Coilable Crystalline Fiber (CCF) Lasers and their Scalability

DTIC Science & Technology

2014-03-01

Fibers: Double-Clad Design Concept of Tm:YAG-Core Fiber and Mode Simulation. Proc. SPIE 2012, 8237 , 82373M. 8. Beach, R. J.; Mitchell, S. C...Dubinskii, M. True Crystalline Fibers: Double-Clad LMA Design Concept of Tm:YAG-Core Fiber and Mode Simulation. Proc. of SPIE 2012, 8237 , 82373M-1...Tm:YAG-Core Fiber and Mode Simulation. Proc. SPIE 8237 , 82373M, 2012. 8. Beach, R. J.; Mitchell, S. C.; Meissner, H. E.; Meissner, O. R.; Krupke, W

SPIE's School Outreach Activity Program (SOAP) by IIT Madras SPIE Student Chapter: a review

NASA Astrophysics Data System (ADS)

Kalikivayi, Lavanya; Kalikivayi, V.; Udayakumar, K.; Ganesan, A. R.

2014-09-01

One of the important aspects of SPIE is "Community Support and Outreach Education", which should raise awareness and interest in optics and photonics among the targeted communities and school children. Hence as part of SPIE IIT Madras student chapter, we carried out SPIE SOAP, a `School Outreach Activity Program'. Two types of schools were identified, one a high socio-economic status school and the other a low socio-economic status school having a majority of poor children. Optics related scientific experiments were demonstrated in these schools followed by oral quiz session to the students to assess the level of their knowledge before and after the experiments. We also clubbed this activity with "Vision Screening" and distribution of free spectacles for those children who live below poverty line. Out of the 415 children screened, 60.84% eyes were having normal vision, while 39.16% were found to have refractive errors (Myopia 35.78% and Hyperopia 3.38%) where some of them could not even read the board. Treatable eye diseases were also found in 0.72% of the children. The entire activity is been discussed and documented in this paper.

The effect of electrical properties for InGaN and InN by high-energy particle irradiation (notice of removal)

NASA Astrophysics Data System (ADS)

Dong, Shao-guang; Fan, Guang-han

2008-03-01

This paper (SPIE Paper 68411H) was removed from the SPIE Digital Library on 8 August 2008 upon discovery that the paper has substantially plagiarized the following two papers: R.E. Jones, S.X. Li, L. Hsu, K.M. Yu, W. Walukiewicz, Z. Liliental-Weber, J.W. Ager III, E.E. Haller, H. Lu, and W.J. Schaff, "Native-defect-controlled n-type conductivity in InN," Physica B 376-377 (2006) 436-439 and S.X. Li, K.M. Yu, J. Wu, R.E. Jones, W. Walukiewicz, J.W. Ager III, W. Shan, E.E. Haller, Hai Lu, and William J. Schaff, "Native defects in InxGa1-xN alloys," Physica B 376-377 (2006) 432-435. As stated in the SPIE Publication Ethics Guidelines, "SPIE defines plagiarism as the reuse of someone else's prior ideas, processes, results, or words without explicit attribution of the original author and source, or falsely representing someone else's work as one's own. Unauthorized use of another researcher's unpublished data or findings without permission is considered to be a form of plagiarism even if the source is attributed. SPIE considers plagiarism in any form, at any level, to be unacceptable and a serious breach of professional conduct." It is SPIE policy to remove such papers and to provide citations to original sources so that interested readers can obtain the information directly from those sources. One of the authors, Shao-guang Dong, accepts full responsibility and apologizes for this plagiarism and has absolved the second author, Guang-han Fan, of any prior knowledge of or professional misconduct in this matter. Guang-han Fan also states that he had not previously seen the paper or given permission to include his name as an author.

Comparative NIR Detector Characterization for NGST

NASA Technical Reports Server (NTRS)

Greenhouse, Matthew (Technical Monitor); Figer, Donald

2004-01-01

List of publications for final perfomance report are: Detectors for the JWST Near-Infrared Spectrometer Rauscher, B.J., Strada, P., Regan, M.W., Figer, D.F., Jakobsen, P., Moseley, H.S., & Boeker, T. 2004, SPIE Detectors for the JWST Near-Infrared Spectrometer Rauscher, B.J., Strada, P., Regan, M.W., Figer, D.F., Jakobsen, P., Moseley, H.S., & Boeker, T. 2004, AAS, 203, 124.07 Independent Testing of JWST Detector Prototypes Figer, D.F., Rauscher, B. J., Regan, M. W., Morse, E., Balleza, J., Bergeron, L., & Stockman, H. S. 2003 , SPIE, 5 167 The Independent Detector Testing Laboratory and the NGST Detector Program Figer, D.F., Agronin, M., Balleza, J., Barkhouser, R., Bergeron, L., Greene, G. R., McCandliss, S. R., Rauscher, B. J., Reeves, T., Regan, M. W., Sharma, U., Stockman, H. S. 2003, SPIE, 4850,981 Intra-Pixel Sensitivity in NIR Detectors for NGST Sharma, U., Figer, D.F., Sivaramakrishnan, A., Agronin, M., Balleza, J., Barkhouser, R., Bergeron, L., Greene, G. R., McCandliss, S. R., Rauscher, B. J., Reeves, T., Regan, M. W., Stockman, H. S. 2003, SPIE, 4850,1001 NIRCAM Image Simulations for NGST Wavefiont SensinglPS A. Sivaramakrishnan, D. Figer, H. Bushouse, H. S. Stockman (STScI),C. Ohara , D. Redding (JPL), M. Im (IPAC), & J. Offenberg (Raytheon) 2003, SPIE, 4850,388 Ultra-Low Background Operation of Near-Infrared Detectors for NGS Rauscher, B. J., Figer, D. F., Agronin, M., Balleza, J., Barkhouser, R., Bergeron, L., Greene, G. R., McCandliss, S. R., Reeves, T., Regan, M. W., Sharma, U., Stockman, H. S. 2003, SPIE, 4850,962 The Independent Detector Testing Laboratory and the JWST Detector Program Figer, D.F. et a1.2003, AAS201, #131.05

Introduction

NASA Technical Reports Server (NTRS)

Wotring, Virginia E.; Southern, Sarka O.; Mentzer, Mark A.; Rodriquez-Chavez, Isaac

2014-01-01

The 2014 SPIE Sensing Technologies for Global Health, Military Medicine and Environmental Monitoring conference embraced a wealth of state-of-the-art information in basic and applied science. This event covered the latest developments in the following areas: Non-invasive Disease Diagnostics for Global Health- This opening series of two consecutive sessions focused on oral biospecimen based rapid assays and point-of-care devices for the detection of pathogens causing infectious diseases, biomarkers for cancer, and analytes for noncommunicable diseases such as diabetes. They also covered presentations on the human proteasome and microbiome with linkage to human diseases and diagnostic approaches. The sessions were built on the past experience and expertise of the National Institutes of Health, National Institutes of Dental and Craniofacial Research. Military Medicine I: Traumatic Brain Injury and PTSD-This assembly covered oral-biomarker based diagnostics for brain damage and TBI as well as prevention and rehabilitation technologies. Neurorehabilitation and noninvasive neuromodulation were also discussed as critical approaches for effective functioning. Military Medicine II: Physiology and Medicine of Extreme Environments and Spaceflight-This scientific segment showcased physiological, pharmacological and diagnostic sensing methodologies during spaceflight per the National Aeronautics and Space Administration as well as military-relevant toxicans and future sensing trends per the Department of Defense. It also included latest technologies to determine hydration status in warfighters, eye surgery using the latest laser technologies, and sensing tools for blood analysis. ? Sensing Technologies for Disease Diagnostics and Environmental Monitoring-This closing series of two consecutive sessions provided the venues to learn and discuss more results on the next generation of diagnostic tools and field technologies for diseases, including biomarker detection by digital imaging, multiplex technologies, capillary electrophoresis and molecular platforms serving as labs-on-chips. This conference allowed cross-fertilization of ideas, projects and collaborative work by a multidisciplinary audience of national and international colleagues from the academia, industry and federal government: The National Institutes of Health, National Aeronautics and Space Administration, and the Department of Defense.

The first SPIE software Hack Day

NASA Astrophysics Data System (ADS)

Kendrew, S.; Deen, C.; Radziwill, N.; Crawford, S.; Gilbert, J.; Gully-Santiago, M.; Kubánek, P.

2014-07-01

We report here on the software Hack Day organised at the 2014 SPIE conference on Astronomical Telescopes and Instrumentation in Montréal. The first ever Hack Day to take place at an SPIE event, the aim of the day was to bring together developers to collaborate on innovative solutions to problems of their choice. Such events have proliferated in the technology community, providing opportunities to showcase, share and learn skills. In academic environments, these events are often also instrumental in building community beyond the limits of national borders, institutions and projects. We show examples of projects the participants worked on, and provide some lessons learned for future events.

Human Infrastructure & Human Activity Detection

DTIC Science & Technology

2007-07-01

Personnel Detection Using Seismic Sensors”, Proc. of SPIE, Vol. 5090, 2003, pp. 162-173. [3] J. M. Cathcart , “Phenomenological investigations into...personnel signatures,” Proc. of the SPIE, Vol. 5796, pp. 428-434, May 2005. [4] B. Mauro & J. M. Cathcart , “Analysis of visible band sensors for

Establishing Tools for Computing Hybrids

DTIC Science & Technology

2006-10-01

moorelaw.html. September 26. pp. 1-28. 47. Sharma , Vijay . 2004. Is it Possible to Build Computers from Living Cells? BioTeach Journal, 2, 53-60. 48...by Vijay K. Varadan, Proceedings of SPIE Vol. 5389, SPIE, Bellingham, WA. Pp. 298-305. 58. Warren, Paul. 2002. The Future of Computing: New

Special Issue of Selected Papers from Visualization and Data Analysis 2011

NASA Technical Reports Server (NTRS)

Kao, David L.; Wong, Pak Chung

2012-01-01

This special issue features the best papers that were selected from the 18th SPIE Conference on Visualization and Data Analysis (VDA 2011). This annual conference is a major international forum for researchers and practitioners interested in data visualization and analytics research, development, and applications. VDA 2011 received 42 high-quality submissions from around the world. Twenty-four papers were selected for full conference papers. The top five papers have been expanded and reviewed for this special issue.

Proceedings of SPIE - the International Society for Optical Engineering. Ocean Optics 12 Held in Bergen, Norway on 13-15 June 1994

DTIC Science & Technology

1994-06-15

that this meeting was noteworthy in that this "thaw" in the cold war was extended to our ocean optics community in a very productive way. It was indeed...light is attenuated significantly in productive waters over fairly short distances. The Doss-Wells instrument which used the Zaneveld-Wells algorithm...these global questions include agriculture, mariculture and fisheries production , deforestation, desertification, ozone depletion, air and water

Celebrating the International Year of Light in Michigan

NASA Astrophysics Data System (ADS)

Sala, Anca L.; Dreyer, Elizabeth F. C.; Aku-Leh, Cynthia; Jones, Timothy; Nees, John A.; Smith, Arlene

2016-09-01

The 2015 International Year of Light created a wonderful opportunity to bring light and optics events and activities to people of all ages and occupations in Michigan. A large spectrum of events took place; from events held in schools, colleges, and universities targeting various groups of students, to events associated with festivals attended by large crowds. The latter included the Ann Arbor Summer Festival held in June and the Flint Back-to-the-Bricks Festival in August. All events included interactive activities where participants learned hands-on about optics and photonics phenomena and applications. Original demonstrations and kits were developed by the Ann Arbor OSA Local Section and the Optics Society at the University of Michigan, the joint OSA/SPIE student chapter, for use during the events. The activities were funded through the student chapter's SPIE grant for IYL outreach events and corporate sponsorships. Under the name Michigan Light Project, these groups along with local technology enthusiasts and science clubs delivered several events across Michigan. Other events took place throughout the year in Mid-Michigan through the efforts of faculty and students in the Photonics and Laser Technology program at Baker College of Flint. The outreach events targeted students in K-12. Teachers, counselors, and parents also learned about the importance of optics and photonics in society. The activities developed will continue this year and in the future. The paper will provide details on the completed events and activities along with tips for implementing similar activities and outreach partnerships in other areas.

Visibility of Monocular Symbology in Transparent Head-Mounted Display Applications

DTIC Science & Technology

2015-07-08

Displays XX, edited by Daniel D. Desjardins, Peter L. Marasco , Kalluri R. Sarma, Paul R. Havig, Michael P. Browne, James E. Melzer, Proc. of SPIE Vol...simulators. in Head- and Helmet-Mounted Displays XV: Design and Applications, Proceedings of SPIE Volume 7688 (ed. Peter L. Marasco , P. R. H.) 7688, (2010

Detection of Explosives on Surfaces Using UV Raman Spectroscopy: Effect of Substrate Color

DTIC Science & Technology

2017-10-01

Jr, editors. Proc. SPIE 5794; Detection and Remediation Technologies for Mines and Minelike Targets X; 2005; Orlando, FL. Bellingham (WA): Society of...detection of 2,4-DNT in contact with sand particles. In: Harmon RS, Broach JT, Holloway JH Jr, editors. Proc. SPIE 6217; Detection and Remediation

Optics and communication technology major of physics undergraduate degree at King Mongkut's Institute of Technology Ladkrabang

NASA Astrophysics Data System (ADS)

Buranasiri, Prathan

2014-09-01

A physics undergraduate degree major in optics and communication technology has been offered at King Mongkut's Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand. There are nine required three credit hour courses including two laboratory courses plus a number of selections in optics and communication based technology courses. For independent thinking and industrial working skills, nine credit hours of research project, practical training or overseas studies are included for selection in the final semester. Students are encouraged to participate in international conferences and professional organizations. Recently the program, with support from SPIE and OSA, has organized its first international conference on photonic solutions 2013 (ICPS 2013).

Data on the distribution of cancer incidence and death across age and sex groups visualized using multilevel spie charts.

PubMed

Feitelson, Dror G

2016-04-01

Cancer incidence and death statistics are typically recorded for multiple age and sex brackets, leading to large data tables which are difficult to digest. Effective visualizations of this data would allow practitioners, policy makers, and the general public to comprehend the data more readily and act on it appropriately. We introduce multilevel spie charts to create a combined visualization of cancer incidence and death statistics. Spie charts combine multiple pie charts, where the base pie chart (representing the general population) is used to set the angles of slices, and the superimposed ones use variable radii to portray the cancer data. Spie charts of cancer incidence and death statistics from Israel for 2009-2011 are used as an illustration. These charts clearly show various patterns of how cancer incidence and death distribute across age and sex groups, illustrating (1) absolute numbers and (2) rates per 100,000 population for different age and sex brackets. In addition, drawing separate charts for different cancer types illustrates relative mortality, both (3) across cancer types and (4) mortality relative to incidence. Naturally, this graphical depiction can be used for other diseases as well. Copyright © 2016 Elsevier Inc. All rights reserved.

Terrestrial Planet Finder Interferometer (TPF-1) Whitepaper for the AAAC Exoplanet Task Force

DTIC Science & Technology

2007-04-02

very strong indication of a biological release ( Lovelock 1980; Sagan et al. 1993). The three strongest bands in the Earth-analog spectrum, O3 band...A., Henry, C. A., et al. 2005, Proc. SPIE, 5905, 8 Lay, O. P. 2006, Proc. SPIE, 6268, 62681A Lovelock , J. E. 1980, Cosmic Search, 2, (4), 2 Martin

ABET accreditation and optics and photonics engineering: an association whose time has come

NASA Astrophysics Data System (ADS)

Shoop, Barry L.; Robinson, Kathleen B.

2012-10-01

The growth and influence of optical and photonics engineering as a discipline warrants increased recognition within both academia and industry. In 2006, SPIE leadership made a strategic decision to pursue membership in ABET, Inc. to lead the profession in the establishment of ABET program criteria for optical and photonics engineering. In 2010, SPIE became a member society of ABET and in 2011 SPIE, in collaboration with our co-lead society IEEE, developed the program criteria for optical and photonics engineering. In this invited presentation we will review the rationale for pursuing ABET accreditation and the benefits of ABET accreditation, discuss the historical context leading to the current state, provide an overview of the process of developing the program specific criteria, and finally describe the way ahead.

Sol-Gel Optics: Proceedings SPIE-The International Society for Optical Engineering Held in San Diego, California on 11-13 July 1990. Volume 1328

DTIC Science & Technology

1992-03-01

are also grateful to the Air Force Office of Scientific Research, Directorate of Chemical and Atmospheric Sciences, for the travel support for some of...Mackenzie) is grateful to the Air Force Office of Scientific Research, Directorate of Chemical and Atmospheric Sciences for the continuing support...of the type Ba 2 Cu2 (O2 CCHMe 2 )8 that provide sufficient rheology to spin fibers. These oligomers, when heated in the appropriate atmosphere to 910

Advanced photonic, electronic, and web engineering systems: WILGA Symposium, January 2013

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2013-10-01

The cycle of WILGA Symposia [wilga.ise.pw.edu.pl] on Photonics and Web Engineering, Advanced Electronic Systems, under the auspices of SPIE, IEEE, KEiT PAN and WEiTI PW was initiated in 1998 by a Research Team PERG/ELHEP ISE PW. The WILGA conferences take place two times a year and the participants are young scientists from this country and abroad. This paper debates chosen topical tracks and some papers presented during the 31 WILGA Multi-Conference, which took place on 8-10 February 2013 at the Faculty of WEiTI PW. The January conference was attended by around 100 persons. Here we discuss closer the subjects of biomedical photonics, electronics and informatics, as well as chosen aspects of applications of advanced photonic, electronic circuits and systems. The 32 nd WILGA Symposium took place on 27 May - 02 June 2013 in WUT WILGA resort near Warsaw. These two editions of WILGA Conferences - January and May have generated more than 250 articles, from which around 100 were chosen by the Symposium and Conference Committees to be published in this volume of Proc.SPIE. WILGA Symposium papers are traditionally submitted via the WILGA web page [wilga.ise.pw.edu.pl] to the SPIE Proceedings publishing system [spie.org]. Email for the correspondence is: photonics@ise.pw.edu.pl. All Wilga papers are published in journals Elektronika, IJET-PAN and in Proc.SPIE. Topical tracks of the symposium usually embrace, among others, new technologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET and pi-of-the sky experiments development. The symposium In its two editions a year is a summary of the development of numerable Ph.D. theses carried out in this country and this geographical region in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP members, young researchers and students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of chosen Wilga references is presented.

High-Performance Solid-State and Fiber Lasers Controlled by Volume Bragg Gratings

DTIC Science & Technology

2013-09-01

Glebov: Proc. SPIE 8237 (2012) 823705. 12） I. Divliansky, D. Ott, B. Anderson, G. Venus, and L. Glebov: To be published in Opt. Express. 13） A. Jain...B. Anderson, D. Drachenberg, V. Rotar, G. Venus, and L. Glebov: Proc. SPIE 8237 (2012) 823705. 47） B. Anderson, S. Kaim, G. B. Venus, J. Lumeau, V

Statistical Modeling of Radiometric Error Propagation in Support of Hyperspectral Imaging Inversion and Optimized Ground Sensor Network Design

DTIC Science & Technology

2008-09-04

mospheric correction. volume 3756, pages 348–353. SPIE, 1999. Daniel Birkenheuer and Seth Gutman. A Comparison of GOES Moisture-Derived Product and GPS...pages 417–428. SPIE, 2001. E. J. Ientilucci and S. D. Brown. Advances in wide-area hyperspectral image sim- ulation. In W. R. Watkins , D. Clement

PREFACE: I International Scientific School Methods of Digital Image Processing in Optics and Photonics

NASA Astrophysics Data System (ADS)

Gurov, I. P.; Kozlov, S. A.

2014-09-01

The first international scientific school "Methods of Digital Image Processing in Optics and Photonics" was held with a view to develop cooperation between world-class experts, young scientists, students and post-graduate students, and to exchange information on the current status and directions of research in the field of digital image processing in optics and photonics. The International Scientific School was managed by: Saint Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University) - Saint Petersburg (Russia) Chernyshevsky Saratov State University - Saratov (Russia) National research nuclear University "MEPHI" (NRNU MEPhI) - Moscow (Russia) The school was held with the participation of the local chapters of Optical Society of America (OSA), the Society of Photo-Optical Instrumentation Engineers (SPIE) and IEEE Photonics Society. Further details, including topics, committees and conference photos are available in the PDF

Stationary Digital Tomosynthesis System for Early Detection of Breast Tumors

DTIC Science & Technology

2011-05-01

selenium flat panel detector. Proc. SPIE 2005. 5745: p. 529-540 4. Kopans, D.B., Breast Imaging. 2 ed. 1997, New York Lippincott Williams and...same. 2005. 8. M. Bissonnette, et al. Digital breast tomosynthesis using an amorphous selenium flat panel detector. in Medical Imaging 2005...tomosynthesis system with selenium based flat panel detector. Proc of SPIE, Physics of Medical Imaging, 2005. 5745. 12

Parallel Algorithms for Computer Vision

DTIC Science & Technology

1990-04-01

NA86-1, Thinking Machines Corporation, Cambridge, MA, December 1986. [43] J. Little, G. Blelloch, and T. Cass. How to program the connection machine for... to program the connection machine for computer vision. In Proc. Workshop on Comp. Architecture for Pattern Analysis and Machine Intell., 1987. [92] J...In Proceedings of SPIE Conf. on Advances in Intelligent Robotics Systems, Bellingham, VA, 1987. SPIE. [91] J. Little, G. Blelloch, and T. Cass. How

VizieR Online Data Catalog: MIR view of polar dust emission in local AGNs (Asmus+, 2016)

NASA Astrophysics Data System (ADS)

Asmus, D.; Honig, S. F.; Gandhi, P.

2018-02-01

The parent sample for this work is the AGN MIR atlas of 253 objects (Asmus et al. 2014, J/MNRAS/439/1648). The optical classifications and distances (using the same cosmology) are adopted from that work. We furthermore use the nuclear MIR flux measurements from Asmus et al. (2014, J/MNRAS/439/1648). These are extracted from ground-based multi-filter photometry obtained with the instruments VLT/VISIR (Lagage et al. 2004Msngr.117...12L), Gemini/T-ReCS (Telesco et al. 1998SPIE.3354..534T), Gemini/Michelle (Glasse et al. 1997SPIE.2871.1197G), and Subaru/COMICS (Kataza et al. 2000SPIE.4008.1144K), with an angular resolution of the order of 0.35" or 120 pc for the median sample distance of 72 Mpc at 12 μm. (2 data files).

Technology transfer—A growing problem

NASA Astrophysics Data System (ADS)

Bell, Peter M.

A joint National Academy of Sciences (NAS)-Department of Defense (DOD) panel on the subject of technology transfer, which usually means giving away valuable industrial and perhaps unclassified military designs and information, set national guidelines in its recent report (Eos, October 5, p. 801). The results could affect the freedom of publication and public presentation of geophysical research.An aspect of the problem surfaced in mid-August of this year, when, at the 26th annual technical symposium of the Society of Photooptical Instrumentation Engineers (SPIE) DOD suddenly censored from presentation at the meeting something close to 100 papers, many of which were on applications of infrared technology and its transmission in the atmosphere. A number of the papers had apparent potential to the military, but none of the research was classified. Generally, research contracts with university professors contain nothing about obtaining clearance before presenting the results at professional meetings, but there are rules that apply, to wit the International Traffic in Arms Regulations (ITAR). Also, the Department of Commerce has export control regulations that could be invoked. The censorship at the San Diego meeting has caused considerable clamor within the scientific community, starting with a report about the SPIE events that was published in Science News (Sept. 4, 1982) as ‘Remote Censoring: DOD Blocks Symposium Papers.’

Investigations of Antiangiogenic Mechanisms Using Novel Imaging Techniques

DTIC Science & Technology

2011-02-01

011112-1 Downloaded from SPIE Digital Library on 22 Feb 2010 to 1lular functions that exacerbate treatment resistance and tumor aggressiveness.9 Cycling...measurements, which further complicates ata acquisition and interpretation. Blood flow on the mi- rovessel level has traditionally been measured using laser...34ournal of Biomedical Optics 011112-2 Downloaded from SPIE Digital Library on 22 Feb 2010 to 1The goal of this study was to dynamically image changes in

Analysis and Evaluation of Technical Data on the Photochromic and Non- Linear Optical Properties of Materials

DTIC Science & Technology

1989-03-01

relatively small contractural effort is to provide technical assistance to Dr. Frank Patten (DARPA) in evaluating data on materials, especially... Musikant , S. (ed.), Advances in Materials for Active Optics, Proceedings of SPIE, Volume 567, SPIE:Washington, 1985. [22] Lewis, Aaron, Del Priore...polysilane," J. Appl. Phys. 60 (1986) 3040-3044. [146] Hache, F., Ricard, D., Flytzanis, C., "Optical nonlinearities of small metal particles: surface

Electroactive Polymers as Artificial Muscles - Reality and Challenges

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.

2001-01-01

Electroactive Polymers (EAPs) are emerging as effective displacement actuators. These materials offer the closest resemblance of biological muscle potentially enabling unique capabilities changing the paradigm about robots construction. Under a NASA task, several EAP driven mechanisms were developed including dust wiper, gripper, and robotic arm EAP are inducing a low actuation force limiting the applications that can use their current capability. In recognition of this limitation a series of international forums were established including SPIE conference, Webhub, Newsletter, and Newsgroup. A challenge was posed to the EAP community to have an arm wrestling between robot that is equipped with EAP actuators and human.

William L. Wolfe, 1989 President of SPIE, encourages scientists from Eastern Europe

NASA Astrophysics Data System (ADS)

Schmit, Joanna

2012-10-01

In 1990 Professor Wolfe after his SPIE presidency trekked the world, even making it as far as post-communist Poland, to see (in the visible and maybe in infrared - who knows) the work of optical scientists hidden behind the iron curtain. I am not sure if he was ready for how different that world was at this time, but for sure he was very inquisitive and eager to learn about the nuances of Poland right after the fall of communism. He met, visited with and encouraged young and old scientists from Poland, Russia, Hungary and Lithuania to add their expertise to the scientific conversations happening in the West. His mission in Poland was to invite us all, and he was ready to help us achieve our dreams. I was one of those he encouraged. This talk is my personal reflection of Professor Wolfe as an encouraging and sometimes brave SPIE pioneer - a stranger in a strange land - and as an energetic, caring SPIE president, Optical Sciences professor and human being. Disclaimer: Professor Bill Wolfe's contributions to the field of radiometry are well known and very well recognized. This conference is a tribute to him. However, my paper is not on radiometry; rather, I wish to illustrate the adventurous, caring and positive Bill Wolfe that helped me find my way to the American desert Southwest.

Proceedings SPIE: Conference Digest, International Conference on Infrared and Millimeter Waves (18th) Held in Colchester, United Kingdom on 6-10 September 1993. Volume 2104

DTIC Science & Technology

1993-09-10

effective dielectric constant appears to decrease upon the substitution of PbO, 1. INRODUCTION In V2 05 - TeO2 glasses several studies on equilibrium... glass increases as TeOg is partially replaced by PbO. Previous studies on V20 5 - TeO2 system 4.5 have reported three Infrared absorption bands at 1010...Laboratory, Dr, K,S. Krishnan Road, New Delhi 110012, India. Th4., REFLECTANCE STUDY OF TM,O. GLASSES - AMemon, M,N.Khan, SAI-Dallal, Department of

Pump Diode Characterization for an Unstable Diode-Pumped Alkali Laser Resonator

DTIC Science & Technology

2013-03-01

2003. Petersen, A., and R. Lane, Second harmonic operation of diode-pumped Rb vapor lasers , Proc. of SPIE, 7005, 2008. Siegman , A. E., Lasers ...University Science Books, Sausalito, CA, 1986. Siegman , A. E., Defining, measuring and optimizing laser beam quality, Proc. of SPIE, 1868, 1993. Steck, D...PUMP DIODE CHARACTERIZATION FOR AN UNSTABLE DIODE-PUMPED ALKALI LASER RESONATOR THESIS Chad T. Taguba, Master Sergeant, USAF AFIT-ENP-13-M-33

Spectral Analysis of Breast Cancer on Tissue Microarrays: Seeing Beyond Morphology

DTIC Science & Technology

2005-04-01

Harvey N., Szymanski J.J., Bloch J.J., Mitchell M. investigation of image feature extraction by a genetic algorithm. Proc. SPIE 1999;3812:24-31. 11...automated feature extraction using multiple data sources. Proc. SPIE 2003;5099:190-200. 15 4 Spectral-Spatial Analysis of Urine Cytology Angeletti et al...Appendix Contents: 1. Harvey, N.R., Levenson, R.M., Rimm, D.L. (2003) Investigation of Automated Feature Extraction Techniques for Applications in

Challenges of anamorphic high-NA lithography and mask making

NASA Astrophysics Data System (ADS)

Hsu, Stephen D.; Liu, Jingjing

2017-06-01

Chip makers are actively working on the adoption of 0.33 numerical aperture (NA) EUV scanners for the 7-nm and 5-nm nodes (B. Turko, S. L. Carson, A. Lio, T. Liang, M. Phillips, et al., in `Proc. SPIE9776, Extreme Ultraviolet (EUV) Lithography VII', vol. 977602 (2016) doi: 10.1117/12.2225014; A. Lio, in `Proc. SPIE9776, Extreme Ultraviolet (EUV) Lithography VII', vol. 97760V (2016) doi: 10.1117/12.2225017). In the meantime, leading foundries and integrated device manufacturers are starting to investigate patterning options beyond the 5-nm node (O. Wood, S. Raghunathan, P. Mangat, V. Philipsen, V. Luong, et al., in `Proc. SPIE. 9422, Extreme Ultraviolet (EUV) Lithography VI', vol. 94220I (2015) doi: 10.1117/12.2085022). To minimize the cost and process complexity of multiple patterning beyond the 5-nm node, EUV high-NA single-exposure patterning is a preferred method over EUV double patterning (O. Wood, S. Raghunathan, P. Mangat, V. Philipsen, V. Luong, et al., in `Proc. SPIE. 9422, Extreme Ultraviolet (EUV) Lithography VI', vol. 94220I (2015) doi: 10.1117/12.2085022; J. van Schoot, K. van Ingen Schenau, G. Bottiglieri, K. Troost, J. Zimmerman, et al., `Proc. SPIE. 9776, Extreme Ultraviolet (EUV) Lithography VII', vol. 97761I (2016) doi: 10.1117/12.2220150). The EUV high-NA scanner equipped with a projection lens of 0.55 NA is designed to support resolutions below 10 nm. The high-NA system is beneficial for enhancing resolution, minimizing mask proximity correction bias, improving normalized image log slope (NILS), and controlling CD uniformity (CDU). However, increasing NA from 0.33 to 0.55 reduces the depth of focus (DOF) significantly. Therefore, the source mask optimization (SMO) with sub-resolution assist features (SRAFs) are needed to increase DOF to meet the demanding full chip process control requirements (S. Hsu, R. Howell, J. Jia, H.-Y. Liu, K. Gronlund, et al., EUV `Proc. SPIE9048, Extreme Ultraviolet (EUV) Lithography VI', (2015) doi: 10.1117/12.2086074). To ensure no assist feature printing, the assist feature sizes need to be scaled with λ/NA. The extremely small SRAF width (below 25 nm on the reticle) is difficult to fabricate across the full reticle. In this paper, we introduce an innovative `attenuated SRAF' to improve SRAF manufacturability and still maintain the process window benefit. A new mask fabrication process is proposed to use existing mask-making capability to manufacture the attenuated SRAFs. The high-NA EUV system utilizes anamorphic reduction; 4× in the horizontal (slit) direction and 8× in the vertical (scanning) direction (J. van Schoot, K. van Ingen Schenau, G. Bottiglieri, K. Troost, J. Zimmerman, et al., `Proc. SPIE. 9776, Extreme Ultraviolet (EUV) Lithography VII', vol. 97761I (2016) doi: 10.1117/12.2220150; B. Kneer, S. Migura, W. Kaiser, J. T. Neumann, J. van Schoot, in `Proc. SPIE9422, Extreme Ultraviolet (EUV) Lithography VI', vol. 94221G (2015) doi: 10.1117/12.2175488). For an anamorphic system, the magnification has an angular dependency, and thus, familiar mask specifications such as mask error factor (MEF) need to be redefined. Similarly, mask-manufacturing rule check (MRC) needs to consider feature orientation.

Long-Wave Infrared (LWIR) Polarimetric and Radiometric Analysis for a Variety of Thermal and Electromagnetic Suppressing Materials

DTIC Science & Technology

2014-08-01

polarimetry for remote sensing applications. Appl Opt. 2006;45(22):5453–5469. 5. Kudenov M, Pezzaniti L, Gerhart G. Microbolometer-infrared imaging...infrared imaging polarimetry . In: Photonics for Port and Harbor Security, DeWeert MJ, Saito TT, editors. Proceedings of SPIE; 2005;5780. 13. Hecht E...metrology. In: Polarimetry : Radar, Infrared, Visible, Ultraviolet, and X-Ray, Chipman RA, Morris JW, editors. Proceedings of SPIE; 1990;1317:280

Review of Fusion Systems and Contributing Technologies for SIHS-TD (Examen des Systemes de Fusion et des Technologies d’Appui pour la DT SIHS)

DTIC Science & Technology

2007-03-31

Unlimited, Nivisys, Insight technology, Elcan, FLIR Systems, Stanford photonics Hardware Sensor fusion processors Video processing boards Image, video...Engineering The SPIE Digital Library is a resource for optics and photonics information. It contains more than 70,000 full-text papers from SPIE...conditions Top row: Stanford Photonics XR-Mega-10 Extreme 1400 x 1024 pixels ICCD detector, 33 msec exposure, no binning. Middle row: Andor EEV iXon

VizieR Online Data Catalog: Very metal-poor stars in the Milky Way's halo (Carollo+, 2014)

NASA Astrophysics Data System (ADS)

Carollo, D.; Freeman, K.; Beers, T. C.; Placco, V. M.; Tumlinson, J.; Martell, S. L.

2017-07-01

The Aoki et al. (2013, J/AJ/145/13) sample comprises 137 stars observed at high spectral resolution (R~30000), in the course of four observing runs between 2008 March and October, using the High Dispersion Spectrograph (Noguchi et al. 2002PASJ...54..855N) at the Subaru Telescope. We also include 190 stars from the Yong et al. (2013, J/ApJ/762/26) sample - the 38 stars from their "program sample," and 152 stars in their literature compilation. High-resolution spectra (22000

Prototypes for Content-Based Image Retrieval in Clinical Practice

PubMed Central

Depeursinge, Adrien; Fischer, Benedikt; Müller, Henning; Deserno, Thomas M

2011-01-01

Content-based image retrieval (CBIR) has been proposed as key technology for computer-aided diagnostics (CAD). This paper reviews the state of the art and future challenges in CBIR for CAD applied to clinical practice. We define applicability to clinical practice by having recently demonstrated the CBIR system on one of the CAD demonstration workshops held at international conferences, such as SPIE Medical Imaging, CARS, SIIM, RSNA, and IEEE ISBI. From 2009 to 2011, the programs of CADdemo@CARS and the CAD Demonstration Workshop at SPIE Medical Imaging were sought for the key word “retrieval” in the title. The systems identified were analyzed and compared according to the hierarchy of gaps for CBIR systems. In total, 70 software demonstrations were analyzed. 5 systems were identified meeting the criterions. The fields of application are (i) bone age assessment, (ii) bone fractures, (iii) interstitial lung diseases, and (iv) mammography. Bridging the particular gaps of semantics, feature extraction, feature structure, and evaluation have been addressed most frequently. In specific application domains, CBIR technology is available for clinical practice. While system development has mainly focused on bridging content and feature gaps, performance and usability have become increasingly important. The evaluation must be based on a larger set of reference data, and workflow integration must be achieved before CBIR-CAD is really established in clinical practice. PMID:21892374

Photonics applications and web engineering: WILGA Winter 2016

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2016-09-01

Since twenty years, young researchers form the Institute of Electronic Systems, Warsaw University of Technology, organize two times a year, under only a marginal supervision of the senior faculty members, under the patronage of WEiTI PW, KEiT PAN, SPIE, IEEE, PKOpto SEP and PSF, the WILGA Symposium on advanced, integrated functional electronic, photonic and mechatronic systems [1-5]. All aspects are considered like: research and development, theory and design, technology - material and construction, software and hardware, commissioning and tests, as well as pilot and practical applications. The applications concern mostly, which turned after several years to be a proud specialization of the WILGA Symposium, Internet engineering, high energy physics experiments, new power industry including fusion, nuclear industry, space and satellite technologies, telecommunications, smart municipal environment, as well as biology and medicine [6-8]. XXXVIIth WILGA Symposium was held on 29-31 January 2016 and gathered a few tens of young researchers active in the mentioned research areas. There were presented a few tens of technical papers which will be published in Proc.SPIE together with the accepted articles from the Summer Edition of the WILGA Symposium scheduled for 29.05-06.06.2016. This article is a digest of chosen presentations from WILGA Symposium 2016 Winter Edition. The survey is narrowed to a few chosen and main topical tracks, like electronics and photonics design using industrial standards like ATCA/MTCA, also particular designs of functional systems using this series of industrial standards. The paper, summarizing traditionally since many years the accomplished WILGA Symposium organized by young researchers from Warsaw University of Technology, is also the following part of a cycle of papers concerning their participation in design of new generations of electronic systems used in discovery experiments in Poland and in leading research laboratories of the world.

VizieR Online Data Catalog: Mid-infrared-X-ray correlation for local AGNs (Asmus+, 2015)

NASA Astrophysics Data System (ADS)

Asmus, D.; Gandhi, P.; Honig, S. F.; Smette, A.; Duschl, W. J.

