committee.

  10. Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on 18F-FDG PET-CT for radiotherapy treatment planning

    PubMed Central

    Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

    2012-01-01

    Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process. PMID:24377032

  11. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid).

    PubMed

    Esposito, Susanna; Bonanni, Paolo; Maggi, Stefania; Tan, Litjan; Ansaldi, Filippo; Lopalco, Pier Luigi; Dagan, Ron; Michel, Jean-Pierre; van Damme, Pierre; Gaillat, Jacques; Prymula, Roman; Vesikari, Timo; Mussini, Cristina; Frank, Uwe; Osterhaus, Albert; Celentano, Lucia Pastore; Rossi, Marta; Guercio, Valentina; Gavazzi, Gaetan

    2016-07-02

    Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.

  12. Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on (18)F-FDG PET-CT for radiotherapy treatment planning.

    PubMed

    Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

    2012-01-01

    Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process.

  13. Beyond a Band-Aid Approach: An Internal Agency Solution to Nurse Staffing.

    PubMed

    Adams, Jewel; Kaplow, Roberta; Dominy, Janet; Stroud, Bridgett

    2015-01-01

    The Institute of Medicine (IOM) affirmed that the employment of temporary or per diem nurses augments risk to patient safety. The IOM recommends health care facilities avoid hiring nurses working from a temporary external agency. The IOM recognizes the need for health care facilities to have a plan in place for situations when confronted with short staffing, higher acuity, and increased patient census. Based on recommendations from the IOM, an internal agency was developed in a university-based health care system. Cost savings were realized because of the collaborative efforts of human resources to fill vacancies, unit management managing their respective budgets by flexing staff based on patient census, and the development and implementation of the Enterprise Staffing Pool.

  14. Radiation Safety in Nuclear Medicine Procedures.

    PubMed

    Cho, Sang-Geon; Kim, Jahae; Song, Ho-Chun

    2017-03-01

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

  15. [National organization of forensic medicine in France].

    PubMed

    Chariot, Patrick

    2012-06-01

    Forensic medicine has long been characterized, in France, by diverse medical practices, which affected its recognition and development. A change was needed, Harmonization procedure includes the development of professional guidelines and allows forensic medicine to look at itself. However, the implementation of the recommendations is still far from complete. A national reform came into effect on 15 January 2011 and has defined a national reform of forensic medicine which includes funding by global budgets instead of fee-for-service. This reform allows easier organization and identification of forensic medicine units. One year later, tangible results are mixed. Forensic medicine is now more clearly identified but properly defined funding criteria are still lacking.

  16. [Expedition medicine].

    PubMed

    Donlagić, Lana

    2009-01-01

    Expedition and wildeness medicine is a term that combines rescue medicine, sport medicine as well as more specific branches as polar or high altitude medicine. It is being intensively studied both at the reaserch institutes and on expeditions. Ophtalmologists are concentrated on the reaserch of HARH (High Altitude Retinal Hemorrhage), neurologists on HACE reaserch (High Altitude Cerebral Edema), psychologists are developing tests to decsribe cognitive functions and many physicians are being trained to work in extreme enviroment. The result of all this effort are numerous new findings in pathophysiology and therapy of altitude illness, increased security on expedition and further development of expeditionism.

  17. Use Medicines Safely

    MedlinePlus

    ... Medicines Safely Print This Topic En español Use Medicines Safely Browse Sections The Basics Overview Prescription Medicines ... Medicines 1 of 7 sections The Basics: Prescription Medicines There are different types of medicine. The 2 ...

  18. The practice of travel medicine in Europe.

    PubMed

    Schlagenhauf, P; Santos-O'Connor, F; Parola, P

    2010-03-01

    Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

  19. Collaborative Education To Ensure Patient Safety.

    ERIC Educational Resources Information Center

    National Advisory Council on Nurse Education and Practice, Rockville, MD.

    Results of a joint meeting between national advisory councils in medicine and nursing on physician-nurse collaboration to enhance patient safety are reported. Recommendations on which participants reached consensus are organized by these Institute of Medicine (IOM) themes: establish a national focus to create leadership through research and…

  20. Vulnerable Medicine

    ERIC Educational Resources Information Center

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  1. Behavioral Medicine.

    ERIC Educational Resources Information Center

    Garfield, Sol L., Ed.

    1982-01-01

    Contains 18 articles discussing the uses of behavioral medicine in such areas as obesity, smoking, hypertension, and headache. Reviews include discussions of behavioral medicine and insomnia, chronic pain, asthma, peripheral vascular disease, and coronary-prone behavior. Newly emerging topics include gastrointestinal disorders, arthritis,…

  2. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2006-01-01

    This abstract describes the content of a presentation for ground rounds at Mt. Sinai School of Medicine. The presentation contains three sections. The first describes the history of aerospace medicine beginning with early flights with animals. The second section of the presentation describes current programs and planning for future missions. The third section describes the medical challenges of exploration missions.

  3. [Sport medicine].

    PubMed

    Epstein, Yoram

    2012-02-01

    It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg.

  4. 78 FR 55727 - Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... FDA's Center for Veterinary Medicine (CVM) recommends for inclusion in food additive petitions (FAPs... for single copies of the guidance to the Communications Staff (HFV-12), Center for Veterinary Medicine... CONTACT: Sharon Benz, Center for Veterinary Medicine (HFV-220), Food and Drug Administration,...

  5. Updated Lightning Safety Recommendations.

    ERIC Educational Resources Information Center

    Vavrek, R. James; Holle, Ronald L.; Lopez, Raul E.

    1999-01-01

    Summarizes the recommendations of the Lightning Safety Group (LSG), which was first convened during the 1998 American Meteorological Society Conference. Findings outline appropriate actions under various circumstances when lightning threatens. (WRM)

  6. Recommended Textbooks (Booksearch).

    ERIC Educational Resources Information Center

    English Journal, 1988

    1988-01-01

    Evaluates four textbooks recommended by junior high and high school teachers for teaching writing and literature: "Enjoying Literature" (published by Macmillan, 1985); "Exposition: Critical Writing and Thinking" (Robert J. Gula); "Situational Writing" (Gene Krupa); and "Double Exposure: Composing through Writing…

  7. Design Review Improvement Recommendations

    DTIC Science & Technology

    2015-06-18

    program execution and mission operations in spite of significant advances in design and analysis tool capabilities and robust command media governing...level of risk a program is willing to accept based on its design heritage . The recommendations in this report complement, but do not duplicate, the...recommendations provided in the following TORs: • Design Assurance Guide, Aerospace Report No.TOR-2009 (8591)-11 • Objective Re-use of Heritage

  8. Social Tagging Recommender Systems

    NASA Astrophysics Data System (ADS)

    Marinho, Leandro Balby; Nanopoulos, Alexandros; Schmidt-Thieme, Lars; Jäschke, Robert; Hotho, Andreas; Stumme, Gerd; Symeonidis, Panagiotis

    The new generation of Web applications known as (STS) is successfully established and poised for continued growth. STS are open and inherently social; features that have been proven to encourage participation. But while STS bring new opportunities, they revive old problems, such as information overload. Recommender Systems are well known applications for increasing the level of relevant content over the "noise" that continuously grows as more and more content becomes available online. In STS however, we face new challenges. Users are interested in finding not only content, but also tags and even other users. Moreover, while traditional recommender systems usually operate over 2-way data arrays, STS data is represented as a third-order tensor or a hypergraph with hyperedges denoting (user, resource, tag) triples. In this chapter, we survey the most recent and state-of-the-art work about a whole new generation of recommender systems built to serve STS.We describe (a) novel facets of recommenders for STS, such as user, resource, and tag recommenders, (b) new approaches and algorithms for dealing with the ternary nature of STS data, and (c) recommender systems deployed in real world STS. Moreover, a concise comparison between existing works is presented, through which we identify and point out new research directions.

  9. Wilderness medicine

    PubMed Central

    Sward, Douglas G.; Bennett, Brad L.

    2014-01-01

    BACKGROUND: Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS: The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS: Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS: The future of wilderness medicine is unfolding on multiple fronts: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes. PMID:25215140

  10. Medicines management.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-04-15

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the fifth essential skills cluster – medicines management. Nursing students should work to attain the knowledge and skills required for effective medicines management throughout their pre-registration education. The roles and responsibilities of the newly registered graduate nurse in the area of medicines management are discussed in this the final article of the essential skills cluster series.

  11. Precision Medicine

    PubMed Central

    Cholerton, Brenna; Larson, Eric B.; Quinn, Joseph F.; Zabetian, Cyrus P.; Mata, Ignacio F.; Keene, C. Dirk; Flanagan, Margaret; Crane, Paul K.; Grabowski, Thomas J.; Montine, Kathleen S.; Montine, Thomas J.

    2017-01-01

    Three key elements to precision medicine are stratification by risk, detection of pathophysiological processes as early as possible (even before clinical presentation), and alignment of mechanism of action of intervention(s) with an individual's molecular driver(s) of disease. Used for decades in the management of some rare diseases and now gaining broad currency in cancer care, a precision medicine approach is beginning to be adapted to cognitive impairment and dementia. This review focuses on the application of precision medicine to address the clinical and biological complexity of two common neurodegenerative causes of dementia: Alzheimer disease and Parkinson disease. PMID:26724389

  12. DIETARY INTAKE OF SUBJECTS WITH PERIPHERAL ARTERY DISEASE AND CLAUDICATION

    PubMed Central

    Gardner, Andrew W.; Bright, Brianna C.; Ort, Kelly A.; Montgomery, Polly S.

    2013-01-01

    We compared the dietary intakes of subjects with peripheral artery disease (PAD) and claudication with diet recommendations of the National Cholesterol Education Program (NCEP) and dietary reference intake values recommended by the Institute of Medicine (IOM) of the National Academy of Sciences. Forty-six subjects consumed a mean macronutrient composition of 17% protein, 51% carbohydrate, and 30% fat. Compared to the NCEP and IOM recommendations, few subjects met the recommended daily intakes for sodium (0%), vitamin E (0%), folate (13%), saturated fat (20%), fiber (26%), and cholesterol (39%). Subjects with PAD and claudication have poor nutrition, with diets particularly high in saturated fat, sodium, and cholesterol, and low in fiber, vitamin E and folate intakes. Subjects should be encouraged to reduce consumption of dietary fat, saturated fat, cholesterol, and sodium, and to increase fiber and vitamin intakes to meet recommendations of the NCEP and IOM. PMID:21406424

  13. Nuclear Medicine

    MedlinePlus

    ... here Home » Science Education » Science Topics » Nuclear Medicine SCIENCE EDUCATION SCIENCE EDUCATION Science Topics Resource Links for ... administered by inhalation, by oral ingestion, or by direct injection into an organ. The mode of tracer ...

  14. Occupational Medical Surveillance Recommendations

    DTIC Science & Technology

    1991-07-01

    friendly, industrial chemical database which is updated jonstantly and. republished every three months. TOMES Plus contains MEDITEXT m , HAZARDTEXT DOT ...worker with an allergic sensitivity to the hazard (animal dander, isocyanate ). For these workers respirators frequently do not reduce exposure enough...Toxicology, Occupational Medicine and Environmental Series) Information System. TOMES Plus contains MEDITEXT , HAZARDTEXT , DOT Emergency Response

  15. Distributed Deliberative Recommender Systems

    NASA Astrophysics Data System (ADS)

    Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

    Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

  16. Urotherapy recommendations for bedwetting.

    PubMed Central

    Robson, Lane M.; Leung, Alexander K. C.

    2002-01-01

    OBJECTIVE: To assess the efficacy of urotherapy recommendations prior to pharmacological or moisture alarm treatment in the management of bedwetting in children. METHODS: Children assessed for bedwetting at a voiding dysfunction clinic were admitted to a prospective, uncontrolled pilot study. The families were instructed to follow specific urotherapy recommendations. RESULTS: Of the 23 children who completed the study, sixteen (70%) improved with at least one less wet night per week, nine (39%) with at least a 50% reduction, and five (22%) resolved. CONCLUSION: Urotherapy recommendations prior to pharmacological or moisture alarm treatment shows promise and potential for the management of children with bedwetting. Further studies are necessary to determine if the improvement is sustained. PMID:12126283

  17. Order Theoretical Semantic Recommendation

    SciTech Connect

    Joslyn, Cliff A.; Hogan, Emilie A.; Paulson, Patrick R.; Peterson, Elena S.; Stephan, Eric G.; Thomas, Dennis G.

    2013-07-23

    Mathematical concepts of order and ordering relations play multiple roles in semantic technologies. Discrete totally ordered data characterize both input streams and top-k rank-ordered recommendations and query output, while temporal attributes establish numerical total orders, either over time points or in the more complex case of startend temporal intervals. But also of note are the fully partially ordered data, including both lattices and non-lattices, which actually dominate the semantic strcuture of ontological systems. Scalar semantic similarities over partially-ordered semantic data are traditionally used to return rank-ordered recommendations, but these require complementation with true metrics available over partially ordered sets. In this paper we report on our work in the foundations of partial order measurement in ontologies, with application to top-k semantic recommendation in workflows.

  18. Space Station Software Recommendations

    NASA Technical Reports Server (NTRS)

    Voigt, S. (Editor)

    1985-01-01

    Four panels of invited experts and NASA representatives focused on the following topics: software management, software development environment, languages, and software standards. Each panel deliberated in private, held two open sessions with audience participation, and developed recommendations for the NASA Space Station Program. The major thrusts of the recommendations were as follows: (1) The software management plan should establish policies, responsibilities, and decision points for software acquisition; (2) NASA should furnish a uniform modular software support environment and require its use for all space station software acquired (or developed); (3) The language Ada should be selected for space station software, and NASA should begin to address issues related to the effective use of Ada; and (4) The space station software standards should be selected (based upon existing standards where possible), and an organization should be identified to promulgate and enforce them. These and related recommendations are described in detail in the conference proceedings.

  19. Children's (Pediatric) Nuclear Medicine

    MedlinePlus Videos and Cool Tools

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  20. [Intensive medicine in Spain].

    PubMed

    2011-03-01

    the future of intensive care medicine in Spain and in Europe, recommendations are made towards specialization in intensive care medicine incorporating in the training program those competences (knowledge, skills and attitudes) that should be present an intensivist in Europe and that are extensively fulfilled by the current Spanish training program. The trajectory followed by intensive care medicine in Europe and recently in China, shows the increasing need of intensive care and the progressive recognition of the specialty in economically growing countries, and emphasizes the need of homogenization in the training of future specialists in intensive care medicine globally.

  1. Analysis of French generic medicines retail market: why the use of generic medicines is limited.

    PubMed

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2014-12-01

    The market share of generic medicines in France is low compared to other European countries. This perspective paper provides an overview of the generic medicines retail market in France and how the current policy environment may affect the long-term sustainability. Looking at the French generic medicines retail market and the surrounding regulatory framework, all conditions seem to be in place to create a healthy generic medicines market: the country has well-respected regulatory authorities, generic medicines enter the market in a timely manner and prices of generic medicines are competitive compared with other European countries. Despite the success of the demand-side policies targeted at pharmacists and patients, those targeted at physicians were less successful due to a lack of enforcement and a lack of trust in generic medicines by French physicians. Recommendations to increase the use of generic medicines in France round off this perspective paper.

  2. Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics

    PubMed Central

    Mofenson, Lynne M.; Brady, Michael T.; Danner, Susie P.; Dominguez, Kenneth L.; Hazra, Rohan; Handelsman, Edward; Havens, Peter; Nesheim, Steve; Read, Jennifer S.; Serchuck, Leslie; Van Dyke, Russell

    2010-01-01

    endorsement by NIH, CDC, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP). The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of the evidence supporting the recommendation so readers can ascertain how best to apply the recommendations in their practice environments. An important mode of acquisition of OIs, as well as HIV infection among children, is from their infected mother; HIV-infected women coinfected with opportunistic pathogens might be more likely than women without HIV infection to transmit these infections to their infants. In addition, HIV-infected women or HIV-infected family members coinfected with certain opportunistic pathogens might be more likely to transmit these infections horizontally to their children, resulting in increased likelihood of primary acquisition of such infections in the young child. Therefore, infections with opportunistic pathogens might affect not just HIV-infected infants but also HIV-exposed but uninfected infants who become infected by the pathogen because of transmission from HIV-infected mothers or family members with coinfections. These guidelines for treating OIs in children therefore consider treatment of infections among all children, both HIV-infected and uninfected, born to HIV-infected women. Additionally, HIV infection is increasingly seen among adolescents with perinatal infection now surviving into their teens and among youth with behaviorally acquired HIV infection. Although guidelines for postpubertal adolescents can be found in the adult OI guidelines, drug pharmacokinetics and response to treatment may differ for younger prepubertal or pubertal adolescents. Therefore, these guidelines also apply to treatment of HIV-infected youth who have not yet completed pubertal development. Major changes in the

  3. Statistical recommendations for papers submitted to Developmental Medicine & Child Neurology.

    PubMed

    Rigby, Alan S

    2010-03-01

    The use of statistics in medical diagnoses and biomedical research may affect whether an individual may live or die, whether their health is protected or jeopardized. Because society depends on sound statistical practice, all practitioners of statistics, whatever their training or occupation, have social obligations to perform their work in a professional, competent, and ethical manner.

  4. [Parenteral administration medicines: recommendations of preparation, administration and stability].

    PubMed

    Gaspar Carreño, M; Torrico Martín, F; Novajarque Sala, L; Batista Cruz, M; Ribeiro Gonçalves, P; Porta Oltra, B; Sánchez Santos, J C

    2014-11-03

    Objetivo: Elaborar unas recomendaciones de preparacion de medicamentos de administracion parenteral (MAP) para valorar la posibilidad de transferir su preparacion, desde las unidades de enfermeria en planta de hospitalizacion al servicio de farmacia (SF). Método: Se procede a elaborar una tabla de estabilidades de los medicamentos incluidos en la guia farmacoterapeutica del Hospital, aplicando la Guia USP (Pharmaceutical compounding Sterile Preparations) y la Guia de de buenas practicas de preparacion de medicamentos en los servicios de farmacia hospitalaria. Se recopilo informacion sobre las MAP: metodo de preparacion, compatibilidad, conservacion, periodo de validez, modo de administracion y tipo de envase. Los datos se obtuvieron mediante consulta de las fichas tecnicas, laboratorios, revision bibliografica y otras bases de datos. Resultados: Tras revisar 209 farmacos se elaboro un listado de recomendaciones. Segun los datos obtenidos, las MAP se prepararan de la siguiente forma: 89 seran preparadas desde el SF, 62 en unidad de enfermeria en planta de hospitalizacion pues son medicamentos que requieren administracion inmediata y 58 ya van acondicionados para su administracion por la industria. De los 62 farmacos que se prepararan por enfermeria, en 14 de ellos las dosis siguientes se prepararan desde el SF. Por lo tanto de los 209 farmacos solo 48 se prepararan exclusivamente en la unidad de enfermeria. Conclusiones: Desde el SF se ha establecido un metodo normalizado de preparacion, conservacion, administracion y periodo de validez de MAP. La preparacion de MAP en SF ampliaria su tiempo de conservacion, al tener en cuenta la estabilidad fisicoquimica, el nivel de riesgo y la vulnerabilidad del preparado a la contaminacion microbiologica. La informacion aportada contribuira a una disminucion de errores asociados al proceso de preparacion y administracion de MAP.

  5. The Fukushima accident and travel medicine--analysis and recommendations.

    PubMed

    Scholl, C; Lieberz, W; Jansing, P; Küpper, T

    2013-01-01

    The accident at the nuclear site in Fukushima has fostered a fear of the consequences of radioactive contamination among many, especially regarding travel to Japan and the import of Japanese goods. We give a general overview of the assessment of the effects of ionizing radiation and a summary of the consequences of the Japanese accident. We report the results of the measurement of radionuclide intake among travelers returning from Japan, carried out at the whole-body counter of the Institute for Work Design of North Rhine-Westphalia (LIA.NRW) in Düsseldorf.

  6. Expedition Medicine--Recommendations from Experience in Guatemala.

    ERIC Educational Resources Information Center

    Malison, Michael D.

    1980-01-01

    Eight guidelines to assist health professionals in the preparation of a team field expedition are: (1) assess the activities; (2) consider the environment; (3) know orientation and preventive measures; (4) take food and water precautions; (5) know the team members; (6) prepare the pharmacy; (7) carry out the field operation; and (8) follow up…

  7. CETA: Assessment and Recommendations.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Committee on Evaluation of Employment and Training Programs.

    This document presents the principal findings and recommendations of a study conducted by the Committee on Evaluation of Employment and Training Program to assess the impact of CETA (Comprehensive Employment and Training Act) on manpower programs. This report is divided into two parts. Part 1 provides an overview of CETA's history, summarizes…

  8. Personalized Course Sequence Recommendations

    NASA Astrophysics Data System (ADS)

    Xu, Jie; Xing, Tianwei; van der Schaar, Mihaela

    2016-10-01

    Given the variability in student learning it is becoming increasingly important to tailor courses as well as course sequences to student needs. This paper presents a systematic methodology for offering personalized course sequence recommendations to students. First, a forward-search backward-induction algorithm is developed that can optimally select course sequences to decrease the time required for a student to graduate. The algorithm accounts for prerequisite requirements (typically present in higher level education) and course availability. Second, using the tools of multi-armed bandits, an algorithm is developed that can optimally recommend a course sequence that both reduces the time to graduate while also increasing the overall GPA of the student. The algorithm dynamically learns how students with different contextual backgrounds perform for given course sequences and then recommends an optimal course sequence for new students. Using real-world student data from the UCLA Mechanical and Aerospace Engineering department, we illustrate how the proposed algorithms outperform other methods that do not include student contextual information when making course sequence recommendations.

  9. Recommendations for Alternative Credit.

    ERIC Educational Resources Information Center

    Lenderman, Ed; And Others

    Following a review of the mathematics topics taught in accounting, electronics, auto, food and clothing, and metals courses at Linn-Benton Community College, Albany, Oregon, recommendations were made to grant one semester of mathematics credit for completing a two-year sequence of these courses. The other required semester of mathematics should be…

  10. Technical Joint Cross Service Group. Analyses and Recommendations. Volume 12

    DTIC Science & Technology

    2005-05-19

    ehicles Sea V ehicles Space Platform s W eapons N uclear T echnology M aterials & Processes B iom edical H um an System s B attlespace...accommodate contingency, mobilization , surge, and future total force requirements, both at existing and potential receiving locations, to support... mobilization , surge, and future total force requirements at both existing and potential receiving locations to support operations and training

  11. Mesopotamian medicine.

    PubMed

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots.

  12. Complementary Therapies and Medicines and Reproductive Medicine.

    PubMed

    Smith, Caroline A; Armour, Mike; Ee, Carolyn

    2016-03-01

    Complementary therapies and medicines are a broad and diverse range of treatments, and are frequently used by women and their partners during the preconception period to assist with infertility, and to address pregnancy-related conditions. Despite frequent use, the evidence examining the efficacy, effectiveness, and safety for many modalities is lacking, with variable study quality. In this article, we provide an overview of research evidence with the aim of examining the evidence to inform clinical practice. During the preconception period, there is mixed evidence for acupuncture to improve ovulation, or increase pregnancy rates. Acupuncture may improve sperm quality, but there is insufficient evidence to determine whether this results in improved pregnancy and live birth rates. Acupuncture can be described as a low-risk intervention. Chinese and Western herbal medicines may increase pregnancy rates; however, study quality is low. The evaluation of efficacy, effectiveness, and safety during the first trimester of pregnancy has most commonly reported on herbs, supplements, and practices such as acupuncture. There is high-quality evidence reporting the benefits of herbal medicines and acupuncture to treat nausea in pregnancy. The benefit from ginger to manage symptoms of nausea in early pregnancy is incorporated in national clinical guidelines, and vitamin B6 is recommended as a first-line treatment for nausea and vomiting in pregnancy. The safety of ginger and vitamin B6 is considered to be well established, and is based on epidemiological studies. Acupuncture has been shown to reduce back pain and improve function for women in early pregnancy. There is little evidence to support the use of cranberries in pregnancy for prevention of urinary tract infections, and chiropractic treatment for back pain. Overall the numbers of studies are small and of low quality, although the modalities appear to be low risk of harm.

  13. Wilderness Medicine.

    PubMed

    Alexander, Whitney; Bright, Steven; Burns, Patrick; Townes, David

    2016-03-01

    Wilderness medicine encompasses prevention and treatment of illness and injury, education and training, emergency medical services, and search and rescue in the wilderness. Although traumatic injuries, including minor injuries, outnumber medical illness as the cause of morbidity in the wilderness, basic understanding of the prevention and management of injury and illness, including recognition, identification, treatment, initial management, and stabilization, is essential, in addition to the ability to facilitate evacuation of affected patients. An important theme throughout wilderness medicine is planning and preparation for the best- and worst-case scenarios, and being ready for the unexpected.

  14. Is old medicine new medicine?

    PubMed

    Montaocean, K

    1991-07-01

    By the year 2000, over 90% of cases of acquired immunodeficiency syndrome (AIDS) are expected in Third World countries where Western medicine is often unavailable, unaffordable, or culturally unacceptable. Thus, there is a need for greater attention to the potential role of traditional medicine and healers in the prevention and treatment of AIDS. A US-based nongovernmental organization, Green Cross Inc, is examining cross-cultural healing traditions and seeking areas of convergence between scientific bio-medicine and indigenous traditional healing systems. At a street clinic operated by Green Cross in Washington DC, both Western medicine and traditional Chinese practices such as acupuncture, herbal remedies, and meditation are offered to AIDS patients at those at risk of infection. Although the individualized nature of Chinese medicine makes it difficult to evaluate through use of Western research methods, there is anecdotal evidence that it reduces the stress, anxiety, depression, and fatigue that accompany AIDS. Health care systems in all parts of the world could benefit from the concept that illness cannot be treated in isolation from individuals and communities.

  15. FELASA Guidelines and Recommendations

    PubMed Central

    Guillen, Javier

    2012-01-01

    The Federation of European Laboratory Animal Science Associations (FELASA) has been releasing guidelines and recommendations on several laboratory animal science disciplines for more than 15 y. The Working Groups producing these documents comprise specialists in each of the addressed topics, are nominated by the FELASA constituent associations, and are elected by the FELASA Board of Management. The FELASA guidelines and recommendations are not regulatory but rather are proposals based on scientific knowledge and the state of the art of laboratory animal science activities. Because they are supported by laboratory animal science associations that represent the vast majority of European professionals, these guidelines and recommendations have influenced the development of various regulatory requirements in Europe, including those related to education and training, routine laboratory animal activities, and animal health monitoring. Some reports fill existing gaps in the European legal framework or complement it. The Working Groups occasionally collaborate with other European organizations, thus enhancing the professional input and effect of the documents produced. The recently established AALAS–FELASA Liaison Body may result in future international cooperation that benefits laboratory animal science and welfare in a global context. PMID:22776188

  16. Medicines for sleep

    MedlinePlus

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... the-counter (OTC) sleeping pills contain antihistamines. These medicines are commonly used to treat allergies. While these ...

  17. Medicinal Plants.

    ERIC Educational Resources Information Center

    Phillipson, J. David

    1997-01-01

    Highlights the demand for medicinal plants as pharmaceuticals and the demand for health care treatments worldwide and the issues that arise from this. Discusses new drugs from plants, anticancer drugs, antiviral drugs, antimalarial drugs, herbal remedies, quality, safety, efficacy, and conservation of plants. Contains 30 references. (JRH)

  18. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    New York State education law, rules, and regulations concerning the practice of medicine are presented, along with requirements and procedures for obtaining licensure and first registration as a physician. State statutory provisions cover: duration and registration of a license, practice and regulation of the profession, supervision by the Board…

  19. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern medical practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for medicine are described including education and postgraduate training requirements, state licensing examinations, and application…

  20. Nuclear medicine

    SciTech Connect

    Wagner, H.N. Jr.