2018-01-01

We start with the total sample from the AGN MIR atlas of 253 objects (Asmus et al. 2014, J/MNRAS/439/1648). Note that sample is a combination of a hard X-ray (14-195 keV) selected and a quasi-MIR selected sample as explained in Asmus et al. (2014, J/MNRAS/439/1648). The MIR continuum fluxes are the unresolved nuclear fluxes extracted from ground-based multifilter photometry obtained with the instruments VISIR (Lagage et al. 2004Msngr.117...12L), T-ReCS (Telesco et al. 1998SPIE.3354..534T), Michelle (Glasse, Atad-Ettedgui & Harris 1997SPIE.2871.1197G), and COMICS; (Kataza et al. 2000SPIE.4008.1144K). We collect observed 14-195 keV fluxes, Fobs(14-195 keV), measured with Swift/BAT (Burst Alert Telescope) by combining the data of the 54 and 70 month source catalogues with preference for the latter (Cusumano et al. 2010, J/A+A/524/A64; Baumgartner et al. 2013, J/ApJS/207/19). (2 data files).

Noise, fluctuation, and HADAMARD-transform spectrometry

NASA Astrophysics Data System (ADS)

Nitzsche, Guenter; Riesenberg, Rainer

2003-05-01

The HADAMARD principle is known in optics as a multiplex technique. It describes the mode with the most advantageous increase of the signal-to-noise ratio (SNR) in terms of scanning (Fellget advantage). The maximum increase of SNR, we call it gain, is (n+1)/(2On), where n is the number of multiplexing. It is valid in the case of pure detector noise. The multiplex encoding Hadamard pattern in case of n = 7 is 1110100, whereby 1 stands for a switched on channel performed by a field selector. The signals of all (switched on) channels are detected by a single detector. n measurement steps with a cyclic change of the pattern is necessary to perform the Hadamard transformation and to get the result of each individual channel. In case of n = 7 the theoretical gain is 1.51. For all possible multiplex pattern (1100000, 1110000 and so on) the gain is theoretically investigated. A multiplexing advantage (gain > 1) is reached only by the Hadamard pattern, the inverse Hadamard pattern and for (0111111)-pattern (gain=1.08). Most of the multiplex pattern are disadvantageous. The reason for maximum gain of the HADAMARD transformation is analysed theoretically. Signal fluctuations during the measurement caused by fluctuations of the illumination or by the object under test, reduce the multiplex gain, too. So the limits for realizing a gain are estimated theoretically. Essential is the transformation procedure and its influence on the error propagation. The results could be verified by experiments with array spectrometeres. Requirements are derived by numerical simulation concerning the stability of the signals to be multiplexed. It is simulated the needed stability of the signals with increasing order of multiplexing. So the increase of the multiplex gain is limited by signal fluctuations. A realized 96 channel spectral reader is presented as a modern application of an optical multiplexing arrangement. ! M. Harvid, N. J. A. Sloane, Hadamard Transform Optics, Academic Press, 1979 ! R.A. De Verse, R.M. Hammaker, W. G. Fately, J.A.Graham, J.D.Tate, "Spectrometry and imaging using a digital micromirror array" American Laboratory, Vol. 30, 21, pp. 112-120, 1998 ! R. Riesenberg, A. Wuttig, B. Harnisch, "Optical MEMS Technology for Multiplexing in High-End Micro-Scpectrometers", Proc. SPIE 4928, 6-14, 2002 ! A. Wuttig, R. Riesenberg, "Hyperspectral imager with a facile MEMS", Proc. SPIE 4881A, 2002, to be published ! R. Riesenberg, G. Nitzsche, W. Voigt, 'HADAMARD Encoding and other optical Multiplexing', VDI-Berichte 1694, pp. 345-350, 2002 ! A. Wuttig, R. Riesenberg, G. Nitzsche, "Subpixel Analysis of Double Array Grating Spectrometer", Proc. SPIE 4480, pp. 334-344, 2002 ! A. Wuttig, R. Riesenberg, G. Nitzsche, "Integral Field and Multi Object Spectrometry with MEMS", Proc. SPIE 4480, pp. 367-376, 2002 ! R. Riesenberg, G. Nitzsche, A. Wuttig, B. Harnisch, "Micro Spectrometer and MEMS for Space" in "Smaller Satellites: Bigger Business?", edited by M. Rycroft, N. Crosby, Kluwer Academic Publisher, pp. 403-406, 2002 ! R. Riesenberg, A. Wuttig, "Optical sensors with MEMS, slit masks and micromechanical devices", Proc. SPIE 4561, pp. 315-322, 2001 ! R. Riesenberg, "MicroMechanical Slit Positioning System as a transmissive spatial Light Modulator", Proc. SPIE 4457, pp.197-203, 2001 ! R. Riesenberg, J. Lonschinski, "HADAMARD-Minispectrometer made by a Micro Device", Proc. "3rd Round Table on Micro/NanoTechnologies for Space", ESTEC, Noordwijk, The Netherlands, pp. 291 - 297, 2000 ! R. Riesenberg, U. Dillner, "HADAMARD Imaging Spectrometers", Proc. SPIE 3753, pp. 203-213, 1999 ! R. Riesenberg, Th. Seifert, "Design of spatial Light Modulator Microdevices - Micro Slit Arrays", Proc. SPIE 3680, Part One, pp. 406-414, 1999 ! R. Riesenberg, W. Voigt, J. Schoneich, "Compact Spectrometers made by Micro System Technology", Sensor 97, Proc. Vol. 2, pp. 145-150,1997

Recent developments on holography in China

NASA Astrophysics Data System (ADS)

Hsu, Dahsiung; Jiao, Jiangzhong; Tao, Huiying; Long, Pin

1991-02-01

Since the 1985 Lake Forest International Conference on display holography, USA) more developments have been made on holographic applications in China among which the important events and progress were: the International Conference on holography applications em bossing holography new holographic optical elements and equipments etc. . 1. INTERNATIONAL CONFEPENCE ON GRAPHY APPLICATIONS'' ( I CHA ''86. BEIJING) More than 280 holographers from 18 countries gathered in the Science Hall in Beijing from July 2 to for the International Conference on holography applications''86. The conference was sponsor ed by the Chinese OPtical Society the Chinese Theoretical Applied Mechanics Society and cosponsored by the Society of Photooptical Instrumentation Engineers the European Photonic Association in cooperation with the China Association for Science And Technology. It was chaired by Prof. Wang Daheng vice president of the China Association for Science Technology and president of the Chinese Optical Society cochaired by DP. H. J. Caulfield of the Univ. of Alabama Dr. G. von Bally of the Munster Univ. in West Germany and Dr. J. Tsujiuchi of the Tokyo Institute of Technology. SPIE Vol. 1238 Three-Dimensional Holography: Science Culture Education (1989) / 13

Accurate viscosity measurements of flowing aqueous glucose solutions with suspended scatterers using a dynamic light scattering approach with optical coherence tomography.

PubMed

Weatherbee, Andrew; Popov, Ivan; Vitkin, Alex

2017-08-01

The viscosity of turbid colloidal glucose solutions has been accurately determined from spectral domain optical coherence tomography (OCT) M-mode measurements and our recently developed OCT dynamic light scattering model. Results for various glucose concentrations, flow speeds, and flow angles are reported. The relative "combined standard uncertainty" uc(η) on the viscosity measurements was ±1% for the no-flow case and ±5% for the flow cases, a significant improvement in measurement robustness over previously published reports. The available literature data for the viscosity of pure water and our measurements differ by 1% (stagnant case) and 1.5% (flow cases), demonstrating good accuracy; similar agreement is seen across the measured glucose concentration range when compared to interpolated literature values. The developed technique may contribute toward eventual noninvasive glucose measurements in medicine. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Hands-on optics: an informal science education initiative

NASA Astrophysics Data System (ADS)

Johnson, Anthony M.; Pompea, Stephen M.; Arthurs, Eugene G.; Walker, Constance E.; Sparks, Robert T.

2007-09-01

The project is collaboration between two scientific societies, the Optical Society of America (OSA) and SPIE - The International Society for Optical Engineering and the National Optical Astronomy Observatory (NOAO). The program is designed to bring science education enrichment to thousands of underrepresented middle school students in more than ten states, including female and minority students, who typically have not been the beneficiaries of science and engineering resources and investments. HOO provides each teacher with up to six activity modules, each containing enough materials for up to 30 students to participate in 6-8 hours of hands-on optics-related activities. Sample activities, developed by education specialists at NOAO, include building kaleidoscopes and telescopes, communicating with a beam of light, and a hit-the-target laser beam challenge. Teachers engage in two days of training and, where possible, are partnered with a local optics professional (drawn from the local rosters of SPIE and OSA members) who volunteers to spend time with the teacher and students as they explore the module activities. Through these activities, students gain experience and understanding of optics principles, as well as learning the basics of inquiry, critical thinking, and problem solving skills involving optics, and how optics interfaces with other disciplines. While the modules were designed for use in informal after- school or weekend sessions, the number of venues has expanded to large and small science centers, Boys and Girls Clubs, Girl Scouts, summer camps, family workshops, and use in the classroom.

Delay Differential Equation-Based Modeling of Passively Mode-Locked Quantum Dot Lasers Using Measured Gain and Loss Spectra (Postprint)

DTIC Science & Technology

2013-01-01

semiconductor laser8, 9: ATAe d dA TQiTGi qg 12 11 2 1 (1) 2 0 1 AeeGgd dG GQ (2) Proc. of SPIE Vol. 8255 82551K-2 Downloaded From: http...1 Downloaded From: http://spiedigitallibrary.org/ on 01/14/2013 Terms of Use: http://spiedl.org/terms 1 Approved for public release; distribution...parameters ( 0g and 0q , respectively) have been derived to yield: Gg0 (10) Proc. of SPIE Vol. 8255 82551K-3 Downloaded From: http

VizieR Online Data Catalog: Radial velocities for the HD 3167 system (Christiansen+, 2017)

NASA Astrophysics Data System (ADS)

Christiansen, J. L.; Vanderburg, A.; Burt, J.; Fulton, B. J.; Batygin, K.; Benneke, B.; Brewer, J. M.; Charbonneau, D.; Ciardi, D. R.; Cameron, A. C.; Coughlin, J. L.; Crossfield, I. J. M.; Dressing, C.; Greene, T. P.; Howard, A. W.; Latham, D. W.; Molinari, E.; Mortier, A.; Mullally, F.; Pepe, F.; Rice, K.; Sinukoff, E.; Sozzetti, A.; Thompson, S. E.; Udry, S.; Vogt, S. S.; Barman, T. S.; Batalha, N. E.; Bouchy, F.; Buchhave, L. A.; Butler, R. P.; Cosentino, R.; Dupuy, T. J.; Ehrenreich, D.; Fiorenzano, A.; Hansen, B. M. S.; Henning, T.; Hirsch, L.; Holden, B. P.; Isaacson, H. T.; Johnson, J. A.; Knutson, H. A.; Kosiarek, M.; Lopez-Morales, M.; Lovis, C.; Malavolta, L.; Mayor, M.; Micela, G.; Motalebi, F.; Petigura, E.; Phillips, D. F.; Piotto, G.; Rogers, L. A.; Sasselov, D.; Schlieder, J. E.; Segransan, D.; Watson, C. A.; Weiss, L. M.

2018-06-01

The final data set includes observations obtained with Keck/HIRES, Automated Planet Finder (APF)/Levy, and HARPS-N. Our observational setup for both Keck/HIRES and the APF/Levy was essentially identical to those described in Fulton et al. (2016, J/ApJ/830/46) and Burt et al. (2014ApJ...789..114B). We collected a total of 60 RV measurements using Keck/HIRES (Vogt et al. 1994SPIE.2198..362V), and 116 measurements using the Levy Spectrograph on the APF (Radovan et al. 2014SPIE.9145E..2BR; Vogt et al. 2014PASP..126..359V) at Lick Observatory between 2016 July 7 and 2016 December 2. We also observed HD 3167 with the HARPS-N spectrograph (Cosentino et al. 2012SPIE.8446E..1VC) located at the 3.58 m Telescopio Nazionale Galileo on the island of La Palma, Spain. HARPS-N is a stabilized spectrograph designed for precise RV measurements. We observed HD 3167 76 times between 2016 July 7 (independently beginning the same night as the HIRES/APF campaign) and 2016 December 7, obtaining high-resolution optical spectra with a spectral resolving power of R=115000. (1 data file).

Strategic business planning for internal medicine.

PubMed

Ervin, F R

1996-07-01

The internal medicine generalist is at market risk with expansion of managed care. The cottage industry of Academic Departments of internal medicine should apply more business tools to the internal medicine business problem. A strength, weakness, opportunity, threat (SWOT) analysis demonstrates high vulnerability to the internal medicine generalist initiative. Recommitment to the professional values of internal medicine and enhanced focus on the master clinician as the competitive core competency of internal medicine will be necessary to retain image and market share.

Postgraduate education in internal medicine in Europe.

PubMed

Cranston, Mark; Slee-Valentijn, Monique; Davidson, Christopher; Lindgren, Stefan; Semple, Colin; Palsson, Runolfur

2013-10-01

Limited information exists on the framework and content of postgraduate education in internal medicine in Europe. This report describes the results of a survey of postgraduate training in internal medicine in the European countries. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine residents from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on postgraduate training in internal medicine was performed. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. The length of training ranged from four to six years and was commonly five years. The majority of countries offered training in internal medicine and a subspecialty. A common trunk of internal medicine was frequently a component of subspecialty training programmes. Hospital inpatient service was the predominant setting used for training. A final certifying examination was in place in 14 countries. Although some similarities exists, there appear to be significant differences in the organisation, content and governance of postgraduate training in internal medicine between the European countries. Our findings will prove invaluable for harmonisation of training and qualification in internal medicine in Europe. © 2013.

Soft x-ray microscopy and extreme ultraviolet lithography: Imaging in the 20-50 nm regime (abstract) (invited)

NASA Astrophysics Data System (ADS)

Attwood, David

2002-03-01

Advances in short wavelength optics, covering the range from 1 to 14 nm, are providing new results and new opportunities. Zone plate lenses [E. Anderson et al., J. Vac. Sci. Techno. B 18, 2970 (2000)] for soft x-ray microscopy [G. Denbeaux, Rev. Sci. Instrum. (these proceedings); W. Chao, Proc. SPIE 4146, 171 (2000)] are now made to high accuracy with outer zone widths of 25 nm, and demonstrated resolution of 23 nm with proper illumination and stability. These permit important advances in the study of protein specific transport and structure in the life sciences [C. Larabell (private communication); W. Meyer-Ilse et al., J. Microsc. 201, 395 (2001)] and the study of magnetic materials [P. Fischer et al., J. Synchrotron. Radiat. 8, 325 (2001)] with elemental sensitivity at the resolution of individual domains. Major corporations (members of the EUV Limited Liability Company are Intel, Motorola, AMD, Micron, Infineon, and IBM) are now preparing the path for the fabrication of future computer chips, in the years 2007 and beyond, using multilayer coated reflective optics, which achieve reflectivities of 70% in the 11-14 nm region [T. Barbee et al., Appl. Opt. 24, 883 (1985); C. Montcalm et al., Proc. SPIE 3676, 710 (1999)]. These coated optics are to be incorporated in extreme ultraviolet (EUV) print cameras, known as "steppers." Electronic patterns with features in the range of 50-70 nm have been printed. The first alpha tool stepper recently demonstrated all critical technologies [D. Tichenor et al., Proc. SPIE 4343, 19 (2001)] needed for EUV lithography. Preproduction beta tools are targeted for delivery by leading suppliers [ASML, the Netherlands, at the SPIE Microlithography Conference, Santa Clara, CA, March 2001] in 2004, with high volume production tools available in late 2006 for manufacturing in 2007. New results in these two areas will be discussed in the context of the synergy of science and technology.

Multimedia content analysis, management and retrieval: trends and challenges

NASA Astrophysics Data System (ADS)

Hanjalic, Alan; Sebe, Nicu; Chang, Edward

2006-01-01

Recent advances in computing, communications and storage technology have made multimedia data become prevalent. Multimedia has gained enormous potential in improving the processes in a wide range of fields, such as advertising and marketing, education and training, entertainment, medicine, surveillance, wearable computing, biometrics, and remote sensing. Rich content of multimedia data, built through the synergies of the information contained in different modalities, calls for new and innovative methods for modeling, processing, mining, organizing, and indexing of this data for effective and efficient searching, retrieval, delivery, management and sharing of multimedia content, as required by the applications in the abovementioned fields. The objective of this paper is to present our views on the trends that should be followed when developing such methods, to elaborate on the related research challenges, and to introduce the new conference, Multimedia Content Analysis, Management and Retrieval, as a premium venue for presenting and discussing these methods with the scientific community. Starting from 2006, the conference will be held annually as a part of the IS&T/SPIE Electronic Imaging event.

Mapping DICOM to OpenDocument format

NASA Astrophysics Data System (ADS)

Yu, Cong; Yao, Zhihong

2009-02-01

In order to enhance the readability, extensibility and sharing of DICOM files, we have introduced XML into DICOM file system (SPIE Volume 5748)[1] and the multilayer tree structure into DICOM (SPIE Volume 6145)[2]. In this paper, we proposed mapping DICOM to ODF(OpenDocument Format), for it is also based on XML. As a result, the new format realizes the separation of content(including text content and image) and display style. Meanwhile, since OpenDocument files take the format of a ZIP compressed archive, the new kind of DICOM files can benefit from ZIP's lossless compression to reduce file size. Moreover, this open format can also guarantee long-term access to data without legal or technical barriers, making medical images accessible to various fields.

Summer school in Kabardino-Balkaria by BMSTU SPIE Student Chapter

NASA Astrophysics Data System (ADS)

Chernomyrdin, Nikita V.; Zaytsev, Kirill I.; Gavdush, Arsenii A.; Fokina, Irina N.; Karasik, Valeriy E.; Yurchenko, Stanislav O.

2014-09-01

This summer BMSTU SPIE Student Chapter have decided to visit Kabardino-Balkaria Republic of Caucasus (Russia) and spent there a week with children in a camp. It was called Summer school. We decided to organize it in order to engage talented and curious children in Optics and to show them how science could be funny. Education and entertainment program included such activities as lectures, optical demonstrations, laser games, hiking in the forest, and others. As a result children had a good time outdoors, learned interesting facts about optics and lasers, and of course found new friends who are keen to know more too. Four Chapter members and about 70 children of age 10-16 took part in this event.

Index of international publications in aerospace medicine.

DOT National Transportation Integrated Search

1993-02-01

The Index of International Publications in Aerospace Medicine is a comprehensive listing of international publications in clinical aerospace medicine, operational aerospace medicine, aerospace physiology, environmental medicine/physiology, diving med...

Index of international publications in aerospace medicine

DOT National Transportation Integrated Search

2001-08-01

The Index of International Publications in Aerospace Medicine is a comprehensive listing of international publications in clinical aerospace medicine, operational aerospace medicine, aerospace physiology, environmental medicine/physiology, diving med...

US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

PubMed

Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

2015-09-01

Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value < 0.01); completion of rotations in ob/gyn and psychiatry were unrelated to internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine examination (coefficient = 0.23 points/week; p value < 0.01). The order in which students complete clinical clerkships and the length of the internal medicine clerkship are associated with their internal medicine subject examination scores. Findings may have implications for curriculum re-design.

Index of international publications in aerospace medicine.

DOT National Transportation Integrated Search

2014-05-01

The 5th edition of the Index of International Publications in Aerospace Medicine is a comprehensive : listing of international publications in clinical aerospace medicine, operational aerospace medicine, : aerospace physiology, environmental medicine...

Index of International Publications in Aerospace Medicine

DOT National Transportation Integrated Search

2007-01-01

The 3rd edition of theIndex of International Publications in Aerospace Medicine is a comprehensive listing of : international publications in clinical aerospace medicine, operational aerospace medicine, aerospace : physiology, environmental medicine/...

Six decades of the chair of Internal Medicine at the Medical Faculty in Skopje.

PubMed

Chakalaroski, K

2013-01-01

The chair of internal medicine in Republic of Macedonia was created in 1947. The Department of Internal Medicine (CIM) is the most numerous at Skopje's medical faculty (currently 56 members). According to the archive material from the first session of the Scientific Teaching Council of the Faculty of Medicine (17.03.1947), Mr Mario Krmpotic (Professor of Internal Medicine) was proposed as the first Director of the Internal Clinic (1947). For reasons unknown, Mr Krmpotic never came to Skopje to accept the post. As a consequence of this fact, the real founder of the CIM was the Russian Professor Alexandar Ignjatovski (1875-1955). Mr Ignjatovski was elected as the first Director of the Clinic for Internal Medicine in 1948 for a period of 4 years (1948-1952). At the same time, he was the first Chief of the CIM in Skopje (Macedonia). Dr D. Arsov was elected as the first Assistant Professor of Medicine in 1947, and second (and last) Director of the Clinic for Internal Medicine (1952-1974). For the same period (22 years) he was Head of the CIM. Dr D. Arsov sequentially and successively became first associated and then ordinary professor of medicine in the years 1951 and 1958. The regular activities of the CIM are as follows: 1) Undergraduate education for students (Clinical Investigation, Internal Medicine, Clinical Pharmacy) in general medicine, dentistry, geriatrics, urgent and family medicine (ECKTS); Undergraduate educationfor nurses, speech therapists, physiotherapists, radiologists (high /three year/ nurses School, ECKTS); 2) Postgraduate education (candidates for specialisation in internal medicine, infectology, anaesthesiology, neurology and surgery; 3) Continual medical education (a traditional morning scientific meeting on Thursdays, 08 h; weekly meetings of all internal medicine subspecialists); Scientific meetings, symposiums, congresses of former internal medicine associations (cardiology, pulmoallergology, gastroenterology, nephrology, haematology, rheumathology, endocriniology and toxicology); 4) Publishing activities in the national journals (Macedonian Medical Review, Journal of Macedonian Medical Science, Acta Physiologica, Medicus); 5) Decision-making: the Head of CIM regularly collaborates with the subspecialities of internal medicine by means of a coordinated body for all questions related to educational purposes in clinical investigation and internal medicine.

Training the Internist for Primary Care: A View From Nevada

PubMed Central

Kurtz, Kenneth J.

1982-01-01

The recent establishment of primary care residencies at the University of Nevada School of Medicine has raised important questions about local priorities in the training of physicians to provide primary care for adults. Because the amount of money available for health care training is decreasing, these questions also have national importance. Primary care internal medicine, not synonymous with general internal medicine, offers distinct advantages to patients over family practice adult care and primary care offered by internist subspecialists. The University of Nevada has a singular opportunity to organize a strong primary care internal medicine residency, but national problems of internal medicine emphasis exist. Nationwide changes in internal medicine residency programs (ongoing) and American Board of Internal Medicine nationalization of the fledgling primary care internal medicine fellowship movement are suggested. Specifically proposed is an extra year for primary care training with a single examination after four years, producing general internists with a primary care “minor.” Alternately, and ideally, there would be a full two-year primary care fellowship with a separate internal medicine primary care subspecialty board examination. Either of the above options would provide necessary training and academic credibility for primary care internists, and would redirect internal medicine certification and training. PMID:7072246

Training the internist for primary care: a view from Nevada.

PubMed

Kurtz, K J

1982-01-01

The recent establishment of primary care residencies at the University of Nevada School of Medicine has raised important questions about local priorities in the training of physicians to provide primary care for adults. Because the amount of money available for health care training is decreasing, these questions also have national importance. Primary care internal medicine, not synonymous with general internal medicine, offers distinct advantages to patients over family practice adult care and primary care offered by internist subspecialists. The University of Nevada has a singular opportunity to organize a strong primary care internal medicine residency, but national problems of internal medicine emphasis exist. Nationwide changes in internal medicine residency programs (ongoing) and American Board of Internal Medicine nationalization of the fledgling primary care internal medicine fellowship movement are suggested. Specifically proposed is an extra year for primary care training with a single examination after four years, producing general internists with a primary care "minor." Alternately, and ideally, there would be a full two-year primary care fellowship with a separate internal medicine primary care subspecialty board examination. Either of the above options would provide necessary training and academic credibility for primary care internists, and would redirect internal medicine certification and training.

American Internal Medicine in the 21st Century

PubMed Central

Huddle, Thomas S; Centor, Robert; Heudebert, Gustavo R

2003-01-01

American internal medicine suffers a confusion of identity as we enter the 21st century. The subspecialties prosper, although unevenly, and retain varying degrees of connection to their internal medicine roots. General internal medicine, identified with primary care since the 1970s, retains an affinity for its traditional consultant-generalist ideal even as primary care further displaces that ideal. We discuss the origins and importance of the consultant-generalist ideal of internal medicine as exemplified by Osler, and its continued appeal in spite of the predominant role played by clinical science and accompanying subspecialism in determining the academic leadership of American internal medicine since the 1920s. Organizing departmental clinical work along subspecialty lines diminished the importance of the consultant-generalist ideal in academic departments of medicine after 1950. General internists, when they joined the divisions of general internal medicine that appeared in departments of medicine in the 1970s, could sometimes emulate Osler in practicing a general medicine of complexity, but often found themselves in a more limited role doing primary care. As we enter the 21st century, managed care threatens what remains of the Oslerian ideal, both in departments of medicine and in clinical practice. Twenty-first century American internists will have to adjust their conditions of work should they continue to aspire to practice Oslerian internal medicine. PMID:12950486

SFG characterization of a cationic ONLO dye in biological thin films

NASA Astrophysics Data System (ADS)

Johnson, Lewis E.; Casford, Michael T.; Elder, Delwin L.; Davies, Paul B.; Johal, Malkiat S.

2013-10-01

Biopolymer-based thin films, such as those composed of CTMA-DNA, can be used as a host material for NLOactive dyes for applications such as electro-optic (EO) switching and second harmonic generation. Previous work by Heckman et al. (Proc. SPIE 6401, 640108-2) has demonstrated functioning DNA-based EO modulators. Improved performance requires optimization of both the first hyperpolarizabilities (β) and degree of acentric ordering exhibited by the chromophores. The cationic dye DANPY-1 (Proc. SPIE 8464, 846409-D) has a high affinity for DNA and a substantial hyperpolarizability; however, its macroscopic ordering has not been previously characterized. We have characterized the acentric ordering of the dye using sum-frequency generation (SFG) vibrational spectroscopy in surface-immobilized DNA and on planar metal and dielectric surfaces.

The practice of internal medicine in Europe: organisation, clinical conditions and procedures.

PubMed

Cranston, Mark; Semple, Colin; Duckitt, Roger; Vardi, Moshe; Lindgren, Stefan; Davidson, Christopher; Palsson, Runolfur

2013-10-01

Current information on the role of internists in the European countries is scarce. This report describes the results of a survey of the practice of internists in Europe. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine trainees from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on the practice of internists was carried out. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. In 8 European countries, most internists practised internal medicine alone and in 7 countries at least half of physicians practised internal medicine together with a subspecialty. Internal medicine was considered a hospital-based specialty in most countries. The majority of selected presenting problems and diagnoses were rated as commonly encountered in all countries. More variability between countries was observed in the performance of diagnostic and therapeutic procedures. Many similarities exist in the practice of internal medicine between the European countries, while some differences are present that likely reflect the variable impact of subspecialisation. The results of the survey should prove valuable for the definition of specific competencies and development of a common curriculum for internal medicine at the European level. © 2013.

[Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig].

PubMed

Engelmann, L; Schneider, D

1989-01-15

Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.

The impact of the internal medicine sub-internship on medical student career choice.

PubMed

Kogan, Jennifer R; Shea, Judy A; O'Grady, Elizabeth; Bellini, Lisa M; Ciminiello, Frank

2010-05-01

Medical student interest in internal medicine is decreasing. Whether the internal medicine sub-internship affects intent to pursue internal medicine is unknown. Determine the immediate and longer-term effect of the medicine sub-internship on students' decision to pursue internal medicine residency. Mixed method, single institution, prospective cohort study. Ninety-two students completing an internal medicine sub-internship in 2006. Survey administered prior to and immediately after the sub-internship and prior to the match. Questions included likelihood of applying in internal medicine and perceived impact of the sub-internship on career choice. Seventy-seven percent of students (N = 63) completed the first two surveys; 63% (N = 58) completed the second and third. Immediately post sub-internship, 21% (N = 13) were less likely to apply in internal medicine and 11% (N = 7) were more likely to apply (net change in plans was not significant, p = 0.38). There was a significant relationship between the perceived impact of the sub-internship and likelihood of applying in medicine (ANOVA comparison across means, p < 0.001). Compared to the second survey, on the third survey more students (41%, N = 24) believed the sub-internship positively impacted their decision to apply in medicine, though overall shifting was not significant (p = 0.39). Key themes describing sub-internship impact included the intense workload, value of experiencing internship, rewards of assuming the physician role, and education received (30%, 25%, 20% and 16% of comments, respectively). Overall, there was not a significant effect of the sub-internship on students' decision to apply in internal medicine. Additional research about the relative impact of the sub-internship in relationship to other career choice predictors is needed to better address factors that may encourage or dissuade students from pursuing internal medicine.

Damage evolution during actuation fatigue in shape memory alloys (SPIE Best Student Paper Award)

NASA Astrophysics Data System (ADS)

Phillips, Francis R.; Wheeler, Robert; Lagoudas, Dimitris C.

2018-03-01

Shape Memory Alloys (SMAs) are unique materials able to undergo a thermomechanically induced, reversible phase transformation. Additionally, SMA are subject to two types of fatigue, that is structural fatigue due to cyclic loading as experienced by most materials, as well as actuation fatigue due to repeated thermally induced phase transformation. The evolution of multiple material characteristics is presented over the actuation fatigue lifetime of NiTiHf actuators, including the accumulation of irrecoverable strain, the evolution of internal voids, and the evolution of the effective modulus of the actuator. The results indicate that all three of these material characteristics are clearly interconnected and careful analysis of each of these characteristics can help to understand the evolution of the others, as well as help to understand how actuation fatigue leads to ultimate failure of the actuator.

Update in outpatient general internal medicine: practice-changing evidence published in 2014.

PubMed

Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

2015-10-01

The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

ERIC Educational Resources Information Center

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

Individualized FAC on bottom tab subassemblies to minimize adhesive gap between emitter and optics

NASA Astrophysics Data System (ADS)

Sauer, Sebastian; Müller, Tobias; Haag, Sebastian; Beleke, Andreas; Zontar, Daniel; Baum, Christoph; Brecher, Christian

2017-02-01

High Power Diode Laser (HPDL) systems with short focal length fast-axis collimators (FAC) require submicron assembly precision. Conventional FAC-Lens assembly processes require adhesive gaps of 50 microns or more in order to compensate for component tolerances (e.g. deviation of back focal length) and previous assembly steps. In order to control volumetric shrinkage of fast-curing UV-adhesives shrinkage compensation is mandatory. The novel approach described in this paper aims to minimize the impact of volumetric shrinkage due to the adhesive gap between HPDL edge emitters and FAC-Lens. Firstly, the FAC is actively aligned to the edge emitter without adhesives or bottom tab. The relative position and orientation of FAC to emitter are measured and stored. Consecutively, an individual subassembly of FAC and bottom tab is assembled on Fraunhofer IPT's mounting station with a precision of +/-1 micron. Translational and lateral offsets can be compensated, so that a narrow and uniform glue gap for the consecutive bonding process of bottom tab to heatsink applies (Figure 4). Accordingly, FAC and bottom tab are mounted to the heatsink without major shrinkage compensation. Fraunhofer IPT's department assembly of optical systems and automation has made several publications regarding active alignment of FAC lenses [SPIE LASE 8241-12], volumetric shrinkage compensation [SPIE LASE 9730-28] and FAC on bottom tab assembly [SPIE LASE 9727-31] in automated production environments. The approach described in this paper combines these and is the logical continuation of that work towards higher quality of HPDLs.

Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital

PubMed Central

Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

2016-01-01

This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely. PMID:27077874

Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

PubMed

Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

2016-04-12

This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

A Learning-Curve Approach to the Self-Assessment of Internal Medicine Training.

ERIC Educational Resources Information Center

Day, Susan C.; And Others

1984-01-01

In response to the perceived need for primary care physicians, two major changes in internal medicine training have occurred: (1) a third year of general training was required for internal medicine board certification and (2) many hospitals developed primary care internal medicine residencies with an increased emphasis on ambulatory training.…

Implementing a Narrative Medicine Curriculum During the Internship Year: An Internal Medicine Residency Program Experience.

PubMed

Wesley, Tiffany; Hamer, Diana; Karam, George

2018-04-18

Narrative medicine develops professional and communication skills that align with Accreditation Council for Graduate Medical Education competencies. However, little is known about a narrative medicine curriculum's impact on physicians in training during residency. Implementing a narrative medicine curriculum during residency can be challenging because of time constraints and limited opportunity for nonclinical education. Six sessions were implemented throughout one academic year to expose first-year internal medicine residents (interns) to narrative medicine. Attendance and participation were documented. At the end of the year, interns completed an open-ended survey to gauge their perception of their experience with the sessions. In total, 17 interns attended at least 1 narrative medicine session, and each session averaged 5.4 attendees. Thirteen eligible interns completed the survey. Thematic analysis identified 3 predominant themes: Mindfulness, physician well-being, and professionalism. Overall, the narrative medicine sessions were well attended and the curriculum was well received. This intervention demonstrates the value of a narrative medicine curriculum during medical resident training. Large prospective studies are necessary to identify the long-term benefits of such a curriculum.

Curricula and Organization of Primary Care Residencies in Internal Medicine.

ERIC Educational Resources Information Center

Eisenberg, John M.

1980-01-01

The organization and curricula of internal medicine residencies programs that emphasize primary care are described and compared with traditional residencies in internal medicine. It is noted that primary care residents spend more time in ambulatory care and are allowed more electives in specialties outside of internal medicine. Out-of-hospital…

Philanthropic endowments in general internal medicine.

PubMed

Murden, R A; Lamb, J F

1999-04-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine.

Topics of internal medicine for undergraduate dental education: a qualitative study.

PubMed

Kunde, A; Harendza, S

2015-08-01

Due to the ageing population, internal medicine has become increasingly important for dental education. Although several studies have reported dentists' dissatisfaction with their internal medicine training, no guidelines exist for internal medicine learning objectives in dental education. The aim of this study was to identify topics of internal medicine considered to be relevant for dental education by dentists and internists. Eight dentists from private dental practices in Hamburg and eight experienced internal medicine consultants from Hamburg University Hospital were recruited for semi-structured interviews about internal medicine topics relevant for dentists. Internal diseases were clustered into representative subspecialties. Dentists and internists were also asked to rate medical diseases or emergencies compiled from the literature by their relevance to dental education. Coagulopathy and endocarditis were rated highest by dentists, whilst anaphylaxis was rated highest by internists. Dentists rated hepatitis, HIV, organ transplantation and head/neck neoplasm significantly higher than internists. The largest number of different internal diseases mentioned by dentists or internists could be clustered under cardiovascular diseases. The number of specific diseases dentists considered to be relevant for dental education was higher in the subspecialties cardiovascular diseases, haematology/oncology and infectiology. We identified the internal medicine topics most relevant for dental education by surveying practising dentists and internists. The relevance of these topics should be confirmed by larger quantitative studies to develop guidelines how to design specific learning objectives for internal medicine in the dental curriculum. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Impact of the Internal Medicine Sub-internship on Medical Student Career Choice

PubMed Central

Shea, Judy A.; O’Grady, Elizabeth; Bellini, Lisa M.; Ciminiello, Frank

2010-01-01

Background Medical student interest in internal medicine is decreasing. Whether the internal medicine sub-internship affects intent to pursue internal medicine is unknown. Objective Determine the immediate and longer-term effect of the medicine sub-internship on students’ decision to pursue internal medicine residency. Design Mixed method, single institution, prospective cohort study. PARTICIPANTS Ninety-two students completing an internal medicine sub-internship in 2006. Measurements Survey administered prior to and immediately after the sub-internship and prior to the match. Questions included likelihood of applying in internal medicine and perceived impact of the sub-internship on career choice. Main Results Seventy-seven percent of students (N = 63) completed the first two surveys; 63% (N = 58) completed the second and third. Immediately post sub-internship, 21% (N = 13) were less likely to apply in internal medicine and 11% (N = 7) were more likely to apply (net change in plans was not significant, p = 0.38). There was a significant relationship between the perceived impact of the sub-internship and likelihood of applying in medicine (ANOVA comparison across means, p <  0.001). Compared to the second survey, on the third survey more students (41%, N = 24) believed the sub-internship positively impacted their decision to apply in medicine, though overall shifting was not significant (p = 0.39). Key themes describing sub-internship impact included the intense workload, value of experiencing internship, rewards of assuming the physician role, and education received (30%, 25%, 20% and 16% of comments, respectively). Conclusions Overall, there was not a significant effect of the sub-internship on students’ decision to apply in internal medicine. Additional research about the relative impact of the sub-internship in relationship to other career choice predictors is needed to better address factors that may encourage or dissuade students from pursuing internal medicine. PMID:20229140

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

PubMed

Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

2015-01-01

The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

PubMed Central

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

Philanthropic Endowments in General Internal Medicine

PubMed Central

Murden, Robert A; Lamb, James F

1999-01-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine. PMID:10203639

Recognizing Faces Like Humans

DTIC Science & Technology

2010-02-01

1995. 3. B. Kamgar-Parsi and B. Kamgar-Parsi, Methods of facial recognition , US Patent pending, 2007. 4. www.frvt.org/FRGC/ Homepage of the Facial Recognition Grand Challenge project. Last accessed 4 February 2010. c 2010 SPIE

Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

PubMed

Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

2014-01-01

Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

Implementing a Narrative Medicine Curriculum During the Internship Year: An Internal Medicine Residency Program Experience

PubMed Central

Wesley, Tiffany; Hamer, Diana; Karam, George

2018-01-01

Introduction Narrative medicine develops professional and communication skills that align with Accreditation Council for Graduate Medical Education competencies. However, little is known about a narrative medicine curriculum’s impact on physicians in training during residency. Implementing a narrative medicine curriculum during residency can be challenging because of time constraints and limited opportunity for nonclinical education. Methods Six sessions were implemented throughout one academic year to expose first-year internal medicine residents (interns) to narrative medicine. Attendance and participation were documented. At the end of the year, interns completed an open-ended survey to gauge their perception of their experience with the sessions. Results In total, 17 interns attended at least 1 narrative medicine session, and each session averaged 5.4 attendees. Thirteen eligible interns completed the survey. Thematic analysis identified 3 predominant themes: Mindfulness, physician well-being, and professionalism. Discussion Overall, the narrative medicine sessions were well attended and the curriculum was well received. This intervention demonstrates the value of a narrative medicine curriculum during medical resident training. Large prospective studies are necessary to identify the long-term benefits of such a curriculum. PMID:29702059

Complexity in graduate medical education: a collaborative education agenda for internal medicine and geriatric medicine.

PubMed

Chang, Anna; Fernandez, Helen; Cayea, Danelle; Chheda, Shobhina; Paniagua, Miguel; Eckstrom, Elizabeth; Day, Hollis

2014-06-01

Internal medicine residents today face significant challenges in caring for an increasingly complex patient population within ever-changing education and health care environments. As a result, medical educators, health care system leaders, payers, and patients are demanding change and accountability in graduate medical education (GME). A 2012 Society of General Internal Medicine (SGIM) retreat identified medical education as an area for collaboration between internal medicine and geriatric medicine. The authors first determined a short-term research agenda for resident education by mapping selected internal medicine reporting milestones to geriatrics competencies, and listing available sample learner assessment tools. Next, the authors proposed a strategy for long-term collaboration in three priority areas in clinical medicine that are challenging for residents today: (1) team-based care, (2) transitions and readmissions, and (3) multi-morbidity. The short-term agenda focuses on learner assessment, while the long-term agenda allows for program evaluation and improvement. This model of collaboration in medical education combines the resources and expertise of internal medicine and geriatric medicine educators with the goal of increasing innovation and improving outcomes in GME targeting the needs of our residents and their patients.

International symposium on clusters and nanomaterials (energy and life-sciences applications)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jena, Purusottam

The International Symposium on Clusters and Nanomaterials was held in Richmond, Virginia during October 26-29, 2015. The symposium focused on the roles clusters and nanostructures play in solving outstanding problems in clean and sustainable energy and life sciences applications; two of the most important issues facing science and society. Many of the materials issues in renewable energies, environmental impacts of energy technologies as well as beneficial and toxicity issues of nanoparticles in health are intertwined. Realizing that both fundamental and applied materials issues require a multidisciplinary approach the symposium provided a forum by bringing researchers from physics, chemistry, materials science,more » and engineering fields to share their ideas and results, identify outstanding problems, and develop new collaborations. Clean and sustainable energy sessions addressed challenges in production, storage, conversion, and efficiency of renewable energies such as solar, wind, bio, thermo-electric, and hydrogen. Environmental issues dealt with air- and water-pollution and conservation, environmental remediation and hydrocarbon processing. Topics in life sciences included therapeutic and diagnostic methods as well as health hazards attributed to nanoparticles. Cross-cutting topics such as reactions, catalysis, electronic, optical, and magnetic properties were also covered. The symposium attracted 132 participants from 24 countries in the world. It featured 39 invited speakers in 14 plenary sessions, in addition to one key-note session. Eighty-five contributed papers were presented in two poster sessions and 14 papers from this list were selected to be presented orally at the end of each session to highlight hot topics. Papers presented at the symposium were reviewed and published in SPIE so that these can reach a wide audience. The symposium was highly interactive with ample time allotted for discussions and making new collaborations. The participants’ response was that this was a high quality conference and covered topics at the cutting edge of science and technology. The symposium was endorsed by the American Physical Society, The Materials Research Society, SPIE, The Metallurgical Society, and the American Vacuum Society. The symposium was supported by external grants from the National Science Foundation and the Department of Energy as well as by internal grants from Virginia Commonwealth University (Offices of the President, Provost and Vice President of Academic Affairs, Vice President of Research, Vice Provost for Life Sciences, Dean of the College of Humanities and Sciences, and the Dean of the School of Engineering). The funding from DOE was used to support partial expenses of invited speakers, students and postdoctoral fellows.« less

Innovative Approach to Senior Practicum Students.

PubMed

Golightly, Melissa; Kennett, Natalie; Stout, Jacqueline A

2017-12-01

Traditional senior practicum experiences (SPEs) are microsystem based-they allow senior nursing students the opportunity to build professional nursing competencies as they transition into practice. As health care transformation continues unabated, there is a need to work toward closing the gap between nursing academia and nursing practice. A cardiovascular service line created an innovative SPE to better prepare senior nursing students for working as professional nurses in a service line model. The Senior Practicum Immersion Experience (SPIE) proved to be beneficial to senior practicum students and offered firsthand experience of the role professional nurses play in a service line model. This model increased the number of senior practicum students accepted into the cardiac service line by 50%. The SPIE creates an innovative solution to increasing the number of senior practicum students while allowing students the ability to learn and practice in a service line model. [J Nurs Educ. 2017;56(12):745-747.]. Copyright 2017, SLACK Incorporated.

VizieR Online Data Catalog: From optical to infrared photometry of SN 2013dy (Pan+, 2015)

NASA Astrophysics Data System (ADS)

Pan, Y.-C.; Foley, R. J.; Kromer, M.; Fox, O. D.; Zheng, W.; Challis, P.; Clubb, K. I.; Filippenko, A. V.; Folatelli, G.; Graham, M. L.; Hillebrandt, W.; Kirshner, R. P.; Lee, W. H.; Pakmor, R.; Patat, F.; Phillips, M. M.; Pignata, G.; Ropke, F.; Seitenzahl, I.; Silverman, J. M.; Simon, J. D.; Sternberg, A.; Stritzinger, M. D.; Taubenberger, S.; Vinko, J.; Wheeler, J. C.

2017-11-01

We obtained broad-band BVRI photometry of SN 2013dy with the 0.76m Katzman Automatic Imaging Telescope (KAIT; Filippenko et al. 2001ASPC..246..121F). The multiband images were observed with the KAIT4 filter set from -16d to +337d relative to B-band maximum (MJD=56501.105). We also obtained riZYJH photometry of SN 2013dy with the multichannel Reionization And Transients InfraRed camera (RATIR; Butler et al. 2012SPIE.8446E..10B) mounted on the 1.5m Johnson telescope at the Mexican Observatorio Astronomico Nacional on Sierra San Pedro Martir in Baja California, Mexico (Watson et al. 2012SPIE.8444E..5LW). Typical observations include a series of 80s exposures in the ri bands and 60s exposures in the ZYJH bands, with dithering between exposures. (2 data files).

Wilga Photonics and Web Engineering 2011

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2011-10-01

The paper presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the SPIE-IEEE Wilga 2011 symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-225].

WILGA Photonics and Web Engineering, January 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

The paper presents a digest of chosen technical work results shown by young researchers from technical universities during the SPIE-IEEE Wilga January 2012 Symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, new technologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics codesign, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET and pi-of-the sky experiments development. The symposium held two times a year is a summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of chosen Wilga references is presented [1-268].

VizieR Online Data Catalog: The 4 brightest red giants in the UFD galaxy Ret 2 (Roederer+, 2016)

NASA Astrophysics Data System (ADS)

Roederer, I. U.; Mateo, M.; Bailey, J. I., III; Song, Y.; Bell, E. F.; Crane, J. D.; Loebman, S.; Nidever, D. L.; Olszewski, E. W.; Shectman, S. A.; Thompson, I. B.; Valluri, M.; Walker, M. G.

2018-03-01

There are only four stars brighter than the horizontal branch that are confirmed members of Ret 2 (Simon et al. 2015, J/ApJ/808/95; Walker et al. 2015, J/ApJ/808/108). We observed these four stars using one arm of the Michigan/Magellan Fiber System (M2FS) and MSpec double spectrograph (Bailey et al. 2012SPIE.8446E..5GB; Mateo et al. 2012SPIE.8446E..4YM) mounted on the Nasmyth platform at the 6.5 m Landon Clay Telescope (Magellan II) at Las Campanas Observatory, Chile. We observed four high-probability members of Ret 2 and one blank sky position simultaneously on 2015 November 14 and 16, with a total integration time of 6.67 hr. Both observations were taken in dark time. (4 data files).

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now.

PubMed

Sabath, Bruce F; Singh, Gurkeerat

2016-01-01

Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available.

SOAR Optical Imager (SOI) | SOAR

Science.gov Websites

SPARTAN Near-IR Camera Ohio State Infrared Imager/Spectrograph (OSIRIS) - NO LONGER AVAILABLE SOAR ?: ADS link to SOI instrument SPIE paper Last update: C. Briceño, Aug 23, 2017 SOAR Optical Imager

Hospitalist career decisions among internal medicine residents.

PubMed

Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

2014-07-01

Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

Hadoop-based implementation of processing medical diagnostic records for visual patient system

NASA Astrophysics Data System (ADS)

Yang, Yuanyuan; Shi, Liehang; Xie, Zhe; Zhang, Jianguo

2018-03-01

We have innovatively introduced Visual Patient (VP) concept and method visually to represent and index patient imaging diagnostic records (IDR) in last year SPIE Medical Imaging (SPIE MI 2017), which can enable a doctor to review a large amount of IDR of a patient in a limited appointed time slot. In this presentation, we presented a new approach to design data processing architecture of VP system (VPS) to acquire, process and store various kinds of IDR to build VP instance for each patient in hospital environment based on Hadoop distributed processing structure. We designed this system architecture called Medical Information Processing System (MIPS) with a combination of Hadoop batch processing architecture and Storm stream processing architecture. The MIPS implemented parallel processing of various kinds of clinical data with high efficiency, which come from disparate hospital information system such as PACS, RIS LIS and HIS.

Active learning in optics and photonics: Fraunhofer diffraction

NASA Astrophysics Data System (ADS)

Ghalila, H.; Ben Lakhdar, Z.; Lahmar, S.; Dhouaidi, Z.; Majdi, Y.

2014-07-01

"Active Learning in Optics and Photonics" (ALOP), funded by UNESCO within its Physics Program framework with the support of ICTP (Abdus Salam International Centre for Theoretical Physics) and SPIE (Society of Photo-Optical Instrumentation Engineers), aimed to helps and promotes a friendly and interactive method in teaching optics using simple and inexpensive equipment. Many workshops were organized since 2005 the year when Z. BenLakhdar, whom is part of the creators of ALOP, proposed this project to STO (Société Tunisienne d'Optique). These workshops address several issues in optics, covering geometrical optics, wave optics, optical communication and they are dedicated to both teachers and students. We focus this lecture on Fraunhofer diffraction emphasizing the facility to achieve this mechanism in classroom, using small laser and operating a slit in a sheet of paper. We accompany this demonstration using mobile phone and numerical modeling to assist in the analysis of the diffraction pattern figure.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Afanas'ev, Yurii V; Zavestovskaya, I N; Zvorykin, V D

A review of reports made on the International Forum on Advanced High-Power Lasers and Applications, which was held at the beginning of November 1999 in Osaka (Japan), is presented. Five conferences were held during the forum on High-Power Laser Ablation, High-Power Lasers in Energy Engineering, High-Power Lasers in Civil Engineering and Architecture, High-Power Lasers in Manufacturing, and Advanced High-Power Lasers. The following trends in the field of high-power lasers and their applications were presented: laser fusion, laser applications in space, laser-triggered lightning, laser ablation of materials by short and ultrashort pulses, application of high-power lasers in manufacturing, application of high-powermore » lasers in mining, laser decommissioning and decontamination of nuclear reactors, high-power solid-state and gas lasers, x-ray and free-electron lasers. One can find complete information on the forum in SPIE, vols. 3885-3889. (chronicle)« less

Evaluation of a Substance Use Disorder Curriculum for Internal Medicine Residents

ERIC Educational Resources Information Center

Stein, Melissa R.; Arnsten, Julia H.; Parish, Sharon J.; Kunins, Hillary V.

2011-01-01

Teaching about diagnosis, treatment, and sequelae of substance use disorders (SUDs) is insufficient in most Internal Medicine residency programs. To address this, the authors developed, implemented, and evaluated a novel and comprehensive SUD curriculum for first year residents (interns) in Internal Medicine, which anchors the ensuing 3-year…

Determining and prioritizing competencies in the undergraduate internal medicine curriculum in Saudi Arabia.

PubMed

Almoallim, H

2011-08-01

To determine knowledge and skills competencies in internal medicine for the undergraduate curriculum in Saudi Arabia, competencies were identified based on group work utilizing common textbooks. The Delphi Technique was used as a consensus method to determine and prioritize competencies in internal medicine. A group of 20 clinicians rated the identified competencies from 0-3 (0: no need to know, 1: interesting to know, 2: should know and 3: must know). After formulating the results, a second Delphi round was conducted with 5 experts in internal medicine. A total of 1513 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to the 12 systems in internal medicine. All competencies rated 2.2-3.0 were produced separately and considered core competencies for the undergraduate internal medicine curriculum. Determining and prioritizing competencies should influence the curriculum reform process.

Herbal medicine research and global health: an ethical analysis.

PubMed

Tilburt, Jon C; Kaptchuk, Ted J

2008-08-01

Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favourable risk-benefit ratio. Significant challenges exist in determining shared concepts of social value, scientific validity and favourable risk-benefit ratio across international research collaborations. However, we argue that collaborative partnership, including democratic deliberation, offers the context and process by which many of the ethical challenges in international herbal medicine research can, and should be, resolved. By "cross-training" investigators, and investing in safety-monitoring infrastructure, the issues identified by this comprehensive framework can promote ethically sound international herbal medicine research that contributes to global health.

Analysis of Drug Information Requested by Medical Students and House Staff Members.

ERIC Educational Resources Information Center

Taylor, A. Thomas

1983-01-01

A clinical pharmacy educational program is described. Under the guidance of pharmacy faculty members, senior pharmacy students participate in patient care activities with general internal medicine and internal medicine subspecialty teams consisting of an attending faculty physician, an internal medicine resident, two interns, and four junior or…

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2017.

PubMed

Wieland, Mark L; Szostek, Jason H; Wingo, Majken T; Post, Jason A; Mauck, Karen F

2018-02-26

Clinicians are challenged to identify new practice-changing articles in the medical literature. To identify the practice-changing articles published in 2017 most relevant to outpatient general internal medicine, 5 internists reviewed the following sources: 1) titles and abstracts from internal medicine journals with the 7 highest impact factors, including New England Journal of Medicine, Lancet, Journal of the American Medical Association, British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine; 2) synopses and syntheses of individual studies, including collections in the American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine; 3) databases of synthesis, including Evidence Updates and the Cochrane Library. Inclusion criteria were perceived clinical relevance to outpatient general medicine, potential for practice change, and strength of evidence. This process yielded 140 articles. Clusters of important articles around one topic were considered as a single-candidate series. A modified Delphi method was utilized by the 5 authors to reach consensus on 7 topics to highlight and appraise from the 2017 literature. Copyright © 2018 Elsevier Inc. All rights reserved.

The kinetic equations for rotating and gravitating spheroidal body

NASA Astrophysics Data System (ADS)

Krot, A.

2003-04-01

In papers [1],[2] it has been proposed a statistical model of the gravitational interaction of particles.In the framework of this model bodies have fuzzy outlines and are represented by means of spheroidal forms. A con- sistency of the proposed statistical model the Einstein general relativity [3], [4], [5] has been shown. In work [6], which is a continuation of the paper[2], it has been investigated a slowly evolving in time process of a gravitational compression of a spheroidal body close to an unstable equilibrium state. In the paper [7] the equation of motion of particles inside the weakly gravitating spheroidal body modeled by means of an ideal liquid has been obtained. It has been derived the equations of hyperbolic type for the gravitational field of a weakly gravitating spheroidal body under observable values of velocities of particles composing it [7],[8]. This paper considers the case of gravitational compres- sion of spheroidal body with observable values of parti- cles.This means that distribution function of particles inside weakly rotating spheroidal body is a sum of an isotropic space-homogeneous stationary distribution function and its change (disturbance) under influence of dymanical gravitational field. The change of initial space-homogeneous stationary distribution function satisfyes the Boltzmann kinetic equation. This paper shows that if gravitating spheroidal body is rotating uniformly or is being at rest then distribution function of its particles satisfyes the Liouville theorem. Thus, being in unstable statistical quasiequilibrium the gravi- tating spheroidal body is rotating with constant angular velocity (or, in particular case, is being at rest). The joint distribution function of spheroidal body's particles in to coordinate space and angular velocity space is introduced. References [1] A.M.Krot, Achievements in Modern Radioelectronics, special issue "Cosmic Radiophysics",no. 8, pp.66-81, 1996 (Moscow, Russia). [2] A.M.Krot, Proc. SPIE 13th Symp."AeroSense", Orlando, Florida,USA, 5-9 April,vol. 3710, pp.1242-1259,1999. [3] L.D.Landau and E.M.Lifshitz, Classical Theory of Fields, Addison-Wesley, 1951. [4] S.Weinberg, Gravitation and Cosmology, John Wiley and Sons: New York, 1972. [5] C.W.Misner, K.S.Thorne,and J.A.Wheeler, Gravitation, W.H.Freeman and Co., San Francisco, 1973. [6] A.M.Krot, Proc. SPIE 14th Symp. "AeroSense",Orlando, Florida, USA, 24-29 April,vol.4038,pp.1318-1329,2000. [7] A.M.Krot, Proc. SPIE 15th Symp. "AeroSense",Orlando, Florida, USA, 16-20 April,vol.4394,pp.1217-1282,2001. [8] A.M.Krot, Proc. 53rd Intern. Astronautical Congress, The World Space Congress-2002, Houston, Texas, USA, 10-19 October,Preprint IAC-02-J.p.1,pp.1-11,2002.

The internal medicine clerkship and ambulatory learning experiences: results of the 2010 clerkship directors in internal medicine survey.

PubMed

Shaheen, Amy; Papp, Klara K; Torre, Dario

2013-01-01

Education in the ambulatory setting should be an integral part of undergraduate medical education. However, previous studies have shown education in this setting has been lacking in medical school. Ambulatory education occurs on some internal medicine clerkships. The extent of this education is unclear. The purpose of this survey was to assess the structure, curriculum, assessment methods, and barriers to implementation of ambulatory education on the internal medicine clerkship. An annual survey of institutional members of the Clerkship Directors in Internal Medicine (CDIM) was done in April 2010. The data were anonymous and descriptive statistics were used to summarize responses. Free text results were analyzed using qualitative techniques. The response rate was 75%. The majority of respondents had a required ambulatory component to the clerkship. Ambulatory experiences distinct from the inpatient internal medicine experience were common (46%). Integration with either the inpatient experiences or other departmental clerkships also occurred. The majority of ambulatory educational experiences were with generalists (74%) and/or subspecialists (45%). The most common assessment tool was the National Board of Medical Examiners (NBME) ambulatory shelf exam. Thematic analysis of the question about how practice based learning was taught elicited four major themes: Not taught; taught in the context of learning evidence based medicine; taught while learning chronic disease management with quality improvement; taught while learning about health care finance. Barriers to implementation included lack of faculty and financial resources. There have been significant increases in the amount of time dedicated to ambulatory internal medicine. The numbers of medical schools with ambulatory internal medicine education has increased. Integration of the ambulatory experiences with other clerkships such as family medicine occurs. Curriculum was varied but difficulties with dissemination and assessment in these disparate settings was noted. Overall, the results of this study demonstrate increased implementation and recognition of the importance of ambulatory education in internal medicine.

[Internal Medicine in the curriculum of General Medicine at Universities of Mexico, 2014].

PubMed

Maldonado, Jesús Adrián; Peinado, José María

2017-01-01

The aim of this study was to analyze Internal Medicine as a subject and its requirement in each of the Universities curriculum in Mexico that offers a degree in General Medicine. By the end of the first quarter of 2014, the research was closed and 81 campuses were studied. This research was quantitative, using an analytical technique, written discourse, exploratory and purposive sampling not random and homogeneous type. The Likert questionnaire was used in this study to analyse the following variables: the record of Internal Medicine as a subject, the burden of credit, and the location of the program. The procedure consisted of three phases. First obtaining an official list of all the Universities in the Mexican Association of Colleges and Schools of Medicine. Second, obtaining an analysis of each of the Universities' curriculums, and lastly gathering each variable of the study. The results of the Universities were 63% were public and 37% private. Internal Medicine as a subject in the curriculum was 37.1%, and 20% of the universities include it for six months and 9% offer it the whole year. However, the undergraduate internship in Internal Medicine offers it 100%. In conclusion, Internal Medicine as a subject could disappear from the curriculum in General Medicine before coming to the undergraduate internship, even though the latter is declared required in hospital shifts.

Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.

PubMed

Page, Cameron; Stumbar, Sarah; Gold, Marji

2012-06-01

Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically. Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians. Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic. A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion. Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor. A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.

Palliative Care Exposure in Internal Medicine Residency Education: A Survey of ACGME Internal Medicine Program Directors.

PubMed

Edwards, Asher; Nam, Samuel

2018-01-01

As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training. In this study, we surveyed 338 Accreditation Council for Graduate Medical Education-accredited internal medicine program directors. We queried how palliative care was integrated into their training programs. The vast majority of respondents felt that palliative care training was "very important" (87.5%) and 75.9% of respondents offered some kind of palliative care rotation, often with a multidisciplinary approach. Moving forward, we are hopeful that the data provided from our survey will act as a launching point for more formal investigations into palliative care education for internal medicine residents. Concurrently, policy makers should aid in palliative care instruction by formalizing required palliative care training for internal medicine residents.

Laser Induced Fluorescence Imaging: Searching for Organics from the Dry Valleys of Queen Maud Land Antarctica to the Regolith and Ices of Mars

NASA Astrophysics Data System (ADS)

Storrie-Lombardi, M. C.; Sattler, B.; Muller, J.-P.; Fisk, M.; Cousins, C.; Dartnell, L.

2009-04-01

Laser induced fluorescence imaging using excitation in ultraviolet (UV) wavelengths has been proposed as a nondestructive astrobiological rapid survey tool to search for amino and nucleic acids [1], microbial life [2], and polycyclic aromatic hydrocarbons (PAHs) deep in the Mars regolith [3, 4]. However, the technique is easily adapted to search for complex biomolecular targets using longer wavelength sources [5]. Of particular interest is the ability of excitation at 532 nm to detect photosynthetic pigments in cyanobacteria-dominated microbial communities populating the ice of alpine, Arctic, and Antarctic lakes, glaciers, and ice sheets [6-8]. During the months of November and December 2008 we tested the technique as part of an extended international, interdisciplinary field campaign in the Dry Valleys of Schirmacher Oasis and Lake Untersee, Queen Maud Land, Antarctica. In this paper we review our recent laboratory experiments on the use of UV excitation for detection of PAHs doped on Mars analogue soils [9] and chasmo- and epilithic lichen communities within basaltic Iceland lavas. We present for the first time the results of our field experiments conducted during the Tawani 2008 International Antarctic Expedition for in situ detection and quantification of photosynthetic biomass in the ice caps of annual and perennially ice-covered Antarctic lakes. We discuss the advantages of using a nondestructive rapid survey photonic tools such as laser induced fluorescence imaging that can be easily implemented from lander, rover, airborne, or orbital platforms. The techniques presented can be utilized to monitor the microbial potential of large, critical ecosystems on Earth, or to facilitate the remote or manned search for organics and photosynthetic life on any terrestrial planet. References 1. Storrie-Lombardi, M.C., Hug, W.F., McDonald, G.D., Tsapin, A.I., and Nealson, K.H. 2001. Hollow cathode ion lasers for deep ultraviolet Raman spectroscopy and fluorescence imaging. Rev. Sci. Ins., 72(12): 4452-4459. 2. Nealson, K.H., Tsapin, A., and Storrie-Lombardi, M. 2002. Searching for life in the universe: unconventional methods for an unconventional problem. International Microbio., 5: 223-230. 3. Storrie-Lombardi, M.C., Muller, J.-P., Fisk, M.R., Griffiths, A.D., and Coates, A.J. 2008a. Potential for non-destructive astrochemistry using the ExoMars PanCam. Geophys. Res. Lett., 35: L12201, doi 10.1029/2008GL034296. 4. Storrie-Lombardi, M.C., Muller, J.-P., Fisk, M.R., Griffiths, A.D., and Coates, A.J. 2008b. Epifluorescence surveys of extreme environments using PanCam imaging systems: Antarctica and the Mars regolith. Instruments, Methods, and Missions for Astrobiology XI (R.B. Hoover, G.V. Levin, & A.Y. Rozanov, Eds.) Proc. SPIE, 7097 (25): 1-10. 5. Storrie-Lombardi, M.C. 2005. Post-Bayesian strategies to optimize astrobiology instrument suites: lessons from Antarctica and the Pilbara. Astrobiology and Planetary Missions (R. B. Hoover, G. V. Levin and A. Y. Rozanov, Eds.), Proc. SPIE, 5906: 288-301. 6. Psenner, R. and Sattler, B. 1998. Life at the freezing point. Science, 280: 2073-2074. 7. Sattler, B., Puxbaum, H., and Psenner, R. 2001. Bacterial growth in supercooled cloud droplets. Geophys. Res. Ltrs., 28(2): 239-242. 8. Sattler, B., Waldhuber, S., Fischer, H., Semmler, H., Sipiera, P., and Psenner, R. 2004. Microbial activity and phylogeny in ice cores retrieved from Lake Paula, a newly detected freshwater lake in Antarctica. Instruments, Methods, and Missions for Astrobiology VIII (R. B. Hoover, G. V. Levin and A. Y. Rozanov, Eds.) Proc. SPIE, 5555: 170-179. 9. Muller, J.-P., Storrie-Lombardi, M.C., Fisk, M.R., Coates, A., Griffiths, A., Rees, K., Walton, D., Theobald, C., Brockley-Blatt, C., and Rousseau, A. 2009. WALI - Wide Angle Laser Imaging enhancement to ExoMars PanCam: a system for organics and life detection in European Geosciences Union General Assembly 2009. Vienna, Austria.

What is the role of general internists in the tertiary or academic setting?

PubMed

Tanriover, Mine Durusu; Rigby, Shirley; van Hulsteijn, L Harry; Ferreira, Faustino; Oliveira, Narcisso; Schumm-Draeger, Petra-Maria; Weidanz, Frauke; Kramer, Mark H H

2015-01-01

The changing demography of European populations mandates a vital role for internists in caring for patients in each level of healthcare. Internists in the tertiary or academic setting are highly ranked in terms of their responsibilities: they are clinicians, educators, researchers, role models, mentors and administrators. Contrary to the highly focused approach of sub-specialties, general internists working in academic settings can ensure that coordinated care is delivered in the most cost-conscious and efficient way. Moreover, internal medicine is one of the most appropriate specialties in which to teach clinical reasoning skills, decision-making and analytical thinking, as well as evidence based, patient oriented medicine. Internists deal with challenging patients of the new millennium with a high burden of chronic diseases and polypharmacy; practice personalised medicine with a wide scientific background and so they are the perfect fit to establish and implement new tools for scientific research. In conclusion, internal medicine is developing a new identity as a specialty in its own right. The European Federation of Internal Medicine supports the concept of academic internists and calls upon the member countries to construct academic (general) internal medicine departments in their respective countries. As 'internal medicine is the cornerstone of every national healthcare system', academic (general) internal medicine should strive to be the cornerstone of every integrated, patient-centred, modern medical care and training system. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2015.

PubMed

Szostek, Jason H; Wieland, Mark L; Post, Jason A; Sundsted, Karna K; Mauck, Karen F

2016-08-01

Identifying new practice-changing articles is challenging. To determine the 2015 practice-changing articles most relevant to outpatient general internal medicine, 3 internists independently reviewed the titles and abstracts of original articles, synopses of single studies and syntheses, and databases of syntheses. For original articles, internal medicine journals with the 7 highest impact factors were reviewed: New England Journal of Medicine, Lancet, Journal of the American Medical Association (JAMA), British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine. For synopses of single studies and syntheses, collections in American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine were reviewed. For databases of synthesis, Evidence Updates and the Cochrane Library were reviewed. More than 100 articles were identified. Criteria for inclusion were as follows: clinical relevance, potential for practice change, and strength of evidence. Clusters of important articles around one topic were considered as a single-candidate series. The 5 authors used a modified Delphi method to reach consensus on inclusion of 7 topics for in-depth appraisal. Copyright © 2016 Elsevier Inc. All rights reserved.

Similarity of nannobacterial lifeforms in cultures, in the human body, in minerals

NASA Astrophysics Data System (ADS)

Folk, R.

Nearly a dozen labs world-wide have succeeded in culturing minute organisms in the 50-200 nm size range, so the characterization of nannobacteria as some form of "life" is no longer arguable. Within the human body, they are found in blood, kidney stones, dental plaque, arterial disease and cataracts as shown by the Kajander group in Finland, and by our work with Mayo Clinic (e.g. Folk et al., 2001 GSA abs.). Nannobacteria can be concentrated in waters from hot springs, lakes, rivers and the sea. Their charged cell walls attract ions thus triggering precipitation of such varied authigenic minerals as aragonite, calcite, dolomite and siderite; sulfur, pyrite, chalcocite, chalcopyrite; phosphates; chalcedony quartz; and smectite, illite, kaolinite, chlorite and palygorskite clay. So it should be no surprise that on Mars, with reactive FeMg minerals, subsurface (and once surface) water, and internal heat, nannobacteria would be able to thrive both in vein-fill carbonates (McKay et al, 1996) and on the altered surfaces of unstable pyroxenes (Folk and Taylor, in press Met. &Plan. S i., 2002). Striking identities of sizes, shapes, and colonial affinitiesc are found between Martian nannobacteria and those in clays from Sicily and elsewhere (Folk and Lynch, 1997 SPIE). Extraterrestrial forms range from spheroids and ovoids of 30-80 nm, to worm- and caterpillar-shaped objects (40 X 150 nm) and chains of 40 nm beads. Even in the Allende carbonaceous chondrite, groups of 40- 150 nm bodies resembly earthly Streptococcus and Staphylococcus are found (Folk and Lynch 1998 SPIE). The highly-matured nature of the kerogen-like carbon in Allende demonstrates that it is not the result of earthly contamination; furthermore Allende contains clay minerals which demand the former presence of some water, a requirement for biology.The only objection to the claimed discovery of extraterrestrial life in the form of nannobacteria is the Old Testament view that God created life only on Earth and nowhere else.

Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study

PubMed Central

Verma, Amol A.; Guo, Yishan; Kwan, Janice L.; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A.; Hwang, Stephen W.; Laupacis, Andreas; Mamdani, Muhammad M.; Shadowitz, Steven; Upshur, Ross; Reid, Robert J.; Razak, Fahad

2017-01-01

Background: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. Methods: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. Results: There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Interpretation: Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. PMID:29237706

An enhanced MMW and SMMW/THz imaging system performance prediction and analysis tool for concealed weapon detection and pilotage obstacle avoidance

NASA Astrophysics Data System (ADS)

Murrill, Steven R.; Jacobs, Eddie L.; Franck, Charmaine C.; Petkie, Douglas T.; De Lucia, Frank C.

2015-10-01

The U.S. Army Research Laboratory (ARL) has continued to develop and enhance a millimeter-wave (MMW) and submillimeter- wave (SMMW)/terahertz (THz)-band imaging system performance prediction and analysis tool for both the detection and identification of concealed weaponry, and for pilotage obstacle avoidance. The details of the MATLAB-based model which accounts for the effects of all critical sensor and display components, for the effects of atmospheric attenuation, concealment material attenuation, and active illumination, were reported on at the 2005 SPIE Europe Security and Defence Symposium (Brugge). An advanced version of the base model that accounts for both the dramatic impact that target and background orientation can have on target observability as related to specular and Lambertian reflections captured by an active-illumination-based imaging system, and for the impact of target and background thermal emission, was reported on at the 2007 SPIE Defense and Security Symposium (Orlando). Further development of this tool that includes a MODTRAN-based atmospheric attenuation calculator and advanced system architecture configuration inputs that allow for straightforward performance analysis of active or passive systems based on scanning (single- or line-array detector element(s)) or staring (focal-plane-array detector elements) imaging architectures was reported on at the 2011 SPIE Europe Security and Defence Symposium (Prague). This paper provides a comprehensive review of a newly enhanced MMW and SMMW/THz imaging system analysis and design tool that now includes an improved noise sub-model for more accurate and reliable performance predictions, the capability to account for postcapture image contrast enhancement, and the capability to account for concealment material backscatter with active-illumination- based systems. Present plans for additional expansion of the model's predictive capabilities are also outlined.

Prostate Cancer Clinical Trials Group - The University of Michigan Site

DTIC Science & Technology

2014-06-01

Medicine and Urology University of Michigan Comprehensive Cancer Center Internal Medicine , Hematology Oncology 7314 Cancer Center, SPC 5946 Ann...Arbor, MI 48109-5946 mahahuss@umich.edu David C. Smith, M.D., FACP, Professor, Departments of Internal Medicine and Urology University of Michigan...Comprehensive Cancer Center Internal Medicine , Hematology Oncology 7302 Cancer Center, SPC 5946 Ann Arbor, MI 48109-5946 dcsmith@umich.edu

Pricing and availability of some essential child specific medicines in Odisha

PubMed Central

Swain, Trupti Rekha; Rath, Bandana; Dehury, Suhasini; Tarai, Anjali; Das, Priti; Samal, Rajashree; Samal, Satyajit; Nayak, Harshavardhan

2015-01-01

Objectives: Continuous availability of affordable medicines in appropriate formulations is essential to reduce morbidity and mortality in children. Odisha an eastern Indian state records very high mortality of children. The study aims at documenting the availability and prices paid for purchasing essential child-specific medicines. Materials and Methods: The survey of 34 essential medicines was conducted in six randomly selected districts of Odisha. Data were collected from medicine outlets of the public, private, and other sector (Nongovernmental Organization [NGO]/mission sectors) of six randomly selected districts, using WHO/Health Action International medicine price collection methodology. For each medicine surveyed, data were collected on the highest and lowest-priced formulations available in each facility. Results: Both public sector and other sector health facilities procure only one brand of medicines, mean percentage availability of medicines being 17% and 21.8%, respectively. In the private sector, the mean percentage availability of the high and lowest-priced medicines for a particular drug product was 10.8% and 38.5%, respectively. The public sector procurement price is 48% lower than international reference prices. In the private sector, high-priced, and low-priced products are sold at 1.83 and 1.46 times the international reference price, respectively. Substantial price variation was observed for some medicines across individual outlets. Medicines were found to cost 2.08 times their international reference price in NGO/mission sector facilities. Conclusions: The availability of children's medicines in public sector facilities of Odisha state is poor. Medicines for children cost relatively high in both private and NGO sectors compared to the international reference price. The availability medicines should be improved on an urgent basis to improve access of medicines for children of Odisha. PMID:26600637

Pricing and availability of some essential child specific medicines in Odisha.

PubMed

Swain, Trupti Rekha; Rath, Bandana; Dehury, Suhasini; Tarai, Anjali; Das, Priti; Samal, Rajashree; Samal, Satyajit; Nayak, Harshavardhan

2015-01-01

Continuous availability of affordable medicines in appropriate formulations is essential to reduce morbidity and mortality in children. Odisha an eastern Indian state records very high mortality of children. The study aims at documenting the availability and prices paid for purchasing essential child-specific medicines. The survey of 34 essential medicines was conducted in six randomly selected districts of Odisha. Data were collected from medicine outlets of the public, private, and other sector (Nongovernmental Organization [NGO]/mission sectors) of six randomly selected districts, using WHO/Health Action International medicine price collection methodology. For each medicine surveyed, data were collected on the highest and lowest-priced formulations available in each facility. Both public sector and other sector health facilities procure only one brand of medicines, mean percentage availability of medicines being 17% and 21.8%, respectively. In the private sector, the mean percentage availability of the high and lowest-priced medicines for a particular drug product was 10.8% and 38.5%, respectively. The public sector procurement price is 48% lower than international reference prices. In the private sector, high-priced, and low-priced products are sold at 1.83 and 1.46 times the international reference price, respectively. Substantial price variation was observed for some medicines across individual outlets. Medicines were found to cost 2.08 times their international reference price in NGO/mission sector facilities. The availability of children's medicines in public sector facilities of Odisha state is poor. Medicines for children cost relatively high in both private and NGO sectors compared to the international reference price. The availability medicines should be improved on an urgent basis to improve access of medicines for children of Odisha.

Mental Health Education in Three Primary Care Specialities.

ERIC Educational Resources Information Center

Strain, James J.; And Others

1986-01-01

The characteristics of the mental health components of residency training in traditional internal medicine, primary care internal medicine, and family practice were examined. Internal medicine programs relied on the consultation method and in-patient facilities, and used the psychiatrist as the primary teacher. Evaluation of the outcome of…

[What is new in 2016 for the specialist in hospital internal medicine?

PubMed

Mraihi, Hamza; Chevaux, Fabienne; Castoni, Julien; Aebischer, Oriane; Christou, Foetini; Jaccard, Evrim; Benmachiche, Malik; Tasheva, Plamena; Giroud, Sabine; Kraege, Vanessa; Lamy, Olivier

2017-01-18

The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings.

Comparison of research trends in korean and international family medicine in journals of family medicine.

PubMed

Jeon, Jin-Kyung; Lee, Jungun; Lee, Dong Ryul

2014-11-01

Research is important for the development of family medicine as a professional field in primary care. The aim of this study was to suggest directions for the development of family medicine research by analyzing research trends in original papers published in the Korean Journal of Family Medicine (KJFM) and international journals. We investigated original research papers published in KJFM and 4 international journals from August 2009 to July 2010. Analysis was conducted according to research topics, authors, methods, participants, and data sources. 'Clinical research' was the most common research topic in both the KJFM (88.3%) and international journals (57.3%); however, international journals had more studies in other domains ('education and research,' 'health service,' and 'family medicine'). More authors other than family physicians participated in international journals than in the KJFM (58% and 3.3%, respectively). Most studies were 'cross-sectional' in KJFM (77.0%) and international journals (51.5%): however, the latter had more 'qualitative' studies, 'cohort' studies, and 'systematic reviews' than the former. The largest study population was 'visitors of health promotion center' in the KJFM and 'outpatients' in international journals. Most of the study sources were 'survey' and 'medical records' in both. There were limitations of diversity in the papers of the KJFM. Future investigation on papers of other than family medicine journals should be planned to assess research trends of family physicians.

Bedside ultrasonography (US), Echoscopy and US point of care as a new kind of stethoscope for Internal Medicine Departments: the training program of the Italian Internal Medicine Society (SIMI).