    1986-10-17

    In 1985 and 1986 nuclear medicine became more and more oriented toward in vov chemistry, chiefly as a result of advances in positron emission tomography (PET). The most important trend was the extension of PET technology into the care of patients with brain tumors, epilepsy, and heart disease. A second trend was the increasing use of single-photon emission computed tomography (SPECT).

  1. [Quality management and safety culture in medicine: context and concepts].

    PubMed

    Wischet, Werner; Eitzinger, Claudia

    2009-01-01

    The publication of the IOM report "To err is human: building a safer health system" in 1999 put spotlight on the primacy of the principle of primum non nocere and made patient safety a central topic of quality management. A key conclusion of the report was the need for a well-developed safety culture. While concepts of quality management have evolved along the lines of ISO and Total Quality Management over the last decades patient safety still has not got the same amount of attention (PubMed). Evidence from other safety-critical areas but also from the field of medicine itself suggests that an efficient culture of safety is a conditio sine qua non for the sustainable improvement of patient safety. Considering these arguments the present paper aims at emphasizing the importance of an efficient culture of safety for patient safety and quality management in healthcare. In addition, key instruments of safety culture as well as their limitations will be presented.

  2. Chinese medicine and martial arts.

    PubMed

    Koh, T C

    1981-01-01

    Wushu (Martial Arts), mistakenly known in the West as Kung-Fu, is a system of Chinese boxing which is closely linked with the traditional practice of Chinese medicine. Many of the masters (Sifu) are Chinese physicians who often recommend health exercises and the soft form of martial arts to their patients, while the hard form is suitable for sport and self-defense. Martial arts is a great discipline for body and mind, suitable for all who treasure physical and mental health.

  3. Clinical Recommendation: Vulvovaginitis.

    PubMed

    Zuckerman, Andrea; Romano, Mary

    2016-12-01

    Vulvovaginitis is a commonly encountered condition among prepubertal and adolescent females. The objective of this report is to provide the latest evidence regarding the diagnosis and management of vulvovaginitis in prepubertal and adolescent females. In this systematic review we used the Grading of Recommendations Assessment, Development and Evaluation evidence system. Vulvovaginal complaints are common in the pediatric and adolescent age group. The patient's age in conjunction with history and associated complaints will guide evaluation, diagnosis, and treatment. Treatment should include counseling on hygiene and voiding techniques as well as therapy for any specific pathogens identified.

  4. Personalized professional content recommendation

    DOEpatents

    Xu, Songhua

    2015-10-27

    A personalized content recommendation system includes a client interface configured to automatically monitor a user's information data stream transmitted on the Internet. A hybrid contextual behavioral and collaborative personal interest inference engine resident to a non-transient media generates automatic predictions about the interests of individual users of the system. A database server retains the user's personal interest profile based on a plurality of monitored information. The system also includes a server programmed to filter items in an incoming information stream with the personal interest profile and is further programmed to identify only those items of the incoming information stream that substantially match the personal interest profile.

  5. Panel summary of recommendations

    NASA Technical Reports Server (NTRS)

    Dunbar, Bonnie J.; Coleman, Martin E.; Mitchell, Kenneth L.

    1990-01-01

    The following Space Station internal contamination topics were addressed: past flight experience (Skylab and Spacelab missions); present flight activities (Spacelabs and Soviet Space Station Mir); future activities (materials science and life science experiments); Space Station capabilities (PPMS, FMS, ECLSS, and U.S. Laboratory overview); manned systems/crew safety; internal contamination detection; contamination control - stowage and handling; and contamination control - waste gas processing. Space Station design assumptions are discussed. Issues and concerns are discussed as they relate to (1) policy and management, (2) subsystem design, (3) experiment design, and (4) internal contamination detection and control. The recommendations generated are summarized.

  6. A bottom-up approach to MEDLINE indexing recommendations.

    PubMed

    Jimeno-Yepes, Antonio; Wilkowski, Bartłomiej; Mork, James G; Van Lenten, Elizabeth; Fushman, Dina Demner; Aronson, Alan R

    2011-01-01

    MEDLINE indexing performed by the US National Library of Medicine staff describes the essence of a biomedical publication in about 14 Medical Subject Headings (MeSH). Since 2002, this task is assisted by the Medical Text Indexer (MTI) program. We present a bottom-up approach to MEDLINE indexing in which the abstract is searched for indicators for a specific MeSH recommendation in a two-step process. Supervised machine learning combined with triage rules improves sensitivity of recommendations while keeping the number of recommended terms relatively small. Improvement in recommendations observed in this work warrants further exploration of this approach to MTI recommendations on a larger set of MeSH headings.

  7. Exercise and Physical Activity Recommendations for People with Cerebral Palsy

    PubMed Central

    Peterson, Mark D.; Balemans, Astrid C.J.; Hurvitz, Edward A.

    2016-01-01

    Physical activity (PA) and its promotion, as well as the avoidance of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases. Guidelines for typically developing youth and adults published by the World Health Organization and American College of Sports Medicine are available. However, detailed recommendations for PA and sedentary behaviour have not been established for children, adolescents and adults with cerebral palsy (CP). This paper presents the first CP-specific PA and exercise recommendations. The recommendations are based on (1) a comprehensive review and analysis of the literature, (2) expert opinion and (3) extensive clinical experience. The evidence supporting these recommendations are based on randomized controlled trials and observational studies involving children, adolescents and adults with CP, and buttressed by the previous guidelines for the general population. These recommendations may be used to guide healthcare providers on exercise and daily PA prescription for individuals with CP. PMID:26853808

  8. ADHD Medicines (for Kids)

    MedlinePlus

    ... Room? What Happens in the Operating Room? ADHD Medicines KidsHealth > For Kids > ADHD Medicines A A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  9. Transfusion medicine

    SciTech Connect

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

  10. French recommendations on electroencephalography.

    PubMed

    André-Obadia, N; Lamblin, M D; Sauleau, P

    2015-03-01

    Electroencephalography allows the functional analysis of electrical brain cortical activity and is the gold standard for analyzing electrophysiological processes involved in epilepsy but also in several other dysfunctions of the central nervous system. Morphological imaging yields complementary data, yet it cannot replace the essential functional analysis tool that is EEG. Furthermore, EEG has the great advantage of being non-invasive, easy to perform and allows repeat testing when follow-up is necessary, even at the patient's bedside. Faced with advances in knowledge, techniques and indications, the Société de neurophysiologie clinique de langue française (SNCLF) and the Ligue française contre l'épilepsie (LFCE) found it necessary to provide an update on EEG recommendations. This article will review the methodology applied to this work, refine the various topics detailed in the following chapters. It will go over the summary of recommendations for each of these chapters and highlight proposals for writing an EEG report. Some questions could not be answered by review of the literature; in such cases, in addition to the guidelines the working and reading groups provided their expert opinion.

  11. [Travel medicine].

    PubMed

    Schubert, S; Grimm, M

    2009-07-01

    Travel medicine deals with travellers' diseases. The target group is therefore distinct from tropical medicine. It has gained in significance due to the increase in tourism and professional work abroad in the last 50 years. Dangerous and widespread diseases in tropical countries, in particular tropical malaria, have come into focus in industrialized countries because of their appearance in travellers. Travel medicine deals not only with infectious or transmittable diseases, but also with the ability of patients with chronic diseases to travel, the medical aspects of flying, as well as the health hazards of professional work or high-risk sports abroad. The risk of disease as a result of travelling can be minimized by advice and prophylactic measures, such as vaccinations and drug prophylaxis against malaria, if indicated. On return, medical symptoms should be investigated promptly to ensure early detection of life-threatening disease courses, particularly tropical malaria, as well as to prevent the occurrence of small-scale epidemics. A small number of diseases can also emerge after several years, such as benign types of malaria, amoebic liver abscess and visceral leishmaniasis (kala-azar). Aids also belongs to these diseases. Therefore, in this era of HIV pandemic travellers concerned should be made aware of the risks.

  12. Many Young Adults with High Cholesterol Not on Statins as Recommended

    MedlinePlus

    ... as recommended. "This article clearly articulates the under-usage of statins in young people with severe elevations ... federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or ...

  13. Space Medicine

    NASA Technical Reports Server (NTRS)

    Pool, Sam L.

    2000-01-01

    The National Academy of Sciences Committee on Space Biology and Medicine points out that space medicine is unique among space sciences, because in addition to addressing questions of fundamental scientific interest, it must address clinical or human health and safety issues as well. Efforts to identify how microgravity affects human physiology began in earnest by the United States in 1960 with the establishment of the National Aeronautics and Space Administration (NASA's) Life Sciences program. Before the first human space missions, prediction about the physiological effects of microgravity in space ranged from extremely severe to none at all. The understanding that has developed from our experiences in space to date allows us to be guardedly optimistic about the ultimate accommodations of humans to space flight. Only by our travels into the microgravity environment of space have we begun to unravel the mysteries associated with gravity's role in shaping human physiology. Space medicine is still at its very earliest stages. Development of this field has been slow for several reasons, including the limited number of space flights, the small number of research subjects, and the competition within the life sciences community and other disciplines for flight opportunities. The physiological changes incurred during space flight may have a dramatic effect on the course of an injury or illness. These physiological changes present an exciting challenge for the field of space medicine: how to best preserve human health and safety while simultaneously deciphering the effects of microgravity on human performance. As the United States considers the future of humans in long-term space travel, it is essential that the many mysteries as to how microgravity affects human systems be addressed with vigor. Based on the current state of our knowledge, the justification is excellent indeed compelling- for NASA to develop a sophisticated capability in space medicine. Teams of physicians

  14. Wind Farm Recommendation Report

    SciTech Connect

    John Reisenauer

    2011-05-01

    On April 21, 2011, an Idaho National Laboratory (INL) Land Use Committee meeting was convened to develop a wind farm recommendation for the Executive Council and a list of proposed actions for proceeding with the recommendation. In terms of land use, the INL Land Use Committee unanimously agrees that Site 6 is the preferred location of the alternatives presented for an INL wind farm. However, further studies and resolution to questions raised (stated in this report) by the INL Land Use Committee are needed for the preferred location. Studies include, but are not limited to, wind viability (6 months), bats (2 years), and the visual impact of the wind farm. In addition, cultural resource surveys and consultation (1 month) and the National Environmental Policy Act process (9 to 12 months) need to be completed. Furthermore, there is no documented evidence of developers expressing interest in constructing a small wind farm on INL, nor a specific list of expectations or concessions for which a developer might expect INL to cover the cost. To date, INL assumes the National Environmental Policy Act activities will be paid for by the Department of Energy and INL (the environmental assessment has only received partial funding). However, other concessions also may be expected by developers such as roads, fencing, power line installation, tie-ins to substations, annual maintenance, snow removal, access control, down-time, and remediation. These types of concessions have not been documented, as a request, from a developer and INL has not identified the short and long-term cost liabilities for such concessions should a developer expect INL to cover these costs. INL has not identified a go-no-go funding level or the priority this Wind Farm Project might have with respect to other nuclear-related projects, should the wind farm remain an unfunded mandate. The Land Use Committee recommends Legal be consulted to determine what, if any, liabilities exist with the Wind Farm Project and

  15. The Inclusion of the Care of the Cancer Survivor in Undergraduate Nursing Curricula

    ERIC Educational Resources Information Center

    Dietmann, Mary E.

    2015-01-01

    As the number of individuals surviving cancer continues to rise, short and long term effects of cancer and its treatment that result in physical, psychosocial, and spiritual needs unique to the care of the cancer survivor has not been addressed in nursing curricula. The Institute of Medicine (IOM, 2005) recommends that all health care providers…

  16. New Idaho Nutrition Standards. Nourishing News. Volume 3, Issue 6

    ERIC Educational Resources Information Center

    Idaho State Department of Education, 2009

    2009-01-01

    The United States Department of Agriculture (USDA) has contracted with the Institute of Medicine (IOM) to examine ways to implement the 2005 Dietary Guidelines for Americans (DGAs) into the school meals programs. In the meantime, USDA has requested that state agencies begin proactively implementing the applicable recommendations for the 2005 DGAs…

  17. Parenteral amino acid intakes in critically ill children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Parenteral amino acid formulas used in parenteral nutrition have a variable composition. To determine the amino acid intake of parenterally fed, critically ill children, and compare it with recommended dietary allowances (RDA) established by the Institute of Medicine (IOM), we retrospectively review...

  18. IRIS Product Recommendations

    NASA Technical Reports Server (NTRS)

    Short, David A.

    2000-01-01

    This report presents the Applied Meteorology Unit's (AMU) evaluation of SIGMET Inc.'s Integrated Radar Information System (IRIS) Product Generator and recommendations for products emphasizing lightning and microburst tools. The IRIS Product Generator processes radar reflectivity data from the Weather Surveillance Radar, model 74C (WSR-74C), located on Patrick Air Force Base. The IRIS System was upgraded from version 6.12 to version 7.05 in late December 1999. A statistical analysis of atmospheric temperature variability over the Cape Canaveral Air Force Station (CCAFS) Weather Station provided guidance for the configuration of radar products that provide information on the mixed-phase (liquid and ice) region of clouds, between 0 C and -20 C. Mixed-phase processes at these temperatures are physically linked to electrification and the genesis of severe weather within convectively generated clouds. Day-to-day variations in the atmospheric temperature profile are of sufficient magnitude to warrant periodic reconfiguration of radar products intended for the interpretation of lightning and microburst potential of convectively generated clouds. The AMU also examined the radar volume-scan strategy to determine the scales of vertical gaps within the altitude range of the 0 C to -20 C isotherms over the Kennedy Space Center (KSC)/CCAFS area. This report present's two objective strategies for designing volume scans and proposes a modified scan strategy that reduces the average vertical gap by 37% as a means for improving radar observations of cloud characteristics in the critical 0 C to -20 C layer. The AMU recommends a total of 18 products, including 11 products that require use of the IRIS programming language and the IRIS User Product Insert feature. Included is a cell trends product and display, modeled after the WSR-88D cell trends display in use by the National Weather Service.

  19. Respiratory medicine

    PubMed Central

    Pinnock, Hilary

    2004-01-01

    The General Medical Services (GMS) contract has focused the attention of United Kingdom (UK) general practitioners (GPs) on the provision of high quality routine care for patients with chronic disease.1 The quality markers defined by the contract endorse the need for objective diagnosis and structured care recommended by the British Thoracic Society/Scottish Intercollegiate Guideline Network (BTS–SIGN) guideline for the management of asthma and the National Institute for Clinical Excellence (NICE) guideline on the management of chronic obstructive pulmonary disease (COPD).2,3 In this paper the key recommendations of these guidelines and their implementation in the pragmatic world of general practice are discussed, with specific focus on diagnosis, monitoring, management, self-management and delivery of care. PMID:15239918

  20. [Psychiatric medicine].

    PubMed

    Ibañez Dominguez, J

    1984-06-01

    The author, after a short historical introduction which shows the Medicine, especially the Neurology, as the predecessor of the Psychiatry, intents to relate in a theorico-practical way the anxiety and the depression within a bio-chemical and endocrinological frame. He presents the hipo and hipercalcemia signals and symptoms demonstrating with a casuistic from his clinical practice the similitude between anxiety and depression respectively. Finally he realizes a theorical analysis about the investigations published over the AMP-ciclic and infers about the hormonal interference and the clinical data linked with the manic-depressive disease.

  1. Nuclear medicine training and practice in Portugal.

    PubMed

    Vieira, Rosário; Costa, Gracinda

    2013-07-01

    Nuclear medicine in Portugal has been an autonomous speciality since 1984. In order to obtain the title of Nuclear Medicine Specialist, 5 years of training are necessary. The curriculum is very similar to the one approved under the auspices of the European Union of Medical Specialists, namely concerning the minimum recommended number of diagnostic and therapeutic procedures. There is a final assessment, and during the training the resident is in an approved continuing education programme. Departments are accredited by the Medical College in order to verify their capacity to host nuclear medicine residencies.

  2. Risk Assessment Considerations for Veterinary Medicines in Aquatic Ecosystems

    EPA Science Inventory

    This chapter provides a critical evaluation of prospective and retrospective risk assessment approaches for veterinary medicines in aquatic ecosystems and provides recommendations for possible alternative approaches for hazard characterization.

  3. Redesigning the nuclear medicine reading room.

    PubMed

    Zemariame, Nigist; Knight, Nancy; Siegel, Eliot L

    2011-11-01

    The process of image review and interpretation has become increasingly complex and challenging for today's nuclear medicine physician from many perspectives, especially with regard to workstation integration and reading room ergonomics. With the recent proliferation of hybrid imaging systems, this complexity has increased rapidly, along with the number of studies performed. At the same time, clinicians throughout the health care enterprise are expecting remote access to nuclear medicine images whereas nuclear medicine physicians require reliable access at the point of care to the electronic medical record and to medical images from radiology and cardiology. The authors discuss the background and challenges related to integration of nuclear medicine into the health care enterprise and provide a series of recommendations for advancing successful integration efforts. Also addressed are unique characteristics of the nuclear medicine environment as well as ergonomic, lighting, and environmental considerations in the design and redesign of the modern reading room.

  4. Emergency medicine ultrasonography

    PubMed Central

    Woo, Michael Y.; Nussbaum, Chris; Lee, A. Curtis

    2009-01-01

    ABSTRACT OBJECTIVE To survey program directors of family medicine–emergency medicine (CCFP[EM]) training programs regarding current and future emergency medicine ultrasonography (EMUS) training. DESIGN A Web-based survey using a modified Dillman method. Two academic emergency physicians reviewed the validity and reliability of the survey. SETTING Canada. PARTICIPANTS Program directors of all 17 Canadian CCFP(EM) residency training programs in 2006. MAIN OUTCOME MEASURES Characteristics of EMUS training currently offered and program directors’ perceptions of needs for future EMUS training. RESULTS The survey, performed in 2006, had a response rate of 100% (17/17), although not all respondents answered all questions. At the time of the study, 82.4% of respondents’ programs used EMUS. Although all program directors recommended that residents attend introductory EMUS courses, only 71.4% (10/14) of programs offered such courses; 60.0% (9/15) of those were mandatory. In one-third of the programs, more than 75% of the attending staff used EMUS. A total of 76.5% of program directors thought that introductory courses in EMUS should be mandatory; 62.5% (10/16) believed that residents were able to acquire sufficient experience to use EMUS independently to make practice decisions before completion of their residency; and 88.2% believed that EMUS should be a part of the scope of practice for emergency medicine physicians. Only 58.8% believed that there should be questions about EMUS on the CCFP(EM) Certification examination. Open responses indicated that funding, resources, and standardization were issues that needed to be addressed. CONCLUSION Formal EMUS training for CCFP(EM) programs is being introduced in Canada. Quality assurance needs to be strengthened. Most program directors thought that an introductory course in EMUS should be mandatory. Fewer directors, however, believed EMUS should be on the CCFP(EM) Certification examination until further funding, resources

  5. Functional Food in Traditional Persian Medicine

    PubMed Central

    Zare, Roghayeh; Hosseinkhani, Ayda

    2016-01-01

    Background: During the last decades, there have been great advancements in the field of preventive medicine. Research has demonstrated that nutrition plays a crucial role in the prevention of chronic diseases. The concept of functional food was first introduced in Japan during the 1980s. It proposes to consider food not only vital to survive, but also a mean for mental and physical well-being, contributing to the prevention and reduction of risk factors for diseases. However, there is evidence that the concept was believed by ancient physicians as well. One of the traditional systems of medicines is traditional Persian medicine (TPM). Rhazes said; “as long as a disease could be treated with food, medicine should be avoided” Methods: We carried out a review of Avicenna’s Canon of medicine and Rhazes books for the definition of food and drug and similar concepts of functional food. We listed the identified concepts along with their examples. Results: The classification of food and their therapeutic use were explained in Canon of medicine. Rhazes has a book called ‘Manafe al-Aghziyeh’, in which he writes about the medicinal benefits of different nutrition. Five concepts (food, drug, medicinal food, nutritional medicine and antidote or poison) were noted in these books. Conclusion: There are many recommendations on food for the prevention and treatment of diseases in TPM books, which can be the basis for novel research studies. PMID:27516666

  6. Functional Food in Traditional Persian Medicine

    PubMed Central

    Zare, Roghayeh; Hosseinkhani, Ayda

    2016-01-01

    Background: During the last decades, there have been great advancements in the field of preventive medicine. Research has demonstrated that nutrition plays a crucial role in the prevention of chronic diseases. The concept of functional food was first introduced in Japan during the 1980s. It proposes to consider food not only vital to survive, but also a mean for mental and physical well-being, contributing to the prevention and reduction of risk factors for diseases. However, there is evidence that the concept was believed by ancient physicians as well. One of the traditional systems of medicines is traditional Persian medicine (TPM). Rhazes said; “as long as a disease could be treated with food, medicine should be avoided” Methods: We carried out a review of Avicenna’s Canon of medicine and Rhazes books for the definition of food and drug and similar concepts of functional food. We listed the identified concepts along with their examples. Results: The classification of food and their therapeutic use were explained in Canon of medicine. Rhazes has a book called ‘Manafe al-Aghziyeh’, in which he writes about the medicinal benefits of different nutrition. Five concepts (food, drug, medicinal food, nutritional medicine and antidote or poison) were noted in these books. Conclusion: There are many recommendations on food for the prevention and treatment of diseases in TPM books, which can be the basis for novel research studies. PMID:27840499

  7. Site Recommendation Subsurface Layout

    SciTech Connect

    C.L. Linden

    2000-06-28

    The purpose of this analysis is to develop a Subsurface Facility layout that is capable of accommodating the statutory capacity of 70,000 metric tons of uranium (MTU), as well as an option to expand the inventory capacity, if authorized, to 97,000 MTU. The layout configuration also requires a degree of flexibility to accommodate potential changes in site conditions or program requirements. The objective of this analysis is to provide a conceptual design of the Subsurface Facility sufficient to support the development of the Subsurface Facility System Description Document (CRWMS M&O 2000e) and the ''Emplacement Drift System Description Document'' (CRWMS M&O 2000i). As well, this analysis provides input to the Site Recommendation Consideration Report. The scope of this analysis includes: (1) Evaluation of the existing facilities and their integration into the Subsurface Facility design. (2) Identification and incorporation of factors influencing Subsurface Facility design, such as geological constraints, thermal loading, constructibility, subsurface ventilation, drainage control, radiological considerations, and the Test and Evaluation Facilities. (3) Development of a layout showing an available area in the primary area sufficient to support both the waste inventories and individual layouts showing the emplacement area required for 70,000 MTU and, if authorized, 97,000 MTU.

  8. Nutritional recommendations for divers.

    PubMed

    Benardot, Dan; Zimmermann, Wes; Cox, Gregory R; Marks, Saul

    2014-08-01

    Competitive diving involves grace, power, balance, and flexibility, which all require satisfying daily energy and nutrient needs. Divers are short, well-muscled, and lean, giving them a distinct biomechanical advantage. Although little diving-specific nutrition research on performance and health outcomes exists, there is concern that divers are excessively focused on body weight and composition, which may result in reduced dietary intake to achieve desired physique goals. This will result in low energy availability, which may have a negative impact on their power-to-weight ratio and health risks. Evidence is increasing that restrictive dietary practices leading to low energy availability also result in micronutrient deficiencies, premature fatigue, frequent injuries, and poor athletic performance. On the basis of daily training demands, estimated energy requirements for male and female divers are 3,500 kcal and 2,650 kcal, respectively. Divers should consume a diet that provides 3-8 g/kg/day of carbohydrate, with the higher values accommodating growth and development. Total daily protein intake (1.2-1.7 g/kg) should be spread evenly throughout the day in 20 to 30 g amounts and timed appropriately after training sessions. Divers should consume nutrient-dense foods and fluids and, with medical supervision, certain dietary supplements (i.e., calcium and iron) may be advisable. Although sweat loss during indoor training is relatively low, divers should follow appropriate fluid-intake strategies to accommodate anticipated sweat losses in hot and humid outdoor settings. A multidisciplinary sports medicine team should be integral to the daily training environment, and suitable foods and fluids should be made available during prolonged practices and competitions.

  9. Ayurvedic medicine and anaesthesia

    PubMed Central

    Pradhan, Sameer L; Pradhan, Priya S

    2011-01-01

    The use of herbal medicines has increased dramatically over the past few years. The United States alone noted a 380% increase in the consumption of these products. Although the common practice of taking over-the-counter herbal soups, herbal teas and other such prepacked preparations was not associated with adverse events at large, still, some herbs are known to cause problems, especially when large doses are taken. The American Society of Anaesthesiologist (ASA) has taken a conservative stance and recommended that it is prudent to stop these products at least 2–3 weeks prior to anaesthesia and surgery. This advice may be difficult to implement as most preoperative evaluations occur only a few days prior to surgery. Some of the Ayurvedic preparations have shown to improve the patient outcome when taken during the perioperative period. Hence, the conservative stance by ASA may not always benefit the patient. More scientific studies are needed to have more targeted recommendations. This article puts forward the facts that need to be addressed by researchers in the future. PMID:22013247

  10. Interpretive Medicine

    PubMed Central

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  11. A Decision Fusion Framework for Treatment Recommendation Systems.

    PubMed

    Mei, Jing; Liu, Haifeng; Li, Xiang; Xie, Guotong; Yu, Yiqin

    2015-01-01

    Treatment recommendation is a nontrivial task--it requires not only domain knowledge from evidence-based medicine, but also data insights from descriptive, predictive and prescriptive analysis. A single treatment recommendation system is usually trained or modeled with a limited (size or quality) source. This paper proposes a decision fusion framework, combining both knowledge-driven and data-driven decision engines for treatment recommendation. End users (e.g. using the clinician workstation or mobile apps) could have a comprehensive view of various engines' opinions, as well as the final decision after fusion. For implementation, we leverage several well-known fusion algorithms, such as decision templates and meta classifiers (of logistic and SVM, etc.). Using an outcome-driven evaluation metric, we compare the fusion engine with base engines, and our experimental results show that decision fusion is a promising way towards a more valuable treatment recommendation.

  12. [Recommendations for neonatal transport].

    PubMed

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital.

  13. Diving medicine.

    PubMed

    Benton, P J; Glover, M A

    2006-01-01

    Recreational diving developed in the late 1940s when self-contained underwater breathing apparatus (SCUBA) first became available for civilian use. At the same time the development of the commercial airliner, in particular the jet airliner, made possible the concept of international travel for pleasure as opposed to business. Over the past 50 years the number of international tourists has increased by over 2500% from a mere 25 million in 1950 to over 700 million in 2002 (Treadwell TL. Trends in travel. In: Zuckerman JN, editor. Principles and practice of travel medicine, 2001; p. 2-6). The popularity of recreational diving has also increased over the same period from an activity experienced by a small number of individuals in the early 1950s to an activity today enjoyed by many millions. The combination of increased international travel and the means by which to enter and explore the underwater world has led to diving becoming increasingly popular as a tourist activity.

  14. Weight gain in pregnancy: is less truly more for mother and infant?

    PubMed Central

    Barbour, Linda A

    2012-01-01

    SUMMARY Although more than 50% of women gain weight above the Institute of Medicine (IOM) guidelines for weight gain in pregnancy and excessive weight gain is an independent risk factor for significant maternal and neonatal morbidity and offspring obesity, there is little consensus over the ideal weight gain during pregnancy. Surprisingly, the 2009 IOM guidelines varied minimally from the 1990 IOM guidelines, and many critics advocate lower weight gain recommendations. This review explores the energy costs of pregnancy, the relationship between gestational weight gain and birth weight, and considers what gestational weight gain minimizes both large-for-gestational age as well as small-for-gestational age infants. An extensive examination of the current data leads this author to question whether the current weight gain recommendations are too liberal, especially for obese pregnant women. PMID:27579137

  15. Rehabilitation Medicine Summit: Building Research Capacity

    ERIC Educational Resources Information Center

    Frontera, Walter R.; Fuhrer, Marcus J.; Jette, Alan M.; Chan, Leighton; Cooper, Rory A.; Duncan, Pamela W.; Kemp, John D.; Ottenbacher, Kenneth J.; Peckham, P. Hunter; Roth, Elliot J.; Tate, Denise G.