PubMed

Arienti, Vincenzo; Di Giulio, Rosella; Cogliati, Chiara; Accogli, Esterita; Aluigi, Leonardo; Corazza, Gino Roberto

2014-10-01

In recent years, thanks to the development of miniaturized ultrasound devices, comparable to personal computers, tablets and even to smart phones, we have seen an increasing use of bedside ultrasound in internal medicine departments as a novel kind of ultrasound stethoscope. The clinical ultrasound-assisted approach has proved to be particularly useful in assessing patients with nodules of the neck, dyspnoea, abdominal pain, and with limb edema. In several cases, it has allowed a simple, rapid and precise diagnosis. Since 2005, the Italian Society of Internal Medicine and its Ultrasound Study Group has been holding a Summer School and training courses in ultrasound for residents in internal medicine. A national network of schools in bedside ultrasound was then organized for internal medicine specialists who want to learn this technique. Because bedside ultrasound is a user-dependent diagnostic method, it is important to define the limits and advantages of different new ultrasound devices, to classify them (i.e. Echoscopy and Point of Care Ultrasound), to establish appropriate different levels of competence and to ensure their specific training. In this review, we describe the point of view of the Italian Internal Medicine Society on these topics.

VizieR Online Data Catalog: Photospheric properties of T Tauri stars (Herczeg+, 2014)

NASA Astrophysics Data System (ADS)

Herczeg, G. J.; Hillenbrand, L. A.

2017-06-01

We obtained low resolution optical spectra with the Double Spectrograph (DBSP; Oke & Gunn 1982PASP...94..586O) on the Hale 200 inch telescope at Palomar Observatory on 2008 January 18-21 and 2008 December 28-30, and with the Low Resolution Imaging Spectrograph (LRIS; Oke et al. 1995PASP..107..375O; McCarthy et al. 1998SPIE.3355...81M) on Keck I on 2006 November 23 and 2008 May 28. The entire sample of the 2006 Keck observations was published in Herczeg & Hillenbrand (2008ApJ...681..594H). The latest spectral types of the 2008 May run were published in Herczeg et al. (2009ApJ...696.1589H). The Atmospheric Dispersion Corrector (Phillips et al. 2006SPIE.6269E..1OP) was used for the 2008 May run but was not yet available in 2006 November. Both DBSP and LRIS use a dichroic to split the light into red and blue beams at ~5600 Å. (1 data file).

VizieR Online Data Catalog: Imaging observations of iPTF 13ajg (Vreeswijk+, 2014)

NASA Astrophysics Data System (ADS)

Vreeswijk, P. M.; Savaglio, S.; Gal-Yam, A.; De Cia, A.; Quimby, R. M.; Sullivan, M.; Cenko, S. B.; Perley, D. A.; Filippenko, A. V.; Clubb, K. I.; Taddia, F.; Sollerman, J.; Leloudas, G.; Arcavi, I.; Rubin, A.; Kasliwal, M. M.; Cao, Y.; Yaron, O.; Tal, D.; Ofek, E. O.; Capone, J.; Kutyrev, A. S.; Toy, V.; Nugent, P. E.; Laher, R.; Surace, J.; Kulkarni, S. R.

2017-08-01

iPTF 13ajg was imaged with the Palomar 48 inch (P48) Oschin iPTF survey telescope equipped with a 12kx8k CCD mosaic camera (Rahmer et al. 2008SPIE.7014E..4YR) in the Mould R filter, the Palomar 60 inch and CCD camera (Cenko et al. 2006PASP..118.1396C) in Johnson B and Sloan Digital Sky Survey (SDSS) gri, the 2.56 m Nordic Optical Telescope (on La Palma, Canary Islands) with the Andalucia Faint Object Spectrograph and Camera (ALFOSC) in SDSS ugriz, the 4.3 m Discovery Channel Telescope (at Lowell Observatory, Arizona) with the Large Monolithic Imager (LMI) in SDSS r, and with LRIS (Oke et al. 1995PASP..107..375O) and the Multi-Object Spectrometer for Infrared Exploration (MOSFIRE; McLean et al. 2012SPIE.8446E..0JM), both mounted on the 10 m Keck-I telescope (on Mauna Kea, Hawaii), in g and Rs with LRIS and J and Ks with MOSFIRE. (1 data file).

Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter.

PubMed

Block, Lauren; Hutzler, Lindsey; Habicht, Robert; Wu, Albert W; Desai, Sanjay V; Novello Silva, Kathryn; Niessen, Timothy; Oliver, Nora; Feldman, Leonard

2013-11-01

Etiquette-based communication may improve the inpatient experience but is not universally practiced. We sought to determine the extent to which internal medicine interns practice behaviors that characterize etiquette-based medicine. Trained observers evaluated the use of 5 key communication strategies by internal medicine interns during inpatient clinical encounters: introducing one's self, explaining one's role in the patient's care, touching the patient, asking open-ended questions, and sitting down with the patient. Participants at 1 site then completed a survey estimating how frequently they performed each of the observed behaviors. A convenience sample of 29 interns was observed on a total of 732 patient encounters. Overall, interns introduced themselves 40% of the time and explained their role 37% of the time. Interns touched patients on 65% of visits, asked open-ended questions on 75% of visits, and sat down with patients during 9% of visits. Interns at 1 site estimated introducing themselves and their role and sitting with patients significantly more frequently than was observed (80% vs 40%, P < 0.01; 80% vs 37%, P < 0.01; and 58% vs 9%, P < 0.01, respectively). Resident physicians introduced themselves to patients, explained their role, and sat down with patients infrequently during observed inpatient encounters. Residents surveyed tended to overestimate their own practice of etiquette-based medicine. © 2013 Society of Hospital Medicine.

Further applications for mosaic pixel FPA technology

NASA Astrophysics Data System (ADS)

Liddiard, Kevin C.

2011-06-01

In previous papers to this SPIE forum the development of novel technology for next generation PIR security sensors has been described. This technology combines the mosaic pixel FPA concept with low cost optics and purpose-designed readout electronics to provide a higher performance and affordable alternative to current PIR sensor technology, including an imaging capability. Progressive development has resulted in increased performance and transition from conventional microbolometer fabrication to manufacture on 8 or 12 inch CMOS/MEMS fabrication lines. A number of spin-off applications have been identified. In this paper two specific applications are highlighted: high performance imaging IRFPA design and forest fire detection. The former involves optional design for small pixel high performance imaging. The latter involves cheap expendable sensors which can detect approaching fire fronts and send alarms with positional data via mobile phone or satellite link. We also introduce to this SPIE forum the application of microbolometer IR sensor technology to IoT, the Internet of Things.

Teaching Prevention in Internal Medicine Clerkships.

ERIC Educational Resources Information Center

Kinsinger, Linda

2000-01-01

Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

The impact of the improvement in internal medicine consultation process on ED length of stay.

PubMed

Shin, Sangheon; Lee, Soo Hoon; Kim, Dong Hoon; Kim, Seong Chun; Kim, Tae Yun; Kang, Changwoo; Jeong, Jin Hee; Lim, Daesung; Park, Yong Joo; Lee, Sang Bong

2018-04-01

Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy. This study is a pre- and post-controlled interventional study. We attempted to improve the internal medicine consultation process to be more concise. After the intervention, only attending emergency physicians consult internal medicine chief residents, clinical fellows, or junior staff of each internal medicine subspecialty who were on duty when patients required special care or an admission to internal medicine. Emergency department length of stay of patients admitted to the department of internal medicine prior to and after the intervention decreased from 996.94min to 706.62min. The times from consultation order to admission order and admission order to emergency department departure prior to and after the intervention were decreased from 359.59min to 180.38min and from 481.89min to 362.37min, respectively. The inpatient mortality rates and Inpatient bed occupancy rates prior to and after the intervention were similar. The improvements in the internal medicine consultation process affected the flow time metrics. Therefore, more comprehensive and cooperative strategies need to be developed to reduce the time cycle metrics and overcrowding of all patients in the emergency department. Copyright © 2017 Elsevier Inc. All rights reserved.

A gravitational potential finding for rotating cosmological body in the context of proto-planetary dynamics problem solving

NASA Astrophysics Data System (ADS)

Krot, Alexander M.

2008-09-01

The statistical theory for a cosmological body forming (so-called the spheroidal body model) has been proposed in [1]-[9]. Within the framework of this theory, bodies have fuzzy outlines and are represented by means of spheroidal forms [1],[2]. In the work [3], it has been investigated a slowly evolving in time process of a gravitational compression of a spheroidal body close to an unstable equilibrium state. In the papers [4],[5], the equation of motion of particles inside the weakly gravitating spheroidal body modeled by means of an ideal liquid has been obtained. Using Schwarzschild's and Kerr's metrics a consistency of the proposed statistical model with the general relativity has been shown in [6]. The proposed theory follows from the conception for forming a spheroidal body from protoplanetary nebula [7],[8]; it permits to derive the form of distribution functions for an immovable [1]-[5] and rotating spheroidal body [6]-[8] as well as their density masses and also the distribution function of specific angular momentum of the rotating uniformly spheroidal body [7],[8]. It is well-known there is not a statistical equilibrium in a gas-dust proto-planetary cloud because of long relaxation time for proto-planets formation in own gravitational field. This proto-planetary system behavior can be described by Jeans' equation in partial derivations relative to a distribution function [9]. The problem for finding a general solution of Jeans' equation is connected directly with an analytical expression for potential of gravitational field. Thus, the determination of gravitational potential is the main problem of statistical dynamics for proto-planetary system [9]. This work shows this task of proto-planetary dynamics can be solved on the basis of spheroidal bodies theory. The proposed theory permits to derive the form of gravitational potential for a rotating spheroidal body at a long distance from its center. Using the obtained analytical expression for potential of gravitational field, the gravitational strength (as well as angular momentum space function) in a remote zone of a slowly gravitational compressed rotating spheroidal body is obtained. As a result, a distribution function describing mechanical state of proto-planetary system can be found from the Jeans' equation. References: [1] Krot AM. The statistical model of gravitational interaction of particles. Uspekhi Sovremennoï Radioelektroniki (special issue "Cosmic Radiophysics", Moscow) 1996; 8: 66-81 (in Russian). [2] Krot AM. Use of the statistical model of gravity for analysis of nonhomogeneity in earth surface. Proc. SPIE's 13th Annual Intern. Symposium "AeroSense", Orlando, Florida, USA, April 5-9, 1999; 3710: 1248-1259. [3] Krot AM. Statistical description of gravitational field: a new approach. Proc. SPIE's 14th Annual Intern.Symposium "AeroSense", Orlando, Florida, USA, April 24-28, 2000; 4038: 1318-1329. [4] Krot AM. Gravidynamical equations for a weakly gravitating spheroidal body. Proc. SPIE's 15th Annual Intern. Symposium "AeroSense", Orlando, Florida, USA, April 16-20, 2001; 4394: 1271-1282. [5] Krot AM. Development of gravidynamical equations for a weakly gravitating body in the vicinity of absolute zero temperature. Proc. 53rd Intern. Astronautical Congress (IAC) - The 2nd World Space Congress-2002, Houston, Texas, USA, October 10-19, 2002; Preprint IAC-02-J.P.01: 1-11. [6] Krot AM. The statistical model of rotating and gravitating spheroidal body with the point of view of general relativity. Proc. 35th COSPAR Scientific Assembly, Paris, France, July 18-25, 2004; Abstract-Nr. COSPAR 04-A- 00162. [7] Krot A. The statistical approach to exploring formation of Solar system. Proc. European Geoscinces Union (EGU) General Assembly, Vienna, Austria, April 02-07, 2006; Geophysical Research Abstracts, vol. 8: EGU06-A- 00216, SRef-ID: 1607-7962/gra/. [8] Krot AM. The statistical model of original and evolution planets of Solar system and planetary satellities. Proc. European Planetary Science Congress, Berlin, Germany, September 18-22, 2006; Planetary Research Abstracts, ESPC2006-A-00014. [9] Krot A. On the principal difficulties and ways to their solution in the theory of gravitational condensation of infinitely distributed dust substance. Proc. XXIV IUGG General Assembly, Perugia, Italy, July 2-13, 2007; GS002 Symposium "Gravity Field", Abstract GS002-3598: 143-144.

Advanced Optical Technologies for Defense Trauma and Critical Care

DTIC Science & Technology

2014-02-04

conventional LSI. We also demonstrated that mcLSI enables improved characterization of curved surfaces of the body by positioning LSI modules at...Implementation of an LED based clinical spatial frequency domain imaging 17 system. Proc SPIE Vol. 8254, Emerging Digital Micromirror Device Based

Transition to international classification of disease version 10, clinical modification: the impact on internal medicine and internal medicine subspecialties.

PubMed

Caskey, Rachel N; Abutahoun, Angelos; Polick, Anne; Barnes, Michelle; Srivastava, Pavan; Boyd, Andrew D

2018-05-04

The US health care system uses diagnostic codes for billing and reimbursement as well as quality assessment and measuring clinical outcomes. The US transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) on October, 2015. Little is known about the impact of ICD-10-CM on internal medicine and medicine subspecialists. We used a state-wide data set from Illinois Medicaid specified for Internal Medicine providers and subspecialists. A total of 3191 ICD-9-CM codes were used for 51,078 patient encounters, for a total cost of US $26,022,022 for all internal medicine. We categorized all of the ICD-9-CM codes based on the complexity of mapping to ICD-10-CM as codes with complex mapping could result in billing or administrative errors during the transition. Codes found to have complex mapping and frequently used codes (n = 295) were analyzed for clinical accuracy of mapping to ICD-10-CM. Each subspecialty was analyzed for complexity of codes used and proportion of reimbursement associated with complex codes. Twenty-five percent of internal medicine codes have convoluted mapping to ICD-10-CM, which represent 22% of Illinois Medicaid patients, and 30% of reimbursements. Rheumatology and Endocrinology had the greatest proportion of visits and reimbursement associated with complex codes. We found 14.5% of ICD-9-CM codes used by internists, when mapped to ICD-10-CM, resulted in potential clinical inaccuracies. We identified that 43% of diagnostic codes evaluated and used by internists and that account for 14% of internal medicine reimbursements are associated with codes which could result in administrative errors.

Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis.

PubMed

Cameron, A; Ewen, M; Ross-Degnan, D; Ball, D; Laing, R

2009-01-17

WHO and Health Action International (HAI) have developed a standardised method for surveying medicine prices, availability, affordability, and price components in low-income and middle-income countries. Here, we present a secondary analysis of medicine availability in 45 national and subnational surveys done using the WHO/HAI methodology. Data from 45 WHO/HAI surveys in 36 countries were adjusted for inflation or deflation and purchasing power parity. International reference prices from open international procurements for generic products were used as comparators. Results are presented for 15 medicines included in at least 80% of surveys and four individual medicines. Average public sector availability of generic medicines ranged from 29.4% to 54.4% across WHO regions. Median government procurement prices for 15 generic medicines were 1.11 times corresponding international reference prices, although purchasing efficiency ranged from 0.09 to 5.37 times international reference prices. Low procurement prices did not always translate into low patient prices. Private sector patients paid 9-25 times international reference prices for lowest-priced generic products and over 20 times international reference prices for originator products across WHO regions. Treatments for acute and chronic illness were largely unaffordable in many countries. In the private sector, wholesale mark-ups ranged from 2% to 380%, whereas retail mark-ups ranged from 10% to 552%. In countries where value added tax was applied to medicines, the amount charged varied from 4% to 15%. Overall, public and private sector prices for originator and generic medicines were substantially higher than would be expected if purchasing and distribution were efficient and mark-ups were reasonable. Policy options such as promoting generic medicines and alternative financing mechanisms are needed to increase availability, reduce prices, and improve affordability.

Study of nuclear medicine practices in Portugal from an internal dosimetry perspective.

PubMed

Bento, J; Teles, P; Neves, M; Santos, A I; Cardoso, G; Barreto, A; Alves, F; Guerreiro, C; Rodrigues, A; Santos, J A M; Capelo, C; Parafita, R; Martins, B

2012-05-01

Nuclear medicine practices involve the handling of a wide range of pharmaceuticals labelled with different radionuclides, for diagnostic and therapeutic purposes. This work intends to evaluate the potential risks of internal contamination of nuclear medicine staff in several Portuguese nuclear medicine services and to conclude about the requirement of a routine internal monitoring. A methodology proposed by the International Atomic Energy Agency (IAEA), providing a set of criteria to determine the need, or not, for an internal monitoring programme, was applied. The evaluation of the risk of internal contaminations in a given set of working conditions is based on the type and amount of radionuclides being handled, as well as the safety conditions with which they are manipulated. The application of the IAEA criteria showed that 73.1% of all the workers included in this study should be integrated in a routine monitoring programme for internal contaminations; more specifically, 100% of workers performing radioimmunoassay techniques should be monitored. This study suggests that a routine monitoring programme for internal exposures should be implemented in Portugal for most nuclear medicine workers.

The Impact of Supervision on Internal Medicine Residents' Attitudes and Management of Depression in Primary Care: A Pilot Study

ERIC Educational Resources Information Center

Milone, Jennifer M.; Gottumukkala, Aruna; Ward, Christopher P.; York, Kaki M.

2013-01-01

Objective: The authors examined the effect of supervision on internal medicine residents' attitudes toward and management of depression. Method: Internal medicine residents completed a survey during preclinical conferences. The survey included a published, validated questionnaire, the Depression Attitude Questionnaire, and items developed by the…

Residents' Perceptions of Primary Care versus Traditional Internal Medicine Programs.

ERIC Educational Resources Information Center

Wilson, Howard K.; And Others

1983-01-01

Two internal medicine residency programs at Baylor College of Medicine are discussed. The traditional program emphasizes experience in the care of acute problems within a hospital inpatient environment. The primary care residency program emphasizes training in the outpatient environment and in noninternal medicine disciplines. (MLW)

Burnout syndrome during residency in internal medicine and pediatrics in a country without working time directive.

PubMed

Aksoy, Duygu Yazgan; Durusu Tanriover, Mine; Unal, Sule; Dizdar, Omer; Kalyoncu, Umut; Karakaya, Jale; Unal, Serhat; Kale, Gulsev

2014-01-01

The purpose of this paper is to demonstrate burnout syndrome among internal medicine and pediatrics residents in a country that does not have the working time directive (WTD) and also to determine the risk factors and consequent impact on efficient functioning in clinical areas. A 57-item questionnaire was given to internal medicine and pediatrics residents. Responses from 22 pediatrics and 33 internal medicine residents were evaluated. Demographic findings, burnout scores, having hobbies, social activities and reading books unrelated to medicine were similar between the two groups. Six pediatrics residents (27.3 per cent) and 11 (33.3 per cent) internal medicine residents met the criteria for clinically significant burnout. Personal accomplishment scores and reading books unrelated to medicine were found to be related to burnout. Burnout is a syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal accomplishment. It is important to document burnout in countries where WTDs are not implemented. Further studies might demonstrate burnout's effect on patient safety, service quality and physician's performance.

[Promising Future in General Internal Medicine for the Next Generation of Physicians].

PubMed

Allenbach, Victoria Perpinias; Rozsnyai, Zsofia; Streit, Sven

2018-06-01

Promising Future in General Internal Medicine for the Next Generation of Physicians Abstract. We are facing a lack of specialists in general internal medicine in general practitioners' practices as well as in hospitals, while at the same time the population ages and usually displays several chronic diseases (multimorbidity). Thanks to more university places, an improved job description for general internal medicine and new further education offers (curricula), interest in general internal medicine increased again, as surveys of students indicate. The young generation of family doctors and generalists in hospitals wishes flexible working conditions in order to reconcile work, family and spare time in the best possible way. Working atmosphere and colleagues have a high priority. These wishes must now be incorporated into attractive further training with flexible curricula and mentoring offers so that young talents can successfully be promoted.

Protecting the rights of producers original medicines.

PubMed

Pashkov, Vitalii; Kotvitska, Alla; Noha, Petro

the article analyzes the state of protection of intellectual property rights of original medicine producers, its accordance with international standards. Attention is focused on the importance of exclusivity of medicine market. the analysis of protection of intellectual property rights of medicine producers in Ukraine and determination of its conformity or non-conformity to the international standards. the experience of certain countries is analyzed in the research. Additionally, we used statistical data of international organizations, conclusions of experts. there are numerous cases of state registration of generic medicinal products using the registration information of original medicinal products and delict of the rights of patent holders. an effective mechanism of judicial protection of the original medicine producers` intellectual property rights from disorders that affect the profit was elaborated in Ukraine.

History and Perspectives of Nuclear Medicine in Myanmar

PubMed Central

Mar, Win

2018-01-01

Nuclear Medicine was established in Myanmar in 1963 by Dr Soe Myint and International Atomic Energy expert Dr R. Hochel at Yangon General Hospital. Nuclear medicine diagnostic and therapeutic services started with Probe Scintillation Detector Systems and rectilinear scanner. In the early stage, many Nuclear Medicine specialists from the International Atomic Energy Agency (IAEA) spent some time in Myanmar and made significant contributions to the development of Nuclear Medicine in our country. The department participated in various IAEA technical cooperation projects and regional cooperation projects. By the late 1990s, new centers were established in Mandalay, Naypyidaw, and North Okkalapa Teaching Hospital of University of Medicine 11, Yangon. The training program related to Nuclear Medicine includes a postgraduate master’s degree (three years) at the University of Medicine. Currently, all centers are equipped with SPECT, SPECT-CT, PET-CT, and cyclotron in Yangon General Hospital. Up until now, the International Atomic Energy Agency has been playing a crucial role in the growth and development of Nuclear Medicine in Myanmar. Our vision is to provide a wide spectrum of nuclear medicine services at a level compatible with the international standards to become a Center of Excellence. PMID:29333470

Outpatient Management of Hypertension By General Medicine and Traditional Track Residents.

ERIC Educational Resources Information Center

Robie, Peter W.; Andrus, Peter L.

1982-01-01

A study to determine whether general internal medicine and traditional track medicine residents differed in their outpatient management of essential hypertension is discussed. General internal medicine residents seem to do better in the areas of assessment of drug side effects and patient education. (MLW)

What skills should new internal medicine interns have in july? A national survey of internal medicine residency program directors.

PubMed

Angus, Steven; Vu, T Robert; Halvorsen, Andrew J; Aiyer, Meenakshy; McKown, Kevin; Chmielewski, Amy F; McDonald, Furman S

2014-03-01

The transition from medical student to intern may cause stress and burnout in new interns and the delivery of suboptimal patient care. Despite a formal set of subinternship curriculum guidelines, program directors have expressed concern regarding the skill set of new interns and the lack of standardization in that skill set among interns from different medical schools. To address these issues, the Accreditation Council for Graduate Medical Education's Next Accreditation System focuses on the development of a competency-based education continuum spanning undergraduate, graduate, and continuing medical education. In 2010, the Clerkship Directors in Internal Medicine subinternship task force, in collaboration with the Association of Program Directors in Internal Medicine survey committee, surveyed internal medicine residency program directors to determine which competencies or skills they expected from new medical school graduates. The authors summarized the results using categories of interest. In both an item rank list and free-text responses, program directors were nearly uniform in ranking the skills they deemed most important for new interns-organization and time management and prioritization skills; effective communication skills; basic clinical skills; and knowing when to ask for assistance. Stakeholders should use the results of this survey as they develop a milestone-based curriculum for the fourth year of medical school and for the internal medicine subinternship. By doing so, they should develop a standardized set of skills that meet program directors' expectations, reduce the stress of transitions across the educational continuum, and improve the quality of patient care.

Politics and Graduate Medical Education in Internal Medicine: A Dynamic Landscape.

PubMed

Wardrop, Richard M; Berkowitz, Lee R

2017-02-01

The promotion of change and growth within medical education is oftentimes the result of a complex mix of societal, cultural and economic forces. Graduate medical education in internal medicine is not immune to these forces. Several entities and organizations can be identified as having a major influence on internal medicine training and graduate medical education as a whole. We have reviewed how this is effectively accomplished through these entities and organizations. The result is a constantly changing and dynamic landscape for internal medicine training. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

One hundred years since the birth of academician Dimitar Arsov, founder and nestor of the modern internal medicine in the Republic of Macedonia.

PubMed

Polenaković, M

2013-01-01

Dimitar Arsov was born in Kriva Palanka on September 28, 1908 and died on July 2, 1974 in Skopje; he had finished elementary education in Kriva Palanka, high school (1922-1926) in Kumanovo, Macedonia and Col-lege of Medicine (1926-1932), Ph. D. University of Paris, Sorbone, France, 1936. He returned to Macedonia in 1937. In 1947 he was elected and Assistant Professor and in 1950 a Docent at the Faculty of Medicine in Skopje. He was appointed Director of the Clinic of Medicine and Head of the Chair of Internal Medicine, who served at those positions in the period 1952-74. In 1958 he was elected Professor of Internal Medicine. The first habilitation of the Medical Faculty in Skopje was defended by D. Arsov in 1954, titled: "The Effects of the Intravenous Epinephrine on the Hypersplenism of Malaria and Cala-Azar". On August 18, 1967, D. Arsov was elected Full Member and also the first member in the field of medicine of the Macedonian Academy of Sciences and Arts. The excellent experience in the work with the patients, precise observation of the symptoms and syndromes of the diseases in each patient, knowing the most advanced therapy at that time enabled D. Arsov to make conclusion for possibility of new therapy and gave him the material for writing scientific papers. In the first half of the 50s, during his regular work, Arsov discovers a new, internationally recognized therapy for rheumatism. Patients of both Cala-Azar and inflammatory rheumatism were treated with small doses of adrenaline therapy and they felt drastic decrease in rheumatism inflammation within one week. This therapy was used a couple of years in several countries around the world. He participated in the undergraduate and graduate studies. He contributed to the development of 2,240 graduated doctors and under his management over 300 doctors specialized in internal medicine and became specialists internists. Under his management, numerous habilitations and dissertations in internal medicine were finished. He contributed also to the development of 25 assistants, 5 docents, 5 full-time professors in internal medicine at the Medical Faculty in Skopje. He has published more than 200 papers from different areas of internal medicine, of which 36 are on the PubMed. He has published 5 books on internal medicine for students and doctors. He was a President and member of several Macedonian medical associations, as well as of medical associations of former Yugoslavia. He was awarded with the highest awards of former Yugoslavia and Macedonia. He was also awarded with international awards, such as: Doctor Honoris Causa by the University in Besancon and Honor and Medal from the City Assembly of Besancon (France). During his management of the Internal clinic the University Internal clinic developed eight different sub-specialist departments: Cardiology, Pneumology, Rheumatology, Nephrology, Hematology, Gastroenterology and Endocrinology with metabolism and Clinical biochemical laboratory. The fast development of subspecialties has led to development of separate clinics for each subspecialty in 1975, so only the Chair of Internal Medicine remained as a connection between the subspecialties for education and scientific research. He was a prolific scientist who after World War II wrote the first scientific and specialist papers and books in the field of internal medicine in Macedonia. He created a school of internal medicine. The scientific and uncompromised attitude towards the expert truth are weaved in the unforgettable face of the Academician Prof. D-r. Dimitar Arsov, scientist, teacher, and doctor. With his vast work in healing the sick and preventing the diseases in the Republic of Macedonia, he became the cornerstone of modern medicine in the Republic of Macedonia. Thus, he truly deserves to be the doyen of internal medicine, one of the leading, most important persons in medicine of the 20th century in our country. Today, his honorary name appears on: Clinic of Rheumatology at the Medical Faculty in Skopje, Medical Center in Kriva Palanka, Scientific Club of the student organization of the Medical Faculty in Skopje.

Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

ERIC Educational Resources Information Center

Rutherford, Bret R.; Hellerstein, David J.

2008-01-01

Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

PubMed

Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

2017-12-11

The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017, Joule Inc. or its licensors.

Payload Isolation System for Launch Vehicles

DTIC Science & Technology

1997-03-01

Payload Isolation System for Launch Vehicles Paul S. Wilke, Conor D. Johnson CSA Engineering Palo Alto, CA Eugene R. Fosness Air Force Phillips ... Laboratory , PL/VTVD Kirkland AFB, NM Spie Smart Structures and Materials San Diego, CA March 1997 Copyright 1997 Society of Photo-Optical Instrumentation

Trend and impact of international collaboration in clinical medicine papers published in Malaysia.

PubMed

Low, Wah Yun; Ng, Kwan Hoong; Kabir, M A; Koh, Ai Peng; Sinnasamy, Janaki

2014-01-01

Research collaboration is the way forward in order to improve quality and impact of its research findings. International research collaboration has resulted in international co-authorship in scientific communications and publications. This study highlights the collaborating research and authorship trend in clinical medicine in Malaysia from 2001 to 2010. Malaysian-based author affiliation in the Web of Science (Science Citation Index Expanded) and clinical medicine journals ( n  = 999) and articles ( n  = 3951) as of 30th Oct 2011 were downloaded. Types of document analyzed were articles and reviews, and impact factors (IF) in the 2010 Journal Citation Report Science Edition were taken to access the quality of the articles. The number of publications in clinical medicine increased from 4.5 % ( n  = 178) in 2001 to 23.9 % ( n  = 944) in 2010. The top three contributors in the subject categories are Pharmacology and Pharmacy (13.9 %), General and Internal Medicine (13.6 %) and Tropical Medicine (7.3 %). By journal tier system: Tier 1 (18.7 %, n  = 738), Tier 2 (22.5 %, n  = 888), Tier 3 (29.6 %, n  = 1170), Tier 4 (27.2 %, n  = 1074), and journals without IF (2.1 %, n  = 81). University of Malaya was the most productive. Local collaborators accounted for 60.3 % and international collaborations 39.7 %. Articles with international collaborations appeared in journals with higher journal IFs than those without international collaboration. They were also cited more significantly than articles without international collaborations. Citations, impact factor and journal tiers were significantly associated with international collaboration in Malaysia's clinical medicine publications. Malaysia has achieved a significant number of ISI publications in clinical medicine participation in international collaboration.

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

Relationship between internal medicine program board examination pass rates, accreditation standards, and program size.

PubMed

Falcone, John L; Gonzalo, Jed D

2014-01-19

To determine Internal Medicine residency program compliance with the Accreditation Council for Graduate Medical Education 80% pass-rate standard and the correlation between residency program size and performance on the American Board of Internal Medicine Certifying Examination. Using a cross-sectional study design from 2010-2012 American Board of Internal Medicine Certifying Examination data of all Internal Medicine residency pro-grams, comparisons were made between program pass rates to the Accreditation Council for Graduate Medical Education pass-rate standard. To assess the correlation between program size and performance, a Spearman's rho was calculated. To evaluate program size and its relationship to the pass-rate standard, receiver operative characteristic curves were calculated. Of 372 Internal Medicine residency programs, 276 programs (74%) achieved a pass rate of =80%, surpassing the Accreditation Council for Graduate Medical Education minimum standard. A weak correlation was found between residency program size and pass rate for the three-year period (p=0.19, p<0.001). The area underneath the receiver operative characteristic curve was 0.69 (95% Confidence Interval [0.63-0.75]), suggesting programs with less than 12 examinees/year are less likely to meet the minimum Accreditation Council for Graduate Medical Education pass-rate standard (sensitivity 63.8%, specificity 60.4%, positive predictive value 82.2%, p<0.001). Although a majority of Internal Medicine residency programs complied with Accreditation Council for Graduate Medical Education pass-rate standards, a quarter of the programs failed to meet this requirement. Program size is positively but weakly associated with American Board of Internal Medicine Certifying Examination performance, suggesting other unidentified variables significantly contribute to program performance.

Dissemination, analysis, and implementation of the World Report on Disability: the roadmap of the International Society for Physical and Rehabilitation Medicine.

PubMed

Gutenbrunner, Christoph; Bethge, Matthias; Stucki, Gerold; Li, Jianan; Lains, Jorge; Olver, John; Frontera, Walter; von Groote, Per; Giustini, Alessandro; Imamura, Marta

2014-01-01

The International Society for Physical and Rehabilitation Medicine has recognized the World Report on Disability as a guide for its future activities and endorsed its responsibility to disseminate, to analyze, and to implement the report's recommendations. The activities of the International Society for Physical and Rehabilitation Medicine on the global stage are embedded in a strategy that includes national and regional associations. This article reports on recent and forthcoming activities of the International Society for Physical and Rehabilitation Medicine regarding the World Report on Disability and identifies five major challenges that will impact future International Society for Physical and Rehabilitation Medicine activities. These challenges relate to (1) education and training, (2) the support of strong role models, (3) disaster management, (4) the development of innovative rehabilitation services, and (5) rehabilitation research.

Citation Analysis of The Korean Journal of Internal Medicine from KoMCI, Web of Science, and Scopus

PubMed Central

2011-01-01

The Korean Journal of Internal Medicine (KJIM) is the international journal published in English by the Korean Association of Internal Medicine. To understand the position of the journal in three different databases, the citation indicators were elucidated. From databases such as Korean Medical Citation Index (KoMCI), Web of Science, and Scopus, citation indicators such as the impact factor, SCImago journal rank (SJR), or Hirsch Index were calculated according to the year and the results were drawn. The KJIM 2010 impact factor increased to 0.623 in Web of Science. That of year 2009 in KoMCI was a 0.149. The 2009 SJR in Scopus was 0.073, with a ranking of 27/72 (37.5%) in the category of internal medicine and 414/1,618 (25.6%) in the category of medicine, miscellaneous. The Hirsch Index from KoMCI, Web of Science and Scopus were 5, 14, and 16, respectively. The KJIM is now cited more by international researchers than Korean researchers, indicating that the content of the journal is now valued at the international level. PMID:21437155

Citation analysis of The Korean Journal of Internal Medicine from KoMCI, Web of Science, and Scopus.

PubMed

Huh, Sun

2011-03-01

The Korean Journal of Internal Medicine (KJIM) is the international journal published in English by the Korean Association of Internal Medicine. To understand the position of the journal in three different databases, the citation indicators were elucidated. From databases such as Korean Medical Citation Index (KoMCI), Web of Science, and Scopus, citation indicators such as the impact factor, SCImago journal rank (SJR), or Hirsch Index were calculated according to the year and the results were drawn. The KJIM 2010 impact factor increased to 0.623 in Web of Science. That of year 2009 in KoMCI was a 0.149. The 2009 SJR in Scopus was 0.073, with a ranking of 27/72 (37.5%) in the category of internal medicine and 414/1,618 (25.6%) in the category of medicine, miscellaneous. The Hirsch Index from KoMCI, Web of Science and Scopus were 5, 14, and 16, respectively. The KJIM is now cited more by international researchers than Korean researchers, indicating that the content of the journal is now valued at the international level.

Classification of 13 DES supernova with OzDES

NASA Astrophysics Data System (ADS)

Macaulay, E.; Allam, S.; Tucker, D.; Asorey, J.; Davis, T. M.; Kremlin, A.; Lewis, G. F.; Lidman, C.; Martini, P.; Sommer, N. E.; Tucker, B. E.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Moller, A.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.

2018-01-01

We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

Classification of 26 DES supernova with OzDES

NASA Astrophysics Data System (ADS)

Calcino, J.; Davis, T. M.; Hoormann, J. K.; Asorey, J.; Glazebrook, K.; Carnero, A.; Lidman, C.; Martini, P.; Moller, A.; Sommer, N. E.; Sharp, R.; Tucker, B. E.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Lewis, G. F.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.

2018-01-01

We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

Classification of 25 DES supernova with OzDES

NASA Astrophysics Data System (ADS)

Calcino, J.; Davis, T. M.; Hoormann, J. K.; Asorey, J.; Glazebrook, K.; Carnero, A.; Lidman, C.; Martini, P.; Moller, A.; Sommer, N. E.; Sharp, R.; Tucker, B. E.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Lewis, G. F.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.

2018-01-01

We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

Classification of 18 DES supernova with OzDES

NASA Astrophysics Data System (ADS)

Swann, E. S.; Lewis, G. F.; Lidman, C.; Panther, F. H.; Sharp, R.; Sommer, N. E.; Tucker, B. E.; Muthukrishna, D.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Moller, A. R.; Yuan, F.; Zhang, B.; Davis, T. M.; Hinton, S.; Asorey, J.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.

2018-06-01

We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

Recent Technology Developments for the Kinetic Kill Vehicle Hardware-In-The-Loop Simulator (KHILS),

DTIC Science & Technology

1998-01-01

Eric Hardware-in-the-Loop Testing III, Proceedings Hedlund, and Chet DeCesaris whose sponsorship SPIE 3368, (1998). through the SDIO/BMDO over the last...Jones, Coker, Garbo, Olson, Murrer, Bergin, Goldsmith, Crow, Guertin, Daugherty, Marler , 6. Trolier, Hall, Tincher, Leone, "Aerothermal Timms

Classification of 17 DES supernova with OzDES

NASA Astrophysics Data System (ADS)

Muthukrishna, D.; Sharp, R. G.; Tucker, B. E.; Moller, A.; Sommer, N. E.; Asorey, J.; Lewis, G. F.; Lidman, C.; Mould, J.; Macaulay, E.; Maartens, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Yuan, F.; Zhang, B.; Davis, T. M.; Hinton, S.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.

2017-09-01

We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

[The "International Society for the History of Medicine" and the "Société Française d'Histoire de la Médecine].

PubMed

Tricot, Jean-Pierre

2003-01-01

Professor J. P. Tricot as President of the International Society for the History of Medicine displayed the significant relationship between both Societies. He conjured up his grand-father's role, Professor J. J. Tricot-Royer, who founded the International Society of Medicine and he dealt with the creation of the Congresses by the International Society and particularly the first congress in Antwerp.

SALT high resolution spectroscopy of GX339-4 in outburst

NASA Astrophysics Data System (ADS)

Buckley, D. A. H.; Aydi, E.; Kotze, M. M.; Gandhi, P.; Altamirano, D.; Charles, P. A.; Russell, D.

2017-10-01

High resolution (R = 15,000) spectroscopy of the current outbursting black hole transient GX339-4 (ATel #10797) was obtained with the SALT High Resolution Spectrograph (HRS; Crause et al. 2014, Proc SPIE, 91476) on 2017-09-29 starting at 17:28 UTC, during evening twilight.

Goodman High Throughput Spectrograph | SOAR

Science.gov Websites

SPARTAN Near-IR Camera Ohio State Infrared Imager/Spectrograph (OSIRIS) - NO LONGER AVAILABLE SOAR 320-850 nm wavelength range. The paper describing the instrument is Clemens et al. (2004) Applying for IRAF. Publishing results based on Goodman data?: ADS link to 2004 SPIE Goodman Spectrograph paper

[International experience in the legal regulation of the circulation of medicines through the prism of the law of the world trade organization].

PubMed

Pasechnyk, Olena V; Hendel, Nataliia V

2018-01-01

Introduction: The development of international legal cooperation in the field of health has largely been driven by the trade interests of states. The aim: The article analyzes the legal regulation of the circulation of medicines through the prism of the law of the World Trade Organization. Materials and methods: Using the historical legal method has allowed to analyze the genesis of legal regulation of the circulation of medicines through the prism of the law of the World Trade Organization. The dialectical method is widely used, in particular, when it comes to the issue of the ratio of market regulation of medicines circulation and public health protection, the formal logic method, in particular, in formulating the general principles, principles and methods of legal regulation in the field of medicines, as well as the systemic method, in particular, in defining the institutional component of legal regulation in the field of medicines. Review: The activities of the WTO include several areas related to health protection: international control over infectious diseases, international legal regulation of food safety (food security), tobacco control, environmental protection, international legal aspects of access and treatment of medicinal and pharmaceutical products, international legal regulation of medical services provision. Conclusions: It is proved that the right to health is a right to access to medicines. However, for many developing countries, it is problematic to obtain patents for the production of necessary medicines or to pay a license fee, which creates a barrier to the realization of the right to health.

Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

PubMed

Ma, Irene W Y; Arishenkoff, Shane; Wiseman, Jeffrey; Desy, Janeve; Ailon, Jonathan; Martin, Leslie; Otremba, Mirek; Halman, Samantha; Willemot, Patrick; Blouw, Marcus

2017-09-01

Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.

Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

PubMed

Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

2015-03-31

During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine subspecialties. Shadowing the on call resident or shorter rotations could provide a more extended patient diversity.

78 FR 38628 - Reclassification of Specially Denatured Spirits and Completely Denatured Alcohol Formulas and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... used in the manufacture of medicines or flavors for internal human use where any of the spirits remain...--which are materials that make alcoholic mixtures unfit for beverage or internal human medicinal use...) Make the spirits unfit for beverage or internal human medicinal use (26 U.S.C. 5242 and 27 CFR 21.11...

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

PubMed

Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

2017-08-01

Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen (median, 5.0; IQR, 3.5-6.7 for ≥20% uninsured), and location (median, 5.3; IQR, 3.8-6.8 for the southeastern United States). Across hospitals, there is wide variation in excess charges on ED services, which are often priced higher than internal medicine services. Our results inform policy efforts to protect uninsured and out-of-network patients from highly variable pricing.

Infrared Stereo Calibration for Unmanned Ground Vehicle Navigation

DTIC Science & Technology

2014-05-01

Josh Harguess: E -mail: joshua.harguess@navy.mil, Telephone: 1 619 553 0777 SPIE Proc. 9084: Unmanned Systems Technology XVI, Baltimore, MD, May 6-8...G., Diniz , H., Silvino, S., and de Andrade, R., “Thermal/visible au- tonomous stereo visio system calibration methodology for non-controlled

Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

PubMed

Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

2010-09-01

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory Commission report to Congress. Work is underway through stakeholder organizations to disseminate and assess the competencies among internal medicine and family medicine residency programs.

Transforming primary care training--patient-centered medical home entrustable professional activities for internal medicine residents.

PubMed

Chang, Anna; Bowen, Judith L; Buranosky, Raquel A; Frankel, Richard M; Ghosh, Nivedita; Rosenblum, Michael J; Thompson, Sara; Green, Michael L

2013-06-01

The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice. We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs? The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, 'medical home builder' tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs). The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs. The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.

The teaching of liberal arts in internal medicine residency training.

PubMed

Povar, G J; Keith, K J

1984-09-01

Forty-four members of the Association of Program Directors in Internal Medicine and 58 members of the Society for Research and Education in Primary Care Internal Medicine completed questionnaires on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine. They rated economics of medical care and bioethics as essential to residency training. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. Although there was great variability in the curricula represented, over 40 percent of the respondents reported having formal lecture and/or seminar exposure to these topics in their programs. Problems encountered in implementing liberal arts programs included lack of curriculum time, limited-faculty members, and a lack of interest on the part of residents. There is a need both to arrive at a consensus among residency directors and to explore means of developing interdisciplinary faculties if the liberal arts are to form an established part of internal medicine residency training.

The statistical model of origin and evolution planets of Solar system and planetary satellities

NASA Astrophysics Data System (ADS)

Krot, A.

There are the theories for exploring Solar system formation in accord Titius-Bode's low: electromagnetic theories (Birkeland (1912), Alfven (1942)), gravitational theories (Schmidt (1944), Woolfson (1964), Safronov (1969), Dole (1970)), nebular theories (Weizsaecker (1943), Kuiper (1949), Nakano (1970)) [1]-[3]. In spite of great number of work aimed to exploring formation of the Solar system, however, the mentioned theories were not able to explain all phenomena. In this connection the statistical theory for a cosmological body forming (so-called the spheroidal body model) has been proposed in [4]-[11]. Within the framework of this theory, bodies have fuzzy outlines and are represented by means of spheroidal forms. In the work [6], which is a continuation of the papers [4], [5], it has been investigated a slowly evolving in time process of a gravitational compression of a spheroidal body close to an unstable equilibrium state. In the papers [7],[8]the equation of motion of particles inside the weakly gravitating spheroidal body modeled by means of an ideal liquid has been obtained. Using Schwarzschild's and Kerr's metrics a consistency of the proposed statistical model with the general relativity has been shown in [12]. The proposed theory proceeds from the conception for forming a spheroidal body as a protoplanet from planetary nebula; it permits to derive the form of distribution functions for an immovable and rotating spheroidal body [4]-[6],[10]-[13] as well as their density masses (gravitational potentials and strengths) and also to find the distribution function of specific angular momentum of the rotating uniformly spheroidal body [13],[14]. Using the specific angular momentum distribution function this work considers a gas- dust protoplanetary cloud as a rotating and gravitating spheroidal body. Because the specific angular momenta are averaged during conglomeration process the specific angular momenta for a planets of Solar system is found. As a result a new low for Solar system planetary distances is derived (it generalizes the well-known Schmidt low). The new low gives a very good estimation of real planetary distances in Solar system (the relative error of estimation is 0%; absolute error of estimation is 0,5% besides its maximal value is equal to 5% for Earth and Pluto). This low has been applied also to estimation of Jupiter's satellities distances in this work. References: [1] M.M.Nieto, The Tutius-Bode low of planetary distances: its his-tory and theory. Pergamon: Oxford, New York et., 1972. [2] V.S. Safronov, Evolution of Protoplanetary cloud and the formation of the Earth and planets. 1969, Moscow, Nauka, (in Russian); NASA Tech. Transl. F-677, Washington, D.C. 1972. [3] A.V. Vityazev, G.V. Pechrnikova and V.S.Safronov, The Terrestrial planets: origin and early evolution. 1990. Moscow, Nauka (in Russian) [4] A.M.Krot, Achievement in Modern Radioelectronics (Special issue "Cosmic Radiophysics", Moscow), no.8, pp.66-81, 1996 (in Russian). [5] A.M.Krot, Proc. SPIE's 13th Annual Intern.Symp. "AeroSense", vol.3710, pp.1248-1259, Orlando, Florida, USA, April 5-9, 1999. [6] A.M.Krot, Proc. SPIE's 14th Annual Intern.Symp. "AeroSense", vol.4038, pp.1318-1329, Orlando, Florida, USA, April 24-28, 2000. [7] A.M.Krot, Proc. SPIE's 15th Annual Intern. Symposium "AeroSense", vol.4394, pp.1271-1282, Orlando, Florida, USA, April 16-20, 2001. [8] A.M.Krot, Proc. 53rd Intern. Astronautical Congress: The World Space Congress-2002, Houston, Texas, USA, October 10-19, 2002, Preprint IAC-02-J.P.01. - 11 p. [9] A.M.Krot, Proc. 34th Scientific Assembly of the Committee on Space Research (COSPAR)- The 2nd World Space Congress (WSC- 2002), October 10-19, 2002,Houston, Texas, USA. [10] A.M.Krot, Proc. of EGS- AGU-EUG Joint Assembly, Nice, France, April 6-11, 2003, Geophysical Research Abstracts, vol.5, EAE03-À-05568, 2003. [11] A.M. Krot, Proc. of 54 Intern. Astronautical Congress (IAC), September 29-October 3, 2003, Bremen, Germany, Preprint IAC-03-J.1.08. -11p. [12] A.M.Krot , Proc. of 35th COSPAR Scientific Assembly, Paris, France, July 18-25, 2004, Abstract-Nr. COSPAR 04-A-00162. [13] A.Krot, Proc. EGU- 2nd General Assembly, Vienna, Austria, April 24-29, 2005, Geophysical Research Abstracts, vol.7, EGU05-A-04550, 2005; SRef-ID: 1607-7962/gra/. [14] A.Krot Proc. EGU- General Assembly, Vienna, Austria, April 02- 07, 2006, Geophysical Research Abstracts, vol.8, EGU06-A-00216, 2006; SRef-ID: 1607-7962/gra/. 2

Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile.

PubMed

Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J

2009-01-01

Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.

Aid conditionalities, international Good Manufacturing Practice standards and local production rights: a case study of local production in Nepal.

PubMed

Brhlikova, Petra; Harper, Ian; Subedi, Madhusudan; Bhattarai, Samita; Rawal, Nabin; Pollock, Allyson M

2015-06-14

Local pharmaceutical production has been endorsed by the WHO as a means of addressing health priorities of developing countries. However, local producers of essential medicines must comply with international pharmaceutical standards in order to be eligible to compete in donor tenders. These standards determine production rights for on-patent and off-patent medicines, and guide international procurement of medicines. We reviewed the literature on the impact of Good Manufacturing Practice (GMP) on local production; a gap analysis from the literature review indicated a need for further research. Over sixty interviews were conducted with people involved in the Nepali pharmaceutical production and distribution chain from 2006 to 2009 on the GMP areas of relevance: regulatory capacity, staffing, funding and training, resourcing of GMP, inspectors' interpretation of the rules and compliance. Although Nepal producers have increased their overall share of the domestic market, only the public manufacturer, Royal Drugs, focuses on medicines for public health programmes; private producers engage mainly in brand competition for private markets, not essential medicines. Nepali regulators and producers state that implementation of GMP standards is hindered by low regulatory capacity, insufficient training of staff in the industry, financial constraints and lack of investment for upgrading capital. The transition period to mandatory compliance with WHO GMP rules is lengthy. Less than half of private producers had WHO GMP in 2013. Producers are not directly affected by international harmonisation of standards as they do not export medicines and the Nepali regulator does not enforce the WHO standards strictly. Without an international GMP certificate they cannot tender for donor dependent health programmes. In Nepal, local private manufacturers focus mainly on brand competition for private consumption not essential medicines, the government preferentially procures essential medicines from the only public producer while donor funded programmes rely on international manufacturers compliant with international GMP standards. We also found evidence of private hospitals bypassing national medicines approvals process. Policies in support of local pharmaceutical production in developing countries as a source of essential medicines need to examine carefully how GMP regulations impact on regulators, local industry and production of essential medicines in practice.

[A history of internal medicine: medical specialization: as old as antiquity].

PubMed

Echenberg, Donald

2007-11-28

This article presents a short review of the history of medical specialization and the evolution of internal medicine within the last two centuries. Medical specialization, far from being a recent phenomenon, existed in the Hellenistic world and in Rome. The development of specialization during the latter part of the 19th century and early 20th century is credited to the rapid expansion of medical knowledge which made it impossible for a single doctor to encompass all the different spheres of the profession. The term innere medizin or internal medicine was adopted from German terminology in the 1880's. The Canadian society of internal medicine was formed in 1983 and its main goal is to promote a broad perspective of medical care and to master the complexity in medicine through a generalist approach.

Factors influencing selection of internal medicine residency--a prospective study.

PubMed

Pereg, David; Gronich, Naomi; Lishner, Michael

2006-08-01

Recently, the popularity of internal medicine residency has been decreasing. We studied the effect of an improved working environment and a decrease in residents' workload on the selection of internal medicine residency. An organizational diagnosis team joined our department and identified several causes for residents' heavy workload. These findings were subsequently discussed in a workshop and led to a modification of the daily routine and a parallel decrease in workload and rise in residents' satisfaction. Following these changes, the demand for residency in our department rose. We conclude that an improvement in the working environment and workload during residency increases the residents' satisfaction and the demand for residency in internal medicine.

Periscopic Spine Surgery

DTIC Science & Technology

2008-06-01

and H. Seraji , “Kinematic analysis of 7 DOF manipulators,” Int. Journal of Robotics Research, vol. 11, no. 5, pp. 469–481, 1992. [9] D. Lawrence...Force/torque Sensor Read joint Angle Forward kinematics Impedance controller Patient Fe Fs ix∆ Xd Xc diθ ciθ riθ P&O Proc. of SPIE Vol

Real-Time Target Motion Animation for Missile Warning System Testing

DTIC Science & Technology

2006-04-01

T. Perkins, R. Sundberg, J. Cordell, Z. Tun , and M. Owen, Real-time Target Motion Animation for Missile Warning System Testing, Proc. SPIE Vol 6208...Z39-18 Real-time target motion animation for missile warning system testing Timothy Perkins*a, Robert Sundberga, John Cordellb, Zaw Tunb, Mark

Changes in Structural Health Monitoring System Capability Due to Aircraft Environmental Factors

DTIC Science & Technology

2009-09-01

and R. Ikegami . “Hot-Spot Fatigue Crack Monitoring of Inaccessible Structural Regions in Air- craft Subsystems Using Structural Health Monitoring...national Society for Optical Engineering, volume 4702 of Smart Structures and Materials 2002, 29–40. Newport Beach, CA: SPIE, 2002. 54. Ikegami , R

[Perspectives and challenges to guarantee training and renewal in general internal medicine].

PubMed

Waeber, G; Cornuz, J; Gaspoz, J-M; Pécoud, A; Perrier, A

2009-01-28

Training new doctors in general internal medicine represents a challenge. This requires to define future needs, which result from interest that are not necessarily convergent between patients, doctors, insurers and politicians. Problems related to medical demography in Switzerland, with the ageing of the population, the increase in health care costs and the place of Switzerland within the European Community require the implementation of specific objectives to train new physicians in general internal medicine. The success of these opportunities depends on social factors, political choices and choices from physician's association. In this article we will approach these challenges by formulating some proposals--nonexhaustive--in order to guarantee sufficient renewal in general internal medicine.

Does educational intervention improve doctors’ knowledge and perceptions of generic medicines and their generic prescribing rate? A study from Malaysia

PubMed Central

Wong, Zhi Yen; Alrasheedy, Alian A.; Saleem, Fahad; Mohamad Yahaya, Abdul Haniff; Aljadhey, Hisham

2014-01-01

Objectives: To investigate the impact of an educational intervention on doctors’ knowledge and perceptions towards generic medicines and their generic (international non-proprietary name) prescribing practice. Methods: This is a single-cohort pre-/post-intervention pilot study. The study was conducted in a tertiary care hospital in Perak, Malaysia. All doctors from the internal medicine department were invited to participate in the educational intervention. The intervention consisted of an interactive lecture, an educational booklet and a drug list. Doctors’ knowledge and perceptions were assessed by using a validated questionnaire, while the international non-proprietary name prescribing practice was assessed by screening the prescription before and after the intervention. Results: The intervention was effective in improving doctors’ knowledge towards bioequivalence, similarity of generic medicines and safety standards required for generic medicine registration (p = 0.034, p = 0.034 and p = 0.022, respectively). In terms of perceptions towards generic medicines, no significant changes were noted (p > 0.05). Similarly, no impact on international non-proprietary name prescribing practice was observed after the intervention (p > 0.05). Conclusion: Doctors had inadequate knowledge and misconceptions about generic medicines before the intervention. Moreover, international non-proprietary name prescribing was not a common practice. However, the educational intervention was only effective in improving doctors’ knowledge of generic medicines. PMID:26770747

SPIE Smart Structures Product Implementation Award: a review of the first ten years

NASA Astrophysics Data System (ADS)

Anderson, Eric H.; Sater, Janet M.

2007-04-01

The research field of smart materials and structures has been a distinct entity for two decades. Over the past ten years, the SPIE Industrial and Commercial Applications Conference has presented a Smart Structures Product Implementation Award at its annual symposium. This paper revisits the nine winning entries to date (1998-2007) and updates their status. The paper begins with a brief description of the original and current intent of the award and follows with a short overview of the evolution of smart structures, from research to products. The winning teams and their respective products are then described. The current status of the products is discussed based on publicly available information and input from the respective companies. Note however that it is not the purpose of the paper to rank the product winners in terms of success or sales. The paper concludes with an assessment of the larger trends in productization of smart structures technologies. The application "form" for the award as well as the evaluation criteria and suggestions for improving award application packages can be found in the appendix.

[Position paper of the German Society for Medical Intensive Care Medicine and Emergency Medicine (DGIIN) on medical intensive care medicine].

PubMed

Riessen, R; Janssens, U; Buerke, M; Kluge, S

2016-05-01

In this paper the German Society for Medical Intensive Care Medicine and Emergency Medicine (DGIIN) provides statements regarding the importance and advancement of Medical Intensive Care Medicine within the structures of Internal Medicine in Germany. Of pivotal importance are the training of medical intensivists, the cooperation with intensivists from other disciplines and the collaboration with emergency departments. In order to fulfil the various and challenging tasks in patient care, training, research and medical education competently and on an international level, more intensivists in leading positions especially in academic institutions are essential.

[Inventory of training of internal medicine in France: Results of a national survey].

PubMed

Samson, M; Terrier, B; Mangin, O; Mouthon, L

2017-05-01

To make an inventory of training of Internal Medicine in France. This study was conducted between May and September 2015 with coordinators (interviews of 45minutes) of local Internal Medicine training and fellows (online questionnaire). All coordinators (n=28) responded to the interviews. Local training of Internal Medicine exists in 86% of regions (3.1±3.1hours/month) and an interregional training in all interregions (34.7±13.9hours/year). When excluding Île-de-France, no correlation between the number of teachers and the amount of lessons was noted (P=0.61). Of the 550 fellows in Internal Medicine in 2014-2015, 223 (41%) responded to the online questionnaire. Mean level was 5.5±2.7 semesters. The rate of satisfaction (1=very dissatisfied and 5=very satisfied) was 3.0±1.0 and 3.8±0.8 for regional and interregional teaching, respectively (P<0.0001). Regional teaching satisfaction was correlated with the perceived expanse of diseases covered into the program (P<0.0001). In addition, 89% of fellows wish to evaluate themselves online, 66% wish to have a practical evaluation at the bedside and 70% in simulation centers. Finally, 91% of fellows support the establishment of a national program for the training of Internal Medicine. This survey states for the first time an inventory of training of Internal Medicine dedicated to fellows in France. This report highlights that fellows wish to have a national program, be further evaluated and have access to more interactive approach of teaching. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Classification of 3 DES supernova with OzDES and DEVILS

NASA Astrophysics Data System (ADS)

Davies, L. J. M.; Driver, S. P.; Hashemizadeh, A.; Kushan, S. l.; Lidman, C.; Mannering, E.; Panther, F.; Sharp, R.; Sommer, N. E.; Tucker, B. E.; Zhang, B.; Mudd, D.; Swann, E. S.; Wiseman, P.; King, A.; Mould, J. R.; Calcino, J.; Bolejko, K.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Moller, A.; Yuan, F.; Davis, T. M.; Hinton, S.; Asorey, J.; Lewis, G. F.; Muthukrishna, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.

2018-06-01

We report new spectroscopic classifications by OzDES and DEVILS of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

VizieR Online Data Catalog: Line list for seven target PAndAS clusters (Sakari+, 2015)

NASA Astrophysics Data System (ADS)

Sakari, C. M.; Venn, K. A.; Mackey, D.; Shetrone, M. D.; Dotter, A.; Ferguson, A. M. N.; Huxor, A.

2017-11-01

The targets were observed with the Hobby-Eberly Telescope (HET; Ramsey et al. 1998, Proc. SPIE, 3352, 34; Shetrone et al. 2007PASP..119..556S) at McDonald Observatory in Fort Davis, TX in 2011 and early 2012. The High Resolution Spectrograph (HRS; Tull 1998, Proc. SPIE, 3355, 387) was utilized with the 3-arcsec fibre and a slit width of 1 arcsec, yielding an instrumental spectral resolution of R=30000. With the 600 g/mm cross-disperser set to a central wavelength of 6302.9Å, wavelength coverages of ~5320-6290 and ~6360-7340Å were achieved in the blue and the red, respectively. The 3-arcsec fibre provided coverage of the clusters past their half-light radii; the additional sky fibres (located 10 arcsec from the central object fibre) provided simultaneous observations for sky subtraction. Exposure times were calculated to obtain a total signal-to-noise ratio (S/N)=80 (per resolution element), although not all targets received sufficient time to meet this goal. (2 data files).

Accelerator Technology and High Energy Physics Experiments, Photonics Applications and Web Engineering, Wilga, May 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

The paper is the second part (out of five) of the research survey of WILGA Symposium work, May 2012 Edition, concerned with accelerator technology and high energy physics experiments. It presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the XXXth Jubilee SPIE-IEEE Wilga 2012, May Edition, symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonicselectronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-275].

VizieR Online Data Catalog: NIR polarimetric study in the LMC N159/N160 field (Kim+, 2017)

NASA Astrophysics Data System (ADS)

Kim, J.; Jeong, W.-S.; Pyo, J.; Pak, S.; Park, W.-K.; Kwon, J.; Tamura, M.

2018-04-01

Simultaneous JHKs polarimetric observations of the N159/N160 c were performed on 2007 February 3 and 5. We used the near-infrared camera SIRIUS (Nagayama et al. 2003SPIE.4841..459N) and the polarimeter SIRPOL (Kandori et al. 2006SPIE.6269E..51K) of the Infrared Survey Facility (IRSF) 1.4 m telescope at the South African Astronomical Observatory in Sutherland, South Africa. The camera has a field of view of 7.7"x7.7" and a pixel scale of 0.45"/pixel. One set of observations for a target field consisted of 20 s exposures at 10 dithered positions for four wave-plate angles (0°, 45°, 22.5°, and 67.5°) in the J, H, and Ks bands, and the whole sequence is repeated 10 and 9 times for the N159 and N160 fields centered at (α, δ)2000=(5h39m37.1s, -69°43'45.1") and (5h40m05.6s, -69°36'25.8"), respectively. (2 data files).

Photon Physics and Plasma Research, Photonics Applications and Web Engineering, Wilga, May 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

This paper is the third part (out of five) of the research survey of WILGA Symposium work, May 2012 Edition, concerned with Photon Physics and Plasma Research. It presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the Jubilee XXXth SPIE-IEEE Wilga 2012, May Edition, symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET tokamak and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-270].

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

PubMed

Bartůněk, Petr

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

Airborne Hyperspectral Remote Sensing

DTIC Science & Technology

1999-09-30

REFERENCES Davis, C. O., M. Kappus , J. Bowles, J. Fisher, J. Antoniades, and M. Carney, “Calibration, Characterization and first Results with the Ocean...PUBLICATIONS Davis, C. O., M. Kappus , J. Bowles, J. Fisher, J. Antoniades, and M. Carney, “Calibration, Characterization and first Results with the Ocean PHILLS Hyperspectral Imager”, Proceedings of the SPIE, V. 3753, In Press.

Broadening of the I2P1/2 P3/2 Transition Lineshape by Unsteady Vortex Motion (Postprint)

DTIC Science & Technology

2008-06-24

vortex core identification functions of Sujudi and Haimes14 implemented in the Tecplot visualization software from Amtec Engineering. The red vortex core...sensors for COIL devices,” Proceedings of SPIE Conference on Gas, Chemical, and Electrical Lasers and Intense Beam Control and Applications, 3931, pp

[Shaare Zedek Medical Center's model of an integrated division of internal medicine].

PubMed

Yinnon, Amos M; Munter, Gabriel; Friedmann, Reuven; Katz, David; Nesher, Gideon; Tichler, Thomas; Zevin, Shoshana

2014-01-01

The specialty and practice of internal medicine have been subject to serious challenges in the last two decades. We describe the integrative model of internal medicine as developed in our hospital, providing solutions to some major challenges. Major components include: (1) Senior physicians and residents are employed by the Division rather than individual Departments of Medicine, allowing for balanced distribution of professional capabilities. (2) Two medical departments specialize in geriatric medicine, while the other departments take care of younger, more intellectually challenging patients. Senior and junior staff members rotate through these departments, allowing for exposure to different patient populations and professional expertise. (3) The backbone of senior physicians is rewarded by a set of incentives, including dedicated time for research. (4) Senior staff from the subspecialties contributes annually 1-2 months as senior physicians in the departments and receive academic and other compensation for their efforts. (5) In cases where medical departments elsewhere are flooded with corridor admissions (a source of frustration and burnout), a short admission unit in the emergency department relieves internal medicine pressures and shortens evaluation and therapy for many patients. Our integrative model of internal medicine allows for improved patient and staff distribution, greater satisfaction among patients and family members, greater professional satisfaction among physicians, while resident vacancies are filled with competent residents.

Divergent fates of the medical humanities in psychiatry and internal medicine: should psychiatry be rehumanized?

PubMed

Rutherford, Bret R; Hellerstein, David J

2008-01-01

To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. The journals searched were the three highest-ranking psychiatry and internal medicine journals on the Institute for Scientific Information's Impact Factor rankings that were published in English and aimed at a clinical audience. Operationalized criteria defining the medical humanities allowed the percentage of text in the selected journals constituting medical humanities to be quantified. Journals were hand searched at 10-year intervals from 1950 to 2000. Mixed effects models were used to describe the change in medical humanities over time. The percentage of text within psychiatry journals meeting the criteria for medical humanities declined from a peak of 17% in 1970 to a low of 2% in 2000, while the percentage of humanities articles in internal medicine journals roughly doubled from 5% to 11% over the same time period. A linear model increasing over time best fit the medical humanities in the internal medicine journals, while a cubic model decreasing over time best fit the psychiatry humanities data. Humanities articles in medical journals had a greater breadth and diversity than those in psychiatry journals. Medical humanities publications dramatically decreased over time in psychiatry journals while they more than doubled in internal medicine journals. These data suggest the need for further empirical research and discussion of the potential roles of the humanities in psychiatry.

[Diagnosis and treatment in general internal medicine. Curriculum selection].

PubMed

Casal, E R; Vázquez, E N; Husni, C

1994-01-01

In our country general internists are the providers of adult medical care in urban areas. In the past twenty years, with the increasing subspecialization within internal medicine and the development of advances in technology, the role of the general internist seems to be endangered. Recently much attention has been focused on this area and Divisions and Programs of General Internal Medicine have been established in most medical schools in the USA. The University of Buenos Aires instituted a Program of General Internal Medicine in its major teaching hospital in 1987. One of its purposes was to offer an educational experience to residents in the field of internal medicine primary care. This paper summarizes how this program was carried out and the subjects proposed in the area of Diagnosis and Treatment. The Program of General Internal Medicine is performed in the Outpatient Division and it is staffed by 3 faculty members and 4 fellows. Residents in Internal Medicine have a three month, full-time block rotation in the Program. A young, city dwelling, lower middle class population participates in the Program, with almost 10000 visits a year. The Program offers an experience that includes supervised patient care, an average of 100 office visits a month, and seminars and/or workshops covering topics of "Diagnosis and Treatment", "Case Presentations", "Clinical Epidemiology", "Prevention", and "Doctor-Patient Interview". In the area of Diagnosis and Treatment, the criteria used were: 1-frequency of diagnosis as determined by previous investigations, 2-relevant clinical conditions absent from the frequency list as determined by a consensus process by faculty members.(ABSTRACT TRUNCATED AT 250 WORDS)

Important Skills for Internship and the Fourth-Year Medical School Courses to Acquire Them: A National Survey of Internal Medicine Residents.

PubMed

Pereira, Anne G; Harrell, Heather E; Weissman, Arlene; Smith, Cynthia D; Dupras, Denise; Kane, Gregory C

2016-06-01

To obtain feedback from internal medicine residents, a key stakeholder group, regarding both the skills needed for internship and the fourth-year medical school courses that prepared them for residency. This feedback could inform fourth-year curriculum redesign efforts. All internal medicine residents taking the 2013-2014 Internal Medicine In-Training Examination were asked to rank the importance of learning 10 predefined skills prior to internship and to use a dropdown menu of 11 common fourth-year courses to rank the 3 most helpful in preparing for internship. The predefined skills were chosen based on a review of the literature, a national subinternship curriculum, and expert consensus. Chi-square statistics were used to test for differences in responses between training levels. Of the 24,820 internal medicine residents who completed the exam, 20,484 (83%) completed the survey, had complete identification numbers, and consented to have their responses used for research. The three skills most frequently rated as very important were identifying when to seek additional help and expertise, prioritizing clinical tasks and managing time efficiently, and communicating with other providers around care transitions. The subinternship/acting internship was most often selected as being the most helpful course in preparing for internship. These findings indicate which skills and fourth-year medical school courses internal medicine residents found most helpful in preparing for internship and confirm the findings of prior studies highlighting the perceived value of subinternships. Internal medicine residents and medical educators agree on the skills students should learn prior to internship.

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

PubMed

Santhosh, Lekshmi; Babik, Jennifer; Looney, Mark R; Hollander, Harry

2017-04-01

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

Dynamic Bidirectional Reflectance Distribution Functions: Measurement and Representation

DTIC Science & Technology

2008-02-01

be included in the harmonic fits. Other sets of orthogonal functions such as Zernike polynomials have also been used to characterize BRDF and could...reflectance spectra of 3D objects,” Proc. SPIE 4663, 370–378 2001. 13J. R. Shell II, C. Salvagio, and J. R. Schott, “A novel BRDF measurement technique

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…

Internal medicine point-of-care ultrasound assessment of left ventricular function correlates with formal echocardiography.

PubMed

Johnson, Benjamin K; Tierney, David M; Rosborough, Terry K; Harris, Kevin M; Newell, Marc C

2016-02-01

Although focused cardiac ultrasonographic (FoCUS) examination has been evaluated in emergency departments and intensive care units with good correlation to formal echocardiography, accuracy for the assessment of left ventricular systolic function (LVSF) when performed by internal medicine physicians still needs independent evaluation. This prospective observational study in a 640-bed, academic, quaternary care center, included 178 inpatients examined by 10 internal medicine physicians who had completed our internal medicine bedside ultrasound training program. The ability to estimate LVSF with FoCUS as "normal," "mild to moderately decreased," or "severely decreased" was compared with left ventricular ejection fraction (>50%, 31-49%, and <31%, respectively) from formal echocardiography interpreted by a cardiologist. Sensitivity and specificity of FoCUS for any degree of LVSF impairment were 0.91 (95% confidence interval [CI] 0.80, 0.97) and 0.88 (95% CI 0.81, 0.93), respectively. The interrater agreement between internal medicine physician-performed FoCUS and formal echocardiography for any LVSF impairment was "good/substantial" with κ = 0.77 (p < 0.001), 95% CI (0.67, 0.87). Formal echocardiography was classified as "technically limited due to patient factors" in 20% of patients; however, echogenicity was sufficient in 100% of FoCUS exams to classify LVSF. Internal medicine physicians using FoCUS identify normal versus decreased LVSF with high sensitivity, specificity, and "good/substantial" interrater agreement when compared with formal echocardiography. These results support the role of cardiac FoCUS by properly trained internal medicine physicians for discriminating normal from reduced LVSF. © 2015 Wiley Periodicals, Inc.

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States

PubMed Central

Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M.; Mehta, Ambar; Anderson, Gerard F.; Makary, Martin A.

2017-01-01

Importance Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. Objective To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Design, Setting, and Participants Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Main Outcomes and Measures Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Results Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen (median, 5.0; IQR, 3.5-6.7 for ≥20% uninsured), and location (median, 5.3; IQR, 3.8-6.8 for the southeastern United States). Conclusions and Relevance Across hospitals, there is wide variation in excess charges on ED services, which are often priced higher than internal medicine services. Our results inform policy efforts to protect uninsured and out-of-network patients from highly variable pricing. PMID:28558093

[Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

PubMed

Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

2011-02-02

Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

[Infectious diseases - a specialty of internal medicine].

PubMed

Fätkenheuer, G; Jung, N; Kern, W V; Fölsch, U R; Salzberger, B

2018-04-01

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

Challenges facing general internal medicine in the 99th Congress.

PubMed

Prout, D M

1986-01-01

Since 1976, federal support for training in general internal medicine has been provided through the primary care residency programs under Title VII of the Public Health Service Act. Continuation of these programs is now in jeopardy because of severe fiscal pressures and the response of Congress to the resulting budgetary stringency. General internal medicine faces immediate problems in the budgetary, authorization, and appropriations arenas. However, Congressional proposals for changing the method by which Medicare pays for all graduate medical education may provide an important opportunity. Under a revised method of financing graduate medical education, general internal medicine could eliminate its historical dependence on increasingly unstable federal grant funds and could contribute to the development of new federal incentives for training in the primary care specialties.

Prescription, Dispensation, and Generic Medicine Replacement Ratios: Influence on Japanese Medicine Costs

PubMed Central

Yokoi, Masayuki; Tashiro, Takao

2016-01-01

This study used publicly available data to examine the effect of the separation of dispensing and prescribing medicines between pharmacists in pharmacies and doctors in medical institutions (the separation system) and the generic medicine replacement ratio on the cost of various medicines in Japanese prefectures. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each administrative district is highly variable. In our multiple regression analysis, the dependent variables were the costs of daily medicines, specifically, total, internal, external, and injection medicines, as well as medical devices, and the independent variables were the expansion rate of the separation system and generic medicine replacement ratio. The expansion rate of the separation system showed a significant negative partial correlation with the daily costs of total, internal, and injection medicines as well as medical devices. Moreover, the rate of replacing brand name medicines with generic medicines showed a significant negative partial correlation with the daily costs of total and internal medicines. However, external and injection medicines and medical devices did not because only a few or no generic products of these types were sold in the Japanese market. Otherwise, expansion of the separation system was effective in reducing medicine costs, except in the case of external medicines. This suggests that the cost efficiency effect of the separation system does not function all the time. PMID:26234979

World Workshop on Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral medicine.

PubMed

Steele, John C; Clark, Hadleigh J; Hong, Catherine H L; Jurge, Sabine; Muthukrishnan, Arvind; Kerr, A Ross; Wray, David; Prescott-Clements, Linda; Felix, David H; Sollecito, Thomas P

2015-08-01

To explore international consensus for the validation of clinical competencies for advanced training in Oral Medicine. An electronic survey of clinical competencies was designed. The survey was sent to and completed by identified international stakeholders during a 10-week period. To be validated, an individual competency had to achieve 90% or greater consensus to keep it in its current format. Stakeholders from 31 countries responded. High consensus agreement was achieved with 93 of 101 (92%) competencies exceeding the benchmark for agreement. Only 8 warranted further attention and were reviewed by a focus group. No additional competencies were suggested. This is the first international validated study of clinical competencies for advanced training in Oral Medicine. These validated clinical competencies could provide a model for countries developing an advanced training curriculum for Oral Medicine and also inform review of existing curricula. Copyright © 2015 Elsevier Inc. All rights reserved.

The Teaching of Liberal Arts in Internal Medicine Residency Training.

ERIC Educational Resources Information Center

Povar, Gail J.; Keith, Karla J.

1984-01-01

A survey on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine is discussed. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. (Author/MLW)

Healthcare provider perceptions of clinical prediction rules

PubMed Central

Richardson, Safiya; Khan, Sundas; McCullagh, Lauren; Kline, Myriam; Mann, Devin; McGinn, Thomas

2015-01-01

Objectives To examine internal medicine and emergency medicine healthcare provider perceptions of usefulness of specific clinical prediction rules. Setting The study took place in two academic medical centres. A web-based survey was distributed and completed by participants between 1 January and 31 May 2013. Participants Medical doctors, doctors of osteopathy or nurse practitioners employed in the internal medicine or emergency medicine departments at either institution. Primary and secondary outcome measures The primary outcome was to identify the clinical prediction rules perceived as most useful by healthcare providers specialising in internal medicine and emergency medicine. Secondary outcomes included comparing usefulness scores of specific clinical prediction rules based on provider specialty, and evaluating associations between usefulness scores and perceived characteristics of these clinical prediction rules. Results Of the 401 healthcare providers asked to participate, a total of 263 (66%), completed the survey. The CHADS2 score was chosen by most internal medicine providers (72%), and Pulmonary Embolism Rule-Out Criteria (PERC) score by most emergency medicine providers (45%), as one of the top three most useful from a list of 24 clinical prediction rules. Emergency medicine providers rated their top three significantly more positively, compared with internal medicine providers, as having a better fit into their workflow (p=0.004), helping more with decision-making (p=0.037), better fitting into their thought process when diagnosing patients (p=0.001) and overall, on a 10-point scale, more useful (p=0.009). For all providers, the perceived qualities of useful at point of care, helps with decision making, saves time diagnosing, fits into thought process, and should be the standard of clinical care correlated highly (≥0.65) with overall 10-point usefulness scores. Conclusions Healthcare providers describe clear preferences for certain clinical prediction rules, based on medical specialty. PMID:26338684

Academic general internal medicine: a mission for the future.

PubMed

Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

2013-06-01

After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

Nurses as Evaluators of the Humanistic Behavior of Internal Medicine Residents.