    2006-01-01

    The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The 5 elements of research capacity that guided the discussions were (a) researchers; (b) research culture, environment, and infrastructure;…

  16. Increasing Women's Leadership in Academic Medicine.

    ERIC Educational Resources Information Center

    Academic Medicine, 1996

    1996-01-01

    This position paper of the Association of American Medical Colleges gives an overview of the current situation regarding women's careers in academic medicine; looks at some reasons for disparities between men and women; and makes recommendations concerning development and mentoring of women faculty, administrators, residents, and students as well…

  17. [The methods of Western medicine in on ancient medicine].

    PubMed

    Ban, Deokjin

    2010-06-30

    The treatise On Ancient Medicine attests that questions of method were being debated both in medicine and in philosophy and is important evidence of cross-discipline methodological controversy. The treatise On Ancient Medicine is the first attempt in the history of Greek thought to provide a detailed account of the development of a science from a starting point in observation and experience. The author of it criticizes philosophical physicians who attempt to systematized medicine by reducing it to the interaction of one or more of the opposites hot, cold, wet, and dry, factors. He regards the theory of his opponents as hypothesis(hypothesis). Medicine has long been in possession of both an archē and a hodos, a principle and a method, which have enabled it to make discoveries over a long period of time. As far as method is concerned, the traditional science of medicine attained the knowledge of the visible by starting from observation and experience, but it recommended the use of reasoning and analogies with familiar objects as a means of learning about the invisible. It also utilized inference from the visible to the visible(epilogismos) and inference from the visible to the invisible(analogismos). The use of analogy as a means of learning about the obscure was also part of the common heritage of early philosophy and medicine. But the author's use of the analogical method distinguishes it from Empedocles' well-known analogy comparisons of the eye to a lantern and the process of respiration to the operations of a clepsydra. According to the author, traditional science of medicine used functional analogy like wine example and cheese example to know the function of humors within the body and utilized structured analogy like a tube example and a cupping instrument example to acknowledge an organ or structure within the body. But the author didn't distinguish between the claim that medicine has a systematic method of making discoveries and very different claim that it

  18. Complementary and Alternative Medicine

    MedlinePlus

    ... use practices like acupuncture in medicine. But until recently, most Western hospitals didn't provide any alternative ... medicine is often used instead of conventional medical techniques. Complementary medicine is used in addition to conventional ...

  19. Taking multiple medicines safely

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000883.htm Taking multiple medicines safely To use the sharing features on this ... directed. Why you may Need More Than one Medicine You may take more than one medicine to ...

  20. Managing Your Medicines

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Managing Your Medicines Updated:Oct 27,2016 If you have heart ... Weight • Tools & Resources Heart Insight Supplement: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

  1. Storing your medicines

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000534.htm Storing your medicines To use the sharing features on this page, ... child latch or lock. Do not use Damaged Medicine Damaged medicine may make you sick. DO NOT ...

  2. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  3. Blood Pressure Medicines

    MedlinePlus

    ... reducing sodium in your diet, you may need medicines. Blood pressure medicines work in different ways to lower blood pressure. ... and widen blood vessels. Often, two or more medicines work better than one. NIH: National Heart, Lung, ...

  4. Complementary and Integrative Medicine

    MedlinePlus

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  5. Medicines for osteoporosis

    MedlinePlus

    ... Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... Your doctor may prescribe certain medicines to help lower your ... make the bones in your hips, spine, and other areas less likely ...

  6. Depression - stopping your medicines

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  7. Medicinal Herbs in Iranian Traditional Medicine for Learning and Memory

    PubMed Central

    Shojaii, Asie; Ghods, Roshanak; Fard, Mehri Abdollahi

    2016-01-01

    Background: A few factors such as age, stress, and emotions may lead to impaired learning, memory loss, amnesia, and dementia or threats like schizophrenia and Alzheimer’s disease (AD). Iranian traditional medicine (ITM) recommends some herbs and herbal preparations for the treatment or prevention of CNS problems. Methods: In this study, scientific evidence related to the effectiveness of ITM herbal medicine on memory, learning and AD is reviewed. The scientific evidence of plant efficacy was searched in electronic databases including PubMed, Scopus, SID, Science Direct, and Google Scholar by keywords such as memory, Alzheimer, amnesia, learning and scientific plant names from 1969 to 2014. Results: The findings of this study confirmed the effectiveness of certain ITM medicinal plants on enhancing memory and learning or in the treatment/prevention of amnesia and AD. Some ITM plants like Melissa officinalis, Crocus sativus and Nigella sativa showed improving effects on memory and the treatment of AD in clinical trials. In some cases, active principles responsible for the efficacy of these plants on memory were also determined. Discussion: Most of the studies on ITM plants were designed in animal models and a few herbs were evaluated in clinical trials on AD. Furthermore, there are insufficient or no investigations on certain herbal medicines used in ITM to confirm their effectiveness on memory and learning. Therefore, further experimental and clinical studies are necessary to evaluate the effectiveness of these plants on memory and AD as well as determining their active components. PMID:27516676

  8. Medicinal Herbs in Iranian Traditional Medicine for Learning and Memory

    PubMed Central

    Shojaii, Asie; Ghods, Roshanak; Fard, Mehri Abdollahi

    2016-01-01

    Background: A few factors such as age, stress, and emotions may lead to impaired learning, memory loss, amnesia, and dementia or threats like schizophrenia and Alzheimer’s disease (AD). Iranian traditional medicine (ITM) recommends some herbs and herbal preparations for the treatment or prevention of CNS problems. Methods: In this study, scientific evidence related to the effectiveness of ITM herbal medicine on memory, learning and AD is reviewed. The scientific evidence of plant efficacy was searched in electronic databases including PubMed, Scopus, SID, Science Direct, and Google Scholar by keywords such as memory, Alzheimer, amnesia, learning and scientific plant names from 1969 to 2014. Results: The findings of this study confirmed the effectiveness of certain ITM medicinal plants on enhancing memory and learning or in the treatment/prevention of amnesia and AD. Some ITM plants like Melissa officinalis, Crocus sativus and Nigella sativa showed improving effects on memory and the treatment of AD in clinical trials. In some cases, active principles responsible for the efficacy of these plants on memory were also determined. Discussion: Most of the studies on ITM plants were designed in animal models and a few herbs were evaluated in clinical trials on AD. Furthermore, there are insufficient or no investigations on certain herbal medicines used in ITM to confirm their effectiveness on memory and learning. Therefore, further experimental and clinical studies are necessary to evaluate the effectiveness of these plants on memory and AD as well as determining their active components. PMID:27840509

  9. Global patterns of water intake: how intake data affect recommendations.

    PubMed

    Shirreffs, Susan M

    2012-11-01

    Studies to assess water intake have been undertaken in many countries around the world. Some of these have been large-scale studies, whereas others have used a small number of subjects. These studies provide an emerging picture of water and/or fluid consumption in different populations around the world. Studies of this nature have also formed the basis of a number of recommendations published by different organizations, including the US Institute of Medicine and the European Food Safety Authority. The results of these intake studies indicate substantial differences in water and/or fluid intake in different populations, which have translated into different intake recommendations.

  10. [Vaccination schedule of the Spanish Association of Pediatrics: recommendations 2004].

    PubMed

    2004-05-01

    The Vaccine Assessment Committee of the Spanish Association of Pediatrics discusses vaccine developments in 2003 and recommends some modifications to the vaccination schedule. The recommendation of substituting the oral polio vaccine for the inactivated polio vaccine, suppressing the fifth dose, is maintained. The introduction of the conjugate pneumococcal vaccine and the varicella vaccine is stressed. Concerning the meningococcal C vaccine, the improvement introduced by being able to immunize with just two doses is discussed. In agreement with the information received from the European Medicines Agency, there appear to be no well-founded reasons to abandon hexavalent preparations.

  11. Medicine organizer

    NASA Astrophysics Data System (ADS)

    Martins, Ricardo; Belchior, Ismael

    2015-04-01

    In the last year of secondary school, students studying physics and chemistry are incentivized to do a project where they must put in practice their improvement of scientific knowledge and skills, like observation of phenomena and analysis of data with scientific knowledge. In this project a group of students, tutored by the teacher, wanted to build an instrument that helps people to take their medical drugs at the right time. This instrument must have some compartments with an alarm and an LED light where the people can put their medical drugs. The instrument must be easily programed using an android program that also registers if the medicine has been taken. The students needed to simulate the hardware and software, draw the electronic system and build the final product. At the end of the school year, a public oral presentation was prepared by each group of students and presented to the school community. They are also encouraged to participate in national and international scientific shows and competitions.

  12. [Disaster medicine].

    PubMed

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations.

  13. Alternative Medicine and Alzheimer's Disease

    PubMed Central

    Kelley, Brendan J.; Knopman, David S.

    2009-01-01

    Background Alternative medicine has an extensive worldwide history and is commonly used by older patients. A number of different alternative medicines are used by patients having Alzheimer's disease. It is both desirable and expected for clinicians to be acquainted with these medications. Review Summary This paper discusses the available clinical trial evidence regarding eight agents commonly used by people having Alzheimer's disease. We provide an overview of the history and basic scientific evidence available for each agent, followed by a critical analysis of the evidence available from clinical trials, including the number of participants, trial duration and specific outcomes evaluated. Conclusion While many of these compounds have been associated with interesting basic science, none has shown clear clinical benefit to date. Data available for some, such as ginkgo biloba, curcumin and huperzine A, suggest that further evaluation is warranted. Familiarity with this literature will allow clinicians to provide meaningful recommendations to patients who wish to use these agents. PMID:18784599

  14. Context-Aware Recommender Systems

    NASA Astrophysics Data System (ADS)

    Adomavicius, Gediminas; Tuzhilin, Alexander

    The importance of contextual information has been recognized by researchers and practitioners in many disciplines, including e-commerce personalization, information retrieval, ubiquitous and mobile computing, data mining, marketing, and management. While a substantial amount of research has already been performed in the area of recommender systems, most existing approaches focus on recommending the most relevant items to users without taking into account any additional contextual information, such as time, location, or the company of other people (e.g., for watching movies or dining out). In this chapter we argue that relevant contextual information does matter in recommender systems and that it is important to take this information into account when providing recommendations. We discuss the general notion of context and how it can be modeled in recommender systems. Furthermore, we introduce three different algorithmic paradigms - contextual prefiltering, post-filtering, and modeling - for incorporating contextual information into the recommendation process, discuss the possibilities of combining several contextaware recommendation techniques into a single unifying approach, and provide a case study of one such combined approach. Finally, we present additional capabilities for context-aware recommenders and discuss important and promising directions for future research.

  15. Teacher Leadership: Federal Policy Recommendations

    ERIC Educational Resources Information Center

    Gran, Jackie; Young, Margaret; Broin, Alexandra

    2015-01-01

    This policy brief was developed specifically for federal policymakers, and builds upon the policy recommendations included in "Leading from Every Seat: Empowering Principals to Cultivate Teacher Leadership for School Improvement." The recommendations in this report include the following: (1) Uncover New Leadership Ideas and Seed…

  16. Antiretroviral treatment of HIV infection: Swedish recommendations 2005.

    PubMed

    Gisslén, Magnus; Ahlqvist-Rastad, Jane; Albert, Jan; Blaxhult, Anders; Hamberg, Anna-Karin; Lindbäck, Stefan; Sandström, Eric; Uhnoo, Ingrid

    2006-01-01

    On 2 earlier occasions, in 2002 and 2003, the Swedish Medical Products Agency (MPA) and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly publicized recommendations for the treatment of HIV infection. A working group from the same expert team that produced the 2002 report has now revised the text again. Since the publication of the last treatment recommendations, 4 new medicines have become available: emtricitabine, atazanavir, fosamprenavir, and enfuvirtid. The last-mentioned belongs to a new class of HIV medications called fusion inhibitors (Box 1). It is likely that tipranavir will also be on the market soon. Simultaneously, the drug zalcitabin has been deregistered. The following updated recommendations parallel the earlier ones, but increased knowledge allows us to be more specific in our recommendations. Thus, it is now suggested that the initial treatment for HIV infection consist of 2 nucleoside reverse transcriptase inhibitors (NRTIs) and 1 non-nucleoside reverse transcriptase inhibitor (NNRTI); or 2 NRTIs and 1 protease inhibitor (PI). In the group of the NRTIs, stavudine is no longer recommended for this purpose. In the NNRTI group, efavirenz should be preferred to nevirapine, except under special circumstances. Finally, PIs ought to be boosted with ritonavir (PI/r). Also new are recommendations regarding treatment choices for patients co-infected with hepatitis B virus (HBV) or tuberculosis (TB). As in the case of the previous publication, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine, 2001 (see http://www.cebm.net/levels_of_evidence.asp#levels), and have been supplemented with references to newly-added sections and data not referred to in earlier background documentation.

  17. Introducing complementary medicine into the medical curriculum.

    PubMed Central

    Rampes, H; Sharples, F; Maragh, S; Fisher, P

    1997-01-01

    We surveyed the deans of British medical schools to determine the provision of complementary medicine in the undergraduate curriculum. We also sampled medical students at one British medical school to determine their knowledge of, and views on instruction in, complementary medicine. There is little education in complementary medicine at British medical schools, but it is an area of active curriculum development. Students' levels of knowledge vary widely between different therapies. Most medical students would like to learn about acupuncture, hypnosis, homoeopathy and osteopathy. We conclude that complementary medicine should be included in the medical undergraduate curriculum. This could be done without a great increase in teaching of facts, and could serve as a vehicle to introduce broader issues, as recommended by the General Medical Council. PMID:9059376

  18. 76 FR 81 - Adoption of Recommendation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ...; ] ADMINISTRATIVE CONFERENCE OF THE UNITED STATES Adoption of Recommendation AGENCY: Administrative Conference of... the attached recommendation at its Fifty-third Plenary Session. The recommendation addresses issues... makes recommendations for improvements to the agencies, collectively or individually, and to...

  19. How Do Asthma Medicines Work?

    MedlinePlus

    ... Happens in the Operating Room? How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines ... of medicines for treating asthma: 1. Quick-relief Medicines Quick-relief medicines (also called rescue or fast- ...

  20. How Do Asthma Medicines Work?

    MedlinePlus

    ... Video: Getting an X-ray How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines ... of medicines for treating asthma: 1. Quick-relief Medicines Quick-relief medicines (also called rescue or fast- ...

  1. Recommended for release on recognizance: factors affecting pretrial release recommendations.

    PubMed

    Petee, T A

    1994-06-01

    Researchers have acknowledged the influence of pretrial release agencies in judicial decision making regarding bail; however, few researchers have focused on the process used by the pretrial release agencies to make bail-bond recommendations. In this study I sought to establish which factors were most salient in making the decision to recommend a defendant for release on recognizance. I found that both officially sanctioned release criteria and "extralegal" variables were predictive of this decision.

  2. Balancing personalized medicine and personalized care.

    PubMed

    Cornetta, Kenneth; Brown, Candy Gunther

    2013-03-01

    The current description of personalized medicine by the National Institutes of Health is "the science of individualized prevention and therapy." Although physicians are beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act on personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. Because these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care.

  3. Medicines for cancers in children: The WHO model for selection of essential medicines

    PubMed Central

    Robertson, Jane; Barr, Ronald; Forte, Gilles; Ondari, Clive

    2015-01-01

    Pressures to include more cancer medicines in the WHO Model List of Essential Medicines (EML) pose challenges for the Expert Committee responsible for recommending changes to the list. How do medicines for cancer fit within a definition of essential medicines as those meeting the priority health needs of the population? Will identifying a medicine as “essential” offer some leverage to improve access to effective cancer medicines in low and middle‐income countries (LMICs)? The addition of a number of medicines for the treatment of cancers in children to the Model List of Essential Medicines for Children (EMLc) in 2011 provides important insights into previous Expert Committee decision‐making and offers a platform for future deliberations. As combination chemotherapy is required for effective treatment of many malignancies, a disease‐based approach makes more sense than an agent‐based approach. Inadequate financing to purchase essential medicines is a reality in many LMICs, thus a consideration of health impact is central to decisions on the selection and procurement of medicines. Inclusion in national EMLs should identify medicines that have priority for procurement in the public sector. This article will discuss some of the factors taken into account by the Expert Committee in developing the WHO EMLc. We argue that the disease‐based approach coupled with the assessment of the magnitude of the clinical benefit provides an appropriate approach for considering further additions of medicines for pediatric cancers and for the review of the adult cancer section of the Model List. Pediatr Blood Cancer 2015;62:1689–1693. © 2015 Wiley Periodicals, Inc. PMID:25929524

  4. Adolescent contraception. Review and recommendations.

    PubMed

    Turetsky, R A; Strasburger, V C

    1983-05-01

    In the light of the increase in teenage sexual activity over the past decade, the authors review current social, psychological, and educational attitudes. Together with a summary of the legal ramifications, they provide recommendations for treatment of this patient group.

  5. Dietary Recommendations for Healthy Children

    MedlinePlus

    ... Physical Activity in Adults Types of Fitness The Price of Inactivity Food as Fuel - Before, During and ... Heart Association recommends this eating pattern for families: Energy (calories) should be adequate to support growth and ...

  6. Recommended Immunizations for Adults 50+

    MedlinePlus

    ... page please turn Javascript on. Health Screenings and Immunizations Recommended Immunizations For Adults 50+ The content in this section ... out more, visit How Vaccines Prevent Disease . Vaccines, Vaccinations, and Immunizations Understanding the difference between vaccines, vaccinations, ...

  7. NUCLEAR DATA EVALUATIONS AND RECOMMENDATIONS

    SciTech Connect

    HOLDEN, N.E.

    2005-05-08

    The published scientific literature is scanned and periodically evaluated for neutron and non-neutron nuclear data and the resulting recommendations are published [1,2]. After the literature has been scanned and appropriate data collected, there are often problems with regard to the treatment of the various types of data during this evaluation process and with regard to the method by which the recommendations are drawn from the assessment of the collection of individual measurements. Some-problems with uncertainties are presented.

  8. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  9. Marijuana and medicine: assessing the science base: a summary of the 1999 Institute of Medicine report.

    PubMed

    Watson, S J; Benson, J A; Joy, J E

    2000-06-01

    In response to public pressure to allow the medical use of marijuana, the Office of National Drug Control Policy, Washington, DC, funded a study by the Institute of Medicine evaluating the scientific evidence for benefits and risks of using marijuana as a medicine. The report used scientific reviews, public hearings, and reports from other agencies, and was evaluated by knowledgeable advisors and reviewers. It called for heavier investment in research on the biology of cannabinoid systems, careful clinical studies of cannabinoids in clinical syndromes, analysis of cannabinoids' psychological effects on symptoms, and evaluations of the health consequences of heavy marijuana use; recommends against the use of smoked marijuana in medicine and for the development of a medical cannabinoid inhaler; and recommends that compassionate use of marijuana be considered under carefully reviewed protocols. Finally, the report evaluates the abuse potential, tolerance, withdrawal, and gateway risks of medical use of cannabinoid drugs.

  10. [Innovation guidelines and strategies for pharmaceutical engineering of Chinese medicine and their industrial translation].

    PubMed

    Cheng, Yi-Yu; Qu, Hai-Bin; Zhang, Bo-Li

    2013-01-01

    This paper briefly analyzes the bottlenecks and major technical requirements for pharmaceutical industry of Chinese medicine, providing current status of pharmaceutical engineering of Chinese medicine. The innovation directions and strategies of the pharmaceutical engineering for manufacturing Chinese medicine are proposed along with the framework of their core technology. As a consequence, the development of the third-generation pharmaceutical technology for Chinese medicine, featured as "precision, digital and intelligent", is recommended. The prospects of the pharmaceutical technology are also forecasted.

  11. [Recommendation on temperature management after cardiopulmonary arrest and severe traumatic brain injury in childhood beyond the neonatal period : Statement of the German Society for Neonatology and Pediatric Intensive Care Medicine (GNPI) and the scientific Working Group for Paediatric Anaesthesia (WAKKA) of the German Society of Anaesthesiology and Intensive Care (DGAI)].

    PubMed

    Brenner, S; Eich, C; Rellensmann, G; Schuhmann, M U; Nicolai, T; Hoffmann, F

    2017-02-01

    The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36.5 °C) for 72 hours after cardiopulmonary arrest or severe traumatic brain injury for children beyond the neonatal period.

  12. Enhancing collaborative leadership in palliative social work in oncology.

    PubMed

    Jones, Barbara; Phillips, Farya; Head, Barbara Anderson; Hedlund, Susan; Kalisiak, Angela; Zebrack, Brad; Kilburn, Lisa; Otis-Green, Shirley

    2014-01-01

    The Institute of Medicine (IOM) Report-Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs-provided recommendations for meeting the palliative care needs of our growing population of older Americans. The IOM report highlights the demand for social work leadership across all aspects of the health care delivery system. Social workers are core interdisciplinary members of the health care team and it is important for them to be well prepared for collaborative leadership roles across health care settings. The ExCEL in Social Work: Excellence in Cancer Education & Leadership education project was created as a direct response to the 2008 IOM Report. This article highlights a sampling of palliative care projects initiated by outstanding oncology social work participants in the ExCEL program. These projects demonstrate the leadership of social workers in palliative care oncology.

  13. Paradigm lost: race, ethnicity, and the search for a new population taxonomy.

    PubMed Central

    Oppenheimer, G M

    2001-01-01

    The Institute of Medicine (IOM) recently recommended that the National Institutes of Health (NIH) reevaluate its employment of "race," a concept lacking scientific or anthropological justification, in cancer surveillance and other population research. The IOM advised the NIH to use a different population classification, that of "ethnic group," instead of "race." A relatively new term, according to the IOM, "ethnic group" would turn research attention away from biological determinism and toward a focus on culture and behavior. This article examines the historically central role of racial categorization and its relationship to racism in the United States and questions whether dropping "race" from population taxonomies is either possible or, at least in the short run, preferable. In addition, a historical examination of "ethnicity" and "ethnic group" finds that these concepts, as used in the United States, derive in part from race and immigration and are not neutral terms; instead, they carry their own burden of political, social, and ideological meaning. PMID:11441730

  14. Interview with quality leaders: Dr. Donna E. Shalala and Dr. Linda Burnes Bolton on the committee on the Robert Wood Johnson Foundation initiative on The Future of Nursing at the Institute of Medicine. Interviewed by Diane Storer Brown.

    PubMed

    Shalala, Donna E; Bolton, Linda Burnes

    2012-01-01

    The Institute of Medicine released a consensus report in October 2010, titled The Future of Nursing (FON): Leading Change, Advancing Health, which concluded significant change was needed in nurses' roles, responsibilities, and education to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system (http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx). Dr. Donna Shalala, Chair of the study, and Dr. Linda Burnes Bolton, Vice Chair of the study, spoke about the Future of Nursing (FON) at the Collaborative Alliance for Nursing Outcomes (CALNOC) conference to a predominately nursing and quality professional audience. This follow-up interview expands the discussion specifically for quality professionals, many of whom are nurses.

  15. The purpose of occupational medicine.

    PubMed Central

    Raffle, P A

    1975-01-01

    The purposes of occupational medicine are described in terms of its clinical medical, environmental medical, research, and administrative content. Each of these components is essential in different proportions in comprehensive occupational health services for different industries, and can only be satisfactorily provided by occupational physicians and occupational health nurses who are an integral part of their organizations. Two-thirds of the working population in the United Kingdom are without the benefits of occupational medicine. The reorganization of the National Health Service and of local government presents the opportunity to extend occupational health services to many more workers who need them. It is suggested that area health authorities should provide occupational health services for all National Health Service staff and, on an agency basis, for local government and associated services, eventually extending to local industry. Such area health authority based services, merged with the Employment Medical Advisory Service, could conveniently then be part of the National Health Service, as recommended by the British Medical Association, the Society of Occupational Medicine, and the Medical Services Review Committee. PMID:1131336

  16. Economics and lighting level recommendations

    SciTech Connect

    Clear, R.; Berman, S.

    1992-04-01

    The Illuminating Engineering Society of North America develops light level recommendations for tasks where visual performance is important. The 1959 and 1972 recommendations for illumination levels were based on the principle of delivering a fixed level of performance as predicted by the visual performance models of the time. This same principle is being considered for future revisions to the recommendations. There is currently no explicit method for determining whether a given fixed performance level is in any sense optimal or best. Visual performance increases with lighting levels, but so do economic and environmental costs. These costs lessen the economic benefits of the improved visual performance. A formal method for including these factors in light level recommendations is to restate the problem in terms of net benefits (benefits minus costs). The resulting equations have well defined optima versus light level, and thus give an explicit estimate of what the best lighting levels are in terms of current visual performance models, and current economic conditions. A simple net-benefit procedure is described, and sample calculations are shown for two current visual performance models. Fixed performance levels do not provide economically optimal recommendations with either model. There are also differences between models, but they are less significant than the large differences between the principles of fixed performance levels and economic optimization.

  17. Rehabilitation Medicine Summit: building research capacity.

    PubMed

    Frontera, Walter R; Fuhrer, Marcus J; Jette, Alan M; Chan, Leighton; Cooper, Rory A; Duncan, Pamela W; Kemp, John D; Ottenbacher, Kenneth J; Peckham, P Hunter; Roth, Elliot J; Tate, Denise G

    2005-12-01

    The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called for to pursue the agendas outlined in this report.

  18. An Evidence-Based Course in Complementary Medicines

    PubMed Central

    Hughes, Jeff

    2012-01-01

    Objective. To evaluate the impact of an evidence-based course in complementary medicines on the attitudes, knowledge, and professional practice behavior of undergraduate pharmacy students. Design. A required 12-week evidence-based complementary medicine course was designed and introduced into the third-year undergraduate pharmacy curriculum. The course included a combination of traditional lectures, interactive tutorial sessions, and a range of formal assessments. Assessment. Pre- and post-course survey instruments were administered to assess changes in students’ attitudes, perceptions, knowledge, and the likelihood they would recommend the use of complementary medicines in a pharmacy practice environment. Conclusion. Completion of a required evidence-based complementary medicines course resulted in a positive change in pharmacy students’ perceptions of the value of various complementary medicines as well as in their willingness to recommend them, and provided students with the required knowledge to make patient-centered recommendations for use of complementary medicines in a professional pharmacy practice setting. These findings support the need for greater evidence-based complementary medicine education within pharmacy curricula to meet consumer demand and to align with pharmacists’ professional responsibilities. PMID:23275665

  19. Plan for early action: Recommendations

    SciTech Connect

    1998-12-31

    This report contains recommendations on the implementation of an action plan to reduce or recapture greenhouse gas (GHG) emissions in British Columbia. The report includes the consensus recommendations of the BC Greenhouse Gas Forum, as well as those items on which Forum participants have agreed to disagree, plus the reasons for those differences. The recommendations include: Umbrella actions which may affect several or all sectors of the economy, or support the success of other actions; actions to reduce vehicle kilometers travelled; actions to increase vehicle efficiency or increase the use of alternative fuels or technologies; actions to decrease GHG emissions from energy production; actions to increase end-use energy efficiency; and actions to reduce non-energy-related emissions. Appendices include work sheets on each action, with a description of the action and information on the action`s rationale, experience elsewhere, related policy initiatives, and key issues regarding feasibility and implementation.