ERIC Educational Resources Information Center

Butterfield, Paula S.; And Others

1987-01-01

The reliability of a 13-item questionnaire designed to assess the humanistic behaviors of internal medicine residents and the reliability of nurses as raters of those behaviors were examined. Residents were evaluated by nurses on two general medicine services and on cardiology and hematology-oncology services. (Author/MLW)

Influence of the Separation of Prescription and Dispensation of Medicine on Its Cost in Japanese Prefectures

PubMed Central

Yokoi, Masayuki; Tashiro, Takao

2014-01-01

We studied how the separation of dispensing and prescribing of medicines between pharmacies and clinics (the “separation system”) can reduce internal medicine costs. To do so, we obtained publicly available data by searching electronic databases and official web pages of the Japanese government and non-profit public service corporations on the Internet. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each of the administrative districts is highly variable. The data were subjected to multiple regression analysis; daily internal medicines were the objective variable and expansion rate of the separation system was the explanatory variable. A multiple regression analysis revealed that the expansion rate of the separation system and the rate of replacing brand name medicine with generic medicine showed a significant negative partial correlation with daily internal medicine costs. Thus, the separation system was as effective in reducing medicine costs as the use of generic medicines. Because of its medical economic efficiency, the separation system should be expanded, especially in Asian countries in which the system is underdeveloped. PMID:24999122

Influence of the separation of prescription and dispensation of medicine on its cost in Japanese prefectures.

PubMed

Yokoi, Masayuki; Tashiro, Takao

2014-04-07

We studied how the separation of dispensing and prescribing of medicines between pharmacies and clinics (the "separation system") can reduce internal medicine costs. To do so, we obtained publicly available data by searching electronic databases and official web pages of the Japanese government and non-profit public service corporations on the Internet. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each of the administrative districts is highly variable. The data were subjected to multiple regression analysis; daily internal medicines were the objective variable and expansion rate of the separation system was the explanatory variable. A multiple regression analysis revealed that the expansion rate of the separation system and the rate of replacing brand name medicine with generic medicine showed a significant negative partial correlation with daily internal medicine costs. Thus, the separation system was as effective in reducing medicine costs as the use of generic medicines. Because of its medical economic efficiency, the separation system should be expanded, especially in Asian countries in which the system is underdeveloped.

Ocular Safety of Topical Naltrexone

DTIC Science & Technology

2013-04-01

prescription medicines , vitamins and herbal supplements. Especially tell your doctor if you take any opioid-containing medicines for pain, cough, or...squamous cell carcinoma. International Journal of Molecular Medicine 2000;5:191-6. 13. Zagon IS, McLaughlin PJ. Naloxone prolongs the survival time of mice...human pancreatic adenocarcinoma. International Journal of Molecular Medicine 2000;5:77-84. 18 35. Zagon IS, Verderame MF, Zimmer WE, McLaughlin PJ

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey.

PubMed

Akl, Elie A; Gunukula, Sameer; Mustafa, Reem; Wilson, Mark C; Symons, Andrew; Moheet, Amir; Schünemann, Holger J

2010-03-25

The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Of 434 responding program directors (52% response rate), 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%). The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).

PubMed

Kaneko, Makoto; Ohta, Ryuichi; Nago, Naoki; Fukushi, Motoharu; Matsushima, Masato

2017-09-13

The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman's rank correlation coefficient to examine the correlation between the proportion of "non-internal medicine-related" RFEs and health problems in each study area in consideration of the population density. We found 17 studies with diverse designs and settings. Among these studies, "non-internal medicine-related" RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, "non-internal medicine-related" health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of "non-internal medicine-related" RFEs and health problems. This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan need to be able to deal with "non-internal-medicine-related" RFEs and health problems, and that curriculum including practical non-internal medicine-related training is likely to be important.

The International Society for Sexual Medicine: A Rich History and a Bright Future.

PubMed

Lewis, Ronald W

2013-07-01

Based upon physical presence at most of the historical moments of the development of the International Society for Sexual Medicine (ISSM), extensive personal records on meetings and correspondence associated with the business and the work of the International Society for Sexual and Impotence Research and the ISSM, and information provided by the business office of the ISSM, a review paper was created to present to the reader an accurate history of the ISSM. The article is divided into the early beginnings of the idea of the field of sexual medicine, followed by the organization of what was to become eventually the International Society for Sexual Medicine, description of the development of biennial meetings and some of the major events that occurred at these meetings, a description of officers and leaders of the society and some of their key contributions, other meetings that the ISSM was actively involved in in the field of sexual medicine, a detailed discussion of publications and communications of the organization, and finally a description of the involvement of the ISSM with the recognition of scientific achievement and research in the field. This history is indeed very rich and unique for the parallelism to the development of the entire field of sexual medicine as a true science. The author has spent a great deal of time in making sure that there is written material that substantiates the history that is outlined in this document. It is provided to the reader as a true historical perspective on the ISSM. Lewis RW. The International Society for Sexual Medicine: A rich history and a bright future. Sex Med Rev 2013; 1:65-75. Copyright © 2013 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The association of students requiring remediation in the internal medicine clerkship with poor performance during internship.

PubMed

Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

2015-04-01

To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Unsuccessful clinical performance which requires remediation in the third year internal medicine clerkship at Uniformed Services University of the Health Sciences continues to be strongly associated with poor performance at the internship level. No significant associations existed between any of the other clerkships and poor performance during internship and Step 3 failure. The strength of this association with the internal medicine clerkship is most likely because of an increased level of sensitivity in detecting poor performance. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Current Status of Standardization of Traditional Chinese Medicine in China

PubMed Central

Guo, Yi; Li, Gui Lan

2016-01-01

As an important component of traditional medicine, Traditional Chinese Medicine (TCM) is widely spread and applied in more than 100 countries across the world. The standardization of TCM is very important for the international application of Chinese medicine. In this paper, we have explained and analyzed the standardization situations of TCM in China with the purpose of providing reference for standardization and international development of TCM. PMID:27110268

International Perspectives on General Internal Medicine and the Case for “Globalization” of a Discipline

PubMed Central

Ghali, William A; Greenberg, Peter B; Mejia, Raul; Otaki, Junji; Cornuz, Jacques

2006-01-01

General internal medicine (GIM) has flourished in the United States (U.S.). Unlike other subspecialties of internal medicine, however, GIM's evolution has not been global in scope, but rather appears to have occurred in isolation within countries. Here, we describe international models of GIM from Canada, Switzerland, Australia/New Zealand, Argentina, and Japan, and compare these with the U.S. model. There are notable differences in the typical clinical roles assumed by General Internists across these 7 countries, but also important overlap in clinical and academic domains. Despite this overlap, there has been a relative lack of contact among General Internists from these and other countries at a truly international GIM meeting; the time is now for increased international exchange and the “globalization” of GIM. PMID:16336623

Exploring the Educational Value of Clinical Vignettes from the Society of General Internal Medicine National Meeting in the Internal Medicine Clerkship

PubMed Central

Wofford, James L; Singh, Sonal

2006-01-01

INTRODUCTION Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE To explore the relevance and learning value of clinical vignettes from the SGIM national meeting in the Internal Medicine clerkship. SETTING Third year Ambulatory Internal Medicine clerkship at one academic medical center (academic year 2005 to 2006). METHODS Students were introduced to the clinical vignette and oriented to the database of clinical vignettes available through the SGIM annual meeting website. Students then reviewed 5 to 10 clinical vignettes using a worksheet, and rated the learning value of each vignette using a 5-point Likert scale (1 = least, 5 = greatest). A single investigator evaluated congruence of the vignette with the Clerkship Directors of Internal Medicine (CDIM)-SGIM curriculum to assess relevance. MAIN RESULTS A total of 42 students evaluated 371 clinical vignettes from the 2004 and 2005 meetings. The clinical vignettes were curriculum-congruent in 42.6% (n = 175), and clearly incongruent in 40.4% (n = 164). The mean rating for learning value was 3.8 (±1.0) (5 signifying greatest learning value). Curriculum-congruent vignettes had a higher mean learning value compared with curriculum-incongruent vignettes (4.0 vs 3.6, Student's t-test, P =.017). CONCLUSION The clinical vignettes presented at the national SGIM meeting offer clinical content that is relevant and of some educational value for third year clerkship students. Based on this pilot study, the educational value and strategies for their use in the clinical clerkships deserve further study. PMID:17026730

Market influences on internal medicine residents' decisions to subspecialize.

PubMed

Valente, E; Wyatt, S M; Moy, E; Levin, R J; Griner, P F

1998-06-01

Managed care reduces the demand for internal medicine subspecialists, but little empirical information is available on how increasing managed care may be affecting residents' training choices. To determine whether increased managed care penetration into an area where residents train was associated with a decreased likelihood that residents who completed general internal medicine training pursued subspecialty training. Secondary logistic regression analysis of data from the 1993 cohort of general internal medicine residents. U.S. residency training sites. 2263 U.S. medical school graduates who completed general internal medicine residency training in 1993. The outcome variable (enrollment in subspecialty training) was derived from the Graduate Medical Education Tracking Census of the Association of American Medical Colleges (AAMC). Health maintenance organization (HMO) penetration (possible range, 0.0 to 1.0; higher values indicate greater penetration) was taken from the Interstudy Competitive Edge Database. Individual and medical school covariates were taken from the AAMC's Student and Applicant Information Management System database and the National Institutes of Health Information for Management Planning, Analysis, and Coordination system. The U.S. Census division was included as a control covariate. 980 participants (43%) enrolled in subspecialty training. Logistic regression analyses indicated a nonlinear association between managed care penetration into a training area and the odds of subspecialization. Increasing managed care penetration was associated with decreasing odds of subspecialization when penetration exceeded 0.15. The choice of subspecialty training increased as HMO penetration increased from 0 to 0.15. Local market forces locally influenced the career decisions of internal medicine residents, but the influence was small compared with the effects of age and sex. These results suggest that market forces help to achieve more desirable generalist-to-specialist physician ratios in internal medicine.

General medicine vs subspecialty career plans among internal medicine residents.

PubMed

West, Colin P; Dupras, Denise M

2012-12-05

Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians. Differences in general internal medicine (GIM) career plans between internal medicine residency program types and across resident demographics are not well understood. To evaluate the general medicine career plans of internal medicine residents and how career plans evolve during training. A study of US internal medicine residents using an annual survey linked to the Internal Medicine In-Training Examination taken in October of 2009-2011 to evaluate career plans by training program, sex, and medical school location. Of 67,207 US eligible categorical and primary care internal medicine residents, 57,087 (84.9%) completed and returned the survey. Demographic data provided by the National Board of Medical Examiners were available for 52,035 (77.4%) of these residents, of whom 51,390 (76.5%) responded to all survey items and an additional 645 (1.0%) responded to at least 1 survey item. Data were analyzed from the 16,781 third-year residents (32.2%) in this sample. Self-reported ultimate career plans of internal medicine residents. A GIM career plan was reported by 3605 graduating residents (21.5%). A total of 562 primary care program (39.6%) and 3043 categorical (19.9%) residents reported GIM as their ultimate career plan (adjusted odds ratio [AOR], 2.76; 99% CI, 2.35-3.23; P < .001). Conversely, 10 008 categorical (65.3%) and 745 primary care program (52.5%) residents reported a subspecialty career plan (AOR, 1.90; 99% CI, 1.62-2.23; P < .001). GIM career plans were reported more frequently by women than men (26.7% vs 17.3%, respectively; AOR, 1.69; 99% CI, 1.53-1.87; P < .001). US medical graduates were slightly more likely to report GIM career plans than international medical graduates (22.0% vs 21.1%, respectively; AOR, 1.76; 99% CI, 1.50-2.06; P < .001). Within primary care programs, US medical graduates were much more likely to report GIM career plans than international medical graduates (57.3% vs 27.3%, respectively; AOR, 3.48; 99% CI, 2.58-4.70; P < .001). Compared with their counterparts, maintaining a first-year GIM career plan over the course of their training was more likely among primary care program residents (68.2% vs 52.3%; AOR, 1.81; 99% CI, 1.25-2.64; P < .001), women (62.4% vs 47.2%; AOR, 1.75; 99% CI, 1.34-2.29; P < .001), and US medical graduates (60.9% vs 49.2%; AOR, 1.48; 99% CI, 1.13-1.93; P < .001). Reported GIM career plans were markedly less common than subspecialty career plans among internal medicine residents, including those in primary care training programs, and differed according to resident sex, medical school location, and program type.

The Inherent Visible Light Signature of an Intense Underwater Ultraviolet Light Source Due to Combined Raman and Fluorescence Effects

DTIC Science & Technology

2000-01-01

Humans cannot see ultraviolet light. The blue-sensitive cones in the retina would respond weakly to ultraviolet wavelengths if exposed to them, but...545, 1992. 3. C. S. Yentsch, and D. A. Phinney, " Autofluorescence and Raman scattering in the marine underwater environment," Ocean Optics X, SPIE

Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

PubMed

Al-Aama, Tareef

2016-06-01

To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

[Referral to internal medicine for alcoholism: influence on follow-up care].

PubMed

Avila, P; Marcos, M; Avila, J J; Laso, F J

2008-11-01

The problem of high rates of patient drop-out in alcohol treatment programs is frequently reported in the literature. Our aim was to investigate if internal medicine referral could improve abstinence and retention rates in a cohort of alcoholic patients. A retrospective observational study was conducted comparing 200 alcoholic patients attending a psychiatric unit (group 1) with 100 patients attending both this unit and an internal medicine unit (group 2). We collected sociodemographic and clinical variables and analysed differences regarding abstinence and retention rates by means of univariate and multivariate analysis. At 3 and 12 months follow-up, group 2 patients had higher retention and abstinence rates than group 1 patients. Multivariate analysis including potential confounding variables showed that independent predictors of one-year retention were internal medicine referral and being married. Independent predictors of one-year abstinence were being married, age > 44 years and receipt of drug treatment. The higher retention rate found among patients referred to Internal Medicine specialists, a result that has not been previously reported to the best of our knowledge, emphasizes the importance of a multidisciplinary team approach in the treatment of alcoholism.

Minimum Entropy Autofocus Correction of Residual Range Cell Migration

DTIC Science & Technology

2017-03-02

reduced the residual to effectively a slowly varying bias on the order of a wavelength ( ∼ 3 cm ) which has negligible impact on the image focus. Fig...Fitzgerrell, and J. Beaver , “Two- dimensional phase gradient autofocus,” Proc. SPIE, vol. 4123, pp. 162– 173, 2000. [6] D. H. Brandwood, “A complex gradient

[Masters of Chilean Internal Medicine].

PubMed

Rosselot, Eduardo

2003-08-01

Master of internal Medicine is the highest award granted by the Chilean Society of Internal Medicine (Sociedad Médica de Santiago) to its members. This article outlines the sense and transcendence of this award and provides an abridged, certainly incomplete, data of the recipients since 1981 when this award was first given. Those who have received it are not the only ones that have the attributes to deserve such distinction. There are many members with similar or even better merits, and therefore the Directory of the Society is usually exposed to a very hard decision when facing each new nomination. When a member is awarded, he becomes a model to be emulated or surpassed by the future generations; thus assumes the great responsibility of maintaining the spirit, the prestige and the projection of Internal Medicine into the future.

Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study.

PubMed

Díez-Manglano, Jesús; de Escalante Yangüela, Begoña; García-Arilla Calvo, Ernesto; Ubis Díez, Elena; Munilla López, Eulalia; Clerencia Sierra, Mercedes; Revillo Pinilla, Paz; Omiste Sanvicente, Teresa

2013-12-01

To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units. A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index was<60 or Pfeiffer questionnaire ≥ 3 errors. 471 polypathological patients, 337 from internal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; p<.001) and locomotive ones (39.1% vs 20.4%; p<.001) in geriatrics inpatients. Charlson index was higher for internal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); p<.001], and lower in Barthel [38.8(32.5) vs 61.2(34.3); p=.001] and Lawton-Brody indexes [0.9(1.6) vs 3.0(2.9); p<.001], and more frequently needed a caregiver (87.8% vs 53.6%; p<.001) and had it. There are differences in disease profile and functional and cognitive situation between polypathological patients of internal medicine and geriatrics departments. © 2013.

A Qualitative Study of Work-Life Choices in Academic Internal Medicine

ERIC Educational Resources Information Center

Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

2014-01-01

The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career…

Nanolaminates with Novel Properties Fabricated Using Atomic Layer Deposition Techniques

DTIC Science & Technology

2006-07-01

Enhance X-Ray Reflectivity of Polysilicon Micro-Mirrors at 1.54 A Wavelength", Proceedings of SPIE 5720, 241-251 (2005). 20. D.C. Miller, C.F...diodes ( OLEDs ). This project has demonstrated that the A120 3 ALD gas diffusion barrier helps to prevent H20 and 02 gases from diffusing through the

Military graduate medical education in internal medicine: an outcomes study.

PubMed

Cation, L J; Lenihan, D J; Gutierrez-Nunez, J J

2001-04-01

Military graduate medical education has come under increasing scrutiny in recent years as the size of the military medical force declines. To document the outcomes of military graduate medical education in internal medicine, a cohort of Air Force internal medicine residency graduates from Wright-Patterson Medical Center were studied and their residency performance, staff performance, and active duty retention recorded. The study cohort had an outstanding residency performance, as measured by research experience and board certification rate. They also performed well as military staff physicians, receiving numerous individual military medals while holding important administrative and supervisory positions in the military. Finally, the study cohort had a higher than expected active duty retention rate. These findings support the notion that military graduate medical education in internal medicine produces outstanding military internists.

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations.

PubMed

Iserson, Kenneth V; Biros, Michelle H; James Holliman, C

2012-06-01

While personal and organizational challenges occur in every area of health care, practitioners of international medicine face unique problems and dilemmas that are rarely discussed in training programs. Health professions schools, residency and fellowship programs, nongovernmental organizations (NGOs), and government programs have a responsibility to make those new to international medicine aware of the special circumstances that they may face and to provide methods for understanding and dealing with these circumstances. Standard "domestic" approaches to such challenges may not work in international medicine, even though these challenges may appear to be similar to those faced in other clinical settings. How should organizations ensure that well-meaning health intervention efforts do not cause adverse unintended sequelae? How should an individual balance respect for cultural uniqueness and local mores that may profoundly differ from his or her own beliefs, with the need to remain a moral agent true to one's self? When is acceptance the appropriate response to situations in which limitations of resources seem to preclude any good solution? Using a case-based approach, the authors discuss issues related to the four major international medicine domains: clinical practice (postdisaster response, resource limitations, standards of care), medical systems and systems development (prehospital care, wartime casualties, sustainable change, cultural awareness), teaching (instruction and local resources, professional preparation), and research (questionable funded studies, clinical trials, observational studies). It is hoped that this overview may help prepare those involved with international medicine for the challenges and dilemmas they may face and help frame their responses to these situations. © 2012 by the Society for Academic Emergency Medicine.

Using AGREE II to Evaluate the Quality of Traditional Medicine Clinical Practice Guidelines in China.

PubMed

Deng, Wei; Li, Le; Wang, Zixia; Chang, Xiaonan; Li, Rui; Fang, Ziye; Wei, Dang; Yao, Liang; Wang, Xiaoqin; Wang, Qi; An, Guanghui

2016-03-15

To evaluate/assess the quality of the Clinical Practice Guidelines (CPGs) of traditional medicine in China. We systematically searched the literature databases WanFang Data, VIP, CNKI and CBM for studies published between 1978 and 2012 to identify and select CPGs of traditional medicine. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate these guidelines. A total of 75 guidelines were included, of which 46 guidelines (62%) were on Traditional Chinese Medicine, 19 (25%) on Chinese Integrated Medicine, and 10 (13%) on Uyghur Medicine. Most traditional medicine CPGs published in domestic journals scored <20% (range: 0-63%). Eleven (14%) CPGs were developed following the methodology of evidence-based medicine. In each domain of AGREE II, traditional Medicine CPGs performed clearly better than international CPGs. The same trend was seen in guidelines of Modern Medicine. An increasing amount of CPGs are being published, but their quality is low. Referring to the key points of international guidelines development, supervision through AGREE II, cooperating with international groups and exploring the strategy of guideline development could improve the quality of CPGs on traditional medicine. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Intern underperformance is detected more frequently in emergency medicine rotations.

PubMed

Aram, Narelle; Brazil, Victoria; Davin, Lorna; Greenslade, Jaimi

2013-02-01

To determine the frequency and nature of intern underperformance as documented on in-training assessment forms. A retrospective review of intern assessment forms from a 2 year period (2009-2010) was conducted at a tertiary referral hospital in Brisbane, Queensland. The frequency of interns assessed as 'requiring substantial assistance' and/or 'requires further development' on mid- or end-of-term assessment forms was determined. Forms were analysed by the clinical rotation, time of year and domain(s) of clinical practice in which underperformance was documented. During 2009 and 2010 the overall documented incidence of intern underperformance was 2.4% (95% CI 1.5-3.9%). Clinical rotation in emergency medicine detected significantly more underperformance compared with other rotations (P < 0.01). Interns predominantly had difficulty with 'clinical judgment and decision-making skills', 'time management skills' and 'teamwork and colleagues' (62.5%, 55% and 32.5% of underperforming assessments, respectively). Time of the year did not affect frequency of underperformance. A proportion of 13.4% (95% CI 9.2-19.0%) of interns working at the institution over the study period received at least one assessment in which underperformance was documented. Seventy-six per cent of those interns who had underperformance identified by mid-term assessment successfully completed the term following remediation. The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

45 CFR 50.5 - Waivers for the delivery of health care service.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Primary care physicians are defined as: physicians practicing general internal medicine, pediatrics... practice, general pediatrics, obstetrics/gynecology, general internal medicine, or general psychiatry; and...

45 CFR 50.5 - Waivers for the delivery of health care service.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Primary care physicians are defined as: physicians practicing general internal medicine, pediatrics... practice, general pediatrics, obstetrics/gynecology, general internal medicine, or general psychiatry; and...

EDITORIAL: Fluctuations and noise in photonics and quantum optics: a special issue in memory of Hermann Haus

NASA Astrophysics Data System (ADS)

Abbott, Derek; Shapiro, Jeffrey H.; Yamamoto, Yoshihisa

2004-08-01

This Special Issue of Journal of Optics B: Quantum and Semiclassical Optics brings together the contributions of various researchers working on theoretical and experimental aspects of fluctuational phenomena in photonics and quantum optics. The topics discussed in this issue extend from fundamental physics to applications of noise and fluctuational methods from quantum to classical systems, and include: bullet Quantum measurement bullet Quantum squeezing bullet Solitons and fibres bullet Gravitational wave inferometers bullet Fluorescence phenomena bullet Cavity QED bullet Photon statistics bullet Noise in lasers and laser systems bullet Quantum computing and information bullet Quantum lithography bullet Teleportation. This Special Issue is published in connection with the SPIE International Symposium on Fluctuations and Noise, held in Santa Fe, New Mexico, on 1-4 June 2003. The symposium contained six parallel conferences, and the papers in this Special Issue are connected to the conference entitled `Fluctuations and Noise in Photonics and Quantum Optics'. This was the first in a series of symposia organized with the support of the SPIE that have greatly contributed to progress in this area. The co-founders of the symposium series were Laszlo B Kish (Texas A&M University) and Derek Abbott (The University of Adelaide). The Chairs of the `Fluctuations and Noise in Photonics and Quantum Optics' conference were Derek Abbott, Jeffrey H Shapiro and Yoshihisa Yamamoto. The practical aspects of the organization were ably handled by Kristi Kelso and Marilyn Gorsuch of the SPIE, USA. Sadly, less than two weeks before the conference, Hermann A Haus passed away. Hermann Haus was a founding father of the field of noise in optics and quantum optics. He submitted three papers to the conference and was very excited to attend; as can be seen in the collection of papers, he was certainly present in spirit. In honour of his creativity and pioneering work in this field, we have dedicated this Special Issue to him. The first item is an obituary reflecting on his life and work. The first technical paper in this issue represents Hermann’s last sole author publication; a special thanks is due to A P Flitney for organizing this manuscript into publishable form. We thank the members of the International Programme Committee, listed below, and all those who contributed to making the event such a success. At this point we take the opportunity to express our gratitude to both the authors and reviewers, for their unfailing efforts in preparing and ensuring the high quality of the papers in this Special Issue. International Programme Committee David A Cardimona Air Force Research Laboratory, USA Howard Carmichael University of Auckland, New Zealand Carlton M Caves University of New Mexico, Albuquerque, USA Peter D Drummond University of Queensland, St Lucia, Australia Paul J Edwards University of Canberra, Australia Luca Gammaitoni Università degli Studi di Perugia, Italy Brage Golding Michigan State University, East Lansing, USA Gabriela Gonzalez Louisiana State University, Baton Rouge, USA Guangcan Guo University of Science and Technology of China, Hefei, China Salman Habib Los Alamos National Laboratory, NM, USA Murray Hamilton University of Adelaide, Australia Bei-Lok Hu University of Maryland/College Park, USA Daniel K Johnstone Virginia Commonwealth University, Richmond, USA Franz X Kärtner Massachusetts Institute of Technology, Cambridge, USA Prem Kumar Northwestern University, Evanston, IL, USA Zachary Lemnios DARPA, Arlington, VA, USA Gerd Leuchs Friedrich-Alexander Universität Erlangen--Nürnberg, Germany Hideo Mabuchi California Institute of Technology, Pasadena, USA Peter W Milonni Los Alamos National Laboratory, NM, USA Adrian C Ottewill University College Dublin, Ireland Martin B Plenio Imperial College, London, UK Rajeev J Ram Massachusetts Institute of Technology, Cambridge, USA Farhan Rana Massachusetts Institute of Technology, Cambridge, USA Peter R Smith Loughborough University of Technology, UK Rodney S Tucker University of Melbourne, Australia Howard M Wiseman Griffith University, Brisbane, Australia Stuart A Wolf DARPA, Arlington, VA, USA Anton Zeilinger University of Vienna, Austria Xi-Cheng Zhang Rensselaer Polytechnic Institute, Troy, NY, USA

Flat holographic stereograms synthesized from computer-generated images by using LiNbO3 crystal

NASA Astrophysics Data System (ADS)

Qu, Zhi-Min; Liu, Jinsheng; Xu, Liangying

1991-02-01

In this paper we used a novel method for synthesizing computer gene rated images in which by means of a series of intermediate holograms recorded on Fe--doped LiNbO crystals a high quality flat stereograni with wide view angle and much deep 3D image ha been obtained. 2. INTRODUCTITJN As we all know the conventional holography is very limited. With the help of a contineous wave laser only stationary objects can be re corded due tO its insufficient power. Although some moving objects could be recorded by a pulsed laser the dimensions and kinds of object are restricted. If we would like to see a imaginary object or a three dimensional image designed by computer it is very difficult by means of above conventional holography. Of course if we have a two-dimensional image on a comouter screen we can rotate it to give a three-dimensional perspective but we can never really see it as a solid. However flat holographic stereograrns synthesized from computer generated images will make one directly see the comoute results in the form of 3D image. Obviously it will have wide applications in design architecture medicine education and arts. 406 / SPIE Vol. 1238 Three-Dimensional Holography: Science Culture Education (1989)

Impact of personal goals on the internal medicine R4 subspecialty match: a Q methodology study.

PubMed

Daniels, Vijay J; Kassam, Narmin

2013-12-21

There has been a decline in interest in general internal medicine that has resulted in a discrepancy between internal medicine residents' choice in the R4 subspecialty match and societal need. Few studies have focused on the relative importance of personal goals and their impact on residents' choice. The purpose of this study was to assess if internal medicine residents can be grouped based on their personal goals and how each group prioritizes these goals compared to each other. A secondary objective was to explore whether we could predict a resident's desired subspecialty choice based on their constellation of personal goals. We used Q methodology to examine how postgraduate year 1-3 internal medicine residents could be grouped based on their rankings of 36 statements (derived from our previous qualitative study). Using each groups' defining and distinguishing statements, we predicted their subspecialties of interest. We also collected the residents' first choice in the subspecialty match and used a kappa test to compare our predicted subspecialty group to the residents' self-reported first choice. Fifty-nine internal medicine residents at the University of Alberta participated between 2009 and 2010 with 46 Q sorts suitable for analysis. The residents loaded onto four factors (groups) based on how they ranked statements. Our prediction of each groups' desired subspecialties with their defining and/or distinguishing statements are as follows: group 1 - general internal medicine (variety in practice); group 2 - gastroenterology, nephrology, and respirology (higher income); group 3 - cardiology and critical care (procedural, willing to entertain longer training); group 4 - rest of subspecialties (non-procedural, focused practice, and valuing more time for personal life). There was moderate agreement (kappa = 0.57) between our predicted desired subspecialty group and residents' self-reported first choice (p < 0.001). This study suggests that most residents fall into four groups based on a constellation of personal goals when choosing an internal medicine subspecialty. The key goals that define and/or distinguish between these groups are breadth of practice, lifestyle, desire to do procedures, length of training, and future income potential. Using these groups, we were able to predict residents' first subspecialty group with moderate success.

[Practice of Internal Medicine in Latin America. Role of the internist].

PubMed

Varela, Nacor

2002-01-01

This article explores the causes of the crisis in the role of internists. As in the United States, the progressive specialization of internists lead to a dehumanized, expensive and technical practice of medicine. Aiming to better incomes and prestige, more than 60% of internists practice as specialists. Primary care physicians, with a very low rate of problem solving, cover 75% of consultations. Specialists, with increasing costs, cover the rest of consultations. Patients, medical schools and health organizations are claiming the return of the general internal medicine specialist. To increase the interest for general internal medicine, several strategies are applicable. Medical students interested in general internal medicine could receive a focused training, provided by these specialists. A greater emphasis should be put on primary care. More independent, secondary care diagnostic and treatment centers, should be created. Continuous medical education should be done with periodical re certification of physicians. The public health system should increase its wages and the generalist view should be maintained by physicians when practicing at their private offices.

[Publication rate of Deutsche Forschungsgemeinschaft (DFG)-supported research projects. An analysis of the "fate" of DFG-support methods in anesthesia, surgery and internal medicine].

PubMed

Boldt, J; Maleck, W

2000-09-22

Outstanding medical research is not possible without financial support. The success of supported research projects have been evaluated only rarely. The publication rate of research projects supported by the German Research Council (Deutsche Forschungsgemeinschaft [DFG]) was assessed separately for internal medicine, surgery, and anesthesiology. Based on the "Figures and Facts" published by the DFG all supported projects of 1996 for all three specialities were included. In a Medline-based analysis all published papers dealing with the supported project and all papers published by the supported persons from 1996 to may 2000 were documented. A total of 315 grants were analysed (internal medicine: 234; surgery: 63; anesthesiology: 18). Projects with clinical topics were less often supported (n = 80) than experimental projects (n = 235). 162 (69.3%) of the grants in internal medicine, 41 (65.1) in surgery, and 14 (77.8%) of the grants in anesthesiology were published. In anesthesiology all published projects were in English language (internal medicine: 98.2%; surgery: 95%). Independent of the topic of the grant, several supported persons in internal medicine and surgery did not publish any papers between 1996 and may 2000, whereas all supported anesthesiologists published papers in peer reviewed journals in this time period. The publication rate of DFG supported projects is not sufficient. Except for a final internal report after finishing the research project no quality control exists for DFG grants. Unfortunately, not all supported projects were published. A better feedback between the financial support by the DFG and the publication rate of DFG grants is desirable.

Interdisciplinary, interinstitutional and international collaboration of family medicine researchers in Taiwan.

PubMed

Lin, Yi-Hsuan; Tseng, Yen-Han; Chang, Hsiao-Ting; Lin, Ming-Hwai; Tseng, Yen-Chiang; Chen, Tzeng-Ji; Hwang, Shinn-Jang

2015-01-01

The family medicine researches flourished worldwide in the past decade. However, the collaborative patterns of family medicine publications had not been reported. Our study analyzed the collaborative activity of family medicine researchers in Taiwan. We focused on the types of collaboration among disciplines, institutions and countries. We searched "family medicine" AND "Taiwan" in address field from Web of Science and documented the disciplines, institutions and countries of all authors. We analyzed the collaborative patterns of family medicine researchers in Taiwan from 2010 to 2014. The journal's impact factor of each article in the same publication year was also retrieved. Among 1,217 articles from 2010 to 2014, interdisciplinary collaboration existed in 1,185 (97.3%) articles, interinstitutional in 1,012 (83.2%) and international in 142 (11.7%). Public health was the most common collaborative discipline. All international researches were also interdisciplinary and interinstitutional. The United States (75 articles), the United Kingdom (21) and the People's Republic of China (20) were the top three countries with which family medicine researchers in Taiwan had collaborated. We found a high degree of interdisciplinary and interinstitutional collaboration of family medicine researches in Taiwan. However, the collaboration of family medicine researchers in Taiwan with family medicine colleagues of other domestic or foreign institutions was insufficient. The future direction of family medicine studies could focus on the promotion of communication among family medicine researchers.

Could international compulsory licensing reconcile tiered pricing of pharmaceuticals with the right to health?

PubMed

Ooms, Gorik; Forman, Lisa; Williams, Owain D; Hill, Peter S

2014-12-18

The heads of the Global Fund and the GAVI Alliance have recently promoted the idea of an international tiered pricing framework for medicines, despite objections from civil society groups who fear that this would reduce the leeway for compulsory licenses and generic competition. This paper explores the extent to which an international tiered pricing framework and the present leeway for compulsory licensing can be reconciled, using the perspective of the right to health as defined in international human rights law. We explore the practical feasibility of an international tiered pricing and compulsory licensing framework governed by the World Health Organization. We use two simple benchmarks to compare the relative affordability of medicines for governments - average income and burden of disease - to illustrate how voluntary tiered pricing practice fails to make medicines affordable enough for low and middle income countries (if compared with the financial burden of the same medicines for high income countries), and when and where international compulsory licenses should be issued in order to allow governments to comply with their obligations to realize the right to health. An international tiered pricing and compulsory licensing framework based on average income and burden of disease could ease the tension between governments' human rights obligation to provide medicines and governments' trade obligation to comply with the Agreement on Trade-Related Aspects of Intellectual Property Rights.

Developing and Implementing a Multispecialty Graduate Medical Education Curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT)

ERIC Educational Resources Information Center

Tetrault, Jeanette M.; Green, Michael L.; Martino, Steve; Thung, Stephen F.; Degutis, Linda C.; Ryan, Sheryl A.; Martel, Shara; Pantalon, Michael V.; Bernstein, Steven L.; O'Connor, Patrick G.; Fiellin, David A.; D'Onofrio, Gail

2012-01-01

The authors sought to evaluate the feasibility and acceptability of initiating a Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and other drug use curriculum across multiple residency programs. SBIRT project faculty in the internal medicine (traditional, primary care internal medicine, medicine/pediatrics),…

ROLE OF THE INTERNATIONAL ORGANIZATIONS IN PREVENTING THE COUNTERFEIT MEDICINES ENTRY INTO THE WORLD MARKETS.

PubMed

Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

2016-09-01

30 years have passed since Conference of Experts on the Rational Use of Drugs was held in Nairobi, Kenya, from 25 to 29 November 1985, where the problem of counterfeit medicines was mentioned as the international for the first time. The problem of counterfeit medicines is not only a major threat to public health and national and private economy, but also it is of great interest for key decision-making actors at the international level. The authors analyzed what has been done since that time by international organizations. Combating the counterfeiting of medicines cannot be successfully achieved by the health sector alone - World Health Organization (WHO), - so the efforts of the other United Nations (UN) organizations relevant to counterfeiting were in need and were studied in the article: World Intellectual Property Organization (WIPO), World Trade Organization (WTO), World Customs Organization (WCO), United Nations Office on Drugs and Crime (UNODC), etc. Today WHO is unable to coordinate all their activities, so the few existing proposals for establishing a new mechanism of international cooperation have been examined. Will the MEDICRIME Convention that will enter into force on January 1, 2016 be the start of the new era in the combating with the counterfeit medicines? - the authors offered their vision on the international developments.

The Evolution of General Internal Medicine (GIM)in Canada: International Implications.

PubMed

Card, Sharon E; Clark, Heather D; Elizov, Michelle; Kassam, Narmin

2017-05-01

General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition. However, interest amongst trainees in GIM was declining, and the GIM workforce in Canada, like that in many other countries, was in danger of serious shortfalls. After much deliberation and consultation, in 2010, the RCPSC recognized GIM as a distinct subspecialty of internal medicine. Since this time, despite the challenges in the educational implementation of GIM as a distinct discipline, there has been a resurgence of interest in this field of medicine. This paper outlines the journey of the Canadian GIM to educational implementation as a distinct discipline, the impact on the discipline, and the implications for the international GIM community.

Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

PubMed Central

Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

2009-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

PubMed

Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

2015-03-01

A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

A novel flight surgeon training model at a joint military and civilian surgical residency program.

PubMed

DeSoucy, Erik S; Zakaluzny, Scott A; Galante, Joseph M

2017-07-01

Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health. During the 2016 iteration attended by 10 interns, pre- and post-participation 10-item Likert scale surveys were administered. Questions focused on perceived preparedness for primary care role and overall enthusiasm for flight medicine. Open-ended surveys from 2013 to 2016 were also used to gauge the effect of the curriculum. The composite number of agreement responses (indicating increased comfort with presented material) increased 63% after course completion. Disagreement responses and neutral responses decreased 78% and 30%, respectively. Open-ended surveys from 14 participants showed an overall positive impression of the curriculum with all indicating it aided their transition to flight medicine. Survey responses indicate an overall perceived benefit from participation in the curriculum with more confidence in primary care topics and improved transition to a flight medicine tour. This model for supplemental aerospace medicine and primary care didactics should be integrated into any residency program responsible for training military preliminary interns who may serve as flight surgeons. Published by Elsevier Inc.

International Telemedicine/Disaster Medicine Conference: Papers and Presentations

NASA Technical Reports Server (NTRS)

1991-01-01

The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students.

PubMed

Robinson, Robert L

2015-01-01

The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. The study reported here was conducted to explore the relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Clinical service intensity data in terms of work relative value units (RVUs), patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation with sharing knowledge/skills and encouraging student initiative. Higher work RVUs and total patient encounters were negatively correlated with timely feedback and constructive criticism. The results suggest that internal medicine clerkship student evaluations of hospitalist faculty are negatively influenced by high clinical service intensity measured in terms of annual work RVUs, patient encounters, and duty days.

VizieR Online Data Catalog: WINERED CN-red band emission in comet C/2013 R1 (Shinnaka+, 2017)

NASA Astrophysics Data System (ADS)

Shinnaka, Y.; Kawakita, H.; Kondo, S.; Ikeda, Y.; Kobayashi, N.; Hamano, S.; Sameshima, H.; Fukue, K.; Matsunaga, N.; Yasui, C.; Izumi, N.; Mizumoto, M.; Otsubo, S.; Takenaka, K.; Watase, A.; Kawanishi, T.; Nakanishi, K.; Nakaoka, T.

2018-05-01

High-resolution spectroscopic observations of comet C/2013 R1 (Lovejoy; hereafter, comet Lovejoy) in the near-infrared wavelength region were performed using the WINERED spectrograph (Ikeda et al. 2016SPIE.9908E..5ZI) mounted on the Nasmyth focus of the 1.3 m Araki telescope (F/10) at Koyama Astronomical Observatory, Japan (Yoshikawa et al. 2012SPIE.8444E..6GY). We used a slit of length 47" and width 1.5". This slit width corresponds to a spectral resolving power of R=28000 (two pixels). The observations of comet Lovejoy were performed on 2013 November 30, from 19:08 UT to 21:04 UT; the total integration time was 6000 s on source. The heliocentric and geocentric distances were 0.91 au and 0.49 au, respectively, and the relative velocities of the comet to the Sun and observer were -14.5 km/s and 25.8 km/s, respectively, at the observations. We put the comet at the center of the slit during the exposures. Other calibration data (darks, flats, and comparison-lamp frames) were also acquired. (1 data file).

Experience the magic of light and color: outreach activity by Universidad del Valle student chapter

NASA Astrophysics Data System (ADS)

Valdes, Claudia; Reyes, Camilo; Osorio, Alberto; Solarte, Efrain

2010-08-01

During 2007, the Universidad del Valle Student Chapter presented a proposal for developing an educational outreach activity for children from an underprivileged zone to the Optical Society of America Foundation (OSAF) and to SPIE. The activity was carried out jointly by OSA and SPIE Universidad del Valle Student Chapters in the hillsides of Santiago de Cali, in a zone known as "Pueblo Joven" during 2008. It was aimed to boys and girls with ages between 8 and 13 years and was called "Experience the magic of light and color". The main purpose was to bring the children some basic concepts on optics and to encourage them to explore science through optics. The Universidad del Valle Student Chapters designed a series of talks and practical workshops where children participated in hands-on experiments that easily explain the fundamental concepts of light phenomena. Afterwards the children presented their achievements in a small science fair offered to the community and tried to explain in their own words what they learned and built. In this work, we present the most successful experimental designs and the educational standards we tried to develop with this activity.

Continuous control systems for non-contact ECG

NASA Astrophysics Data System (ADS)

Kodkin, Vladimir L.; Yakovleva, Galina V.; Smirnov, Alexey S.

2017-03-01

South Ural State University is still conducting the research work dedicated to innovations in biomedicine. Development of system for continuous control and diagnosis of the functional state in large groups of people is based on studies of non-contact ECG recording reported by the authors at the SPIE conference in 2016. The next stage of studies has been performed this year.

Discrete Jordan curve theorem

NASA Astrophysics Data System (ADS)

Chen, Li

1999-09-01

According to a general definition of discrete curves, surfaces, and manifolds (Li Chen, 'Generalized discrete object tracking algorithms and implementations, ' In Melter, Wu, and Latecki ed, Vision Geometry VI, SPIE Vol. 3168, pp 184 - 195, 1997.). This paper focuses on the Jordan curve theorem in 2D discrete spaces. The Jordan curve theorem says that a (simply) closed curve separates a simply connected surface into two components. Based on the definition of discrete surfaces, we give three reasonable definitions of simply connected spaces. Theoretically, these three definition shall be equivalent. We have proved the Jordan curve theorem under the third definition of simply connected spaces. The Jordan theorem shows the relationship among an object, its boundary, and its outside area. In continuous space, the boundary of an mD manifold is an (m - 1)D manifold. The similar result does apply to regular discrete manifolds. The concept of a new regular nD-cell is developed based on the regular surface point in 2D, and well-composed objects in 2D and 3D given by Latecki (L. Latecki, '3D well-composed pictures,' In Melter, Wu, and Latecki ed, Vision Geometry IV, SPIE Vol 2573, pp 196 - 203, 1995.).

VizieR Online Data Catalog: Detection of 715 Kepler planet candidates host stars (Law+, 2014)

NASA Astrophysics Data System (ADS)

Law, N. M.; Morton, T.; Baranec, C.; Riddle, R.; Ravichandran, G.; Ziegler, C.; Johnson, J. A.; Tendulkar, S. P.; Bui, K.; Burse, M. P.; Das, H. K.; Dekany, R. G.; Kulkarni, S.; Punnadi, S.; Ramaprakash, A. N.

2017-03-01

We selected targets from the KOIs catalog based on a Q1-Q6 Kepler data search (Batalha et al. 2013, J/ApJS/204/24). Our initial targets were selected randomly from the Q1-Q6 KOIs, requiring only that the targets are brighter than mi = 16.0, a restriction which removed only 2% of the KOIs. While it is our intent to observe every KOI with Robo-AO, this initial target selection provides a wide coverage of the range of KOI properties. Given Robo-AO's low time overheads, we took the time to re-observe KOIs which already had detected companions, to produce a complete and homogenous survey. We obtained high-angular-resolution images of the 715 Kepler targeted planet candidate host stars in summer 2012. We performed all the observations in a queue-scheduled mode with the Robo-AO laser adaptive optics system (Baranec et al. 2012SPIE.8447E..04B; 2013, J. Visualized Exp., 72, e50021; Riddle et al. 2012SPIE.8447E..2OR) mounted on the robotic Palomar 60 inch telescope (Cenko et al. 2006PASP..118.1396C). (4 data files).

Venous thromboembolism: the prevailing approach to diagnosis, prevention and treatment among Internal Medicine practitioners.

PubMed

Markel, Arie; Gavish, Israel; Kfir, Hila; Rimbrot, Sofia

2017-02-01

Venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. We performed a survey among directors of Internal Medicine departments in our country in order to evaluate their attitude and approach to this issue. A questionnaire with pertinent questions regarding prevention and treatment of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) was sent to each one of the directors of Internal Medicine Departments around the country. Sixty-nine out of 97 (71%) of the Internal Medicine departments directors responded the questionnaire. We found that several of the current guidelines were followed in a reasonable way. On the other hand, heterogeneity of responses was also present and the performance of current guidelines was imperfectly followed, and showed to be deficient in several aspects. An effort should be done in order to reemphasize and put in effect current guidelines for the prevention and treatment of VTE among hospitalists and Internal Medicine practitioners.

Recent trends in internal medicine education: a brief update.

PubMed

Flannery, Michael T

2014-03-01

This perspective attempts to bring graduate medical offices, residency programs and medical students interested in categorical internal medicine (CIM) a brief update on the American Board of Internal Medicine (ABIM), Accreditation Council for Graduate Medical Education (ACGME) and the National Registry for Medical Programs (NRMP) changes for the past 3-5 years in the United States (US). The US model for certification and recertification may serve as a homogenous example for other countries. This model will be described so that there is an understanding of the importance of such changes in the American system and its effect on resident education. This is critical knowledge for both teachers and learners in internal medicine in preparation for a lifetime career and requirements for certification/credentialing for both programs and their residents/fellows. Data from the review indicate a small increase in the number of applicants but a concordant decrease in ABIM initial certification exams. Programs should well be aware of the new focus on outcomes via the Next Accreditation System (NAS) being put forth by the ACGME. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Low Temperature Deposition of Diamond Films for Optical Coatings

DTIC Science & Technology

1989-10-18

Optical Materials, " Infrared Opfical Materials VI, Solomon Musikant , Editor, Proc. SPIE 929, p. 65 (1988). 14. M.S. Wong, R. Meilunas, T.P. Ong and...of the grinding. The small arrow indicates the materials transferred from the steel bearing. So0 600 ’-400 200- At 00 n 0 20 40 60 So t (min) r.m.s

Astronomy and Space Technologies, Photonics Applications and Web Engineering, Wilga, May 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

This paper is the first part (out of five) of the research survey of WILGA Symposium work, May 2012 Edition, concerned with photonics and electronics applications in astronomy and space technologies. It presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the Jubilee XXXth SPIE-IEEE Wilga 2012, May Edition, symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET tokamak and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-275].

Optoelectronic Devices, Sensors, Communication and Multimedia, Photonics Applications and Web Engineering, Wilga, May 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

This paper is the fourth part (out of five) of the research survey of WILGA Symposium work, May 2012 Edition, concerned with Optoelectronic Devices, Sensors, Communication and Multimedia (Video and Audio) technologies. It presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the Jubilee XXXth SPIE-IEEE Wilga 2012, May Edition, symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET tokamak and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-270].

Biomedical, Artificial Intelligence, and DNA Computing Photonics Applications and Web Engineering, Wilga, May 2012

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2012-05-01

This paper is the fifth part (out of five) of the research survey of WILGA Symposium work, May 2012 Edition, concerned with Biomedical, Artificial Intelligence and DNA Computing technologies. It presents a digest of chosen technical work results shown by young researchers from different technical universities from this country during the Jubilee XXXth SPIE-IEEE Wilga 2012, May Edition, symposium on Photonics and Web Engineering. Topical tracks of the symposium embraced, among others, nanomaterials and nanotechnologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET tokamak and pi-of-the sky experiments development. The symposium is an annual summary in the development of numerable Ph.D. theses carried out in this country in the area of advanced electronic and photonic systems. It is also a great occasion for SPIE, IEEE, OSA and PSP students to meet together in a large group spanning the whole country with guests from this part of Europe. A digest of Wilga references is presented [1-270].

Clinical Trials in Veterinary Medicine: A New Era Brings New Challenges.

PubMed

Oyama, M A; Ellenberg, S S; Shaw, P A

2017-07-01

Randomized clinical trials (RCTs) are among the most rigorous ways to determine the causal relationship between an intervention and important clinical outcome. Their use in veterinary medicine has become increasingly common, and as is often the case, with progress comes new challenges. Randomized clinical trials yield important answers, but results from these studies can be unhelpful or even misleading unless the study design and reporting are carried out with care. Herein, we offer some perspective on several emerging challenges associated with RCTs, including use of composite endpoints, the reporting of different forms of risk, analysis in the presence of missing data, and issues of reporting and safety assessment. These topics are explored in the context of previously reported veterinary internal medicine studies as well as through illustrative examples with hypothetical data sets. Moreover, many insights germane to RCTs in veterinary internal medicine can be drawn from the wealth of experience with RCTs in the human medical field. A better understanding of the issues presented here can help improve the design, interpretation, and reporting of veterinary RCTs. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Importance of international networking in academic family medicine.

PubMed

Klemenc-Ketiš, Zalika; Kersnik, Janko

2014-01-01

European family medicine/general practice (FM/GP) has travelled the long and successful journey of profiling the discipline and has produced valuable position papers on education and research. Nowadays, academic medicine is one of the pillars in the future development of FM/GP in Europe. A common European curriculum on undergraduate and postgraduate family medicine is needed. Also, a sound international platform of teaching institutions and/or teachers of family medicine would foster the further development of family medicine as an academic discipline. This would stimulate students and teachers to engage in international exchange to gain new knowledge and experiences, present their work and ideas abroad and prepare the conditions for further exchange of students and teachers. Established departments of FM/GP, led by a teacher who is a family physician/general practitioner, at each Medical School in Europe should provide students with knowledge and skills related to the core attributes of FM/GP. International exchanges of teachers and students should foster the development of a common curriculum on FM in Europe and foster improvement in the quality of FM education. Copyright © 2014 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

PubMed

Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

2015-09-01

Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p < 0.001. Admitting new patients, following their course and responding to emergencies were rated as important overnight tasks for both clerkship and sub-internship students. Overnight experiences offer students additional educational opportunities. Clerkship directors felt that the overnight experience for the sub-intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

How far has The Korean Journal of Internal Medicine advanced in terms of journal metrics?

PubMed

Huh, Sun

2013-11-01

The Korean Journal of Internal Medicine has already been valued as an international journal, according to a citation analysis in 2011. Now, 2 years later, I would like to confirm how much the Journal has advanced from the point of view of journal metrics by looking at the impact factor, cites per document (2 years), SCImago Journal Rank (SJR), and the Hirsch index. These were obtained from a variety of databases, such as the Korean Medical Citation Index, KoreaMed Synapse, Web of Science, JCR Web, and SCImago Journal & Country Rank. The manually calculated 2012 impact factor was 1.252 in the Web of Science, with a ranking of 70/151 (46.4%) in the category of general and internal medicine. Cites per documents (2 years) for 2012 was 1.619, with a ranking of 267/1,588 (16.8%) in the category of medicine (miscellaneous). The 2012 SJR was 0.464, with a ranking of 348/1,588 (21.9%) in the category of medicine (miscellaneous). The Hirsch index from KoreaMed Synapse, Web of Science, and SCImago Journal & Country Rank were 12, 15, and 19, respectively. In comparison with data from 2010, the values of all the journal metrics increased consistently. These results reflect favorably on the increased competency of editors and authors of The Korean Journal of Internal Medicine.

How far has The Korean Journal of Internal Medicine advanced in terms of journal metrics?

PubMed Central

2013-01-01

The Korean Journal of Internal Medicine has already been valued as an international journal, according to a citation analysis in 2011. Now, 2 years later, I would like to confirm how much the Journal has advanced from the point of view of journal metrics by looking at the impact factor, cites per document (2 years), SCImago Journal Rank (SJR), and the Hirsch index. These were obtained from a variety of databases, such as the Korean Medical Citation Index, KoreaMed Synapse, Web of Science, JCR Web, and SCImago Journal & Country Rank. The manually calculated 2012 impact factor was 1.252 in the Web of Science, with a ranking of 70/151 (46.4%) in the category of general and internal medicine. Cites per documents (2 years) for 2012 was 1.619, with a ranking of 267/1,588 (16.8%) in the category of medicine (miscellaneous). The 2012 SJR was 0.464, with a ranking of 348/1,588 (21.9%) in the category of medicine (miscellaneous). The Hirsch index from KoreaMed Synapse, Web of Science, and SCImago Journal & Country Rank were 12, 15, and 19, respectively. In comparison with data from 2010, the values of all the journal metrics increased consistently. These results reflect favorably on the increased competency of editors and authors of The Korean Journal of Internal Medicine. PMID:24307835

The research rotation: competency-based structured and novel approach to research training of internal medicine residents.

PubMed

Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

2006-10-17

In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

The research rotation: competency-based structured and novel approach to research training of internal medicine residents

PubMed Central

Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

2006-01-01

Background In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program. PMID:17044924

Photonic-Networks-on-Chip for High Performance Radiation Survivable Multi-Core Processor Systems

DTIC Science & Technology

2013-12-01

Loss Spectra” Proceedings of SPIE 8255, (2012) and in a journal publication: M. T. Crowley, D. Murrell, N. Patel, M. Breivik , C.-Y. Lin, Y. Li, B.-O...Crowley, D. Murrell, N. Patel, M. Breivik , C.-Y. Lin, Y. Li, B.-O. Fimland and L. F. Lester, "Analytical Modeling of the Temperature Performance of

Monitoring stress among internal medicine residents: an experience-driven, practical and short measure.

PubMed

Myszkowski, Nils; Villoing, Barbara; Zenasni, Franck; Jaury, Philippe; Boujut, Emilie

2017-07-01

Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents. The Internal Medicine Residency Stress Scale (IMRSS) was then administered in a sample of 259 internal medicine residents (199 females, 60 males, M Age  = 25.6) along with the Hospital Anxiety and Depression Scale, Maslach Burnout Inventory, Satisfaction With Life Scale and Ways of Coping Checklist. The IMRSS showed satisfactory internal reliability (Cronbach's α = .86), adequate structural validity - studied through Confirmatory Factor Analysis (χ 2 /df = 2.51, CFI = .94; SRMR = .037, RMSEA = .076) - and good criterion validity - the IMRSS was notably strongly correlated with emotional exhaustion (r = .64; p < .001) and anxiety (r = .57; p < .001). Because of its short length and robust psychometric qualities, the use of the IMRSS is recommended to quickly and frequently assess and monitor stress among internal medicine residents.

The PHOTON explorations: sixteen activities, many uses

NASA Astrophysics Data System (ADS)

Donnelly, Judith; Amatrudo, Kathryn; Robinson, Kathleen; Hanes, Fenna

2014-07-01

The PHOTON Explorations were adapted from favorite demonstrations of teacher participants in the PHOTON projects of the New England Board of Higher Education as well as Hands-on-Optics activities and interesting demonstrations found on the web. Since the end of project PHOTON2 in 2006, the sixteen inquiry-based activities have formed the basis for a hands-on "home lab" distance- learning course that has been used for college students, teacher professional development and corporate training. With the support of OSA, they have been brought to life in a series of sixteen short videos aimed at a middle school audience. The Explorations are regularly used as activities in outreach activities for middle and high school students and are introduced yearly to an international audience at an outreach workshop at SPIE's Optics and Photonics meeting. In this paper we will demonstrate the Explorations, trace their origins and explain the content. We will also provide details on the development of the Exploration videos, the online course, and outreach materials and give statistics on their use in each format. Links to online resources will be provided.

Long time-series of turbid coastal water using AVHRR: An example from Florida Bay, USA

USGS Publications Warehouse

Stumpf, R.P.; Frayer, M.L.

1997-01-01

The AVHRR can provide information on the reflectance of turbid case II water, permitting examination of large estuaries and plumes from major rivers. The AVHRR has been onboard several NOAA satellites, with afternoon overpasses since 1981, offering a long time-series to examine changes in coastal water. We are using AVHRR data starting in December 1989, to examine water clarity in Florida Bay, which has undergone a decline since the late 1980's. The processing involves obtaining a nominal reflectance for red light with standard corrections including those for Rayleigh and aerosol path radiances. Established relationships between reflectance and the water properties being measured in the Bay provide estimates of diffuse attenuation and light limitation for phytoplankton and seagrass productivity studies. Processing also includes monthly averages of reflectance and attenuation. The AVHRR data set describes spatial and temporal patterns, including resuspension of bottom sediments in the winter, and changes in water clarity. The AVHRR also indicates that Florida Bay has much higher reflectivity relative to attenuation than other southeastern US estuaries. ??2005 Copyright SPIE - The International Society for Optical Engineering.

The Internal Medicine of the 21st century: Organizational and operational standards.

PubMed

Casariego-Vales, E; Zapatero-Gaviria, A; Elola-Somoza, F J

2017-12-01

The Spanish Society of Internal Medicine has developed a consensus document on the standards and recommendations that they consider essential to the organisation of internal medicine units for conducting their activities efficiently and with high quality. We defined 3 groups of key processes: the care of acutely ill adult patients, the comprehensive care of complex chronic patients and the examination of a patient with a difficult diagnosis and no organ-specific disease. As support processes, we identified the structure and operation of the Internal Medicine units. As strategic processes, we identified training and research. The main subprocesses are structured below, and we established the standards and recommendations for each of them. Lastly, we proposed resulting workloads. The prepared standards must be reviewed within a maximum of 4 years. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

A Survey of Knowledge and Practices of Transfusion Medicine Among Post Intern Doctors in Specialized Hospital in Sri Lanka.

PubMed

Kumarage, Samantha; Fernando, Rahal; Gunasekara, Lanka

2017-02-01

Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors. To assess the knowledge of transfusion medicine among post intern doctors in working in our hospital. Self administrated questionnaire was used. 45 questions of transfusion medicine included in the questioner. A total 57 post internship doctors participated in the survey. Statistical analysis was done using SPSS. In overall survey average score was 41.45%. Lowest score 19.8% was for the area of lab result interpretation. Highest score 56.63% obtained for the administration of blood component. Differences among the medical officers of various specialties were not statistically significant. Transfusion medicine knowledge among post internship doctors in our hospital need to be upgraded. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Grade inflation in the internal medicine clerkship: a national survey.

PubMed

Fazio, Sara B; Papp, Klara K; Torre, Dario M; Defer, Thomas M

2013-01-01

Grade inflation is a growing concern, but the degree to which it continues to exist in 3rd-year internal medicine (IM) clerkships is unknown. The authors sought to determine the degree to which grade inflation is perceived to exist in IM clerkships in North American medical schools. A national survey of all Clerkship Directors in Internal Medicine members was administered in 2009. The authors assessed key aspects of grading. Response rate was 64%. Fifty-five percent of respondents agreed that grade inflation exists in the Internal Medicine clerkship at their school. Seventy-eight percent reported it as a serious/somewhat serious problem, and 38% noted students have passed the IM clerkship at their school who should have failed. A majority of clerkship directors report that grade inflation still exists. In addition, many note students who passed despite the clerkship director believing they should have failed. Interventions should be developed to address both of these problems.

Curriculum on Resident Education in Care of Older Adults in Acute, Transitional and Extended Care Settings

ERIC Educational Resources Information Center

Kumar, Chandrika; Bensadon, Benjamin A.; Van Ness, Peter H.; Cooney, Leo M.

2016-01-01

Most geriatric care is provided in non-hospital settings. Internal Medicine and Family Medicine residents should therefore learn about these different clinical sites and acuity levels of care. To help facilitate this learning, a geriatrics training curriculum for internal medicine residents was developed that focused on cognition, function, goals…

Actual light deflections in regions of crack tips and their influence on measurements in photomechanics

NASA Astrophysics Data System (ADS)

Hecker, Friedrich W.; Pindera, Jerzy T.; Wen, Baicheng

Crack-tip photomechanics procedures are based on certain simplifying assumptions that are seldom discussed. In a recent paper the theoretical bases of the shadow optical methods of caustics have been analysed and tested using the results obtained by three analytical-experimental procedures, namely classical strain gage techniques, isodynes, and strain-gradient index method. It has been concluded that the straing-radient index method appears to be a suitable tool for analysis of stress states near crack tips and notches and, in particular, for testing the predictive power of the pertinent singular solutions of the linear elastic fracture mechanics and the ranges of their applicability. In the present paper, a more detailed analysis of all results obtained in light deflection experiments allows to quantify the contribution of both involved effects and to determine the distortion of the faces of the investigated plates along their crack planes. The ability of the strain-gradient light bending method to analyse some features of the three-dimensional stress-state is reported. Finally, the presented experimental evidence allows to draw conclusions related to limits of applicability of certain photomechanical measurements near crack tips. An extensive summary of this paper is published in the Proceedings of the Second International Conference on Photomechanics and Speckle Metrology, Vol. 1554A, part of SPIE's 1991 International Symposium on Optical Applied Science and Engineering, 22-26 July 1991, San Diego, CA, USA. 1

Outreach activities on light science and technology at TecnOpto-UMH during the International Year of Light

NASA Astrophysics Data System (ADS)

Sánchez-López, María. del Mar; García-Martínez, Pascuala; Espinosa, Rocío.; Carnicer, Jesús; Arias, Julia; Moreno, Ignacio

2016-09-01

TecnOpto is a group of researchers and teachers with interests in Optics and Photonics, located at the University Miguel Hernández (UMH) of Elche (Spain). Here we report on our outreach activities carried out during the International Year of Light - 2015. They include experiments and demonstrations at elementary and secondary schools, seminars and exhibitions at the university, and the activity named the "Classroom for the Experience", targeted to elder people. We also report on our participation in the science fair in Elche and in the launching of "the Room of Light", a complete new section of the MUDIC science museum devoted to light and optics. MUDIC is located in the UMH campus of Orihuela, and receives visitors from all over the region, mainly young students from elementary and secondary schools. Finally, we report on the exhibition "Women in Light Science and Light Technologies" which was organized by members of our group in collaboration with RSEF - the Spanish Royal Physical Society and SEDOPTICA - the Spanish Optical Society and sponsored by SPIE. This exhibition consisting of twelve posters on relevant women scientists was inaugurated in the XI Spanish Meeting on Optics and has travelled around many universities and cultural centers in Spain. A summary of the contents, participation and developing of all these activities is presented.

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

PubMed

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a general internist. Prospective fellows anticipate extending their active duty commitment, as do those with longer commitments. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination

PubMed Central

Sisson, Stephen D.; Bertram, Amanda; Yeh, Hsin-Chieh

2015-01-01

Background A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. Objective We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). Methods A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. Results The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Conclusions Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE. PMID:26217421

The relationship between communication scores from the USMLE Step 2 Clinical Skills examination and communication ratings for first-year internal medicine residents.

PubMed

Winward, Marcia L; Lipner, Rebecca S; Johnston, Mary M; Cuddy, Monica M; Clauser, Brian E

2013-05-01

This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice. Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training. Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors. The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

The composition of intern work while on call.

PubMed

Fletcher, Kathlyn E; Visotcky, Alexis M; Slagle, Jason M; Tarima, Sergey; Weinger, Matthew B; Schapira, Marilyn M

2012-11-01

The work of house staff is being increasingly scrutinized as duty hours continue to be restricted. To describe the distribution of work performed by internal medicine interns while on call. Prospective time motion study on general internal medicine wards at a VA hospital affiliated with a tertiary care medical center and internal medicine residency program. Internal medicine interns. Trained observers followed interns during a "call" day. The observers continuously recorded the tasks performed by interns, using customized task analysis software. We measured the amount of time spent on each task. We calculated means and standard deviations for the amount of time spent on six categories of tasks: clinical computer work (e.g., writing orders and notes), non-patient communication, direct patient care (work done at the bedside), downtime, transit and teaching/learning. We also calculated means and standard deviations for time spent on specific tasks within each category. We compared the amount of time spent on the top three categories using analysis of variance. The largest proportion of intern time was spent in clinical computer work (40 %). Thirty percent of time was spent on non-patient communication. Only 12 % of intern time was spent at the bedside. Downtime activities, transit and teaching/learning accounted for 11 %, 5 % and 2 % of intern time, respectively. Our results suggest that during on call periods, relatively small amounts of time are spent on direct patient care and teaching/learning activities. As intern duty hours continue to decrease, attention should be directed towards preserving time with patients and increasing time in education.

[On the way to national reference system of laboratory medicine].

PubMed

Muravskaia, N P; Men'shikov, V V

2014-10-01

The application of standard samples and reference techniques of implementation of measurements is needed for a valid support of reliability of analyses applied in clinical diagnostic laboratories. They play role of landmarks under metrologic monitoring, calibration of devices and control of quality of results. The article presents analysis of shortcomings interfering with formation of national reference system in Russia harmonized with possibilities provided by international organizations. Among them are the joint Committee on metrologic monitoring in laboratory medicine under the auspices of the International Bureau of Weights and Measures, the International Federation of clinical chemistry and laboratory medicine, etc. The results of the recent development of national normative documents, standard samples and techniques assisted by the authors of article are considered. They are the first steps to organization of national reference system which would comprise all range of modern analytical technologies of laboratory medicine. The national and international measures are proposed to enhance the promptest resolving of task of organization of national reference system for laboratory medicine in the interests of increasing of effectiveness of medical care to citizen of Russia.

Teaching the internist to see: effectiveness of a 1-day workshop in bedside ultrasound for internal medicine residents.

PubMed

Clay, Ryan D; Lee, Elizabeth C; Kurtzman, Marc F; Dversdal, Renee K

2016-12-01

A growing body of evidence supports the use of bedside ultrasound for core Internal Medicine procedures and increasingly as augmentation of the physical exam. The literature also supports that trainees, both medical students and residents, can acquire these skills. However, there is no consensus on training approach. To implement and study the effectiveness of a high-yield and expedited curriculum to train internal medicine interns to use bedside ultrasound for physical examination and procedures. The study was conducted at a metropolitan, academic medical center and included 33 Internal Medicine interns. This was a prospective cohort study of a new educational intervention consisting of a single-day intensive bedside ultrasound workshop followed by two optional hour-long workshops later in the year. The investigation was conducted at Oregon Health & Science University in Portland, Oregon. The intensive day consisted of alternating didactic sessions with small group hands-on ultrasound practice sessions and ultrasound simulations. A 30-question assessment was used to assess ultrasound interpretation knowledge prior to, immediately post, and 6 months post intervention. Thirty-three interns served as their own historical controls. Assessment performance significantly increased after the intervention from a mean pre-test score of 18.3 (60.9 % correct) to a mean post-test score 25.5 (85.0 % correct), P value of <0.0001. This performance remained significantly better at 6 months with a mean score of 23.8 (79.3 % correct), P value <0.0001. There was significant knowledge attrition compared to the immediate post-assessment, P value 0.0099. A single-day ultrasound training session followed by two optional noon conference sessions yielded significantly improved ultrasound interpretation skills in internal medicine interns.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

PubMed

Perez, Jose A; Greer, Sharon

2009-12-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value <0.05. The r values for USMLE Step 1 and ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

European School of Internal Medicine: a window of opportunity for RCP activities in Europe.

PubMed

Davidson, Chris; Higgens, Clare

2009-04-01

The Royal College of Physicians (RCP) is to host the European School of Internal Medicine for two years from 2009-10. This affords a unique opportunity for specialist registrars to exchange ideas about professional development and training and to make contacts with young internists from across Europe. Such links should prove useful for future RCP initiatives in European medicine.

Studying microbiology with Glenn F. Webb.

PubMed

Blaser, Martin J

2015-08-01

I began working with Glenn F. Webb in 1997. At that time, I was on the faculty of Vanderbilt University, in the School of Medicine, in the Department of Medicine, in its Division of Infectious Diseases. As with mathematics, modern medicine has its different disciplines (e.g. Surgery and Internal Medicine), and then further subdivisions (e.g. Cardiology and Infectious Diseases). Within Internal Medicine, most of the divisions are based on the treatment of conditions that relate to a single organ or group of organs -- the heart, the lungs, the kidneys, the digestive system. But the discipline of Infectious Diseases was based on a different concept: the war between humans and microbes.

Development of a Spectropolarimetric Remote Sensing Capability

DTIC Science & Technology

2013-03-01

34Review of passive imaging polarimetry for remote sensing applications," Appl. Opt. 45, 5453-5469 (2006). [8] D. B. Chenault, "Infrared...Annen, “Hyperspectral IR polarimetry with application in demining and unexploded ordnance detection,” SPIE Vol. 3534 (1998). [30] Pesses, M... Polarimetry , Fourier Transform Spectrometer, DOLP, Spectropolarimetry, Stokes 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18

Single-Pulse Dual-Energy Mammography Using a Binary Screen Coupled to Dual CCD Cameras

DTIC Science & Technology

1999-08-01

Fossum, "Active pixel sensors—Are CCD’s Dinosaurs ?," Proc. SPIE 1900, 2-14 (1993). "S. Mendis, S. E. Kemeny, R. Gee, B. Pain, and E. R. Fossum, "Progress...Clin Oncol 13:1470-1477, 1995 12. Wahl RL, Zasadny K, Helvie M, et al: Metabolic monitoring of breast cancer chemohormonotherapy using posi- tron

Accurate 3D Modeling of Breast Deformation for Temporal Mammogram Registration

DTIC Science & Technology

2009-09-01

U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION...MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland...Towards Registration of Temporal Mammograms by Finite Element Simulation of MR Breast Volumes”, Proceedings of SPIE Medical Imaging 2008 2. Qiu Y

42 CFR 62.9 - Under what circumstances can the period of obligated service be deferred to complete approved...

Code of Federal Regulations, 2011 CFR

2011-10-01

... sponsorship includes approved residencies in family practice, internal medicine, pediatrics, or a categorical first-year program in family practice, internal medicine, or pediatrics; (2) a rotating internship in...

Evolution of the Varrier autostereoscopic VR display: 2001-2007

NASA Astrophysics Data System (ADS)

Peterka, Tom; Kooima, Robert L.; Girado, Javier I.; Ge, Jinghua; Sandin, Daniel J.; DeFanti, Thomas A.

2007-02-01

Autostereoscopy (AS) is an increasingly valuable virtual reality (VR) display technology; indeed, the IS&T / SPIE Electronic Imaging Conference has seen rapid growth in the number and scope of AS papers in recent years. The first Varrier paper appeared at SPIE in 2001, and much has changed since then. What began as a single-panel prototype has grown to a full scale VR autostereo display system, with a variety of form factors, features, and options. Varrier is a barrier strip AS display system that qualifies as a true VR display, offering a head-tracked ortho-stereo first person interactive VR experience without the need for glasses or other gear to be worn by the user. Since Varrier's inception, new algorithmic and systemic developments have produced performance and quality improvements. Visual acuity has increased by a factor of 1.4X with new fine-resolution barrier strip linescreens and computational algorithms that support variable sub-pixel resolutions. Performance has improved by a factor of 3X using a new GPU shader-based sub-pixel algorithm that accomplishes in one pass what previously required three passes. The Varrier modulation algorithm that began as a computationally expensive task is now no more costly than conventional stereoscopic rendering. Interactive rendering rates of 60 Hz are now possible in Varrier for complex scene geometry on the order of 100K vertices, and performance is GPU bound, hence it is expected to continue improving with graphics card enhancements. Head tracking is accomplished with a neural network camera-based tracking system developed at EVL for Varrier. Multiple cameras capture subjects at 120 Hz and the neural network recognizes known faces from a database and tracks them in 3D space. New faces are trained and added to the database in a matter of minutes, and accuracy is comparable to commercially available tracking systems. Varrier supports a variety of VR applications, including visualization of polygonal, ray traced, and volume rendered data. Both AS movie playback of pre-rendered stereo frames and interactive manipulation of 3D models are supported. Local as well as distributed computation is employed in various applications. Long-distance collaboration has been demonstrated with AS teleconferencing in Varrier. A variety of application domains such as art, medicine, and science have been exhibited, and Varrier exists in a variety of form factors from large tiled installations to smaller desktop forms to fit a variety of space and budget constraints. Newest developments include the use of a dynamic parallax barrier that affords features that were inconceivable with a static barrier.

The 52nd International Conference on Medicinal Chemistry (RICT 2016) of the French Medicinal Chemistry Society (SCT) Held in Caen (Normandy).

PubMed

Sapi, Janos; Van Hijfte, Luc; Dallemagne, Patrick

2017-06-21

Outstanding Medchem in France: Guest editors Janos Sapi, Luc Van Hjfte, and Patrick Dallemagne look back at the 52 nd International Conference on Medicinal Chemistry (RICT 2016) held in Caen, France. They discuss the history of the French Medicinal Chemistry Society (Société de Chimie Thérapeutique, SCT) and provide highlights of last year's events, including some key presentations now collected in this Special Issue. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Distributed Pheromone-Based Swarming Control of Unmanned Air and Ground Vehicles for RSTA

DTIC Science & Technology

2008-03-20

Forthcoming in Proceedings of SPIE Defense & Security Conference, March 2008, Orlando, FL Distributed Pheromone -Based Swarming Control of Unmanned...describes recent advances in a fully distributed digital pheromone algorithm that has demonstrated its effectiveness in managing the complexity of...onboard digital pheromone responding to the needs of the automatic target recognition algorithms. UAVs and UGVs controlled by the same pheromone algorithm

An ultra low noise telecom wavelength free running single photon detector using negative feedback avalanche diode

NASA Astrophysics Data System (ADS)

Yan, Zhizhong; Hamel, Deny R.; Heinrichs, Aimee K.; Jiang, Xudong; Itzler, Mark A.; Jennewein, Thomas

2012-07-01

It is challenging to implement genuine free running single-photon detectors for the 1550 nm wavelength range with simultaneously high detection efficiency (DE), low dark noise, and good time resolution. We report a novel read out system for the signals from a negative feedback avalanche diode (NFAD) [M. A. Itzler, X. Jiang, B. Nyman, and K. Slomkowski, "Quantum sensing and nanophotonic devices VI," Proc. SPIE 7222, 72221K (2009), 10.1117/12.814669; X. Jiang, M. A. Itzler, K. ODonnell, M. Entwistle, and K. Slomkowski, "Advanced photon counting techniques V," Proc. SPIE 8033, 80330K (2011), 10.1117/12.883543; M. A. Itzler, X. Jiang, B. M. Onat, and K. Slomkowski, "Quantum sensing and nanophotonic devices VII," Proc. SPIE 7608, 760829 (2010), 10.1117/12.843588], which allows useful operation of these devices at a temperature of 193 K and results in very low darkcounts (˜100 counts per second (CPS)), good time jitter (˜30 ps), and good DE (˜10%). We characterized two NFADs with a time-correlation method using photons generated from weak coherent pulses and photon pairs produced by spontaneous parametric down conversion. The inferred detector efficiencies for both types of photon sources agree with each other. The best noise equivalent power of the device is estimated to be 8.1 × 10-18 W Hz-1/2, more than 10 times better than typical InP/InGaAs single photon avalanche diodes (SPADs) show in free running mode. The afterpulsing probability was found to be less than 0.1% per ns at the optimized operating point. In addition, we studied the performance of an entanglement-based quantum key distribution (QKD) using these detectors and develop a model for the quantum bit error rate that incorporates the afterpulsing coefficients. We verified experimentally that using these NFADs it is feasible to implement QKD over 400 km of telecom fiber. Our NFAD photon detector system is very simple, and is well suited for single-photon applications where ultra-low noise and free-running operation is required, and some afterpulsing can be tolerated.

An ultra low noise telecom wavelength free running single photon detector using negative feedback avalanche diode.

PubMed

Yan, Zhizhong; Hamel, Deny R; Heinrichs, Aimee K; Jiang, Xudong; Itzler, Mark A; Jennewein, Thomas

2012-07-01

It is challenging to implement genuine free running single-photon detectors for the 1550 nm wavelength range with simultaneously high detection efficiency (DE), low dark noise, and good time resolution. We report a novel read out system for the signals from a negative feedback avalanche diode (NFAD) [M. A. Itzler, X. Jiang, B. Nyman, and K. Slomkowski, "Quantum sensing and nanophotonic devices VI," Proc. SPIE 7222, 72221K (2009); X. Jiang, M. A. Itzler, K. ODonnell, M. Entwistle, and K. Slomkowski, "Advanced photon counting techniques V," Proc. SPIE 8033, 80330K (2011); M. A. Itzler, X. Jiang, B. M. Onat, and K. Slomkowski, "Quantum sensing and nanophotonic devices VII," Proc. SPIE 7608, 760829 (2010)], which allows useful operation of these devices at a temperature of 193 K and results in very low darkcounts (∼100 counts per second (CPS)), good time jitter (∼30 ps), and good DE (∼10%). We characterized two NFADs with a time-correlation method using photons generated from weak coherent pulses and photon pairs produced by spontaneous parametric down conversion. The inferred detector efficiencies for both types of photon sources agree with each other. The best noise equivalent power of the device is estimated to be 8.1 × 10(-18) W Hz(-1/2), more than 10 times better than typical InP/InGaAs single photon avalanche diodes (SPADs) show in free running mode. The afterpulsing probability was found to be less than 0.1% per ns at the optimized operating point. In addition, we studied the performance of an entanglement-based quantum key distribution (QKD) using these detectors and develop a model for the quantum bit error rate that incorporates the afterpulsing coefficients. We verified experimentally that using these NFADs it is feasible to implement QKD over 400 km of telecom fiber. Our NFAD photon detector system is very simple, and is well suited for single-photon applications where ultra-low noise and free-running operation is required, and some afterpulsing can be tolerated.