  20. Publication recommendations for electrodermal measurements.

    PubMed

    Boucsein, Wolfram; Fowles, Don C; Grimnes, Sverre; Ben-Shakhar, Gershon; roth, Walton T; Dawson, Michael E; Filion, Diane L

    2012-08-01

    This committee was appointed by the SPR Board to provide recommendations for publishing data on electrodermal activity (EDA). They are intended to be a stand-alone source for newcomers and experienced users. A short outline of principles for electrodermal measurement is given, and recommendations from an earlier report (Fowles et al., ) are incorporated. Three fundamental techniques of EDA recording are described: (1) endosomatic recording without the application of an external current, (2) exosomatic recording with direct current (the most widely applied methodology), and (3) exosomatic recording with alternating current-to date infrequently used but a promising future methodology. In addition to EDA recording in laboratories, ambulatory recording has become an emerging technique. Specific problems that come with this recording of EDA in the field are discussed, as are those emerging from recording EDA within a magnetic field (e.g., fMRI). Recommendations for the details that should be mentioned in publications of EDA methods and results are provided.

  1. Recommended Practices in Thrust Measurements

    NASA Technical Reports Server (NTRS)

    Polk, James E.; Pancotti, Anthony; Haag, Thomas; King, Scott; Walker, Mitchell; Blakely, Joseph; Ziemer, John

    2013-01-01

    Accurate, direct measurement of thrust or impulse is one of the most critical elements of electric thruster characterization, and one of the most difficult measurements to make. The American Institute of Aeronautics and Astronautics has started an initiative to develop standards for many important measurement processes in electric propulsion, including thrust measurements. This paper summarizes recommended practices for the design, calibration, and operation of pendulum thrust stands, which are widely recognized as the best approach for measuring micro N- to mN-level thrust and micro Ns-level impulse bits. The fundamentals of pendulum thrust stand operation are reviewed, along with its implementation in hanging pendulum, inverted pendulum, and torsional balance configurations. Methods of calibration and recommendations for calibration processes are presented. Sources of error are identified and methods for data processing and uncertainty analysis are discussed. This review is intended to be the first step toward a recommended practices document to help the community produce high quality thrust measurements.

  2. [2013 Ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals (summary). Joint recommendations from the International Society for Chronobiology (ISC), American Association of Medical Chronobiology and Chronotherapeutics (AAMCC), Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk (SECAC), Spanish Society of Atherosclerosis (SEA), and Romanian Society of Internal Medicine (RSIM)].

    PubMed

    Hermida, Ramón C; Smolensky, Michael H; Ayala, Diana E; Portaluppi, Francesco; Crespo, Juan J; Fabbian, Fabio; Haus, Erhard; Manfredini, Roberto; Mojón, Artemio; Moyá, Ana; Piñeiro, Luis; Ríos, María T; Otero, Alfonso; Balan, Horia; Fernández, José R

    2013-01-01

    Correlation between systolic (SBP) and diastolic (DBP) blood pressure (BP) level and target organ damage, cardiovascular disease (CVD) risk, and long-term prognosis is much greater for ambulatory BP monitoring (ABPM) than daytime office measurements. The 2013 ABPM guidelines specified herein are based on ABPM patient outcomes studies and constitute a substantial revision of current knowledge. The asleep SBP mean and sleep-time relative SBP decline are the most significant predictors of CVD events, both individually as well as jointly when combined with other ABPM-derived prognostic markers. Thus, they should be preferably used to diagnose hypertension and assess CVD and other associated risks. Progressive decrease by therapeutic intervention in the asleep BP mean is the most significant predictor of CVD event-free interval. The 24 h BP mean is not recommended to diagnose hypertension because it disregards the more valuable clinical information pertaining to the features of the 24 h BP pattern. Persons with the same 24 h BP mean may display radically different 24 h BP patterns, ranging from extreme-dipper to riser types, representative of markedly different risk states. Classification of individuals by comparing office with either the 24 h or awake BP mean as "masked normotensives" (elevated clinic BP but normal ABPM), which should replace the terms of "isolated office" or "white-coat hypertension", and "masked hypertensives" (normal clinic BP but elevated ABPM) is misleading and should be avoided because it disregards the clinical significance of the asleep BP mean. Outcome-based ABPM reference thresholds for men, which in the absence of compelling clinical conditions are 135/85 mmHg for the awake and 120/70 mmHg for the asleep SBP/DBP means, are lower by 10/5 mmHg for SBP/DBP in uncomplicated, low-CVD risk, women and lower by 15/10 mmHg for SBP/DBP in male and female high-risk patients, e.g., with diabetes, chronic kidney disease (CKD), and/or past CVD events. In

  3. Veterinary medicines update.

    PubMed

    2017-03-11

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  4. Sports Medicine Today

    ERIC Educational Resources Information Center

    Ryan, Allan J.

    1978-01-01

    Includes a general discussion of sports medicine including exercise and conditioning techniques, prevention of illness and injury, treatment of and rehabilitation after sports injury, and the future of sports medicine. (BB)

  5. Alternative and Integrative Medicine

    MedlinePlus

    ... Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side Effects & their ... Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side Effects & their ...

  6. Society for Vascular Medicine

    MedlinePlus

    ... Certification with this new online course from the Society for Vascular Medicine. Learn more. Looking for a ... jobs are listed right now. Copyright © 2016 The Society for Vascular Medicine. All Rights Reserved.

  7. Cold and Cough Medicines

    MedlinePlus

    ... What can you do for your cold or cough symptoms? Besides drinking lots of fluids and getting ... medicines. There are lots of different cold and cough medicines, and they do different things. Nasal decongestants - ...

  8. Is Marijuana Medicine?

    MedlinePlus

    ... Share Print Home » Publications » DrugFacts » Marijuana as Medicine Marijuana as Medicine Email Facebook Twitter Revised March 2017 What is medical marijuana? Photo by ©Shutterstock.com/ Atomazul The term medical ...

  9. Medicine safety and children

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000619.htm Medicine safety and children To use the sharing features ... especially careful if you have toddlers around. Keep Medicines out of Reach and Sight Safety tips: DO ...

  10. Using Medicines Wisely

    MedlinePlus

    ... Consumers Consumer Information by Audience For Women Use Medicines Wisely Share Tweet Linkedin Pin it More sharing ... or foods should I avoid? 2. Keep a Medicine List Write down the important facts about each ...

  11. Veterinary medicines: product update.

    PubMed

    2014-04-05

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  12. Veterinary medicines: product update.

    PubMed

    2014-03-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  13. Veterinary medicines: product update.

    PubMed

    2014-08-02

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  14. Veterinary medicines: product update.

    PubMed

    2014-11-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  15. Veterinary medicines: product update.

    PubMed

    2014-09-06

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK, and on other relevant issues.

  16. ADHD Medicines (for Kids)

    MedlinePlus

    ... Dictionary of Medical Words En Español What Other Kids Are Reading Taking Care of Your Ears Taking ... Getting an X-ray ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A A What's in ...

  17. Medicines for ADHD

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007592.htm Medicines for ADHD To use the sharing features on ... that the treatment plan is successful. TYPES OF MEDICINES Stimulants are the most commonly used type of ...

  18. Pregnancy and Medicines

    MedlinePlus

    Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, and supplements. Always speak with your health ...

  19. HIV/AIDS Medicines

    MedlinePlus

    ... few years. But today, there are many effective medicines to fight the infection, and people with HIV ... healthier lives. There are five major types of medicines: Reverse transcriptase (RT) inhibitors - interfere with a critical ...

  20. Cough & Cold Medicine Abuse

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... Someone Quit? Avoiding DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ...

  1. Society for Vascular Medicine

    MedlinePlus

    ... Journal Scientific Sessions Website FAQ Copyright © 2017 The Society for Vascular Medicine. All Rights Reserved. Phone: +1- ... page Videos Training Programs Journal Access the Journal Society Communications Patient Information Pages Vascular Medicine Journal CME ...

  2. Traveling Safely with Medicines

    MedlinePlus

    ... means taking a trip. To be sure that you can stay healthy on your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you always carry a list of all the medicines ...

  3. Operational and Research Musculoskeletal Summit: Summit Recommendations

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Walton, Marlei; Davis-Street, Janis; Smaka, Todd J.; Griffin, DeVon

    2006-01-01

    The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

  4. Action Recommendation for Cyber Resilience

    SciTech Connect

    Choudhury, Sutanay; Rodriguez, Luke R.; Curtis, Darren S.; Oler, Kiri J.; Nordquist, Peter L.; Chen, Pin-Yu; Ray, Indrajit

    2015-09-01

    This paper presents an unifying graph-based model for representing the infrastructure, behavior and missions of an enterprise. We describe how the model can be used to achieve resiliency against a wide class of failures and attacks. We introduce an algorithm for recommending resilience establishing actions based on dynamic updates to the models. Without loss of generality, we show the effectiveness of the algorithm for preserving latency based quality of service (QoS). Our models and the recommendation algorithms are implemented in a software framework that we seek to release as an open source framework for simulating resilient cyber systems.

  5. Individualized medicine, health medicine, and constitutional theory in Chinese medicine.

    PubMed

    Wang, Qi

    2012-03-01

    The patterns of modern science and changes in the medical model can result in the transformation of the current state of individualized and health medicines into being the primary trend in medical development. Chinese and Western medical systems are dissimilar in terms of value orientations, thinking style, and research directions because of their different historical and cultural backgrounds. Individualized treatment in modern medicine is mainly established based on individual genome information and the differences in mononucleotide polymorphisms. However, such treatment method is expensive, creates an uncertain genetic marker, and leads to different result interpretations, among other problems. The Chinese constitutional theory developed in the 1970s expresses the principle behind Chinese health medicine and individual treatment and provides the corresponding methods. The Chinese constitutional theory divides the constitution of the Chinese population into nine categories based on established classification criteria. It promotes the study of the relationship of each constitution to diseases and Chinese medicine preparation toward adjusting the constitution and preventing diseases. The theory also provides methods and tools for individualized treatment. Constitution identification shows the direction and provides the core technology for the evaluation of the health status. By combining the developments in modern biotechnology, new diagnostic techniques and treatment models of constitution-differentiation, disease-differentiation, and syndrome-differentiation can be established for the development of individualized Chinese medicine treatment and health medicine for the international medical community.

  6. Essential Medicines for Children.

    PubMed

    Kalle, Hoppu

    2017-02-09

    WHO defines Essential medicines as those that satisfy the priority health-care needs of the population (1). The right to Essential medicines has been considered an important component of the right to health. In the name of equity children should also have access to appropriate, available, affordable, and quality essential medicines they need, but children's essential medicines are too often missing. This article is protected by copyright. All rights reserved.

  7. [Complementary and alternative medicine in oncology].

    PubMed

    Hübner, J

    2013-06-01

    Complementary and alternative medicine are frequently used by cancer patients. The main benefit of complementary medicine is that it gives patients the chance to become active. Complementary therapy can reduce the side effects of conventional therapy. However, we have to give due consideration to side effects and interactions: the latter being able to reduce the effectiveness of cancer therapy and so to jeopardise the success of therapy. Therefore, complementary therapy should be managed by the oncologist. It is based on a common concept of cancerogenesis with conventional therapy. Complement therapy can be assessed in studies. Alternative medicine in contrast rejects common rules of evidence-based medicine. It starts from its own concepts of cancerogenesis, which is often in line with the thinking of lay persons. Alternative medicine is offered as either "alternative" to recommended cancer treatment or is used at the same time but without due regard for the interactions. Alternative medicine is a high risk to patients. In the following two parts of the article, the most important complementary and alternative therapies cancer patients use nowadays are presented and assessed according to published evidence.

  8. The University of Maryland experience in integrating preventive medicine into the clinical medicine curriculum.

    PubMed Central

    Havas, S; Rixey, S; Sherwin, R; Zimmerman, S I; Anderson, S

    1993-01-01

    Lifestyle risk factors play a major role in the etiology of premature mortality, morbidity, and disability in the United States. Numerous professional groups as well as the Surgeon General of the Public Health Service have recommended that increased attention be devoted to training medical students and physicians to improve their knowledge and skills in health promotion and disease prevention. Such training is critical for attaining many of the "Healthy People 2000" objectives. For a variety of reasons, however, most medical schools have had difficulty in successfully integrating preventive medicine into their clinical curriculums. This article describes the critical elements that allowed the faculty at the University of Maryland School of Medicine to accomplish this goal through its fourth year clinical preventive medicine course. The strategies employed in this course may serve as a model for other institutions to achieve the integration of preventive medicine into their clinical curriculums. PMID:8497571

  9. Performing Narrative Medicine

    ERIC Educational Resources Information Center

    Langellier, Kristin M.

    2009-01-01

    In this article, the author weaves narrative medicine and performance together to consider what might it mean to call narrative medicine a performance. To name narrative medicine as performance is to recognize the texts and bodies, the stories and selves, that participate in its practice--patients' and physicians' embodied stories as well as the…

  10. Medicines By Design

    ERIC Educational Resources Information Center

    Davis, Alison

    2006-01-01

    This publication discusses the many different ways medicines work in the body and how this information guides the hunt for drugs of the future. The science of pharmacology--understanding the basics of how our bodies react to medicines and how medicines affect our bodies--is already a vital part of 21st-century research. Pharmacology is a broad…

  11. Nuclear medicine annual, 1984

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1984-01-01

    The following topics are reviewed in this work: nuclear physicians role in planning for and handling radiation accidents; the role of nuclear medicine in evaluating the hypertensive patient; studies of the heart with radionuclides; role of radionuclide imaging in the patient undergoing chemotherapy; hematologic nuclear medicine; the role of nuclear medicine in sports related injuries; radionuclide evaluation of hepatic function with emphasis on cholestatis.

  12. New Recommendations for Mefloquine Use in Pregnancy

    MedlinePlus

    ... CDC Malaria Branch clinician. malaria@cdc.gov Update: New Recommendations for Mefloquine Use in Pregnancy Recommend on Facebook Tweet Share Compartir Update: New Recommendations for Mefloquine Use in Pregnancy The Centers ...

  13. A Flexible Electronic Commerce Recommendation System

    NASA Astrophysics Data System (ADS)

    Gong, Songjie

    Recommendation systems have become very popular in E-commerce websites. Many of the largest commerce websites are already using recommender technologies to help their customers find products to purchase. An electronic commerce recommendation system learns from a customer and recommends products that the customer will find most valuable from among the available products. But most recommendation methods are hard-wired into the system and they support only fixed recommendations. This paper presented a framework of flexible electronic commerce recommendation system. The framework is composed by user model interface, recommendation engine, recommendation strategy model, recommendation technology group, user interest model and database interface. In the recommender strategy model, the method can be collaborative filtering, content-based filtering, mining associate rules method, knowledge-based filtering method or the mixed method. The system mapped the implementation and demand through strategy model, and the whole system would be design as standard parts to adapt to the change of the recommendation strategy.

  14. Recommendations for Institutional Prematriculation Immunizations

    ERIC Educational Resources Information Center

    Journal of American College Health, 2011

    2011-01-01

    The recommendations presented in this article are provided to colleges and universities to facilitate the implementation of a comprehensive institutional prematriculation immunization policy. Vaccine-preventable diseases continue to occur on American campuses. In response to changing epidemiology and the introduction of new vaccines, the ACHA…

  15. Annual Manpower Report with Recommendations.

    ERIC Educational Resources Information Center

    Hawaii State Commission on Manpower and Full Employment, Honolulu.

    A coordinated approach to attain full employment in Hawaii remains a priority need in governmental policy. Manpower problems which began to mount after 1970 were compounded by fuel and material shortages in 1974. The report urges that adequate policies now be formulated to meet the problems. It recommends the adoption of a State policy which…

  16. Recommendations for Institutional Prematriculation Immunizations

    ERIC Educational Resources Information Center

    Journal of American College Health, 2006

    2006-01-01

    The "Recommendations for Institutional Prematriculation Immunizations" described in this article are provided to colleges and universities to facilitate the implementation of a comprehensive institutional prematriculation immunization policy. In response to changing epidemiology and the introduction of new vaccines, the American College Health…

  17. Ubiquitous Multicriteria Clinic Recommendation System.

    PubMed

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant.

  18. Recommended Guidelines for PKU Programs.

    ERIC Educational Resources Information Center

    Children's Bureau (DHEW), Washington, DC.

    A discussion of screening tests for phenylketonuria recommends and provides some data on two tests, lists five disadvantages of urine tests, and discusses three new tests. Also considered are the role of the central laboratory facility and seven suggestions for screening different types of infants at different times. Treatment or followup programs…

  19. Recommended Vaccines for Healthcare Workers

    MedlinePlus

    ... and your family members. Make sure you are up-to-date with recommended vaccines. Healthcare workers include physicians, nurses, ... series, or if you don't have an up-to-date blood test that shows you are immune to ...

  20. HIV Medicines and Side Effects

    MedlinePlus

    ... on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people with HIV live longer, healthier lives. Sometimes HIV medicines can also cause side effects. Most side effects from HIV medicines are manageable, ...

  1. [Orphan diseases and orphan medicines: a Belgian and European study].

    PubMed

    Denis, Alain; Mergaert, Lut; Fostier, Christel; Cleemput, Irina; Simoens, Steven

    2009-12-01

    The objective of this study is to analyze policies concerning orphan medicines, used to treat patients suffering from a rare disease. The decisions about orphan designation and marketing authorization of orphan medicines are taken at European level, but each Member State is responsible for decisions regarding reimbursement. The European measures to encourage the development of orphan medicines, such as market exclusivity for a period of ten years, seem to be successful. However, this market exclusivity should be revised once the profitability of such medicines has clearly been demonstrated. Our study recommends the implementation of patient registries at the European level in order to describe the natural evolution of rare diseases and the efficacy of orphan medicines, the majority of which are relatively expensive. In 2008, Belgian social security services reimbursed orphan medicines for an amount of 66 million euro, accounting for more than 5% of the hospital pharmaceutical budget. The reimbursement of an orphan medicine to an individual patient is subject to multiple conditions. Our study recommends that a unique counter within the NIHDI is created which centralizes all reimbursement requests. The reimbursement of an orphan medicine must be linked to the provision of standardized information needed for a patient register. The NIHDI administration could then, in collaboration with external experts, evaluate reimbursement requests and ensure a coherent application of reimbursement criteria.

  2. [Anti-aging medicine: science or marketing ?].

    PubMed

    Cogan, E

    2015-09-01

    Anti-aging medicine is self defined as a preventive medicine, combining nutritional recommendations, dietary supplements, prescriptions for hormones and various aesthetic techniques. The essential aim is to reduce the risk of aging, both psychically, physically and aesthetically. Although many scientific studies in animals or in vitro models have demonstrated the deleterious role of oxidative stress and of hormonal, vitamin or trace elements deficiencies, the transposition to humans of these findings is marginal and does not justify the therapeutic proposals advocated by the anti aging medicine. These practices are mostly not based on any scientific basis both in the diagnostic and therapeutic fields. These approaches are particularly costly for gullible patients in search of well being and abused by a carefully organized marketing involving tacit complicity of doctors, laboratories and firms producing hormones and dietary supplements and various substances devoted for aesthetic purposes.

  3. [Schiller and the history of medicine].

    PubMed

    Schäfer, Daniel; Neuhausen, Karl August

    2014-01-01

    Friedrich Schiller (1759-1805), one of the most renowned German poets, also received a professional training (1776-80) as surgeon at the military academy at Stuttgart. It is almost unknown that Schiller received a formal education in medical history during the first year of his academic curriculum. His exam in medical history included the public defense of 38 Latin theses presenting historical interpretations, philological criticism and an evaluation of 18th century medicine side by side. These theses had been compiled by his teacher Johann Friedrich Consbruch, who recommended an eclectic use of contemporary knowledge and was an adherent of Haller's experimental medicine. This paper presents a thorough examination of these doctrines in historical perspective. As our investigation shows, at Schiller's time medical history as an academic discipline was primarily used to emphasize medicine's significance as a healing art and to ascertain the practicing physician's professional identity.

  4. Occupational medicine programs for animal research facilities.

    PubMed

    Wald, Peter H; Stave, Gregg M

    2003-01-01

    Occupational medicine is a key component of a comprehensive occupational health and safety program in support of laboratory animal research and production facilities. The mission of the department is to maximize employee health and productivity utilizing a population health management approach, which includes measurement and analysis of health benefits utilization. The department works in close cooperation with other institutional health and safety professionals to identify potential risks from exposure to physical, chemical, and biological hazards in the workplace. As soon as exposures are identified, the department is responsible for formulating and providing appropriate medical surveillance programs. Occupational medicine is also responsible for targeted delivery of preventive and wellness services; management of injury, disease, and disability; maintenance of medical information; and other clinic services required by the institution. Recommendations are provided for the organization and content of occupational medicine programs for animal research facilities.

  5. Dance medicine: current concepts.

    PubMed

    Miller, Clay

    2006-11-01

    Dance medicine has grown exponentially over the past 10 to 15 years and continues to grow every year as more former professional dancers and students of dance enter into the field of medicine. Dance medicine is part of the field of performing arts medicine, which specializes in evaluating and treating performing artists such as musicians, dancers, actors/actresses, and vocalists. This article reviews the literature on dance medicine for various health-related medical issues, for the types of injuries commonly found, for the common surgical and rehabilitation interventions, and for injury prevention used in this unique group of patients.

  6. Medicinal plants: conception / contraception.

    PubMed

    Chaing, H S; Merino-chavez, G; Yang, L L; Wang, F N; Hafez, E S

    1994-01-01

    Researchers have conducted considerable experiments on the effectiveness and therapeutic values of Chinese herbs and parts of plants. We should not ignore the significance of natural medicine. The Chinese have been perfecting medicinal therapy based on the raw ingredients of plants/herbs and their derivatives for thousands of years. Chinese practitioners of traditional medicine prescribe medicines based on yin and yang. Traditional medicine is communicated in a verb or written form. Natural resources used in traditional medicine to treat diseases are not limited to just medicinal plants but also include animals, shell fish, and minerals. Parts of plants used in traditional medicine are leaves, stems, flowers, bark, and root. Chinese medicine is the world's oldest continuous surviving tradition. The Chinese experimented with local plants, often resulting in mild to violent reactions. This process allowed them to become familiar with poisonous plants and those that could relieve pain or successfully treat illness. Current allopathic medicines are composed of synthetic compounds copied from natural chemical derivatives, which tend to be more potent than the original compound. Some medicinal plants used to effect conception/contraception include Striga astiatica (contraceptive); Eurycoma longifolia (male virility); and a mixture of lengkuas, mengkudu masak, black pepper seeds, ginger, salt, and 2 eggs (increase libido). Women in Malaysia take jamu to preserve their body shape and to provide nutrition during pregnancy. Praneem causes local cell-mediated immunity in the uterus. Clinical trials of Praneem with or without the hCG vaccine are planned.

  7. Essential medicines for children.

    PubMed

    Hoppu, Kalle; Sri Ranganathan, Shalini

    2015-02-01

    Millions of children die every year before they reach the age of 5 years, of conditions largely treatable with existing medicines. The WHO Model List of Essential Medicines was launched in 1977 to make the most necessary drugs available to populations whose basic health needs could not be met by the existing supply system. During the first 30 years of the Model List of Essential Medicines, children's needs were not systematically considered. After adoption of the 'Better medicines for children' resolution by the World Health Assembly, things changed. The first WHO Model List of Essential Medicines for Children was drawn up by a Paediatric Expert Subcommittee and adopted in October 2007. The most recent, 4th Model List of Essential Medicines for Children was adopted in 2013. Data from country surveys show that access to essential medicines for children is still generally poor; much more work is needed.

  8. Equipment and supplies for sports and event medicine.

    PubMed

    Yan, Chris B; Rubin, Aaron L

    2005-06-01

    There is an art and a science to determining the contents of an appropriate medical bag for sports and event medicine. Sports and event medicine encompass a broad range of activities and venues, and the medical bag's contents must be adapted accordingly. We discuss relevant considerations as well as general principles and recommendations accompanied by a checklist, using coverage of football games as a model.

  9. [Assertive medicine: a proposal against defensive medicine].

    PubMed

    Tena Tamayo, Carlos; Sánchez González, Jorge Manuel

    2005-10-01

    More than ever the physician-patient relationship is deteriorated by diverse factors, among these liability complaints stand out, and have propitiated the practice of defensive medicine, an attitude considered in many countries as inappropriate, expensive and unethical. Defensive medicine widens the distance between a physician and his patient. To revert this vice and its noxious effects which corrupt the patient-physician relationship in our country, we propose that physicians put to practice actions which permit the renewal of the essence of humanistic medicine in their daily practice and the restoration of the relationship. These changes in attitude sum up to a proposition of professional practice which we have denominated assertive medicine. This offer is resumed in four points: 1) Maintain a proper verbal and non verbal communication with each patient, 2) Keep continuously up to date skills, knowledge and abilities, 3) Respect the patient's rights and 4) Defend their own rights as physicians.

  10. [Contribution of occupational medicine to social medicine].

    PubMed

    Geraut, Christian

    2010-01-01

    Occupational medicine has always been part of social medicine, but focuses on the part of the population in paid employment. Investigations of occupational diseases have identified several toxic chemicals that can affect other sectors of society: examples include cancers due to sawdust, asbestos, benzene, as well as carcinogens, mutagens and reproductive toxins. Better knowledge of the risks posed by epoxy resins, cements, formaldehyde, lead, toluene and other chemical agents has helped to understand certain diseases in the population. Knowledge of musculoskeletal disorders due to repetitive work has been of help in other areas; gradual resumption of appropriate activity seems to be the best basic treatment. Studies of mental overload and its consequences in the workplace (suicide, depression, etc.) have implications for human relations in society as a whole. Multidisciplinary networking helps to regularly take stock of findings in occupational medicine that may be applicable to social medicine.

  11. The delivery of behavioral sleep medicine to college students.

    PubMed

    Kloss, Jacqueline D; Nash, Christina O; Horsey, Sarah E; Taylor, Daniel J

    2011-06-01

    College students are vulnerable to a variety of sleep disorders, which can result in sleep deprivation and a variety of other consequences. The delivery of behavioral sleep medicine is particularly relevant for the college student population, as the early intervention on their sleep problems might prevent lifelong consequences. This article critically reviews the efficacy of relevant behavioral sleep medicine interventions and discusses special considerations for using them with college students who have unique sleep patterns and lifestyles. Recommendations are also given regarding ways to disseminate these empirically supported treatments into this environment. Finally, recommendations regarding future research directions are discussed in the present study.

  12. Overdose effect of aconite containing Ayurvedic Medicine ('Mahashankha Vati').

    PubMed

    Panda, Ashok Kumar; Debnath, Saroj Kumar

    2010-07-01

    There are chances that the use of larger than recommended dose of Ayurvedic medicines containing aconite can produce drug reactions. Vatsanabha (Aconitum ferox Wall.) is a very well-known ingredient of Ayurvedic formulations and is prescribed as an antipyretic, analgesic, anti-rheumatic, appetizer and digestive. The recommended dose of purified Vatsanabha (A. ferox Wall.) root is 15 mg. We present a case of hypotension and bradycardia due to aconite poisoning caused by overdosing of an Ayurvedic medicine (Mahashankha Vati), which was primarily managed by Ayurvedic treatment.

  13. Herbal Remedies for Functional Dyspepsia and Traditional Iranian Medicine Perspective

    PubMed Central

    Babaeian, Mahmoud; Naseri, Mohsen; Kamalinejad, Mohammad; Ghaffari, Farzaneh; Emadi, Fatemeh; Feizi, Awat; Hosseini Yekta, Nafiseh; Adibi, Peyman

    2015-01-01

    Context: Functional dyspepsia (FD) is a functional gastro-intestinal disorder with high prevalence. Among various treatment options, treatment by complementary and alternative medicines especially herbal remedies also practiced. Traditional Iranian medicine (TIM), a valuable resource of valid applied studies of ancient Iranian scholars, recommends numerous medicinal plants to treat dyspepsia symptoms. In this study, through investigation of TIM references, we aimed to identify medicinal plants for treatment of digestion insufficiency. Evidence Acquisition: In this qualitative study, dyspepsia symptoms including fullness, early satiety, bloating, nausea, and belching were checked under reliable sources of traditional medicine. Then medicinal plants recommended for the treatment of the symptoms were extracted from the books. Likewise, for investigating the pharmacological properties of medicinal plants used for the relieving of dyspepsia symptoms, electronic databases such as PubMed, Scopus, Google Scholar and some Iranian databases like SID and IranMedex were employed. Results: The study yielded 105 plants from 37 families which could treat various dyspepsia symptoms; fifty-seven plants, mainly from Apiaceae, Lamiaceae, Amaryllidaceae and Zingiberaceae had digestive effects. In this research, based on the information in TIM reference texts, we obtained 58 plants effective for bloating, 40 for nausea, 37 for appetite loss and 7 for belching. In human clinical trials conducted on medicinal plants effective for FD symptoms, 7 single plants were used. Conclusions: Finding the medicinal plants effective on digestion insufficiency based on TIM could suggest a better strategy for the relieving of dyspepsia symptoms. Traditional Iranian medicine prescribes medicinal plants based on each patient’s personal characteristics and practices multiple target therapies. PMID:26734483

  14. Comparison between Complementary Dietary Treatment of Alzheimer Disease in Iranian Traditional Medicine and Modern Medicine

    PubMed Central

    AHMADIAN-ATTARI, Mohammad Mahdi; MOSADDEGH, Mahmoud; KAZEMNEJAD, Anooshiravan; NOORBALA, Ahmad Ali

    2013-01-01

    Abstract Background Dietary notifications have been introduced recently for Alzheimer Disease (AD). In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent). The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM) with novel medical outcomes. Methods 1) Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2) Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3) Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4) Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5) Comparing traditional and new dietary suggestions with each other. Results 1) Traditionally recommended foods are fattier than abstinent ones (P<0.001). There are meaningful differences between unsaturated fatty acids (UFAs) (P<0.001), saturated fatty acids (P<0.001), and cholesterol (P<0.05) of recommended foods and abstinent ones. 2) Traditionally recommended diet is also fattier than the abstinent diet (4.5 times); UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times); 3) Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4) Traditional recommended diet is in agreement with recent studies. Conclusion ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD. PMID:26060643

  15. Automatic Home Nursing Activity Recommendation

    PubMed Central

    Luo, Gang; Tang, Chunqiang

    2009-01-01

    The rapid deployment of Web-based, consumer-centric electronic medical records (CEMRs) is an important trend in healthcare. In this paper, we incorporate nursing knowledge into CEMR so that it can automatically recommend home nursing activities (HNAs). Those more complex HNAs are made clickable for users to find detailed implementation procedures. We demonstrate the effectiveness of our techniques using USMLE medical exam cases. PMID:20351888

  16. Aggregated Recommendation through Random Forests

    PubMed Central

    2014-01-01

    Aggregated recommendation refers to the process of suggesting one kind of items to a group of users. Compared to user-oriented or item-oriented approaches, it is more general and, therefore, more appropriate for cold-start recommendation. In this paper, we propose a random forest approach to create aggregated recommender systems. The approach is used to predict the rating of a group of users to a kind of items. In the preprocessing stage, we merge user, item, and rating information to construct an aggregated decision table, where rating information serves as the decision attribute. We also model the data conversion process corresponding to the new user, new item, and both new problems. In the training stage, a forest is built for the aggregated training set, where each leaf is assigned a distribution of discrete rating. In the testing stage, we present four predicting approaches to compute evaluation values based on the distribution of each tree. Experiments results on the well-known MovieLens dataset show that the aggregated approach maintains an acceptable level of accuracy. PMID:25180204

  17. Raspberry leaf--should it be recommended to pregnant women?

    PubMed

    Holst, Lone; Haavik, Svein; Nordeng, Hedvig

    2009-11-01

    This review evaluates the safety and efficacy of raspberry leaf (Rubus idaeus) in pregnancy. The electronic databases PubMed, ISI Web of Science, AMED, EMBASE, Natural Medicines Comprehensive Database and Cochrane Library were searched. Altogether 12 original publications with focus on safety or efficacy during pregnancy, pharmacology and in vitro tests explaining mode of action or constituents in Rubus idaeus were reviewed. Limited documentation exists and part of it is 50 years old or older. Only the latest animal study indicates an increased risk for the unborn child; however, all the studies are small and cannot rule out negative effects on pregnancy outcome. The efficacy of raspberry leaf is not convincingly documented. The use of raspberry leaf in pregnancy is a traditional herbal therapy and is recommended by some midwives. Due to the lack of evidence for safety and efficacy such recommendations are questionable. Suggestions for future work are given.

  18. [Sports medicine in Germany].

    PubMed

    Dickhuth, H-H

    2005-08-01

    Sports medicine covers many different aspects, ranging from clinical specialties, such as internal medicine, orthopedics or pediatrics to physiology and sports sciences. The requirements for sports medicine evolve mainly from exercise physiology (elite, leisure and health oriented physical activity), orthopedics and traumatology as well as from preventive and rehabilitative issues. In the new German curriculum, sports medicine is defined as a subspecialty. Historically, sports medicine in Germany has a federal structure with a governing body (Deutsche Gesellschaft für Sportmedizin und Prävention). Due to these facts, University Departments of Sports Medicine (which vary greatly in size and performance) are either attached to Medical or non-Medical Faculties, such as Sports Sciences. In medical schools, sports medicine can be selected as an elective subject. However, the main part of teaching sports medicine is covered by Sports Science Faculties. In an international context, the strength of German sports medicine is its clinical orientation and close cooperation with the sport itself, especially high-performance sports. In the future, like in the Anglo- American countries, sports medicine in Germany will play a major role in health prevention and rehabilitation.

  19. Extended family medicine training

    PubMed Central

    Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F.

    2016-01-01

    Abstract Objective To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Design Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Setting Canada. Participants All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Main outcome measures Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. Results The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. Conclusion New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS–Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of

  20. 28 CFR 0.36 - Recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Recommendations. 0.36 Section 0.36... Pardon Attorney § 0.36 Recommendations. The Pardon Attorney shall submit all recommendations in clemency... recommendations to the President....

  1. 28 CFR 0.36 - Recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Recommendations. 0.36 Section 0.36... Pardon Attorney § 0.36 Recommendations. The Pardon Attorney shall submit all recommendations in clemency... recommendations to the President....

  2. 28 CFR 0.36 - Recommendations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Recommendations. 0.36 Section 0.36... Pardon Attorney § 0.36 Recommendations. The Pardon Attorney shall submit all recommendations in clemency... recommendations to the President....

  3. 28 CFR 0.36 - Recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Recommendations. 0.36 Section 0.36... Pardon Attorney § 0.36 Recommendations. The Pardon Attorney shall submit all recommendations in clemency... recommendations to the President....

  4. 28 CFR 0.36 - Recommendations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Recommendations. 0.36 Section 0.36... Pardon Attorney § 0.36 Recommendations. The Pardon Attorney shall submit all recommendations in clemency... recommendations to the President....

  5. Towards Information Enrichment through Recommendation Sharing

    NASA Astrophysics Data System (ADS)

    Weng, Li-Tung; Xu, Yue; Li, Yuefeng; Nayak, Richi

    Nowadays most existing recommender systems operate in a single organisational basis, i.e. a recommender system recommends items to customers of one organisation based on the organisation's datasets only. Very often the datasets of a single organisation do not have sufficient resources to be used to generate quality recommendations. Therefore, it would be beneficial if recommender systems of different organisations with similar nature can cooperate together to share their resources and recommendations. In this chapter, we present an Ecommerce-oriented Distributed Recommender System (EDRS) that consists of multiple recommender systems from different organisations. By sharing resources and recommendations with each other, these recommenders in the distributed recommendation system can provide better recommendation service to their users. As for most of the distributed systems, peer selection is often an important aspect. This chapter also presents a recommender selection technique for the proposed EDRS, and it selects and profiles recommenders based on their stability, average performance and selection frequency. Based on our experiments, it is shown that recommenders' recommendation quality can be effectively improved by adopting the proposed EDRS and the associated peer selection technique.

  6. Asthma and allergy: short texts and recommendations of the expert conference of the French Speaking Pneumology Society (SPLF), in partnership with the French Society of Allergology and Clinical Immunology (SFAIC), the French Society of Occupational Medicine (SFMT) and the "Asthma-Allergy" association.

    PubMed

    Tillie-Leblond, Isabelle; Magnan, Antoine; Pauli, Gabrielle; Vervloet, Daniel; Wallaert, Benoît; Didier, Alain; Ameille, Jacques; Godard, Philippe

    2008-10-01

    The Asthma Plan published by the French Health Ministry in 2002, the experts conferences edited by ANAES on therapeutic education and follow-up of asthma, the inclusion of this disease in the Public Health Law have been remarkable steps in France during the last few years. The medical community, more particularly the pneumological community, has shown its commitment in the treatment of this public health problem. But allergy was not sufficiently taken into account, although it is responsible for nearly 50 to 60% cases of asthma. In most so-called developed countries the prevalence of asthma and of allergies has increased in the last twenty years. Its progress varies according to country and age group: the increased prevalence of allergy, more specifically of rhinitis and eczema, is most marked in children aged 6-7 year. The prevalence of asthma seems to have reached a plateau in certain northern countries or seems to have decreased in 13-14 year olds (Anglo-Saxon countries). There were multiple reasons, generally attributed to changes in life-style. Asthma is the result of an interaction between a genetic predisposition and the environment, where allergens are present, but also smoking. The relationships between allergy and asthma are complex. This conference discussed the various essential issues that face doctors who treat patients with asthma in their daily practice. The risk factors, the methods of exploration in children and adults and the specific treatments are, indeed, essential issues to be evaluated in a frequent pathology that interests a large number of physicians. The variety of experts is wide, representing pneumology (French Speaking Pneumology Society), the occupational medicine world (French Society of Occupational Medicine), the allergic pathology (French Society of Allergology and Clinical Immunology), and patients with the patient association "Asthma & Allergy", physicians belonging to the general medicine community, general hospitals, private

  7. The transfusion medicine we want

    PubMed Central

    2011-01-01

    The Associação Brasileira de Hematologia e Hemoterapia (ABHH), through its Board of Directors, hosted a national symposium called "Forum: The Transfusion Medicine we want", to discuss proposed policies and techniques related to the area. This meeting was held in São Paulo on August 19 and 20, 2010, with the participation of experts, authorities and representatives of organized groups of patients and users. The discussions were organized around three specific issues selected from over 100 suggestions sent to the ABHH through public consultation on the web: 1. Strategies; 2. Financing; 3. Blood products. A plenary session, held at the end of the meeting, adopted recommendations that are relevant to the different discussion topics. This document contains actions proposed by the ABHH to meet the demands discussed. PMID:23284248

  8. The transfusion medicine we want.

    PubMed

    2011-01-01

    The Associação Brasileira de Hematologia e Hemoterapia (ABHH), through its Board of Directors, hosted a national symposium called "Forum: The Transfusion Medicine we want", to discuss proposed policies and techniques related to the area. This meeting was held in São Paulo on August 19 and 20, 2010, with the participation of experts, authorities and representatives of organized groups of patients and users. The discussions were organized around three specific issues selected from over 100 suggestions sent to the ABHH through public consultation on the web: 1. Strategies; 2. Financing; 3. Blood products. A plenary session, held at the end of the meeting, adopted recommendations that are relevant to the different discussion topics.This document contains actions proposed by the ABHH to meet the demands discussed.

  9. Journal of Special Operations Medicine, Volume 7, Edition 3

    DTIC Science & Technology

    2007-01-01

    07 Volume 7, Edition 3 Dedication 108 Special Operations Medicine: A Federal Law Enforcement Perspective Daniel J. Schmidt, Special Agent , DEA...guidelines recommend that HemCon® be the hemostatic agent of first choice and that QuickClot® be used only if HemCon® fails. RECOMMENDATION: That the TCCC...casualties in whom conventional pressure dressings do not control bleeding, the first hemostatic agent that should be ap- 19What’s New Journal of Special

  10. Factors Associated with Medicaid Providers Recommendation of the HPV Vaccine to Low-Income Adolescent Girls

    PubMed Central

    Bynum, Shalanda A.; Staras, Stephanie A. S.; Malo, Teri L.; Giuliano, Anna R.; Shenkman, Elizabeth; Vadaparampil, Susan T.

    2013-01-01

    Background HPV vaccination in the US remains a public health challenge with vaccine rates of 50%. Although health care providers can facilitate HPV vaccination, several factors may impede their ability to universally recommend the vaccine. To maximize the potential of HPV vaccines, it is important to understand challenges providers face in the clinical environment. Purpose The study sought to identify factors associated with recommendation of the HPV vaccine for low-income adolescents in the early (9–10), target (11–12), early adolescent catch-up (13–14), and late adolescent catch-up (15–17) vaccination groups. Methods Surveys were mailed from October 2009-April 2010 to a random sample of Florida-based physicians serving Medicaid-enrolled adolescents. Data were analyzed in 2013. Results Among early adolescents, discomfort discussing sexually transmitted infections (STIs) with teens (odds ratio [OR]=1.75), difficulty ensuring vaccine completion (OR=0.73), and discomfort discussing STIs with parents (OR=0.44) were associated with recommendation. For target adolescents, discomfort discussing STIs with teens (OR=2.45), time constraints (OR=0.70), vaccine efficacy concerns (OR=0.65), discomfort discussing STIs with parents (OR=0.33), obstetrics/gynecology (OR=0.25) and family medicine (OR=0.24) specialty, and non-Hispanic Black patient (OR=0.15) were associated with recommendation. In early catch-up adolescents, concerns that teens will practice riskier behaviors (OR=0.57), discomfort discussing STIs with parents (OR=0.47), and family medicine specialty (OR=0.20) were associated with recommendation. For late catch-up adolescents, family medicine specialty (OR=0.13) was associated with recommendation. Conclusion Modifiable factors that impede or influence provider recommendations of HPV vaccines can be addressed through intervention. Overall, findings suggest that efforts should focus on sexuality communication and family medicine specialty. PMID:24064282

  11. Development of cell therapy medicinal products by academic institutes.

    PubMed

    de Wilde, Sofieke; Guchelaar, Henk-Jan; Herberts, Carla; Lowdell, Mark; Hildebrandt, Martin; Zandvliet, Maarten; Meij, Pauline

    2016-08-01

    In the rapidly evolving fields of cellular immunotherapy, gene therapy and regenerative medicine, a wide range of promising cell therapy medicinal products are in clinical development. Most products originate from academic research and are explored in early exploratory clinical trials. However, the success rate toward approval for regular patient care is disappointingly low. In this paper, we define strengths and hurdles applying to the development of cell therapy medicinal products in academic institutes, and analyze why only a few promising cell therapies have reached late-stage clinical development. Subsequently, we provide recommendations to stakeholders involved in development of cell therapies to exploit their potential clinical benefit.

  12. Nuclear medicine applications: Summary of Panel 4

    SciTech Connect

    Wolf, A.P.

    1988-01-01

    Nuclear medicine is currently facing a desperate shortage of organic and inorganic chemists and nuclear pharmacists who also have advanced training in nuclear and radiochemistry. Ironically, this shortfall is occurring in the face of rapid growth and technological advances which have made the practice of nuclear medicine an integral part of the modern health care system. This shortage threatens to limit the availability of radiopharmaceuticals required in routine hospital procedures and to impede the development of new diagnostic and therapeutic agents. To redress this need and prevent a similar shortfall in the future, this panel recommends immediate action and a long-term commitment to the following: educating the public on the benefits of nuclear medicine; informing undergraduate and graduate chemistry students about career opportunities in nuclear medicine; offering upper level courses in nuclear and radiochemistry (including laboratory) in universities; establishing training centers and fellowships at the postgraduate level for specialized education in the aspects of nuclear and radiochemistry required by the nuclear medicine profession. 1 tab.

  13. Research of intelligent recommendation for mobile reading

    NASA Astrophysics Data System (ADS)

    Li, Qu

    2013-07-01

    Mobile reading is the trend of current publishing industry. Intelligent Recommendation system is useful and profitable for mobile reading platforms. Currently, intelligent recommendation systems mainly focus on news recommendation or production recommendation in e-commerce. In this paper, we designed and implemented an intelligent recommendation system based on slope one algorithm. Results show that our algorithm can help the users to find their interested books and thus greatly improve the income of mobile reading platform.

  14. Ethics in sports medicine.

    PubMed

    Dunn, Warren R; George, Michael S; Churchill, Larry; Spindler, Kurt P

    2007-05-01

    Physicians have struggled with the medical ramifications of athletic competition since ancient Greece, where rational medicine and organized athletics originated. Historically, the relationship between sport and medicine was adversarial because of conflicts between health and sport. However, modern sports medicine has emerged with the goal of improving performance and preventing injury, and the concept of the "team physician" has become an integral part of athletic culture. With this distinction come unique ethical challenges because the customary ethical norms for most forms of clinical practice, such as confidentiality and patient autonomy, cannot be translated easily into sports medicine. The particular areas of medical ethics that present unique challenges in sports medicine are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology. Unfortunately, there is no widely accepted code of sports medicine ethics that adequately addresses these issues.

  15. An Introduction to Survival, Evasion, Resistance, and Escape (SERE) Medicine.

    PubMed

    Smith, Michael B

    2013-01-01

    When an individual finds himself/herself in a survival, evasion, resistance, or escape (SERE) scenario, the ability to treat injuries/illnesses can be the difference between life and death. SERE schools are responsible for preparing military members for these situations, but the concept of SERE medicine is not particularly well defined. To provide a comprehensive working description of SERE medicine, operational and training components were examined. Evidence suggests that SERE medicine is diverse, injury/illness patterns are situationally dependent, and treatment options often differ from conventional clinical medicine. Ideally, medical lessons taught in SERE training are based on actual documented events. Unfortunately, the existing body of literature is dated and does not appear to be expanding. In this article, four distinct facets of SERE medicine are presented to establish a basis for future discussion and research. Recommendations to improve SERE medical curricula and data-gathering processes are also provided.

  16. Clinical Space Medicine Panel

    NASA Technical Reports Server (NTRS)

    Baisden, Denise L.; Billica, Roger (Technical Monitor)

    2000-01-01

    The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

  17. Recommendations for weight gain during pregnancy in the context of the obesity epidemic

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Institute of Medicine and the National Research Council have issued new guidelines for gestational weight gain as well as recommendations for action and research that call for “a radical change in the care provided to women of childbearing age.” For the first time, these guidelines consider the ...

  18. [Precision and personalized medicine].

    PubMed

    Sipka, Sándor

    2016-10-01

    The author describes the concept of "personalized medicine" and the newly introduced "precision medicine". "Precision medicine" applies the terms of "phenotype", "endotype" and "biomarker" in order to characterize more precisely the various diseases. Using "biomarkers" the homogeneous type of a disease (a "phenotype") can be divided into subgroups called "endotypes" requiring different forms of treatment and financing. The good results of "precision medicine" have become especially apparent in relation with allergic and autoimmune diseases. The application of this new way of thinking is going to be necessary in Hungary, too, in the near future for participants, controllers and financing boards of healthcare. Orv. Hetil., 2016, 157(44), 1739-1741.

  19. Technologists for Nuclear Medicine

    ERIC Educational Resources Information Center

    Barnett, Huey D.

    1974-01-01

    Physicians need support personnel for work with radioisotopes in diagnosing dangerous diseases. The Nuclear Medicine Technology (NMT) Program at Hillsborough Community College in Tampa, Florida, is described. (MW)

  20. Fluorine in medicinal chemistry.

    PubMed

    Swallow, Steven

    2015-01-01

    Since its first use in the steroid field in the late 1950s, the use of fluorine in medicinal chemistry has become commonplace, with the small electronegative fluorine atom being a key part of the medicinal chemist's repertoire of substitutions used to modulate all aspects of molecular properties including potency, physical chemistry and pharmacokinetics. This review will highlight the special nature of fluorine, drawing from a survey of marketed fluorinated pharmaceuticals and the medicinal chemistry literature, to illustrate key concepts exploited by medicinal chemists in their attempts to optimize drug molecules. Some of the potential pitfalls in the use of fluorine will also be highlighted.

  1. Perspective: Balancing Personalized Medicine and Personalized Care

    PubMed Central

    Cornetta, Kenneth; Brown, Candy Gunther

    2013-01-01

    The current description of personalized medicine by the National Institutes of Health is “the science of individualized prevention and therapy.” Although physicians are just beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a true revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers an individual’s physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act upon personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. As these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care. PMID:23348082

  2. The Future of General Internal Medicine

    PubMed Central

    Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark

    2004-01-01

    The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863

  3. Nuclear medicine training and practice in the Czech Republic.

    PubMed

    Kamínek, Milan; Koranda, Pavel

    2014-08-01

    Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic.

  4. Clinical recommendation: pediatric lichen sclerosus.

    PubMed

    Bercaw-Pratt, Jennifer L; Boardman, Lori A; Simms-Cendan, Judith S

    2014-04-01

    Lichen sclerosus is a chronic inflammatory condition affecting the anogenital region that may present in the prepubertal or adolescent patient. Clinical presentations include significant pruritus, labial adhesions, and loss of pigmentation. Treatment includes topical anti-inflammatory agents and long-term follow-up as there is a high risk of recurrence and an increased risk of vulvar cancer in adult women with history of lichen sclerosus. These recommendations are intended for pediatricians, gynecologists, nurse practitioners and others who care for pediatric/adolescent girls in order to facilitate diagnosis and treatment.

  5. [Military medicine and medicine of accidents].

    PubMed

    Chizh, I M

    2010-09-01

    The article presents an observe of such parts of military medicine as intensive aid and operative treatment on the place of case, contestation against infectious diseases, preservation of psychic health, medical and social rehabilitation. Were lighted successful activity of military physicians during liquidation of Chernobyl accident (1986), earthquakes in Armenia (1988), railway accident in Bashkiria (1989) and other accidents. Experience of military medicine (particularly using medical units of special purposes) was used in proving of conception of medicine of accidents, and in organization of medical supply of troops in armed conflicts of restricted scale--in effectuating of antiterrorist operations in Northern Caucasus (1994-1996, 1999-2002), in effectuating of peacemaking operation in Kosovo (1999-2003), natural disasters.

  6. [Herbal medicines alternative to synthetical medicines].

    PubMed

    Beer, A M; Schilcher, H; Loew, D

    2013-12-16

    Herbal pharmaceuticals in medical practice are similarly used as chemically well defined drugs. Like other synthetical drugs, they are subject to pharmaceutical legislature (AMG) and EU directives. It is to differentiate between phytopharmaceuticals with effectiveness of proven indications and traditional registered herbal medicine. Through the Health Reform Act January 2004 and the policy of the Common Federal Committee (G-BA)on the contractual medical care from March 2009--with four exceptions--Non-prescription Phytopharmaka of the legal Health insurance is no longer (SHI) refundable and must be paid by the patients. The result is that more and more well-established preparations disappear from the market. This article gives an overview of practical relevant indications for herbal medicines, which according to its licensing status, the scientific assessment by the Cochrane Collaboration and the Institute for Quality and Efficiency in Health Care (IQWiG) and evidence-based Medicine (EBM)/ meta-analyzes as an alternative to synthetics can be used.

  7. Reconciling evidence-based medicine and precision medicine in the era of big data: challenges and opportunities.

    PubMed

    Beckmann, Jacques S; Lew, Daniel

    2016-12-19

    This era of groundbreaking scientific developments in high-resolution, high-throughput technologies is allowing the cost-effective collection and analysis of huge, disparate datasets on individual health. Proper data mining and translation of the vast datasets into clinically actionable knowledge will require the application of clinical bioinformatics. These developments have triggered multiple national initiatives in precision medicine-a data-driven approach centering on the individual. However, clinical implementation of precision medicine poses numerous challenges. Foremost, precision medicine needs to be contrasted with the powerful and widely used practice of evidence-based medicine, which is informed by meta-analyses or group-centered studies from which mean recommendations are derived. This "one size fits all" approach can provide inadequate solutions for outliers. Such outliers, which are far from an oddity as all of us fall into this category for some traits, can be better managed using precision medicine. Here, we argue that it is necessary and possible to bridge between precision medicine and evidence-based medicine. This will require worldwide and responsible data sharing, as well as regularly updated training programs. We also discuss the challenges and opportunities for achieving clinical utility in precision medicine. We project that, through collection, analyses and sharing of standardized medically relevant data globally, evidence-based precision medicine will shift progressively from therapy to prevention, thus leading eventually to improved, clinician-to-patient communication, citizen-centered healthcare and sustained well-being.

  8. Evolving Recommendations on Prostate Cancer Screening.

    PubMed

    Brawley, Otis W; Thompson, Ian M; Grönberg, Henrik

    2016-01-01

    Results of a number of studies demonstrate that the serum prostate-specific antigen (PSA) in and of itself is an inadequate screening test. Today, one of the most pressing questions in prostate cancer medicine is how can screening be honed to identify those who have life-threatening disease and need aggressive treatment. A number of efforts are underway. One such effort is the assessment of men in the landmark Prostate Cancer Prevention Trial that has led to a prostate cancer risk calculator (PCPTRC), which is available online. PCPTRC version 2.0 predicts the probability of the diagnosis of no cancer, low-grade cancer, or high-grade cancer when variables such as PSA, age, race, family history, and physical findings are input. Modern biomarker development promises to provide tests with fewer false positives and improved ability to find high-grade cancers. Stockholm III (STHLM3) is a prospective, population-based, paired, screen-positive, prostate cancer diagnostic study assessing a combination of plasma protein biomarkers along with age, family history, previous biopsy, and prostate examination for prediction of prostate cancer. Multiparametric MRI incorporates anatomic and functional imaging to better characterize and predict future behavior of tumors within the prostate. After diagnosis of cancer, several genomic tests promise to better distinguish the cancers that need treatment versus those that need observation. Although the new technologies are promising, there is an urgent need for evaluation of these new tests in high-quality, large population-based studies. Until these technologies are proven, most professional organizations have evolved to a recommendation of informed or shared decision making in which there is a discussion between the doctor and patient.

  9. Shoulder injuries in the skeletally immature baseball pitcher and recommendations for the prevention of injury.

    PubMed

    Zaremski, Jason L; Krabak, Brian J

    2012-07-01

    Since 1996, when the first article on pitch restriction recommendations was published, the number of research articles involving skeletally immature pitchers has increased. Potential shoulder injuries in this age group are proximal humeral epiphysiolysis, glenohumeral instability, rotator cuff dysfunction, and superior labrum anteroposterior lesions. Fatigue, improper biomechanics, and overuse are the most common reasons for these injuries. In the hopes of preventing injury to young pitchers, numerous organizations, including the USA Baseball Medical & Safety Advisory Committee, The American Sports Medicine Institute, Little League Baseball & Softball, and the Long Term Athlete Development Program for Baseball Canada, have developed recommendations on pitching restrictions that include limits on pitch count, pitches per week, pitches per season, and rest between pitching. Awareness by sports medicine providers, coaches, and parents/guardians of the most up-to-date recommendations on injury prevention and return to play guidelines should reduce the incidence of acute and chronic injuries in adolescent baseball pitchers.

  10. A heterogeneous graph-based recommendation simulator

    SciTech Connect

    Yeonchan, Ahn; Sungchan, Park; Lee, Matt Sangkeun; Sang-goo, Lee

    2013-01-01

    Heterogeneous graph-based recommendation frameworks have flexibility in that they can incorporate various recommendation algorithms and various kinds of information to produce better results. In this demonstration, we present a heterogeneous graph-based recommendation simulator which enables participants to experience the flexibility of a heterogeneous graph-based recommendation method. With our system, participants can simulate various recommendation semantics by expressing the semantics via meaningful paths like User Movie User Movie. The simulator then returns the recommendation results on the fly based on the user-customized semantics using a fast Monte Carlo algorithm.

  11. MEDICINAL PLANTS OF RAJASTHAN IN INDIAN SYSTEM OF MEDICINE

    PubMed Central

    Tripathi, Y.C.; Prabhu, V.V.; Pal, R.S.; Mishra, R.N.

    1996-01-01

    Medicinal plants used in Indian system of medicine from Rajasthan state have been surveyed and catagorised systematically. The paper deals with 205 medicinal plants, thoroughly indexed along with their important traditional application for the cure of various ailments. PMID:22556743

  12. Wilderness Medicine Newsletter, 1995.

    ERIC Educational Resources Information Center

    Weber, Holly, Ed.; Thompson, Ken, Ed.

    1995-01-01

    This document consists of the six issues of the "Wilderness Medicine Newsletter" issued during 1995. The newsletter addresses issues related to the treatment and prevention of medical emergencies in the wilderness. Issues typically include feature articles, interviews with doctors in the field of wilderness medicine, product reviews,…

  13. Children's Knowledge about Medicines.

    ERIC Educational Resources Information Center

    Almarsdottir, Anna B.; Zimmer, Catherine

    1998-01-01

    Examined knowledge about medicines and perceived benefit among 101 children, ages 7 and 10. Found that medicine knowledge was explained using age, educational environment, and degree of internal locus of control as significant predictors. The negative effect of internal locus of control predicted perceived benefit. Retention of drug advertising…

  14. Prehistoric Iroquois Medicine

    ERIC Educational Resources Information Center

    Hosbach, Richard E.; Doyle, Robert E.

    1976-01-01

    Study of pre-1750 medicine reveals that Iroquois diagnosis and treatment of disease was more advanced than the medicine of their European counterparts. The Iroquois developed a cure for scurvy, treated hypertension, and head lice, and even designed sauna baths. Indian psychiatry also included modern day techniques such as dream analysis. (MR)

  15. Indians into Medicine.

    ERIC Educational Resources Information Center

    Beiswenger, James N.

    Located at the University of North Dakota School of Medicine, Indians Into Medicine (INMED) is a multi-faceted program providing academic, financial, and personal support for Indian students preparing for health careers. The program has the following goals: (1) increase awareness and motivation among Indian students with the potential for health…

  16. Medicines and Bone Loss

    MedlinePlus

    ... studies also show that drinking a lot of alcohol might weaken bones. Questions to ask your doctor • Do any of my medicines cause bone loss? • Are there different medicines I can take? • Do I need a bone density test? • What should I do to protect my ...

  17. Medicines from Marine Invertebrates

    ERIC Educational Resources Information Center

    Davies-Coleman, Mike

    2011-01-01

    Few of us realise that the oceans of the world are a relatively untapped reservoir of new natural product-derived medicines to combat the many diseases that plague humanity. We explore the role that an unremarkable sea snail and sea squirt are playing in providing us with new medicines for the alleviation of chronic pain and cancer respectively.…

  18. Textbook of respiratory medicine

    SciTech Connect

    Murray, J.F.; Nadel, J.

    1987-01-01

    This book presents a clinical reference of respiratory medicine. It also details basic science aspects of pulmonary physiology and describes recently developed, sophisticated diagnostic tools and therapeutic methods. It also covers anatomy, physiology, pharmacology, and pathology; microbiologic, radiologic, nuclear medicine, and biopsy methods for diagnosis.

  19. Personalized Regenerative Medicine.

    PubMed

    Arjmand, Babak; Goodarzi, Parisa; Mohamadi-Jahani, Fereshteh; Falahzadeh, Khadijeh; Larijani, Bagher

    2017-03-01

    Personalized medicine as a novel field of medicine refers to the prescription of specific therapeutics procedure for an individual. This approach has established based on pharmacogenetic and pharmacogenomic information and data. The terms precision and personalized medicines are sometimes applied interchangeably. However, there has been a shift from "personalized medicine" towards "precision medicine". Although personalized medicine emerged from pharmacogenetics, nowadays it covers many fields of healthcare. Accordingly, regenerative medicine and cellular therapy as the new fields of medicine use cell-based products in order to develop personalized treatments. Different sources of stem cells including mesenchymal stem cells, embryonic stem cells and induced pluripotent stem cells (iPSCs) have been considered in targeted therapies which could give many advantages. iPSCs as the novel and individual pluripotent stem cells have been introduced as the appropriate candidates for personalized cell therapies. Cellular therapies can provide a personalized approach. Because of person-to-person and population differences in the result of stem cell therapy, individualized cellular therapy must be adjusted according to the patient specific profile, in order to achieve best therapeutic results and outcomes. Several factors should be considered to achieve personalized stem cells therapy such as, recipient factors, donor factors, and the overall body environment in which the stem cells could be active and functional. In addition to these factors, the source of stem cells must be carefully chosen based on functional and physical criteria that lead to optimal outcomes.

  20. The Priority of Intersectionality in Academic Medicine.

    PubMed

    Eckstrand, Kristen L; Eliason, Jennifer; St Cloud, Tiffani; Potter, Jennifer

    2016-07-01

    Recent societal events highlight inequities experienced by underrepresented and marginalized communities. These inequities are the impetus for ongoing efforts in academic medicine to create inclusive educational and patient care environments for diverse stakeholders. Frequently, approaches focus on singular populations or broad macroscopic concepts and do not always elucidate the complexities that arise at the intersection between multiple identities and life experiences. Intersectionality acknowledges multidimensional aspects of identity inclusive of historical, structural, and cultural factors. Understanding how multiple identity experiences impact different individuals, from patients to trainees to providers, is critical for improving health care education and delivery. Building on existing work within academic medicine, this Commentary outlines six key recommendations to advance intersectionality in academic medicine: embrace personal and collective loci of responsibility; examine and rectify unbalanced power dynamics; celebrate visibility and intersectional innovation; engage all stakeholders in the process of change; select and analyze meaningful metrics; and sustain the commitment to achieving health equity over time. Members of the academic medical community committed to advancing health equity can use these recommendations to promote and maintain meaningful changes that recognize and respond to the multidimensional voices and expressed needs of all individuals engaged in providing and receiving health care.

  1. Maimonides’ Appreciation for Medicine

    PubMed Central

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for with his knowledge and experience the physician can restore good health to his sick fellow human being; (B) medicine provides a unique opportunity to practice imitatio dei, as it reflects the religious duty to maintain a healthy life-style; (C) as an important natural science, medicine offers tools to recognize, love, and fear God. These three aspects address man’s relationship and obligation towards his fellow-man, himself and God. Biographical insights supported by additional sources from Maimonides’ writings are discussed. PMID:23908790

  2. Maimonides' appreciation for medicine.

    PubMed

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides' motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for with his knowledge and experience the physician can restore good health to his sick fellow human being; (B) medicine provides a unique opportunity to practice imitatio dei, as it reflects the religious duty to maintain a healthy life-style; (C) as an important natural science, medicine offers tools to recognize, love, and fear God. These three aspects address man's relationship and obligation towards his fellow-man, himself and God. Biographical insights supported by additional sources from Maimonides' writings are discussed.

  3. Some Medicinal Plants Used in Chinese Medicine.

    DTIC Science & Technology

    2007-11-02

    plant, widely grown in China, probably of hybrid origin. The plant is a source for high-grade mint oil and menthol which are exported. In the world...1.8-2$ while the menthol content is 86-92$. Plants Used as Anodynes Some alkaloid plants have found wide use in Chinese medicine as anodynes. Fang

  4. [Vaccination schedule of the Spanish Association of Pediatrics: recommendations 2006].

    PubMed

    2006-01-01

    Based on the evidence available, the Vaccines Advisory Committee (VAC) of the Spanish Association of Pediatrics reports and comments on the new developments in vaccines that have taken place in 2005 and recommends some modifications to the vaccination schedule for 2006. In agreement with changes in the product monographs for the meningococcal C vaccine, the VAC recommends two doses for the three commercially available preparations with a booster dose in the second year of life. The European Medicines Evaluation Agency (EMEA) has temporarily suspended the sale of the Hexavac vaccine due to doubts about its long-term protection against hepatitis B. The VAC continues to support the use of these combined vaccines. Currently only Infranrix Hexa is available in Spain. The recommendation of vaccinating adolescents with a booster dose of pertussis vaccine via the administration of an acellular preparation of low antigenic load together with the adult diphtheria and tetanus vaccine remains valid. Vaccination against chickenpox in susceptible children aged more than 12 months old continues to be recommended. There is wide coverage for the 7-valent pneumococcal conjugate vaccine in many areas of Spain. In view of the studies published, the VAC reiterates the need for universal immunization by introducing this vaccine in the official vaccination schedule. Finally, other vaccines not included in this schedule are discussed, with special mention of the advisability of influenza vaccination in children, according to the recommendations of the VAC available at the beginning of each season on the web site of the Spanish Association of Pediatrics www.aeped.es; www. vacunasaep.org.

  5. Conclusions and Recommendations. Chapter 37

    NASA Technical Reports Server (NTRS)

    Lamar, John E.; Hummel, Dietrich

    2009-01-01

    This chapter provides a brief wrap-up of the task group report and focuses on the overall conclusions and recommendations for future work for the CAWAPI and VFE-2 facets beyond the task group. The overall conclusion is that the Technology Readiness Level (TRL) of CFD solvers has been improved in predicting the flow-physics of vortex-dominated flows during the work of the task group, by having flight and wind-tunnel data available for comparison. Moreover, like all good scientific studies, this task group has identified flight conditions on the F-16XL airplane or wind-tunnel test conditions for a specific leading-edge radius on the 65 delta-wing model where the TRL still needs to be increased.

  6. Recommendations for managing hospital closure.

    PubMed

    van der Wal, R; Bouthillette, F; Havlovic, S J

    1998-01-01

    An acute care hospital was closed by the British Columbia Ministry of Health in 1993. A research study was conducted to investigate the ways closure of the hospital affected hospital employees and to identify ways to facilitate the closure/reorganization process. Unstructured interviews were conducted with 25 employees around the time of closure and six months after the closure. In the category Living with Closure, six themes arose from the qualitative analysis. They related to (1) provision of information; (2) effect of closure on the working environment and colleagues; (3) perceived stress; (4) recognition of one's worth; (5) provision of support services; and (6) the process of having a new job. The authors offer recommendations stemming from the analysis, which are intended to assist others planning for future hospital reorganizations or closures.

  7. [GEIPC-SEIMC (Study Group for Infections in the Critically Ill Patient of the Spanish Society for Infectious Diseases and Clinical Microbiology) and GTEI-SEMICYUC ( Working Group on Infectious Diseases of the Spanish Society of Intensive Medicine, Critical Care, and Coronary Units) recommendations for antibiotic treatment of gram-positive cocci infections in the critical patient].

    PubMed

    Astigarraga, P M Olaechea; Montero, J Garnacho; Cerrato, S Grau; Colomo, O Rodríguez; Martínez, M Palomar; Crespo, R Zaragoza; García-Paredes, P Muñoz; Cerdá, E Cerdá; Lerma, F Alvarez

    2007-01-01

    In recent years, an increment of infections caused by gram-positive cocci has been documented in nosocomial and hospital-acquired-infections. In diverse countries, a rapid development of resistance to common antibiotics against gram-positive cocci has been observed. This situation is exceptional in Spain but our country might be affected in the near future. New antimicrobials active against these multi-drug resistant pathogens are nowadays available. It is essential to improve our current knowledge about pharmacokinetic properties of traditional and new antimicrobials to maximize its effectiveness and to minimize toxicity. These issues are even more important in critically ill patients because inadequate empirical therapy is associated with therapeutic failure and a poor outcome. Experts representing two scientific societies (Grupo de estudio de Infecciones en el Paciente Crítico de la SEIMC and Grupo de trabajo de Enfermedades Infecciosas de la SEMICYUC) have elaborated a consensus document based on the current scientific evidence to summarize recommendations for the treatment of serious infections caused by gram-positive cocci in critically ill patients.

  8. TRIBAL MEDICINAL PLANTS OF CHITTOOR

    PubMed Central

    Vedavathy, S.; Sudhakar, A.; Mrdula, V.

    1997-01-01

    Medicinal plants used in tribal medicine from chittoor district have been surveyed and documented systematically. The paper deals with 202 medicinal plants, indexed along with important tribal applications for the cure of various ailments. PMID:22556807

  9. Your Radiologist Explains Nuclear Medicine

    MedlinePlus

    ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify ...

  10. Your Radiologist Explains Nuclear Medicine

    MedlinePlus Videos and Cool Tools

    ... by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

  11. Women and Diabetes -- Diabetes Medicines

    MedlinePlus

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  12. Preventive Care Recommendations for Adults with MS

    MedlinePlus

    Preventive Care Recommendations THE BASIC FACTS MULTIPLE SCLEROSIS The Three Most Common Eye Disorders Carlos Healey, diagnosed in 2001 in Multiple Sclerosis Medical checklist: Recommendations: Dates of last & next test ...

  13. Herbal medicine use in pregnancy: results of a multinational study

    PubMed Central

    2013-01-01

    Background The use of complementary and alternative medicines (CAM) is growing in the general population. Herbal medicines are used in all countries of the world and are included in the top CAM therapies used. Methods A multinational study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North and South America and Australia. In this study, the primary aim was to determine the prevalence of herbal medicine use in pregnancy and factors related to such use across participating countries and regions. The secondary aim was to investigate who recommended the use of herbal medication in pregnancy. Results There were 9,459 women from 23 countries participating in the study. Of these, 28.9% reported the use of herbal medicines in pregnancy. Most herbal medicines were used for pregnancy-related health ailments such as cold and nausea. Ginger, cranberry, valerian and raspberry were the most commonly used herbs in pregnancy. The highest reported rate of herbal use medicines was in Russia (69%). Women from Eastern Europe (51.8%) and Australia (43.8%) were twice as likely to use an herbal medicine versus other regions. Women using herbal medicines were characteristically having their first child, non-smokers, using folic acid and consuming some alcohol in pregnancy. Also, women who were currently students and women with an education other than a high school degree were more likely to use herbal medicines than other women. Although 1 out of 5 women stated that a physician had recommended the herbal use, most women used herbal medicine in pregnancy on their own initiative. Conclusions In this multinational study herbal medicine use in pregnancy was high although there were distinct differences in the herbs and users of herbal medicines across regions. Most commonly the women self-medicated with herbal medicine to treat pregnancy-related health ailments. More knowledge regarding the efficacy and safety

  14. Pregnancy outcomes, embryonic and fetal development in maternal exposure to Chinese medicines.

    PubMed

    Wang, Chi Chiu; Li, Lu; San Lau, Clara Bik; Leung, Ping Chung; Fung, Kwok Pui

    2013-12-01

    Chinese medicine is a common name for a collection of Chinese Materia Medica with therapeutic properties for medical treatment and healing. Similar to Western pharmaceuticals, Chinese medicines are not free of risk, and have the potential to cause adverse pregnancy outcomes and affect embryonic and fetal development. However, most clinical data concerning safety of maternal exposure to Chinese medicines during pregnancy are not available and the conclusion remains elusive. Some individual clinical trials of Chinese medicines reported some minor adverse effects during pregnancy, whereas few animal studies identified some adverse maternal and perinatal effects, as well as embryotoxic potentials. Basic research and mechanistic studies of the teratogenicity of Chinese medicines are still lacking. There is an urgent need for testing the safety of Chinese medicines before recommendation and commercialization. Until more reliable and scientific research data become available, clinicians should consider both the risks and benefits before recommending Chinese medicines to pregnant women. More systematic investigations of the safety implications of the use of Chinese medicines are highly recommended, in addition to more clinical trials with a larger sample size to confirm its safety during pregnancy. This review includes a critical overview of available clinical and experimental data and provides directions to study the safety issue of Chinese medicines for pregnancy.

  15. 5 CFR 2638.506 - Director's recommendation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Director's recommendation. 2638.506... Cases Involving Individual Executive Agency Employees § 2638.506 Director's recommendation. (a) Where... employee is the head of an agency, the Director shall make any such recommendation to the President and...

  16. 45 CFR 1616.4 - Recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Recommendations. 1616.4 Section 1616.4 Public... § 1616.4 Recommendations. (a) Before filling an attorney position, a recipient shall notify the organized... seek recommendations for attorneys who meet the qualifications established for the position. (b)...

  17. 22 CFR 908.3 - Board recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Board recommendations. 908.3 Section 908.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD REMEDIES § 908.3 Board recommendations. (a) If the Board... disciplinary action against any employee of an Agency, it shall make an appropriate recommendation to the...

  18. 16 CFR 1.43 - Recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Recommendations. 1.43 Section 1.43... PROCEDURES Export Trade Associations § 1.43 Recommendations. Whenever the Commission has reason to believe... association recommendations for the readjustment of its business. If the association fails to comply with...

  19. 5 CFR 2638.506 - Director's recommendation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Director's recommendation. 2638.506... Cases Involving Individual Executive Agency Employees § 2638.506 Director's recommendation. (a) Where... employee is the head of an agency, the Director shall make any such recommendation to the President and...

  20. 16 CFR 1.43 - Recommendations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Recommendations. 1.43 Section 1.43... PROCEDURES Export Trade Associations § 1.43 Recommendations. Whenever the Commission has reason to believe... association recommendations for the readjustment of its business. If the association fails to comply with...

  1. 45 CFR 1616.4 - Recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Recommendations. 1616.4 Section 1616.4 Public... § 1616.4 Recommendations. (a) Before filling an attorney position, a recipient shall notify the organized... seek recommendations for attorneys who meet the qualifications established for the position. (b)...

  2. 45 CFR 1616.4 - Recommendations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Recommendations. 1616.4 Section 1616.4 Public... § 1616.4 Recommendations. (a) Before filling an attorney position, a recipient shall notify the organized... seek recommendations for attorneys who meet the qualifications established for the position. (b)...

  3. 40 CFR 108.6 - Recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Recommendations. 108.6 Section 108.6... HEARINGS § 108.6 Recommendations. At the conclusion of any hearing under this part, the Administrative Law Judge shall, based on the record, issue tentative findings of fact and recommendations concerning...

  4. 16 CFR 1.43 - Recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Recommendations. 1.43 Section 1.43... PROCEDURES Export Trade Associations § 1.43 Recommendations. Whenever the Commission has reason to believe... association recommendations for the readjustment of its business. If the association fails to comply with...

  5. 5 CFR 9001.108 - Prohibited recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Prohibited recommendations. 9001.108... CONDUCT FOR EMPLOYEES OF THE FEDERAL HOUSING FINANCE AGENCY § 9001.108 Prohibited recommendations. Employees shall not make any recommendation or suggestion, directly or indirectly, concerning...

  6. 22 CFR 908.3 - Board recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Board recommendations. 908.3 Section 908.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD REMEDIES § 908.3 Board recommendations. (a) If the Board... disciplinary action against any employee of an Agency, it shall make an appropriate recommendation to the...

  7. 22 CFR 908.3 - Board recommendations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Board recommendations. 908.3 Section 908.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD REMEDIES § 908.3 Board recommendations. (a) If the Board... disciplinary action against any employee of an Agency, it shall make an appropriate recommendation to the...

  8. 22 CFR 909.3 - Board recommendation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Board recommendation. 909.3 Section 909.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD DECISIONMAKING § 909.3 Board recommendation. Where the Board's decision is a recommendation, it shall be directed to the head of the Agency. A copy of...

  9. 5 CFR 9001.108 - Prohibited recommendations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Prohibited recommendations. 9001.108... CONDUCT FOR EMPLOYEES OF THE FEDERAL HOUSING FINANCE AGENCY § 9001.108 Prohibited recommendations. Employees shall not make any recommendation or suggestion, directly or indirectly, concerning...

  10. 22 CFR 909.3 - Board recommendation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Board recommendation. 909.3 Section 909.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD DECISIONMAKING § 909.3 Board recommendation. Where the Board's decision is a recommendation, it shall be directed to the head of the Agency. A copy of...

  11. 5 CFR 9001.108 - Prohibited recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Prohibited recommendations. 9001.108... CONDUCT FOR EMPLOYEES OF THE FEDERAL HOUSING FINANCE AGENCY § 9001.108 Prohibited recommendations. Employees shall not make any recommendation or suggestion, directly or indirectly, concerning...

  12. 16 CFR 1.43 - Recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Recommendations. 1.43 Section 1.43... PROCEDURES Export Trade Associations § 1.43 Recommendations. Whenever the Commission has reason to believe... association recommendations for the readjustment of its business. If the association fails to comply with...

  13. 5 CFR 9401.110 - Prohibited recommendations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Prohibited recommendations. 9401.110 Section 9401.110 Administrative Personnel BUREAU OF CONSUMER FINANCIAL PROTECTION SUPPLEMENTAL STANDARDS... recommendations. An employee shall not make recommendations or suggestions, directly or indirectly, concerning...

  14. 22 CFR 909.3 - Board recommendation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Board recommendation. 909.3 Section 909.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD DECISIONMAKING § 909.3 Board recommendation. Where the Board's decision is a recommendation, it shall be directed to the head of the Agency. A copy of...

  15. 22 CFR 908.3 - Board recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Board recommendations. 908.3 Section 908.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD REMEDIES § 908.3 Board recommendations. (a) If the Board... disciplinary action against any employee of an Agency, it shall make an appropriate recommendation to the...

  16. 5 CFR 9401.110 - Prohibited recommendations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Prohibited recommendations. 9401.110 Section 9401.110 Administrative Personnel BUREAU OF CONSUMER FINANCIAL PROTECTION SUPPLEMENTAL STANDARDS... recommendations. An employee shall not make recommendations or suggestions, directly or indirectly, concerning...

  17. 5 CFR 2638.506 - Director's recommendation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Director's recommendation. 2638.506... Cases Involving Individual Executive Agency Employees § 2638.506 Director's recommendation. (a) Where... employee is the head of an agency, the Director shall make any such recommendation to the President and...

  18. 22 CFR 909.3 - Board recommendation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Board recommendation. 909.3 Section 909.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD DECISIONMAKING § 909.3 Board recommendation. Where the Board's decision is a recommendation, it shall be directed to the head of the Agency. A copy of...

  19. Distribute The Highest Selected Textual Recommendation (DTHSTR)

    SciTech Connect

    2012-05-01

    The DTHSTR computer code uses a set of documents as seed documents to recommend documents of interest from a large, target set of documents. The computer code provides results that show the highest recommended documents as well as the terms in common between the recommend document and the corresponding seed document that is most similar.

  20. 5 CFR 2638.506 - Director's recommendation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Director's recommendation. 2638.506... Cases Involving Individual Executive Agency Employees § 2638.506 Director's recommendation. (a) Where... employee is the head of an agency, the Director shall make any such recommendation to the President and...

  1. 45 CFR 1616.4 - Recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Recommendations. 1616.4 Section 1616.4 Public... § 1616.4 Recommendations. (a) Before filling an attorney position, a recipient shall notify the organized... seek recommendations for attorneys who meet the qualifications established for the position. (b)...

  2. 5 CFR 9001.108 - Prohibited recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Prohibited recommendations. 9001.108... CONDUCT FOR EMPLOYEES OF THE FEDERAL HOUSING FINANCE AGENCY § 9001.108 Prohibited recommendations. Employees shall not make any recommendation or suggestion, directly or indirectly, concerning...

  3. 40 CFR 108.6 - Recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Recommendations. 108.6 Section 108.6... HEARINGS § 108.6 Recommendations. At the conclusion of any hearing under this part, the Administrative Law Judge shall, based on the record, issue tentative findings of fact and recommendations concerning...

  4. 40 CFR 108.6 - Recommendations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Recommendations. 108.6 Section 108.6... HEARINGS § 108.6 Recommendations. At the conclusion of any hearing under this part, the Administrative Law Judge shall, based on the record, issue tentative findings of fact and recommendations concerning...

  5. 22 CFR 908.3 - Board recommendations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Board recommendations. 908.3 Section 908.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD REMEDIES § 908.3 Board recommendations. (a) If the Board... disciplinary action against any employee of an Agency, it shall make an appropriate recommendation to the...

  6. 5 CFR 2638.506 - Director's recommendation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Director's recommendation. 2638.506... Cases Involving Individual Executive Agency Employees § 2638.506 Director's recommendation. (a) Where... employee is the head of an agency, the Director shall make any such recommendation to the President and...

  7. 45 CFR 1616.4 - Recommendations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Recommendations. 1616.4 Section 1616.4 Public... § 1616.4 Recommendations. (a) Before filling an attorney position, a recipient shall notify the organized... seek recommendations for attorneys who meet the qualifications established for the position. (b)...

  8. 16 CFR 1.43 - Recommendations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Recommendations. 1.43 Section 1.43... PROCEDURES Export Trade Associations § 1.43 Recommendations. Whenever the Commission has reason to believe... association recommendations for the readjustment of its business. If the association fails to comply with...

  9. 22 CFR 909.3 - Board recommendation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Board recommendation. 909.3 Section 909.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD DECISIONMAKING § 909.3 Board recommendation. Where the Board's decision is a recommendation, it shall be directed to the head of the Agency. A copy of...

  10. Decision-Guided Recommenders with Composite Alternatives

    ERIC Educational Resources Information Center

    Alodhaibi, Khalid

    2011-01-01

    Recommender systems aim to support users in their decision-making process while interacting with large information spaces and recommend items of interest to users based on preferences they have expressed, either explicitly or implicitly. Recommender systems are increasingly used with product and service selection over the Internet. Although…

  11. [Evidence-based medicine].

    PubMed

    Saad, E D; Grunspun, H

    1996-01-01

    Evidence-based medicine has been described as a new approach to teaching and practicing clinical medicine. Although the search for evidence is an established practice among physicians, what is being proposed is the systematic gathering and critical interpretation of data, which can then be used in the appropriate context. The main objective is to provide better care for patients. This is accomplished by transforming clinical problems in specific questions to be answered by searching the literature for the levels of evidence favoring the possible interventions for one particular case. This has to be done in a systematic and conscientious fashion. Through its method, evidence-based medicine places less value on clinical experience, the study understanding of pathophysiology, and common sense; instead, it emphasizes observation, levels of evidence, and critical interpretation of original literature. In this manner, evidence-based medicine may be seen by the authoritarian physician as a threat. Other obstacles to the acceptance of the method include lack of time and lack of familiarity with computers. One important limitation of evidence-based medicine is the incomplete or contradictory evidence available in many areas of clinical medicine, or the so-called "grey zones". We outline the main aspects of evidence-based medicine, expecting a growing interest among brazilian physicians for this useful clinical tool.

  12. Timing of Administration: For Commonly-Prescribed Medicines in Australia

    PubMed Central

    Kaur, Gagandeep; Phillips, Craig L.; Wong, Keith; McLachlan, Andrew J.; Saini, Bandana

    2016-01-01

    Chronotherapy involves the administration of medication in coordination with the body’s circadian rhythms to maximise therapeutic effectiveness and minimise/avoid adverse effects. The aim of this study is to investigate the “time of administration” recommendations on chronotherapy for commonly-prescribed medicines in Australia. This study also aimed to explore the quality of information on the timing of administration presented in drug information sources, such as consumer medicine information (CMI) and approved product information (PI). Databases were searched for original research studies reporting on the impact of “time of administration” of the 30 most commonly-prescribed medicines in Australia for 2014. Further, time of administration recommendations from drug information sources were compared to the evidence from chronotherapy trials. Our search revealed 27 research studies, matching the inclusion and exclusion criteria. In 56% (n = 15) of the research studies, the therapeutic effect of the medicine varied with the time of administration, i.e., supported chronotherapy. For some medicines (e.g., simvastatin), circadian-based optimal administration time was evident in the information sources. Overall, dedicated studies on the timing of administration of medicines are sparse, and more studies are required. As it stands, information provision to consumers and health professionals about the optimal “time” to take medications lags behind emerging evidence. PMID:27092523

  13. Developing the medicinal plants sector in northern India: challenges and opportunities

    PubMed Central

    Kala, Chandra Prakash; Dhyani, Pitamber Prasad; Sajwan, Bikram Singh

    2006-01-01

    The medicinal properties of plant species have made an outstanding contribution in the origin and evolution of many traditional herbal therapies. These traditional knowledge systems have started to disappear with the passage of time due to scarcity of written documents and relatively low income in these traditions. Over the past few years, however, the medicinal plants have regained a wide recognition due to an escalating faith in herbal medicine in view of its lesser side effects compared to allopathic medicine in addition the necessity of meeting the requirements of medicine for an increasing human population. Through the realization of the continuous erosion of traditional knowledge of plants used for medicine in the past and the renewed interest at the present time, a need existed to review this valuable knowledge of medicinal plants with the purpose of developing medicinal plants sectors across the different states in India. Our major objectives therefore were to explore the potential in medicinal plants resources, to understand the challenges and opportunities with the medicinal plants sector, and also to suggest recommendations based upon the present state of knowledge for the establishment and smooth functioning of the medicinal plants sector along with improving the living standards of the underprivileged communities. The review reveals that northern India harbors a rich diversity of valuable medicinal plants, and attempts are being made at different levels for sustainable utilization of this resource in order to develop the medicinal plants sector.

  14. Humanism in emergency medicine.

    PubMed

    Rosenzweig, S

    1993-09-01

    Emergency medicine has not yet appropriated "humanism" as a term of its own. Medical humanism needs to be interpreted in a way that is consistent with the practical goals of emergency medicine. In this essay, humanism in emergency medicine is defined by identifying the dehumanizing aspects of sudden illness and exploring of ways for sustaining the humanity of emergency department patients. Excerpts from Dr Oliver Sacks' autobiographical work A Leg to Stand On give voice to the human needs created by sudden illness and its treatment.

  15. Genetics and genomic medicine.

    PubMed

    Bogaard, Kali; Johnson, Marlene

    2009-01-01

    Genetics is playing an increasingly important role in the diagnosis, monitoring and treatment of diseases, and the expansion of genetics into health care has generated the field of genomic medicine. Health care delivery is shifting away from general diagnostic evaluation toward a generation of therapeutics based on a patient's genetic makeup. Meanwhile, the scientific community debates how best to incorporate genetics and genomic medicine into practice. While obstacles remain, the ultimate goal is to use information generated from the study of human genetics to improve disease treatment, cure and prevention. As the use of genetics in medical diagnosis and treatment increases, health care workers will require an understanding of genetics and genomic medicine.

  16. Nuclear Medicine Annual, 1989

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1989-01-01

    Among the highlights of Nuclear Medicine Annual, 1989 are a status report on the thyroid scan in clinical practice, a review of functional and structural brain imaging in dementia, an update on radionuclide renal imaging in children, and an article outlining a quality assurance program for SPECT instrumentation. Also included are discussions on current concepts in osseous sports and stress injury scintigraphy and on correlative magnetic resonance and radionuclide imaging of bone. Other contributors assess the role of nuclear medicine in clinical decision making and examine medicolegal and regulatory aspects of nuclear medicine.

  17. Geriatric management in medieval Persian medicine.

    PubMed

    Emami, Morteza; Sadeghpour, Omid; Zarshenas, Mohammad M

    2013-10-01

    In Iran, a large group of patients are elderly people and they intend to have natural remedies as treatment. These remedies are rooted in historical of Persian and humoral medicine with a backbone of more than 1000 years. The current study was conducted to draw together medieval pharmacological information related to geriatric medicine from some of the most often manuscripts of traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plants through a search of the PubMed, Scopus and Google Scholar databases. In the medieval Persian documents, digestible and a small amount of food such as chicken broth, honey, fig and plum at frequent intervals as well as body massage and morning unctioning are highly recommended. In the field of pharmacotherapy, 35 herbs related to 25 families were identified. Plants were classified as tonic, anti-aging, appetizer, memory and mood enhancer, topical analgesic and laxative as well as health improvement agents. Other than historical elucidation, this paper presents medical and pharmacological approaches that medieval Persian practitioners applied to deal with geriatric complications.

  18. Chasing Mendel: five questions for personalized medicine

    PubMed Central

    Joyner, Michael J; Prendergast, Franklyn G

    2014-01-01

    Ideas about personalized medicine are underpinned in part by evolutionary biology's Modern Synthesis. In this essay we link personalized medicine to the efforts of the early statistical investigators who quantified the heritability of human phenotype and then attempted to reconcile their observations with Mendelian genetics. As information about the heritability of common diseases was obtained, similar efforts were directed at understanding the genetic basis of disease phenotypes. These ideas were part of the rationale driving the Human Genome Project and subsequently the personalized medicine movement. In this context, we discuss: (1) the current state of the genotype–phenotype relationship in humans, (2) the common-disease–common-variant hypothesis, (3) the current ability of ‘omic’ information to inform clinical decision making, (4) emerging ideas about the therapeutic insight available from rare genetic variants, and (5) the social and behavioural barriers to the wider potential success of personalized medicine. There are significant gaps in knowledge as well as conceptual, intellectual, and philosophical limitations in each of these five areas. We then provide specific recommendations to mitigate these limitations and close by asking if it is time for the biomedical research community to ‘stop chasing Mendel?’ PMID:24882820

  19. Geriatric management in medieval Persian medicine

    PubMed Central

    Emami, Morteza; Sadeghpour, Omid; Zarshenas, Mohammad M.

    2013-01-01

    In Iran, a large group of patients are elderly people and they intend to have natural remedies as treatment. These remedies are rooted in historical of Persian and humoral medicine with a backbone of more than 1000 years. The current study was conducted to draw together medieval pharmacological information related to geriatric medicine from some of the most often manuscripts of traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plants through a search of the PubMed, Scopus and Google Scholar databases. In the medieval Persian documents, digestible and a small amount of food such as chicken broth, honey, fig and plum at frequent intervals as well as body massage and morning unctioning are highly recommended. In the field of pharmacotherapy, 35 herbs related to 25 families were identified. Plants were classified as tonic, anti-aging, appetizer, memory and mood enhancer, topical analgesic and laxative as well as health improvement agents. Other than historical elucidation, this paper presents medical and pharmacological approaches that medieval Persian practitioners applied to deal with geriatric complications. PMID:24381461

  20. Evidence-based Medicine in Animal Reproduction.

    PubMed

    Arlt, S P; Heuwieser, W

    2014-09-01

    With new knowledge being generated and published daily, the importance of evidence-based approaches in veterinary medicine is obvious. Clinicians must stay current or risk making poor decisions that clients may challenge. Especially in animal reproduction, several new substances and procedures to diagnose or treat reproductive disorders have been introduced in the last years. On the other hand, a closer look at the quality of published literature on animal reproduction reveals major deficits in methodology and reporting of many clinical trials. We strongly recommend systematically assessing the quality of scientific information when reading journal papers before using the given information in practice. The aim of evidence-based medicine (EBM) is to base the decisions in the practice of medicine on valid, clinically relevant research data. Therefore, we suggest that students should become familiar with the concepts of evidence-based veterinary medicine (EBVM) at the beginning of their veterinary education. Concepts and supporting tools such as checklists for literature assessment have been developed and validated. The purpose of this article is to review and discuss the importance of incorporating EBVM in animal reproduction. The need for further research that produces strong evidence in different fields of animal reproduction and better reporting of relevant study information is obvious.

  1. The Beginnings of Industrial Medicine in England*

    PubMed Central

    Buess, H.

    1962-01-01

    Industrial medicine saw its tentative beginnings among the inquiring minds of 16th century physicians such as Paracelsus. In the 17th century, reports of conditions in mines on the Continent prompted natural scientists at the Royal Society to initiate a research programme into what we now know as mercurial poisoning. The latter part of the eighteenth century witnessed the change from domestic to factory industry with its concomitant social, economic, and technological upheaval, resulting in great shifts of population away from the countryside to the towns. Men, women, and children were employed in the new factories in primitive, unhygienic conditions, and mill fever and illness generally were rife. It was against this background that Percival and Thackrah, prompted no doubt in large measure by the conditions of child labour, inquired into, and made recommendations for, the improvement of hygiene in the factories, thus laying the foundations of industrial medicine as we know it today.

  2. Medicines optimisation: priorities and challenges.

    PubMed

    Kaufman, Gerri

    2016-03-23

    Medicines optimisation is promoted in a guideline published in 2015 by the National Institute for Health and Care Excellence. Four guiding principles underpin medicines optimisation: aim to understand the patient's experience; ensure evidence-based choice of medicines; ensure medicines use is as safe as possible; and make medicines optimisation part of routine practice. Understanding the patient experience is important to improve adherence to medication regimens. This involves communication, shared decision making and respect for patient preferences. Evidence-based choice of medicines is important for clinical and cost effectiveness. Systems and processes for the reporting of medicines-related safety incidents have to be improved if medicines use is to be as safe as possible. Ensuring safe practice in medicines use when patients are transferred between organisations, and managing the complexities of polypharmacy are imperative. A medicines use review can help to ensure that medicines optimisation forms part of routine practice.

  3. Value added medicines: what value repurposed medicines might bring to society?

    PubMed

    Toumi, Mondher; Rémuzat, Cécile

    2017-01-01

    Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing (healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders. Results: Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as 'medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers'. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine access; (2

  4. Hybrid recommendation methods in complex networks.

    PubMed

    Fiasconaro, A; Tumminello, M; Nicosia, V; Latora, V; Mantegna, R N

    2015-07-01

    We propose two recommendation methods, based on the appropriate normalization of already existing similarity measures, and on the convex combination of the recommendation scores derived from similarity between users and between objects. We validate the proposed measures on three data sets, and we compare the performance of our methods to other recommendation systems recently proposed in the literature. We show that the proposed similarity measures allow us to attain an improvement of performances of up to 20% with respect to existing nonparametric methods, and that the accuracy of a recommendation can vary widely from one specific bipartite network to another, which suggests that a careful choice of the most suitable method is highly relevant for an effective recommendation on a given system. Finally, we study how an increasing presence of random links in the network affects the recommendation scores, finding that one of the two recommendation algorithms introduced here can systematically outperform the others in noisy data sets.

  5. Nutritional recommendations for synchronized swimming.

    PubMed

    Robertson, Sherry; Benardot, Dan; Mountjoy, Margo

    2014-08-01

    The sport of synchronized swimming is unique, because it combines speed, power, and endurance with precise synchronized movements and high-risk acrobatic maneuvers. Athletes must train and compete while spending a great amount of time underwater, upside down, and without the luxury of easily available oxygen. This review assesses the scientific evidence with respect to the physiological demands, energy expenditure, and body composition in these athletes. The role of appropriate energy requirements and guidelines for carbohydrate, protein, fat, and micronutrients for elite synchronized swimmers are reviewed. Because of the aesthetic nature of the sport, which prioritizes leanness, the risks of energy and macronutrient deficiencies are of significant concern. Relative Energy Deficiency in Sport and disordered eating/eating disorders are also of concern for these female athletes. An approach to the healthy management of body composition in synchronized swimming is outlined. Synchronized swimmers should be encouraged to consume a well-balanced diet with sufficient energy to meet demands and to time the intake of carbohydrate, protein, and fat to optimize performance and body composition. Micronutrients of concern for this female athlete population include iron, calcium, and vitamin D. This article reviews the physiological demands of synchronized swimming and makes nutritional recommendations for recovery, training, and competition to help optimize athletic performance and to reduce risks for weight-related medical issues that are of particular concern for elite synchronized swimmers.

  6. Recommendations for pathology peer review.

    PubMed

    Morton, Daniel; Sellers, Rani S; Barale-Thomas, Erio; Bolon, Brad; George, Catherine; Hardisty, Jerry F; Irizarry, Armando; McKay, Jennifer S; Odin, Marielle; Teranishi, Munehiro

    2010-12-01

    Pathology peer review verifies and improves the accuracy and quality of pathology diagnoses and interpretations. Pathology peer review is recommended when important risk assessment or business decisions are based on nonclinical studies. For pathology peer review conducted before study completion, the peer-review pathologist reviews sufficient slides and pathology data to assist the study pathologist in refining pathology diagnoses and interpretations. Materials to be reviewed are selected by the peer-review pathologist. Consultations with additional experts or a formal (documented) pathology working group may be used to resolve discrepancies. The study pathologist is solely responsible for the content of the final pathology data and report, makes changes resulting from peer-review discussions, initiates the audit trail for microscopic observations after all changes resulting from peer-review have been made, and signs the final pathologist's report. The peer-review pathologist creates a signed peer-review memo describing the peer-review process and confirming that the study pathologist's report accurately and appropriately reflects the pathology data. The study pathologist also may sign a statement of consensus. It is not necessary to archive working notes created during the peer-review process.

  7. Vietnam recommended dietary allowances 2007.

    PubMed

    Khan, Nguyen Cong; Hoan, Pham Van

    2008-01-01

    It has been well acknowledged that Vietnam is undergoing a nutrition transition. With a rapid change in the country's reform and economic growth, food supply at the macronutrient level has improved. Changes of the Vietnamese diet include significantly more foods of animal origin, and an increase of fat/oils, and ripe fruits. Consequently, nutritional problems in Vietnam now include not only malnutrition but also overweight/obesity, metabolic syndrome and other chronic diseases related to nutrition and lifestyles. The recognition of these shifts, which is also associated with morbidity and mortality, was a major factor in the need to review and update the Recommended Dietary Allowances (RDA) for the Vietnamese population. This revised RDA established an important science-based tool for evaluation of nutrition adequacy, for teaching, and for scientific communications within Vietnam. It is expected that the 2007 Vietnam RDA and its conversion to food-based dietary guidelines will facilitate education to the public, as well as the policy implementation of programs for prevention of non-communicable chronic diseases and addressing the double burden of both under and over nutrition.

  8. Impact of patient outcomes and cost aspects on reimbursement recommendations in Poland in 2012-2014.

    PubMed

    Malinowski, Krzysztof Piotr; Kawalec, Paweł; Trąbka, Wojciech

    2016-11-01

    The aim of this study was to assess the influence of different factors on the final reimbursement recommendations for drugs in Poland and to identify the correlation between these factors and the probability of a positive reimbursement recommendation for an applicant drug issued by the President of the Agency for Health Technology Assessment and Tariff System (AOTMiT). We analysed all recommendations for the period of 2012-2014 in Poland, three years following the launch of the new Reimbursement Act of Medicines, Foodstuffs Intended for Particular Nutritional Uses and Medical Devices. For each recommendation we collected data on efficacy, safety, cost of therapy, cost-effectiveness, quality of evidence, orphan drug status and others. Logistic regression was used to identify factors that increase the odds of a positive reimbursement recommendation. We analysed 221 recommendations for drugs, of which 78% were positive. We observed significant associations of all selected factors with positive recommendations. Proven efficacy and safety were associated with much greater odds for a positive reimbursement recommendation (123.5 and 42.6, respectively) than cost factors, which may suggest that patient outcome is much more important than the results of the cost-effectiveness analysis (odds ratio of 3.5) and the general cost of therapy (odds ratio of 3) in the analysed period.

  9. Children's (Pediatric) Nuclear Medicine

    MedlinePlus

    ... nuclear medicine facility. Through the natural process of radioactive decay, the small amount of radiotracer in your child’s body will lose its radioactivity over time. In many cases, the radioactivity will ...

  10. [Market oriented occupational medicine].

    PubMed

    Rurik, Imre; Cseh, Károly

    2012-09-09

    The history and the recent state of occupational medicine in Hungary, and its relation with governmental labor organizations are analyzed. In the past 20 years, large "socialist" factories were replaced by smaller companies employing fewer workers. They have been forced to establish contract with occupational health providers. Many of them offer primary care services, whereas family physicians having a board examination in occupational medicine are allowed to work in this field as well. The market of occupational medicine is less regulated, and ethical rules are not always considered. Undercutting prices is a common practice. The recent system could be improved by some regulations which should be respected. There is no reason to make rough changes establishing a new market for profit oriented insurance companies, and to allow employees and employers to work without specification neglecting international agreements. Occupational medicine should be supervised again by the health authorities instead of economists who have quite different, short-term priorities.

  11. Chronic Pain Medicines

    MedlinePlus

    ... part of their therapy. If your doctor prescribes narcotics for your pain, be sure to carefully follow ... when taking these medicines.When you're taking narcotics, it's important to remember that there is a ...

  12. Emergency medicine in space.

    PubMed

    Stewart, Lowan H; Trunkey, Donald; Rebagliati, G Steve

    2007-01-01

    Recent events, including the development of space tourism and commercial spaceflight, have increased the need for specialists in space medicine. With increased duration of missions and distance from Earth, medical and surgical events will become inevitable. Ground-based medical support will no longer be adequate when return to Earth is not an option. Pending the inclusion of sub-specialists, clinical skills and medical expertise will be required that go beyond those of current physician-astronauts, yet are well within the scope of Emergency Medicine. Emergency physicians have the necessary broad knowledge base as well as proficiency in basic surgical skills and management of the critically ill and injured. Space medicine shares many attributes with extreme conditions and environments that many emergency physicians already specialize in. This article is an introduction to space medicine, and a review of current issues in the emergent management of medical and surgical disease during spaceflight.

  13. Marketing herbal medicines.

    PubMed

    Lazarus, M

    1999-01-01

    HIV-positive support groups, together with hospital pharmacists in Thailand are fighting the high cost and lack of access to pharmaceuticals by producing and distributing herbal medicines. In Theung district, Chiang Rai province, members of the local support group for people with HIV produce their own, low-cost, herbal medicines. Although the herbal medicines they produce do not provide a cure for HIV/AIDS, they do offer relief for some of the symptoms of opportunistic infections. The herbs are prepared by the group members under the supervision of the pharmacy department at the district hospital. Local people judge their effectiveness by hearing testimonials from people who have witnessed improvement in symptoms. In response to the popularity and effectiveness of herbal medicines, the Ministry of Public Health has approved plans to sell products derived from local herbs in the pharmacies of government hospitals.

  14. Alternative Medicine for Menopause

    MedlinePlus

    ... to be part of mainstream medicine. CAM includes herbs and other plant-based treatments (botanicals), non-botanical ... warfarin, a blood thinner May include other untested herbs Evening primrose No effect on menopausal symptoms May ...

  15. Pregnancy and Medicines

    MedlinePlus

    ... providers. OTC medicines Did you know? Things like caffeine, vitamins, and herbal remedies can affect the growing ... Talk with your doctor about cutting down on caffeine and ask which type of vitamin you should ...

  16. Astronomy, Astrology, and Medicine

    NASA Astrophysics Data System (ADS)

    Greenbaum, Dorian Gieseler

    Astronomy and astrology were combined with medicine for thousands of years. Beginning in Mesopotamia in the second millennium BCE and continuing into the eighteenth century, medical practitioners used astronomy/astrology as an important part of diagnosis and prescription. Throughout this time frame, scientists cited the similarities between medicine and astrology, in addition to combining the two in practice. Hippocrates and Galen based medical theories on the relationship between heavenly bodies and human bodies. In an enduring cultural phenomenon, parts of the body as well as diseases were linked to zodiac signs and planets. In Renaissance universities, astronomy and astrology were studied by students of medicine. History records a long tradition of astrologer-physicians. This chapter covers the topic of astronomy, astrology, and medicine from the Old Babylonian period to the Enlightenment.

  17. Occupational Space Medicine

    NASA Technical Reports Server (NTRS)

    Tarver, William J.

    2012-01-01

    Learning Objectives are: (1) Understand the unique work environment of astronauts. (2) Understand the effect microgravity has on human physiology (3) Understand how NASA Space Medicine Division is mitigating the health risks of space missions.

  18. Medicines for Diabetes

    MedlinePlus

    ... kid stay healthy and feel good. All About Insulin The most common diabetes medicine is insulin, which ... lower blood sugar how long they last continue Insulin Table The table below shows the types of ...

  19. Medicines by Design

    MedlinePlus

    ... of each chapter. » more Chapter 1: ABCs of Pharmacology ADME, pharmacogenetics, pharmacokinetics, dose-response curve, agonists/antagonists, ... more Medicines for the Future Career options in pharmacology » more Glossary Defines scientific terms used in the ...

  20. [Homeopathic medicine and magic].

    PubMed

    Angutek, Dorota

    2007-01-01

    The article compares homeopathic medicine and primitive magic. The author realises formal similarities beetwen these two fields of knowledge. The primitive homeopathic magic characterised by J. G. Frazer in his The Golden Bought announces that "similar courses similar". M. Mauss and H. Hubert added to this "low" an another formula: "similar acts on similar that courses a contrary phenomenon". The last formula is an identic one with the "low" of homeopathic medicine. Moreover there is a similarity between pantheistic religion of Hahnemann and magician beliefs in the power named mana in Melanesia and Polinesia or orenda, wakan, manitou and so on, by the Indians from The North America. The amazing thing is that homeopathic chemists belive that kinetic power transforms itself into esoteric one, during preparation of homeopathic medicines.In the end of this article the author ascertains that homeopathic medicine and magic has certain paradigm in common what is opposit to racionalism of official European paradigm of thinking.

  1. 3-D Medicine.

    ERIC Educational Resources Information Center

    Reese, Susan

    2001-01-01

    Describes the Visible Human Project of the National Library of Medicine that links the print library of functional-physiological knowledge with the image library of structural-anatomical knowledge into one unified resource. (JOW)

  2. Personalized Medicine and Pharmacogenomics

    MedlinePlus

    Healthy Lifestyle Consumer health Pharmacogenomics holds the promise that drugs might one day be tailored to your genetic ... 05, 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/personalized-medicine/art-20044300 . ...

  3. [Medicine of Liao Dynasty].

    PubMed

    Huang, Z

    1995-01-01

    The Taizhu Emperor of Liao Dynasty forced the popularization of medical knowledge by imitating that of the Tang Dynasty. After entering the Capital Bian, Taizong Emperor, seized the medical men of Jin to the North, while Jingzong Emperor treasured medicine. All the above had pushed the development of Liao's medicine in Northern China to its mature stage. Special administration institutions for medicine were established. Autopsy and anatomy were advocated. Therapeutic modalities were mainly TCM, traditional materia medica and acu-moxibustion. Zhilugu and Yeludilu were among the famous physicians. However, viewing from an overall standpoints, Liao medicin was rather backward. Due to its small territory, religious superstition and special humanities and geographical conditions, the development was rather limited.

  4. Medicinal cannabis: moving the debate forward.

    PubMed

    Newton-Howes, Giles; McBride, Sam

    2016-11-18

    There has been increased interest in cannabis as a medicine both nationally and internationally. Internationally, cannabis is accepted as a medication for a variety of purposes in a variety of legal guises and this, associated with anecdotes of the utility of cannabis as medication has led for calls for it to be 'medicalised' in New Zealand. This viewpoint discusses the issues associated with this approach to accessing cannabis and some of the difficulties that may be associated with it. It is important doctors are at the forefront of the debate surrounding medicalised cannabis. Recommendations as to the ongoing debate are offered.

  5. Biomarkers in Veterinary Medicine.

    PubMed

    Myers, Michael J; Smith, Emily R; Turfle, Phillip G

    2017-02-08

    This article summarizes the relevant definitions related to biomarkers; reviews the general processes related to biomarker discovery and ultimate acceptance and use; and finally summarizes and reviews, to the extent possible, examples of the types of biomarkers used in animal species within veterinary clinical practice and human and veterinary drug development. We highlight opportunities for collaboration and coordination of research within the veterinary community and leveraging of resources from human medicine to support biomarker discovery and validation efforts for veterinary medicine.

  6. [Plato and medicine].

    PubMed

    Siqueira-Batista, Rodrigo; Schramm, Fermin Roland

    2004-01-01

    Medicine and philosophy are branches of knowledge that had decisive influence on each other in the time of Ancient Greece, shaping the development of both. A landmark of this interrelationship was the thought of the philosopher Plato (427-347 A. C.), considered the greatest thinker in Western tradition. The text discusses how Platonic reflection reached into the most varied aspects of medicine in the philosopher's days.

  7. What is medicine?

    PubMed Central

    Bly, Jared

    2006-01-01

    PROBLEM ADDRESSED Family medicine is a vital part of health care in Canada. The decline in numbers of new family physicians being trained bodes ill for a sustainable and efficacious health care system. We need to recruit young people more effectively into careers in primary care. Early outreach to high-school students is one approach that holds promise. OBJECTIVE OF PROGRAM To provide high-school students with exposure to and appreciation for careers in medicine, particularly family medicine. PROGRAM DESCRIPTION Family medicine residents in the University of Alberta’s Rural Alberta North Program initiated an outreach project that was implemented in rural and regional high schools in northern Alberta. The program consisted of visits to high schools by residents who gave interactive presentations introducing medicine as a career. The regional hospital subsequently hosted a career day involving medical and paramedical professionals, such as physicians, pharmacists, nurses, and physical and occupational therapists. CONCLUSION Physicians’ visits to high-school students could be an effective way to increase interest in careers in rural family medicine. PMID:16572578

  8. Precision medicine in cardiology.

    PubMed

    Antman, Elliott M; Loscalzo, Joseph

    2016-10-01

    The cardiovascular research and clinical communities are ideally positioned to address the epidemic of noncommunicable causes of death, as well as advance our understanding of human health and disease, through the development and implementation of precision medicine. New tools will be needed for describing the cardiovascular health status of individuals and populations, including 'omic' data, exposome and social determinants of health, the microbiome, behaviours and motivations, patient-generated data, and the array of data in electronic medical records. Cardiovascular specialists can build on their experience and use precision medicine to facilitate discovery science and improve the efficiency of clinical research, with the goal of providing more precise information to improve the health of individuals and populations. Overcoming the barriers to implementing precision medicine will require addressing a range of technical and sociopolitical issues. Health care under precision medicine will become a more integrated, dynamic system, in which patients are no longer a passive entity on whom measurements are made, but instead are central stakeholders who contribute data and participate actively in shared decision-making. Many traditionally defined diseases have common mechanisms; therefore, elimination of a siloed approach to medicine will ultimately pave the path to the creation of a universal precision medicine environment.

  9. Robotics in medicine

    NASA Astrophysics Data System (ADS)

    Kuznetsov, D. N.; Syryamkin, V. I.

    2015-11-01

    Modern technologies play a very important role in our lives. It is hard to imagine how people can get along without personal computers, and companies - without powerful computer centers. Nowadays, many devices make modern medicine more effective. Medicine is developing constantly, so introduction of robots in this sector is a very promising activity. Advances in technology have influenced medicine greatly. Robotic surgery is now actively developing worldwide. Scientists have been carrying out research and practical attempts to create robotic surgeons for more than 20 years, since the mid-80s of the last century. Robotic assistants play an important role in modern medicine. This industry is new enough and is at the early stage of development; despite this, some developments already have worldwide application; they function successfully and bring invaluable help to employees of medical institutions. Today, doctors can perform operations that seemed impossible a few years ago. Such progress in medicine is due to many factors. First, modern operating rooms are equipped with up-to-date equipment, allowing doctors to make operations more accurately and with less risk to the patient. Second, technology has enabled to improve the quality of doctors' training. Various types of robots exist now: assistants, military robots, space, household and medical, of course. Further, we should make a detailed analysis of existing types of robots and their application. The purpose of the article is to illustrate the most popular types of robots used in medicine.

  10. Biobanking for Personalized Medicine.

    PubMed

    Liu, Angen; Pollard, Kai

    2015-01-01

    A biobank is an entity that collects, processes, stores, and distributes biospecimens and relevant data for use in basic, translational, and clinical research. Biobanking of high-quality human biospecimens such as tissue, blood and other bodily fluids along with associated patient clinical information provides a fundamental scientific infrastructure for personalized medicine. Identification of biomarkers that are specifically associated with particular medical conditions such as cancer, cardiovascular disease and neurological disorders are useful for early detection, prevention, and treatment of the diseases. The ability to determine individual tumor biomarkers and to use those biomarkers for disease diagnosis, prognosis and prediction of response to therapy is having a very significant impact on personalized medicine and is rapidly changing the way clinical care is conducted. As a critical requirement for personalized medicine is the availability of a large collection of patient samples with well annotated patient clinical and pathological data, biobanks thus play an important role in personalized medicine advancement. The goal of this chapter is to explore the role of biobanks in personalized medicine and discuss specific needs regarding biobank development for translational and clinical research, especially for personalized medicine advancement.

  11. Nanomedicine: The Medicine of Tomorrow

    NASA Astrophysics Data System (ADS)

    Logothetidis, S.

    Nowadays nanotechnology has become a technological field with great potential since it can be applied in almost every aspect of modern life. One of the sectors where nanotechnology is expected to play a vital role is the field of medical science. The interaction of nanotechnology with medicine gave birth to a completely new scientific field called nanomedicine. Nanomedicine is a field that aims to use the nanotechnology tools and principles in order to improve human health in every possible way. Nanotechnology provides monitoring tools and technology platforms that can be used in terms of detection, diagnostic, bioanalysis and imaging. New nanoscale drug-delivery systems are constantly designed with different morphological and chemical characteristics and unique specificity against tumours, offering a less harmful approach alternative to chemo- and radiotherapies. Furthermore, nanotechnology has led to great breakthroughs in the field of tissue engineering, making the replacement of damaged tissues and organs a much feasible procedure. The thorough analysis of bio and non-bio interactions achieved by versatile nanotools is essential for the design and development of highly performed medical implants. The continuous revolution in nanotechnology will result in the fabrication of nanostructures with properties and functionalities that can benefit patient's physiology faster and more effectively than conventional medical procedures and protocols. The number of nanoscale therapeutical products is rapidly growing since more and more nanomedical designs are reaching the global market. However the nanotoxic impact that these designs can have on human health is an era that requires still more investigation. The development of specific guidance documents at a European level for the safety evaluation of nanotechnology products in medicine is strongly recommended and the need for further research in nanotoxicology is identified. Ethical and moral concerns also need to be

  12. Social medicine and social policy.

    PubMed Central

    Silver, G. A.

    1984-01-01

    Social medicine as a term has achieved acceptance in medical education and medical practice, although there is still some question as to its acceptance in reality. The term had its origin in the vigorous nineteenth-century efforts at both medical and social reform, combining the two in a recognition of the intimate connection between social factors and the causation of disease. Henry Ernest Sigerist, a Swiss physician and noted scholar of medical history, formulated the broadest concept in the 1930s, attracting students and a latent American reform movement toward the idea of restructuring medical education as one part of social reform, and indicating ways of restructuring medical practice as another element in improving medical care at the same time. In addition to promulgating the doctrine, he established the policy of examining and describing systems of medical education and medical care in other parts of the world, not only to assist in improving medical care in countries with well-organized systems, but to assist countries with poor resources and lesser organizational capability in meeting the goals of social medicine. Doubt as to the durability of the concept has been expressed, insofar as the recommended improvements have lagged behind the expression, and because so many changes have taken place in the nature of medical practice, medical discoveries, and advances in technology. A closer examination of Sigerist's writings on the subject and evaluation of the circumstances around present-day problems would seem to indicate that the flaw is not in the doctrine, but in the lack of social application. PMID:6537694

  13. Chinese medicine and integrative medicine in the United States.

    PubMed

    Bauer, Brent A

    2015-08-01

    Health wellness is a state of the homeostasis. Chinese medicine incorporate many concept including holistic medicine and individualized medicine to promote health wellness. Different domains of Chinese medicine were exclusively adopted after the first introduction of acupuncture to USA. Mayo as one of the best USA hospital created a foundation for the more widespread introduction of Chinese medicine into the US especially on the health wellness promotion.

  14. Taking medicines - what to ask your doctor

    MedlinePlus

    ... medicine you take. Know what medicines, vitamins, and herbal supplements you take. Make a list of your medicines ... Will this medicine change how any of my herbal or dietary supplements work? Ask if your new medicine interferes with ...

  15. Recommendations from NASA's Operational and Research Musculoskeletal Summit

    NASA Technical Reports Server (NTRS)

    Jones, J. A.; Johnson-Throop, K. A.; Scheuring, R. A.; Walton, M. E.; Davis-Street, J. E.; Smaka, T.; McCulley, P. A.; Jones, J. A.; Stokes, C. R.; Parker, K. K.; Wear, M.; Johnson-Throop, K. A.

    2006-01-01

    Introduction: Continuously evolving medical standards of care, limited crew training time, and the inherent constraints of space flight necessitate regular revisions of the mission medical support infrastructure and methodology. A three-day Operational and Research Musculoskeletal Summit was held to review NASA s current strategy for preflight health maintenance and injury screening, risk mitigation for musculoskeletal injuries or syndromes, treatment methods during flight, and research topics to mitigate risks to astronaut health. The Summit also undertook consideration of the best evidence-based terrestrial musculoskeletal practices to recommend their adaptation for use in space. Methods: The types and frequencies of musculoskeletal injuries sustained by short- and long-duration astronauts were obtained from the Longitudinal Study of Astronaut Health. The Summit panel was comprised of experts from the clinical and research communities, as well as representatives from NASA Headquarters, the Astronaut corps, and the offices of JSC Medical Operations, JSC Human Adaptation and Countermeasures, Glenn Research Center Human Research, and Astronaut Strength Conditioning and Rehabilitation. Before the summit, panelists participated in a Web-based review of NASA s Space Medical Conditions List (SMCL). Results: The Summit generated seventy-five operational and research recommendations to the NASA Office of Space Medicine, including changes to the SMCL and to the musculoskeletal section of the ISS debrief questionnaire. From these recommendations, seven were assigned highest value and priority, and could be immediately adopted for the exploration architecture. Discussion: Optimized exercise and conditioning to improve performance and forestall musculoskeletal damage on orbit were the primary area of focus. Special attention was paid to exercise timing and muscle group specificity. The panel s recommendations are currently in various stages of consideration or integration

  16. Malaria vaccine: WHO position paper, January 2016 - Recommendations.

    PubMed

    2017-04-03

    This article presents the World Health Organization's (WHO) recommendations on the use of malaria vaccine excerpted from the WHO position paper on malaria vaccine published in the Weekly epidemiological Record in January 2016 [1]. The current document is the first WHO position paper on malaria vaccination and focuses primarily on the available evidence concerning the only malaria vaccine having received a positive regulation assessment from the European Medicines Agency (EMA) [2]. The position paper gives consideration to the epidemiological features of the disease and assesses the potential use of the vaccine for public health benefits. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence to recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the joint recommendation of the WHO's Strategic Advisory Group of Experts (SAGE) on immunization and the Malaria Policy Advisory Committee (MPAC). These recommendations were discussed by SAGE and MPAC at the October 2015 SAGE meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html.

  17. Integrative medicine and patient-centered care.

    PubMed

    Maizes, Victoria; Rakel, David; Niemiec, Catherine

    2009-01-01

    Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies

  18. Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

    PubMed

    Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

    2015-01-01

    Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system.

  19. Recommendations for clinical electron beam dosimetry: supplement to the recommendations of Task Group 25.

    PubMed

    Gerbi, Bruce J; Antolak, John A; Deibel, F Christopher; Followill, David S; Herman, Michael G; Higgins, Patrick D; Huq, M Saiful; Mihailidis, Dimitris N; Yorke, Ellen D; Hogstrom, Kenneth R; Khan, Faiz M

    2009-07-01

    The goal of Task Group 25 (TG-25) of the Radiation Therapy Committee of the American Association of.Physicists in Medicine (AAPM) was to provide a methodology and set of procedures for a medical physicist performing clinical electron beam dosimetry in the nominal energy range of 5-25 MeV. Specifically, the task group recommended procedures for acquiring basic information required for acceptance testing and treatment planning of new accelerators with therapeutic electron beams. Since the publication of the TG-25 report, significant advances have taken place in the field of electron beam dosimetry, the most significant being that primary standards laboratories around the world have shifted from calibration standards based on exposure or air kerma to standards based on absorbed dose to water. The AAPM has published a new calibration protocol, TG-51, for the calibration of high-energy photon and electron beams. The formalism and dosimetry procedures recommended in this protocol are based on the absorbed dose to water calibration coefficient of an ionization chamber at 60Co energy, N60Co(D,w), together with the theoretical beam quality conversion coefficient k(Q) for the determination of absorbed dose to water in high-energy photon and electron beams. Task Group 70 was charged to reassess and update the recommendations in TG-25 to bring them into alignment with report TG-51 and to recommend new methodologies and procedures that would allow the practicing medical physicist to initiate and continue a high quality program in clinical electron beam dosimetry. This TG-70 report is a supplement to the TG-25 report and enhances the TG-25 report by including new topics and topics that were not covered in depth in the TG-25 report. These topics include procedures for obtaining data to commission a treatment planning computer, determining dose in irregularly shaped electron fields, and commissioning of sophisticated special procedures using high-energy electron beams. The use of

  20. Recommendations for clinical electron beam dosimetry: Supplement to the recommendations of Task Group 25

    SciTech Connect

    Gerbi, Bruce J.; Antolak, John A.; Deibel, F. Christopher; and others

    2009-07-15

    The goal of Task Group 25 (TG-25) of the Radiation Therapy Committee of the American Association of Physicists in Medicine (AAPM) was to provide a methodology and set of procedures for a medical physicist performing clinical electron beam dosimetry in the nominal energy range of 5-25 MeV. Specifically, the task group recommended procedures for acquiring basic information required for acceptance testing and treatment planning of new accelerators with therapeutic electron beams. Since the publication of the TG-25 report, significant advances have taken place in the field of electron beam dosimetry, the most significant being that primary standards laboratories around the world have shifted from calibration standards based on exposure or air kerma to standards based on absorbed dose to water. The AAPM has published a new calibration protocol, TG-51, for the calibration of high-energy photon and electron beams. The formalism and dosimetry procedures recommended in this protocol are based on the absorbed dose to water calibration coefficient of an ionization chamber at {sup 60}Co energy, N{sub D,w}{sup 60{sub C}{sub o}}, together with the theoretical beam quality conversion coefficient k{sub Q} for the determination of absorbed dose to water in high-energy photon and electron beams. Task Group 70 was charged to reassess and update the recommendations in TG-25 to bring them into alignment with report TG-51 and to recommend new methodologies and procedures that would allow the practicing medical physicist to initiate and continue a high quality program in clinical electron beam dosimetry. This TG-70 report is a supplement to the TG-25 report and enhances the TG-25 report by including new topics and topics that were not covered in depth in the TG-25 report. These topics include procedures for obtaining data to commission a treatment planning computer, determining dose in irregularly shaped electron fields, and commissioning of sophisticated special procedures using high

  1. Mengele medicus: medicine's Nazi heritage.

    PubMed

    Seidelman, W E

    1988-01-01

    Nazi medicine is commonly considered to be an aberration that began and ended with the horrors of the Hitler regime. But its beginnings were more gradual and its legacy is more pernicious. Data derived from research conducted on unknowing and unwilling subjects in death camps continue to be cited in authoritative contemporary medical literature. Nazi medicine has become a part of the professional genotype of modern medicine. This continuing influence of Nazi medicine raises profound questions for the epistemology and morality of medicine.

  2. Medicinal herbs in the United States: research needs.

    PubMed Central

    Matthews, H B; Lucier, G W; Fisher, K D

    1999-01-01

    Virtually all cultures have, throughout history, used a variety of plants or materials derived from plants for the prevention and treatment of disease. Evidence of the beneficial therapeutic effects of these medicinal herbs is seen in their continued use. Additionally, the development of modern chemistry permitted the isolation of chemicals from medicinal herbs that have served as drugs or starting materials for the synthesis of many important drugs used today. Many more modern drugs have been synthesized as a result of knowledge gained from studies of mechanisms of actions of chemicals first isolated from medicinal herbs. Thus, medicinal herbs have played a major role in the development of modern medicine and continue to be widely used in their original form. Whereas it is generally agreed that most medicinal herbs are safe under the conditions used, some are toxic and should be avoided even though they are readily available, and others have significant adverse side effects when misused. Also, little has been done to investigate potential adverse effects that may be associated with extended or high-dose use of medicinal herbs. Thus, concern has been expressed that the lack of quality control used in the preparation of medicinal herbs, plus their unregulated sale and uninformed use, pose potential adverse health effects for consumers. There is also concern regarding potential herb/herb or herb/drug interactions and possible untoward health effects of medicinal herbs in sensitive subpopulations such as the young and the elderly and certain genetically predisposed individuals. In this paper, we discuss these concerns at some length and make recommendations for additional research and education discussed in the recent International Workshop to Evaluate Research Needs on the Use and Safety of Medicinal Herbs. PMID:10504141

  3. Network-based recommendation algorithms: A review

    NASA Astrophysics Data System (ADS)

    Yu, Fei; Zeng, An; Gillard, Sébastien; Medo, Matúš

    2016-06-01

    Recommender systems are a vital tool that helps us to overcome the information overload problem. They are being used by most e-commerce web sites and attract the interest of a broad scientific community. A recommender system uses data on users' past preferences to choose new items that might be appreciated by a given individual user. While many approaches to recommendation exist, the approach based on a network representation of the input data has gained considerable attention in the past. We review here a broad range of network-based recommendation algorithms and for the first time compare their performance on three distinct real datasets. We present recommendation topics that go beyond the mere question of which algorithm to use-such as the possible influence of recommendation on the evolution of systems that use it-and finally discuss open research directions and challenges.

  4. Status report: Development of emergency medicine research since the Macy Report.

    PubMed

    Pollack, Charles V; Hollander, Judd E; O'Neil, Brian J; Neumar, Robert W; Summers, Richard; Camargo, Carlos A; Younger, John G; Callaway, Clifton W; Gallagher, E John; Kellermann, Arthur L; Krause, Gary S; Schafermeyer, Robert W; Sloan, Edward; Stern, Susan

    2003-07-01

    In Williamsburg, VA, April 17 to 20, 1994, the Josiah Macy, Jr. Foundation sponsored a conference entitled "The Role of Emergency Medicine in the Future of American Medical Care," a report on which was published in Annals in 1995. This report promulgated recommendations for the development and enhancement of academic departments of emergency medicine and a conference to develop an agenda for research in emergency medicine. The American College of Emergency Physicians' Research Committee, along with several ad hoc members, presents updates in several of the areas addressed by the Macy Report and subsequent conferences, as a status report for the development of emergency medicine research as a whole, as of late 2002.

  5. How older Vietnamese Australian women manage their medicines.

    PubMed

    O'Callaghan, Cathy; Quine, Susan

    2007-12-01

    Safe use of medicines is relevant to all, but especially older people, primarily because they have ageing bodies that require more medicines and are therefore more likely to experience complications, including adverse drug interactions. Australia has a rapidly growing migrant older population composed of people with different beliefs about, and practices using, medicines. This paper presents qualitative findings from interviews and focus groups conducted with older Vietnamese-Australian women living in Sydney, Australia. The findings show how the women's health literacy influenced their medication use and explain the cultural reasons behind their decision to vary medicine use from that prescribed by their western trained doctors. Concern that health professionals do not favour combining western with traditional medicines led some participants to manage their medicines without advice from their doctor. The findings support recommendations to reduce the likelihood of adverse medication outcomes by increasing health professionals' cultural competence, encouraging patients to work with their doctor and report all medications taken, and increasing funding for research into the effects of combining western with traditional medicines.

  6. Recommendation advertising method based on behavior retargeting

    NASA Astrophysics Data System (ADS)

    Zhao, Yao; YIN, Xin-Chun; CHEN, Zhi-Min

    2011-10-01

    Online advertising has become an important business in e-commerce. Ad recommended algorithms are the most critical part in recommendation systems. We propose a recommendation advertising method based on behavior retargeting which can avoid leakage click of advertising due to objective reasons and can observe the changes of the user's interest in time. Experiments show that our new method can have a significant effect and can be further to apply to online system.

  7. Uncovering the information core in recommender systems

    PubMed Central

    Zeng, Wei; Zeng, An; Liu, Hao; Shang, Ming-Sheng; Zhou, Tao

    2014-01-01

    With the rapid growth of the Internet and overwhelming amount of information that people are confronted with, recommender systems have been developed to effectively support users' decision-making process in online systems. So far, much attention has been paid to designing new recommendation algorithms and improving existent ones. However, few works considered the different contributions from different users to the performance of a recommender system. Such studies can help us improve the recommendation efficiency by excluding irrelevant users. In this paper, we argue that in each online system there exists a group of core users who carry most of the information for recommendation. With them, the recommender systems can already generate satisfactory recommendation. Our core user extraction method enables the recommender systems to achieve 90% of the accuracy of the top-L recommendation by taking only 20% of the users into account. A detailed investigation reveals that these core users are not necessarily the large-degree users. Moreover, they tend to select high quality objects and their selections are well diversified. PMID:25142186

  8. Uncovering the information core in recommender systems

    NASA Astrophysics Data System (ADS)

    Zeng, Wei; Zeng, An; Liu, Hao; Shang, Ming-Sheng; Zhou, Tao

    2014-08-01

    With the rapid growth of the Internet and overwhelming amount of information that people are confronted with, recommender systems have been developed to effectively support users' decision-making process in online systems. So far, much attention has been paid to designing new recommendation algorithms and improving existent ones. However, few works considered the different contributions from different users to the performance of a recommender system. Such studies can help us improve the recommendation efficiency by excluding irrelevant users. In this paper, we argue that in each online system there exists a group of core users who carry most of the information for recommendation. With them, the recommender systems can already generate satisfactory recommendation. Our core user extraction method enables the recommender systems to achieve 90% of the accuracy of the top-L recommendation by taking only 20% of the users into account. A detailed investigation reveals that these core users are not necessarily the large-degree users. Moreover, they tend to select high quality objects and their selections are well diversified.

  9. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations.

    PubMed

    Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; van Delden, Otto; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

    2016-04-01

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

  10. WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 4. Thyroid.

    PubMed

    Cosgrove, David; Barr, Richard; Bojunga, Joerg; Cantisani, Vito; Chammas, Maria Cristina; Dighe, Manjiri; Vinayak, Sudhir; Xu, Jun-Mei; Dietrich, Christoph F

    2017-01-01

    The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced guidelines for the use of elastography techniques including basic science, breast and liver. Here we present elastography in thyroid diseases. For each available technique, procedure, reproducibility, results and limitations are analyzed and recommendations are given. Finally, recommendations are given based on the level of evidence of the published literature and on the WFUMB expert group's consensus. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of thyroid diseases.

  11. Constipation and herbal medicine

    PubMed Central

    Iizuka, Norio; Hamamoto, Yoshihiko

    2015-01-01

    Constipation is characterized by a variety of bowel symptoms such as difficulty passing stool, hard stool, and a feeling of incomplete evacuation. The multifactorial causes of constipation limit the clinical efficacy of current conventional treatments that use a single drug that acts through only one pathway. To complement the shortcomings of the current Western medical model and provide a complete holistic approach, herbal medicines capable of targeting multiple organs and cellular sites may be used. In Japan, many herbs and herbal combinations have traditionally been used as foods and medicines. Currently, Japanese physicians use standardized herbal combinations that provide consistent and essential quality and quantity. This review highlights representative Japanese herbal medicines (JHMs), Rhei rhizoma-based JHMs including Daiokanzoto and Mashiningan, and Kenchuto-based JHMs including Keishikashakuyakuto and Daikenchuto, which coordinate the motility of the alimentary tract. This review provides a framework to better understand the clinical and pharmacological efficacies of JHMs on constipation according to the unique theory of Japanese traditional medicine, known as Kampo medicine. PMID:25904866

  12. Transmitting Chinese Medicine

    PubMed Central

    Scheid, Volker

    2015-01-01

    Historians of Chinese medicine acknowledge the plurality of Chinese medicine along both synchronic and diachronic dimensions. Yet, there remains a tendency to think of tradition as being defined by some unchanging features. The Chinese medical body is a case in point. This is assumed to have been formalised by the late Han dynasty around a system of internal organs, conduits, collaterals, and associated body structures. Although criticism was voiced from time to time, this body and the micro/macrocosmic cosmological resonances that underpin it are seen to persist until the present day. I challenge this view by attending to attempts by physicians in China and Japan in the period from the mid 16th to the late 18th century to reimagine this body. Working within the domain of cold damage therapeutics and combining philological scholarship, empirical observations, and new hermeneutic strategies these physicians worked their way towards a new territorial understanding of the body and of medicine as warfare that required an intimate familiarity with the body’s topography. In late imperial China this new view of the body and medicine was gradually re-absorbed into the mainstream. In Japan, however, it led to a break with this orthodoxy that in the Republican era became influential in China once more. I argue that attending further to the innovations of this period from a transnational perspective - commonly portrayed as one of decline - may help to go beyond the modern insistence to frame East Asian medicines as traditional. PMID:26869864

  13. Problems in medicine: hypercalcemia

    SciTech Connect

    Weller, R.E.

    1985-06-01

    The pathophysiologic mechanisms for hypercalcemia are reviewed and a diagnostic approach to determining the cause of hypercalcemia in clinical cases in dogs and cats is recommended. 5 refs., 1 fig., 1 tab. (ACR)

  14. Value added medicines: what value repurposed medicines might bring to society?

    PubMed Central

    Toumi, Mondher; Rémuzat, Cécile

    2017-01-01

    ABSTRACT Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing (healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders. Results: Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as ‘medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers’. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine

  15. Current perspectives on curriculum needs in zoological medicine.

    PubMed

    Stoskopf, Michael K

    2006-01-01

    Advances have been made in expanding veterinary curricula to deliver basic key knowledge and skills necessary for provision of health care to captive and companion non-domestic or non-traditional species in the veterinary colleges of the United States and Canada. These advances were in large part facilitated by the deliberations and recommendations of the White Oak Accords. Though a five-year review of curricular opportunities at US and Canadian veterinary colleges shows that progress has been made in implementing the recommendations of the White Oak Accords, there remains room for improvement. The broadly comparative and health-maintenance basis of zoological medicine contributes critically to the potential for veterinary medicine to make important contributions to the concept of the integrated health of the planet. Emergence of key zoonotic and production-animal diseases derived from and within wildlife populations since 2000 has increased awareness worldwide of the importance of zoological medicine in protecting both production livestock and public health. These areas are addressed in elective curricula at colleges emerging as centers of excellence in zoological medicine, but it is critical that core curricula in zoological medicine at all schools be strengthened to include these important areas to prepare our DVM/VMD graduates to protect companion-animal, production-animal, and public health.

  16. When falsified medicines enter the supply chain: description of an incident in Kenya and lessons learned for rapid response.

    PubMed

    Cohn, Jennifer; von Schoen-Angerer, Tido; Jambert, Elodie; Arreghini, Guido; Childs, Michelle

    2013-01-01

    Falsified and substandard medicines present serious concerns for public health. We describe an event that occurred in late 2011 involving falsified antiretroviral medicines found in the supplies of Médecins Sans Frontières (MSF) projects in Kenya. We discuss factors contributing to these falsified medicines entering the supply chain as well as the response by MSF and others. We make recommendations to help defend against future episodes of entry of falsified medicines into the supply chain as well as comments on appropriate responses in cases of falsified medicines.

  17. Nutrition for Tennis: Practical Recommendations

    PubMed Central

    Ranchordas, Mayur K.; Rogersion, David; Ruddock, Alan; Killer, Sophie C.; Winter, Edward M.

    2013-01-01

    Tennis is a pan-global sport that is played year-round in both hemispheres. This places notable demands on the physical and psychological preparation of players and included in these demands are nutritional and fluid requirements both of training and match- play. Thus, the purpose of this article is to review nutritional recommendations for tennis. Notably, tennis players do not excel in any particular physiological or anthropometric characteristic but are well adapted in all areas which is probably a result of the varied nature of the training demands of tennis match play. Energy expenditures of 30.9 ± 5.5 and 45.3 ± 7.3 kJ·min-1 have been reported in women and men players respectively regardless of court surface. Tennis players should follow a habitually high carbohydrate diet of between 6-10 g·kg-1·d-1 to ensure adequate glycogen stores, with women generally requiring slightly less than men. Protein intake guidelines for tennis players training at a high intensity and duration on a daily basis should be ~1.6 g·kg-1·d-1 and dietary fat intake should not exceed 2 g·kg-1·d-1. Caffeine in doses of 3 mg·kg-1 provides ergogenic benefit when taken before and/or during tennis match play. Depending on environmental conditions, sweat rates of 0.5 to and over 5 L·hr-1 and sodium losses of 0.5 - 1.8 g have been recorded in men and women players. 200 mL of fluid containing electrolytes should be consumed every change-over in mild to moderate temperatures of < 27°C but in temperatures greater than 27°C players should aim for ≤ 400 mL. 30-60 g·hr-1 of carbohydrate should be ingested when match play exceeds 2 hours. Key Points Tennis players should follow a habitually high carbohydrate diet of between 6-10 g·kg-1 to ensure adequate glycogen stores, with women generally requiring slightly less than men. Protein intake guidelines for tennis players training at a high intensity and duration on a daily basis should be ~1.6 g·kg-1·d-1. Dietary fat intake should

  18. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy.

    PubMed

    Baber, R J; Panay, N; Fenton, A

    2016-04-01

    The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.

  19. Medicinal chemistry for 2020

    PubMed Central

    Satyanarayanajois, Seetharama D; Hill, Ronald A

    2011-01-01

    Rapid advances in our collective understanding of biomolecular structure and, in concert, of biochemical systems, coupled with developments in computational methods, have massively impacted the field of medicinal chemistry over the past two decades, with even greater changes appearing on the horizon. In this perspective, we endeavor to profile some of the most prominent determinants of change and speculate as to further evolution that may consequently occur during the next decade. The five main angles to be addressed are: protein–protein interactions; peptides and peptidomimetics; molecular diversity and pharmacological space; molecular pharmacodynamics (significance, potential and challenges); and early-stage clinical efficacy and safety. We then consider, in light of these, the future of medicinal chemistry and the educational preparation that will be required for future medicinal chemists. PMID:22004084

  20. Polypharmacy in Zoological Medicine.

    PubMed

    Hunter, Robert P; Isaza, Ramiro

    2017-02-22

    Polypharmacy is a term that describes the inappropriate, concurrent use of multiple drugs in an individual patient. Zoological medicine practitioners must take approved agents (veterinary or human) and extrapolate their use to non-approved species often with little species-specific pharmacological evidence to support their decisions. When considering polypharmacy, even less information exists concerning multi-drug pharmacokinetics, pharmacodynamics, or potential drug-drug interactions in non-domestic species. Unfortunately, captive, zoological species are susceptible, just like their domestic counterparts, to chronic diseases and co-morbidities that may lead to the usage of multiple drugs. Polypharmacy is a recognized and important issue in human medicine, as well as an emerging issue for veterinarians; thus, this paper will discuss the novel, potential risks of polypharmacy in zoological medicine. Hopefully, this discussion will help bring the attention of veterinarians to this issue and serve as an interesting discussion topic for pharmacologists in general.