The Third International Genomic Medicine Conference (3rd IGMC, 2015): overall activities and outcome highlights.

PubMed

Abu-Elmagd, Muhammad; Assidi, Mourad; Dallol, Ashraf; Buhmeida, Abdelbaset; Pushparaj, Peter Natesan; Kalamegam, Gauthaman; Al-Hamzi, Emad; Shay, Jerry W; Scherer, Stephen W; Agarwal, Ashok; Budowle, Bruce; Gari, Mamdooh; Chaudhary, Adeel; Abuzenadah, Adel; Al-Qahtani, Mohammed

2016-10-17

The Third International Genomic Medicine Conference (3 rd IGMC) was organised by the Centre of Excellence in Genomic Medicine Research (CEGMR) at the King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia (KSA). This conference is a continuation of a series of meetings, which began with the first International Genomic Medicine Conference (1 st IGMC, 2011) followed by the second International Genomic Medicine Conference (2 nd IGMC, 2013). The 3 rd IGMC meeting presented as a timely opportunity to bring scientists from across the world to gather, discuss, and exchange recent advances in the field of genomics and genetics in general as well as practical information on using these new technologies in different basic and clinical applications. The meeting undoubtedly inspired young male and female Saudi researchers, who attended the conference in large numbers, as evidenced by the oversubscribed oral and poster presentations. The conference also witnessed the launch of the first content for npj Genomic Medicine, a high quality new journal was established in partnership by CEGMR with Springer Nature and published as part of the Nature Partner Journal series. Here, we present a brief summary report of the 2-day meeting including highlights from the oral presentations, poster presentations, workshops, poster prize-winners and comments from the distinguished scientists.

Teaching strategies used by internal medicine residents on the wards.

PubMed

Smith, Dustin T; Kohlwes, R Jeffrey

2011-01-01

Residents serve as teachers to interns and students in most internal medicine residency programs. The purpose of our study is to explore what internal medicine residents perceive as effective teaching strategies in the inpatient setting and to formulate a guideline for preparing residents to lead their ward teams. Housestaff identified as excellent teaching residents were recruited from a large internal medicine residency program. Focus groups were formed and interviews were conducted using open-ended questions. Transcripts of the interviews were reviewed, analyzed, and compared for accuracy by two investigators. The transcripts were then coded to categorize data into similar subjects from which recurrent themes in resident teaching were identified. Twenty-two residents participated in four focus group interviews held in 2008. We identified five principal themes for effective teaching by residents: (T)aking advantage of teaching opportunities, (E)mpowering learners, (A)ssuming the role of leader, (C)reating a learning environment, and (H)abituating the practice of teaching. Strategies for effective teaching by residents exist. The TEACH mnemonic is a resident-identified method of instruction. Use of this tool could enable residency programs to create instructional curricula to prepare their residents and interns to take on the roles of team leaders and teachers.

Adolf Friedrich Fercher: a pioneer of biomedical optics.

PubMed

Hitzenberger, Christoph K

2017-11-01

Adolf Friedrich Fercher, an outstanding pioneer of biomedical optics, passed away earlier this year. He was a brilliant and visionary researcher who pioneered various fields of biomedical optics, such as laser speckle flowgraphy, tissue interferometry, and optical coherence tomography (OCT). On the occasion of the 25th anniversary of OCT, this paper reviews and commemorates Fercher's pioneering work. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Fundamental Limitations for Imaging GEO Satellites

DTIC Science & Technology

2015-10-18

details of a geostationary satellite can be phase stabilized. We conclude that it is possible to phase such an interferometer with shorter baselines using...Jorgensen, A., Restaino, S., Armstrong, J., Baines, E., Hindsley, R. “Simulated Synthesis Imaging of Geostationary Satellites” Proceedings of the AMOS...A. M. “Simulated optical interferometric observations of geostationary satellites” Proceedings of the SPIE 8165, 2011 [3] C Leinert, S. Bowyer, L

Automated diagnosis of prostate cancer in multi-parametric MRI based on multimodal convolutional neural networks

NASA Astrophysics Data System (ADS)

Le, Minh Hung; Chen, Jingyu; Wang, Liang; Wang, Zhiwei; Liu, Wenyu; (Tim Cheng, Kwang-Ting; Yang, Xin

2017-08-01

Automated methods for prostate cancer (PCa) diagnosis in multi-parametric magnetic resonance imaging (MP-MRIs) are critical for alleviating requirements for interpretation of radiographs while helping to improve diagnostic accuracy (Artan et al 2010 IEEE Trans. Image Process. 19 2444-55, Litjens et al 2014 IEEE Trans. Med. Imaging 33 1083-92, Liu et al 2013 SPIE Medical Imaging (International Society for Optics and Photonics) p 86701G, Moradi et al 2012 J. Magn. Reson. Imaging 35 1403-13, Niaf et al 2014 IEEE Trans. Image Process. 23 979-91, Niaf et al 2012 Phys. Med. Biol. 57 3833, Peng et al 2013a SPIE Medical Imaging (International Society for Optics and Photonics) p 86701H, Peng et al 2013b Radiology 267 787-96, Wang et al 2014 BioMed. Res. Int. 2014). This paper presents an automated method based on multimodal convolutional neural networks (CNNs) for two PCa diagnostic tasks: (1) distinguishing between cancerous and noncancerous tissues and (2) distinguishing between clinically significant (CS) and indolent PCa. Specifically, our multimodal CNNs effectively fuse apparent diffusion coefficients (ADCs) and T2-weighted MP-MRI images (T2WIs). To effectively fuse ADCs and T2WIs we design a new similarity loss function to enforce consistent features being extracted from both ADCs and T2WIs. The similarity loss is combined with the conventional classification loss functions and integrated into the back-propagation procedure of CNN training. The similarity loss enables better fusion results than existing methods as the feature learning processes of both modalities are mutually guided, jointly facilitating CNN to ‘see’ the true visual patterns of PCa. The classification results of multimodal CNNs are further combined with the results based on handcrafted features using a support vector machine classifier. To achieve a satisfactory accuracy for clinical use, we comprehensively investigate three critical factors which could greatly affect the performance of our multimodal CNNs but have not been carefully studied previously. (1) Given limited training data, how can these be augmented in sufficient numbers and variety for fine-tuning deep CNN networks for PCa diagnosis? (2) How can multimodal MP-MRI information be effectively combined in CNNs? (3) What is the impact of different CNN architectures on the accuracy of PCa diagnosis? Experimental results on extensive clinical data from 364 patients with a total of 463 PCa lesions and 450 identified noncancerous image patches demonstrate that our system can achieve a sensitivity of 89.85% and a specificity of 95.83% for distinguishing cancer from noncancerous tissues and a sensitivity of 100% and a specificity of 76.92% for distinguishing indolent PCa from CS PCa. This result is significantly superior to the state-of-the-art method relying on handcrafted features.

Investigation of Closed Loop Adaptive Optics with the Deformable Mirror not in Pupil- Part 2: Theory (POSTPRINT)

DTIC Science & Technology

2008-07-01

Photo-Optical Instrumentation Engineers (SPIE) Conference 6272, July 2006. 2. F. P. Wildi , G. Brusa, A. Riccardi, M. Lloyd-Hart, H. M. Martin, and L. M...2003. 3. G. Brusa, A. Riccardi, P. Salinari, F. P. Wildi , M. Lloyd-Hart, H. M. Martin, R. Allen, D. Fisher, D. L. Miller, R. Biasi, D. Gallieni, and F

Cloud Effects in Hyperspectral Imagery from First-Principles Scene Simulations

DTIC Science & Technology

2009-01-01

SPIE. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, or distribution to multiple locations...scattering and absorption, scattering events, surface scattering with material-dependent bidirectional reflectances, multiple surface adjacency...aerosols or clouds, they may be absorbed, or they may reflect off the ground or an object. A given photon may undergo multiple scattering events

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The same tool could then be applied to assess any improvement after corrective actions are taken. This is the first comprehensive audit program in nuclear medicine that helps evaluate managerial aspects, safety of patients and workers, clinical practice, and radiopharmacy, and, above all, keeps them under control all together, with the intention of continuous improvement. Copyright © 2017. Published by Elsevier Inc.

International Journal of Occupational Medicine and Environmental Health in world documentation services: the SCOPUS based analysis of citation.

PubMed

Przyłuska, Jolanta

2006-01-01

A high classification of scientific journals in the ranking of international transfer of knowledge is reflected by other researchers' citations. The International Journal of Occupational Medicine and Environmental Health (IJOMEH) is an international professional quarterly focused on such areas as occupational medicine, toxicology and environmental health edited in Poland. IJOMEH, published in English, is indexed in numerous world information services (MEDLINE, EMBASE, EBSCO, SCOPUS). This paper presents the contribution of IJOMEH publications to the world circulation of scientific information based on the citation analysis. The analysis, grounded on the SCOPUS database, assessed the frequency of citations in the years 1996-2005. Journals in which they have been cited were retrieved and their list is also included.

Public health interventions to protect against falsified medicines: a systematic review of international, national and local policies.

PubMed

Hamilton, William L; Doyle, Cormac; Halliwell-Ewen, Mycroft; Lambert, Gabriel

2016-12-01

Falsified medicines are deliberately fraudulent drugs that pose a direct risk to patient health and undermine healthcare systems, causing global morbidity and mortality. To produce an overview of anti-falsifying public health interventions deployed at international, national and local scales in low and middle income countries (LMIC). We conducted a systematic search of the PubMed, Web of Science, Embase and Cochrane Central Register of Controlled Trials databases for healthcare or pharmaceutical policies relevant to reducing the burden of falsified medicines in LMIC. Our initial search identified 660 unique studies, of which 203 met title/abstract inclusion criteria and were categorised according to their primary focus: international; national; local pharmacy; internet pharmacy; drug analysis tools. Eighty-four were included in the qualitative synthesis, along with 108 articles and website links retrieved through secondary searches. On the international stage, we discuss the need for accessible pharmacovigilance (PV) global reporting systems, international leadership and funding incorporating multiple stakeholders (healthcare, pharmaceutical, law enforcement) and multilateral trade agreements that emphasise public health. On the national level, we explore the importance of establishing adequate medicine regulatory authorities and PV capacity, with drug screening along the supply chain. This requires interdepartmental coordination, drug certification and criminal justice legislation and enforcement that recognise the severity of medicine falsification. Local healthcare professionals can receive training on medicine quality assessments, drug registration and pharmacological testing equipment. Finally, we discuss novel technologies for drug analysis which allow rapid identification of fake medicines in low-resource settings. Innovative point-of-purchase systems like mobile phone verification allow consumers to check the authenticity of their medicines. Combining anti-falsifying strategies targeting different levels of the pharmaceutical supply chain provides multiple barriers of protection from falsified medicines. This requires the political will to drive policy implementation; otherwise, people around the world remain at risk. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Historical Roots of International Biomedical and Health Informatics: The Road to IFIP-TC4 and IMIA through Cybernetic Medicine and the Elsinore Meetings.

PubMed

Kulikowski, C A

2017-08-01

Background: It is 50 years since the International Federation of Information Processing (IFIP) Societies approved the formation of a new Technical Committee (TC) 4 on Medical Information Processing under the leadership of Professor Francois Grémy, which was the direct precursor of the International Medical Informatics Association (IMIA). Objectives: The goals of this paper are to give a very brief overview of early international developments leading to informatics in medicine, with the origins of the applications of computers to medicine in the USA and Europe, and two meetings - of the International Society of Cybernetic Medicine, and the Elsinore Meetings on Hospital Information Systems-that took place in 1966. These set the stage for the formation of IFIP-TC4 the following year, with later sponsorship of the first MEDINFO in 1974, setting the path for the evolution to IMIA. Methods: This paper reviews and analyzes some of the earliest research and publications, together with two critical contrasting meetings in 1966 involving international activities in what evolved into biomedical and health informatics in terms of their probable influence on the formation of IFIP-TC4. Conclusion: The formation of IFIP-TC 4 in 1967 by Francois Grémy arose out of his concerns for merging, at an international level, the diverse strands from the more abstract work on cybernetic medicine and its basis in biophysical and neural modeling, with the more concrete and health-oriented medical information processing that was developing at the time for hospitals and clinical decision-making. Georg Thieme Verlag KG Stuttgart.

A novel bedside cardiopulmonary physical diagnosis curriculum for internal medicine postgraduate training.

PubMed

Garibaldi, Brian Thomas; Niessen, Timothy; Gelber, Allan Charles; Clark, Bennett; Lee, Yizhen; Madrazo, Jose Alejandro; Manesh, Reza Sedighi; Apfel, Ariella; Lau, Brandyn D; Liu, Gigi; Canzoniero, Jenna VanLiere; Sperati, C John; Yeh, Hsin-Chieh; Brotman, Daniel J; Traill, Thomas A; Cayea, Danelle; Durso, Samuel C; Stewart, Rosalyn W; Corretti, Mary C; Kasper, Edward K; Desai, Sanjay V

2017-10-06

Physicians spend less time at the bedside in the modern hospital setting which has contributed to a decline in physical diagnosis, and in particular, cardiopulmonary examination skills. This trend may be a source of diagnostic error and threatens to erode the patient-physician relationship. We created a new bedside cardiopulmonary physical diagnosis curriculum and assessed its effects on post-graduate year-1 (PGY-1; interns) attitudes, confidence and skill. One hundred five internal medicine interns in a large U.S. internal medicine residency program participated in the Advancing Bedside Cardiopulmonary Examination Skills (ACE) curriculum while rotating on a general medicine inpatient service between 2015 and 2017. Teaching sessions included exam demonstrations using healthy volunteers and real patients, imaging didactics, computer learning/high-fidelity simulation, and bedside teaching with experienced clinicians. Primary outcomes were attitudes, confidence and skill in the cardiopulmonary physical exam as determined by a self-assessment survey, and a validated online cardiovascular examination (CE). Interns who participated in ACE (ACE interns) by mid-year more strongly agreed they had received adequate training in the cardiopulmonary exam compared with non-ACE interns. ACE interns were more confident than non-ACE interns in performing a cardiac exam, assessing the jugular venous pressure, distinguishing 'a' from 'v' waves, and classifying systolic murmurs as crescendo-decrescendo or holosystolic. Only ACE interns had a significant improvement in score on the mid-year CE. A comprehensive bedside cardiopulmonary physical diagnosis curriculum improved trainee attitudes, confidence and skill in the cardiopulmonary examination. These results provide an opportunity to re-examine the way physical examination is taught and assessed in residency training programs.

Reforming the core clerkship in internal medicine: the SGIM/CDIM Project. Society of General Internal Medicine/Clerkship Directors in Internal Medicine.

PubMed

Goroll, A H; Morrison, G; Bass, E B; Jablonover, R; Blackman, D; Platt, R; Whelan, A; Hekelman, F P

2001-01-02

Dramatic changes in health care have stimulated reform of undergraduate medical education. In an effort to improve the teaching of generalist competencies and encourage learning in the outpatient setting, the Society of General Internal Medicine joined with the Clerkship Directors in Internal Medicine in a federally sponsored initiative to develop a new curriculum for the internal medicine core clerkship. Using a broad-based advisory committee and working closely with key stakeholders (especially clerkship directors), the project collaborators helped forge a new national consensus on the learning agenda for the clerkship (a prioritized set of basic generalist competencies) and on the proportion of time that should be devoted to outpatient care (at least one third of the clerkship). From this consensus emerged a new curricular model that served as the basis for production of a curriculum guide and faculty resource package. The guide features the prioritized set of basic generalist competencies and specifies the requisite knowledge, skills, and attitudes/values needed to master them, as well as a list of suggested training problems. It also includes recommended training experiences, schedules, and approaches to faculty development, precepting, and student evaluation. Demand for the guide has been strong and led to production of a second edition, which includes additional materials, an electronic version, and a pocket guide for students and faculty. A follow-up survey of clerkship directors administered soon after completion of the first edition revealed widespread use of the curricular guide but also important barriers to full implementation of the new curriculum. Although this collaborative effort appears to have initiated clerkship reform, long-term success will require an enhanced educational infrastructure to support teaching in the outpatient setting.

Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants.

PubMed

Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry

2017-09-01

Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Update of the ERS international Adult Respiratory Medicine syllabus for postgraduate training.

PubMed

Tabin, Nathalie; Mitchell, Sharon; O'Connell, Elaine; Stolz, Daiana; Rohde, Gernot

2018-03-01

First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes. Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

Allocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening Shifts.

PubMed

Wenger, Nathalie; Méan, Marie; Castioni, Julien; Marques-Vidal, Pedro; Waeber, Gérard; Garnier, Antoine

2017-04-18

Little current evidence documents how internal medicine residents spend their time at work, particularly with regard to the proportions of time spent in direct patient care versus using computers. To describe how residents allocate their time during day and evening hospital shifts. Time and motion study. Internal medicine residency at a university hospital in Switzerland, May to July 2015. 36 internal medicine residents with an average of 29 months of postgraduate training. Trained observers recorded the residents' activities using a tablet-based application. Twenty-two activities were categorized as directly related to patients, indirectly related to patients, communication, academic, nonmedical tasks, and transition. In addition, the presence of a patient or colleague and use of a computer or telephone during each activity was recorded. Residents were observed for a total of 696.7 hours. Day shifts lasted 11.6 hours (1.6 hours more than scheduled). During these shifts, activities indirectly related to patients accounted for 52.4% of the time, and activities directly related to patients accounted for 28.0%. Residents spent an average of 1.7 hours with patients, 5.2 hours using computers, and 13 minutes doing both. Time spent using a computer was scattered throughout the day, with the heaviest use after 6:00 p.m. The study involved a small sample from 1 institution. At this Swiss teaching hospital, internal medicine residents spent more time at work than scheduled. Activities indirectly related to patients predominated, and about half the workday was spent using a computer. Information Technology Department and Department of Internal Medicine of Lausanne University Hospital.

Dark Skies Preservation through Responsible Lighting: the IYL2015 Quality Lighting Kit

NASA Astrophysics Data System (ADS)

Walker, Constance E.

2015-01-01

Poor quality lighting not only impedes astronomy research, but creates safety issues, affects human circadian sensitivities, disrupts ecosystems, and wastes more than a few billion dollars/year of energy in the USA alone. The United Nations-sanctioned the International Year of Light in 2015 (IYL2015) is providing an opportunity to increase public awareness of dark skies preservation, quality lighting and energy conservation. The Education and Public Outreach (EPO) group at the National Optical Astronomy Observatory (NOAO) has received a small grant through the International Astronomical Union (IAU) to produce official 'Quality Lighting Teaching Kits' for the IYL2015 cornerstone theme, 'Cosmic Light'. These kits will emphasize the use of proper optical design in achieving quality lighting that promotes both energy efficiency and energy conservation of an endangered natural resource, our dark skies. The concepts and practice of 'quality lighting' will be explored through demonstrations, hands-on/minds-on activities, formative assessment probes, and engineering design projects that explore basic principles of optics and the physics of light. The impact of the kits will be amplified by providing professional development using tutorial videos created at NOAO and conducting question and answer sessions via Google+ Hangouts for the outreach volunteers. The quality lighting education program will leverage NOAO EPO's work in the last ten years on lighting and optics education (e.g., the IAU 'Dark Skies Africa', APS 'Dark Skies Yuma' and 'Hands-On Optics' programs). NOAO's partners are CIE (International Commission on Illumination), IDA (International Dark-Sky Association) and SPIE (International Society for Optics and Photonics), as well as the IAU Office of Astronomy for Development, Galileo Teacher Training Program, Universe Awareness, and Global Hands-on Universe. Their networks will disseminate the program and kits to formal and informal audiences worldwide. The impact sought is a change in knowledge, attitude, and behavior in each community by learning how to light responsibly, improving the quality of life in 'illuminating' ways.

42 CFR 57.2209 - Conditions of scholarship grant.

Code of Federal Regulations, 2011 CFR

2011-10-01

... internal medicine, rotating internships with an emphasis on pediatrics, rotating internships with an... pediatrics and straight internships in obstetrics and gynecology; Provided, That such internships are... internal medicine, general pediatrics and general obstetrics and gynecology; Provided, That such...

42 CFR 57.2209 - Conditions of scholarship grant.

Code of Federal Regulations, 2010 CFR

2010-10-01

... internal medicine, rotating internships with an emphasis on pediatrics, rotating internships with an... pediatrics and straight internships in obstetrics and gynecology; Provided, That such internships are... internal medicine, general pediatrics and general obstetrics and gynecology; Provided, That such...

"Beginning with the end in mind": imagining personal retirement speeches to promote professionalism.

PubMed

Yu, Eunice; Wright, Scott M

2015-06-01

The goal of teaching professionalism in medicine is to transform a theoretical concept into an internalized and actualized identity. Many trainees struggle with professionalism in the abstract, particularly when instruction methods are didactic and disconnected from personal experience. The authors aim to demonstrate the feasibility of having interns frame a personal definition of professionalism based on a reflective technique called "beginning with the end in mind." Interns composed remarks that might be used to introduce them at their own retirement ceremony following a career in medicine. This "career eulogies" exercise was introduced to groups of six interns during the first third of the internship year as part of a two-week curriculum focused on professional development. Two investigators independently coded the written introductions, identifying emergent themes through content analysis. Of the 19 interns in an internal medicine residency program (2012-13), 17 participated in the exercise. Six themes emerged from the data: aligning behaviors with core values, achieving excellence in medicine, changing the world and giving back, valuing teamwork and relationships, realizing work-life balance, and appreciating a career in medicine. These themes correlate with accepted published definitions of professionalism. The personal reflections produced through this exercise allow physicians to begin to formulate their professional self-conception. Extensions of this work might include linking such forms of critical reflection to individualized learning plans and updating the speeches over time. Further research on "reflecting forward" may determine its impact as a complement to traditional narrative reflection.

Internal Medicine Residents' Clinical and Didactic Experiences After Work Hour Regulation

PubMed Central

Horwitz, Leora I; Krumholz, Harlan M; Huot, Stephen J; Green, Michael L

2006-01-01

BACKGROUND Work hour regulations for house staff were intended in part to improve resident clinical and educational performance. OBJECTIVE To characterize the effect of work hour regulation on internal medicine resident inpatient clinical experience and didactic education. DESIGN Cross-sectional mail survey. PARTICIPANTS Chief residents at all accredited U.S. internal medicine residency programs outside New York. MEASUREMENTS AND MAIN RESULTS The response rate was 62% (202/324). Most programs (72%) reported no change in average patient load per intern after work hour regulation. Many programs (48%) redistributed house staff admissions through the call cycle. The number of admissions per intern on long call (the day interns have the most admitting responsibility) decreased in 31% of programs, and the number of admissions on other days increased in 21% of programs. Residents on outpatient rotations were given new ward responsibilities in 36% of programs. Third-year resident ward and float time increased in 34% of programs, while third-year elective time decreased in 22% of programs. The mean weekly hours allotted to educational activities did not change significantly (12.7 vs 12.4, P = .12), but 56% of programs reported a decrease in intern attendance at educational activities. CONCLUSIONS In response to work hour regulation, many internal medicine programs redistributed rather than reduced residents' inpatient clinical experience. Hours allotted to educational activities did not change; however, most programs saw a decrease in intern attendance at conferences, and many reduced third-year elective time. PMID:16918742

Internal medicine residents' clinical and didactic experiences after work hour regulation: a survey of chief residents.

PubMed

Horwitz, Leora I; Krumholz, Harlan M; Huot, Stephen J; Green, Michael L

2006-09-01

Work hour regulations for house staff were intended in part to improve resident clinical and educational performance. To characterize the effect of work hour regulation on internal medicine resident inpatient clinical experience and didactic education. Cross-sectional mail survey. Chief residents at all accredited U.S. internal medicine residency programs outside New York. The response rate was 62% (202/324). Most programs (72%) reported no change in average patient load per intern after work hour regulation. Many programs (48%) redistributed house staff admissions through the call cycle. The number of admissions per intern on long call (the day interns have the most admitting responsibility) decreased in 31% of programs, and the number of admissions on other days increased in 21% of programs. Residents on outpatient rotations were given new ward responsibilities in 36% of programs. Third-year resident ward and float time increased in 34% of programs, while third-year elective time decreased in 22% of programs. The mean weekly hours allotted to educational activities did not change significantly (12.7 vs 12.4, P = .12), but 56% of programs reported a decrease in intern attendance at educational activities. In response to work hour regulation, many internal medicine programs redistributed rather than reduced residents' inpatient clinical experience. Hours allotted to educational activities did not change; however, most programs saw a decrease in intern attendance at conferences, and many reduced third-year elective time.

The emergence of family medicine in Kyrgyzstan.

PubMed

Hardison, Charles; Fonken, Paul; Chew, Tom; Smith, Barton

2007-10-01

In post-Soviet Central Asia, Kyrgyzstan has emerged as the leader in family medicine reform. This paper examines the factors that have allowed family medicine to become the foundation of primary care and the rationale for retraining specialists in primary care. Critical elements of successful family medicine reform have included national policy, international cooperation, training programs, support structures, and quality measures. The national policy has contributed to an environment that has allowed many international organizations to participate in the process of reforming the health care system. The 9-year training process was a momentous nationwide development task that was supported by various structures, organizations, and events and included the implementation of quality measures. Various reports, studies, and evaluations support the positive impact family medicine has had on patient satisfaction, physician attitude, and scope of practice. Further, one study indicates improved health outcomes in terms of decreased years of potential life lost. The national policy of reform that is in favor of family medicine, and international donor agencies-supported training, produced the following results: a group of family medicine teachers, 98% (2,691) of the country's primary care doctors retrained in family medicine, and there were 372 family medicine resident graduates. To ensure quality, objective structured clinical exams were implemented in all levels of training. It will take many more years to fully establish family medicine in the medical culture of Kyrgyzstan and reap its full benefits, but already it is contributing toward improvements in the quality of patient care.

Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare?

PubMed

Walby, A; Kelly, A M; Georgakas, C

2001-12-01

The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.

Search and Pursuit with Unmanned Aerial Vehicles in Road Networks

DTIC Science & Technology

2013-11-01

production volume in each area for use in consumer electronics. Simultaneously, a shift in defense strategy towards unmanned vehicles, particularly...Vöcking. Randomized pursuit-evasion in graphs. Combinatorics, Probability and Computing, 12:225–244, May 2003. [3] AeroVironment Inc. Raven Product Data...Ali and Mubarak Shah. COCOA - tracking in aerial imagery. In SPIE Airborne Intelligence, Surveillance, Reconnaissance Systems and Applications, 2006

Solid State Research

DTIC Science & Technology

1988-11-15

Reduction of Intermodulation L.M. Johnson Opt. Lett. 13, 928 (1988) Distortion in Interferometric H.V. Roussell Optical Modulators * Author not at Lincoln...Engineering V, Proc. Niobate Interferometric Modulators SPIE 835, 29 (1988), DTIC AD-A198029 7553 Advanced Device Fabrication with W.D. Goodhue Proc...Colorado, 3 October 1988 7741 B Integrated-Optical Interferometric L.M. Johnson 2 X 2 Switches H.V.Roussell 7927B Free-Space Optical Interconnects

Statistical Memristor Modeling and Case Study in Neuromorphic Computing

DTIC Science & Technology

2012-06-01

use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and...Sundareswaran, R. Panda , and D. Pan, “Electrical impact of line-edge roughness on sub-45nm node standard cell,” in Proc. SPIE, vol. 7275, 2009, pp. 727 518–727 518–10. 590 26.3

ASAP members view LVSA and Orion Stage Adapter

NASA Image and Video Library

2018-03-12

ASAP, (Aerospace Safety Advisory Panel), members, Dr. Sandra Magnus, Dr. Donald P. McErlean, Dr. George Nield, Captain Christopher Saindon, Mr. David West, Dr. Patricia Sanders, Ms. Carol Hamilton, Ms. Evette Whatley, Ms. Paula Frankel, view LVSA, (Launch Vehicle Stage Adapter), and Orion Stage Adapter. Members were escorted to buildings 4707 and 4708 by Andrew Schorr, Deputy Manager for Spacecraft/Payload Integration & Evolution Office (SPIE)

Pulmonary and Critical Care In-Service Training Examination Score as a Predictor of Board Certification Examination Performance.

PubMed

Kempainen, Robert R; Hess, Brian J; Addrizzo-Harris, Doreen J; Schaad, Douglas C; Scott, Craig S; Carlin, Brian W; Shaw, Robert C; Duhigg, Lauren; Lipner, Rebecca S

2016-04-01

Most trainees in combined pulmonary and critical care medicine fellowship programs complete in-service training examinations (ITEs) that test knowledge in both disciplines. Whether ITE scores predict performance on the American Board of Internal Medicine Pulmonary Disease Certification Examination and Critical Care Medicine Certification Examination is unknown. To determine whether pulmonary and critical care medicine ITE scores predict performance on subspecialty board certification examinations independently of trainee demographics, program director competency ratings, fellowship program characteristics, and prior medical knowledge assessments. First- and second-year fellows who were enrolled in the study between 2008 and 2012 completed a questionnaire encompassing demographics and fellowship training characteristics. These data and ITE scores were matched to fellows' subsequent scores on subspecialty certification examinations, program director ratings, and previous scores on their American Board of Internal Medicine Internal Medicine Certification Examination. Multiple linear regression and logistic regression were used to identify independent predictors of subspecialty certification examination scores and likelihood of passing the examinations, respectively. Of eligible fellows, 82.4% enrolled in the study. The ITE score for second-year fellows was matched to their certification examination scores, which yielded 1,484 physicians for pulmonary disease and 1,331 for critical care medicine. Second-year fellows' ITE scores (β = 0.24, P < 0.001) and Internal Medicine Certification Examination scores (β = 0.49, P < 0.001) were the strongest predictors of Pulmonary Disease Certification Examination scores, and were the only significant predictors of passing the examination (ITE odds ratio, 1.12 [95% confidence interval, 1.07-1.16]; Internal Medicine Certification Examination odds ratio, 1.01 [95% confidence interval, 1.01-1.02]). Similar results were obtained for predicting Critical Care Medicine Certification Examination scores and for passing the examination. The predictive value of ITE scores among first-year fellows on the subspecialty certification examinations was comparable to second-year fellows' ITE scores. The Pulmonary and Critical Care Medicine ITE score is an independent, and stronger, predictor of subspecialty certification examination performance than fellow demographics, program director competency ratings, and fellowship characteristics. These findings support the use of the ITE to identify the learning needs of fellows as they work toward subspecialty board certification.

Sex Differences in Rank Attainment among Radiology and Internal Medicine Faculty.

ERIC Educational Resources Information Center

Dial, Thomas H.; And Others

1989-01-01

The Association of American Medical Colleges Faculty Roster System allows comparison of a cohort of faculty at any selected time following their first faculty appointments. Disparities between men and women in rank attained in radiology and internal medicine were examined. (Author/MLW)

Standard operating procedures for female orgasmic disorder: consensus of the International Society for Sexual Medicine.

PubMed

Laan, Ellen; Rellini, Alessandra H; Barnes, Tricia

2013-01-01

As the field of sexual medicine evolves, it is important to continually improve patient care by developing contemporary "standard operating procedures" (SOPs), reflecting the consensus view of experts in sexual medicine. Few, if any, consensus SOPs have been developed for the diagnosis and treatment of Female Orgasmic Disorder (FOD). The objective is to provide standard operating procedures for FOD. The SOP Committee was composed of a chair, selected by the International Society for the Study of Sexual Medicine, and two additional experts. To inform its key recommendations, the Committee used systematic reviews of available evidence and discussions during a group meeting, conference calls and e-mail communications. The Committee received no corporate funding or remuneration. A total of 12 recommendations for the assessment and treatment of FOD were generated, including suggestions for further research. Evidence-based, practice recommendations for the treatment of FOD are provided that will hopefully inform clinical decision making for those treating this common condition. © 2012 International Society for Sexual Medicine.

CART V: recent advancements in computer-aided camouflage assessment

NASA Astrophysics Data System (ADS)

Müller, Thomas; Müller, Markus

2011-05-01

In order to facilitate systematic, computer aided improvements of camouflage and concealment assessment methods, the software system CART (Camouflage Assessment in Real-Time) was built up for the camouflage assessment of objects in multispectral image sequences (see contributions to SPIE 2007-2010 [1], [2], [3], [4]). It comprises a semi-automatic marking of target objects (ground truth generation) including their propagation over the image sequence and the evaluation via user-defined feature extractors as well as methods to assess the object's movement conspicuity. In this fifth part in an annual series at the SPIE conference in Orlando, this paper presents the enhancements over the recent year and addresses the camouflage assessment of static and moving objects in multispectral image data that can show noise or image artefacts. The presented methods fathom the correlations between image processing and camouflage assessment. A novel algorithm is presented based on template matching to assess the structural inconspicuity of an object objectively and quantitatively. The results can easily be combined with an MTI (moving target indication) based movement conspicuity assessment function in order to explore the influence of object movement to a camouflage effect in different environments. As the results show, the presented methods contribute to a significant benefit in the field of camouflage assessment.

Advances in Acoustic Landmine Detection

DTIC Science & Technology

2006-10-01

8] A. Petculescu and J. M. Sabatier, “ Feasibility study of an air - coupled acoustic sensor for measuring small vibrations, Proc. SPIE 17th...the acoustic-to-seismic (A/S) coupling of airborne sound into the ground for buried anti-personnel and anti-tank landmine detection is well established...113, pp.1333-1341 (2003)]. A sound source is used to insonify the ground surface. The airborne sound couples into the soil and excites the

Feasibility Study of Compressive Sensing Underwater Imaging Lidar

DTIC Science & Technology

2014-03-28

Texas Instruments Digital Micromirror Devices development system. In addition, through these studies, the deficiencies and/or areas of lack...device, such as the Digital Micromirror Device (DMD), to spatially modulate the laser source that illuminates the target plane. The same binary patterns...Digital Micromirror Device (DMD) Applications," Proc. of SPIE, 2003, 4985, 14-25. [8] T. E. Giddings and J. J. Shirron, "Numerical Simulation of the

Internal Medicine House Officers' Performance as Assessed by Experts and Standardized Patients.

ERIC Educational Resources Information Center

Calhoun, Judith G.; And Others

1987-01-01

Three chronically ill patients were trained to evaluate the performance of 31 second-year internal medicine house officers based upon: a checklist for the medical data elicited during the medical interview; the process of the interview; and the physical examination technique. (Author/MLW)

Photonic Analog-to-Digital Converters

DTIC Science & Technology

2006-03-01

Edward W. Taylor, “Gamma-Ray Induced Damage and Recovery Behavior in an Erbium-Doped Fiber Laser ”, SPIE Proceedings, Vol. 4547, Sep. 2001, pp.126-133...requirements. The center frequency of the bandpass filter determined the laser mode-locked frequency. SNDP’s COEO had an operating frequency of... laser . Better filters and amplifiers were needed to improve operation and to reduce the phase noise to a level comparable with Delfyett’s actively

Reflection Properties of Scarabaeidae

DTIC Science & Technology

2005-08-01

coated silicon membrane beam splitters for the division-of-amplitude photopolarimeter (DOAP),” presented at the OSA Annual Meeting, October 2, 2002. SPIE Vol. 5888, Polarization Science and Remote Sensing II ...measures spectral polarization properties of materials in transmission and reflection has been previously designed , patented 10 , and described 11 . The...may be generalized to compensate for systematic errors that result when orientation misalignment and non -ideal retarders are used. If the

Illuminating math with optics

NASA Astrophysics Data System (ADS)

Donnelly, Judith F.; Donnelly, Matthew J.

2014-09-01

Forty-five high school students engaged in hands-on optics applications of pre-calculus topics. Pre- and post-testing was conducted to determine changes in attitudes towards mathematics education. Experiments were performed in community college labs and in the high school classroom, facilitated by college and high school faculty and with the assistance of SPIE student chapter members. We will describe the structure and activities of the four-month program and pre/post test results.

Microwave Semiconductor Research - Materials, Devices, Circuits.

DTIC Science & Technology

1982-04-30

34, C.L. Tang and J-M. Halbout, invited talk, SPIE Technical Symposium, Los Angeles, CA (January, 1982). 3. "Observation of light induced refractive index ... index slab its desirable dispersive properties. The relatively poor dispersion characteristics of the uniform dielectric slab can be attributed to the...34, January 1982. 2. H. Zmuda completed his M.S. program. Thesis: "Simplified Dispersion Analysis of the Multistep and Graded Index Dielectric Slab Waveguide

Enhancing the far-UV sensitivity of silicon CMOS imaging arrays

NASA Astrophysics Data System (ADS)

Retherford, K. D.; Bai, Yibin; Ryu, Kevin K.; Gregory, J. A.; Welander, Paul B.; Davis, Michael W.; Greathouse, Thomas K.; Winter, Gregory S.; Suntharalingam, Vyshnavi; Beletic, James W.

2014-07-01

We report our progress toward optimizing backside-illuminated silicon PIN CMOS devices developed by Teledyne Imaging Sensors (TIS) for far-UV planetary science applications. This project was motivated by initial measurements at Southwest Research Institute (SwRI) of the far-UV responsivity of backside-illuminated silicon PIN photodiode test structures described in Bai et al., SPIE, 2008, which revealed a promising QE in the 100-200 nm range as reported in Davis et al., SPIE, 2012. Our effort to advance the capabilities of thinned silicon wafers capitalizes on recent innovations in molecular beam epitaxy (MBE) doping processes. Key achievements to date include: 1) Representative silicon test wafers were fabricated by TIS, and set up for MBE processing at MIT Lincoln Laboratory (LL); 2) Preliminary far-UV detector QE simulation runs were completed to aid MBE layer design; 3) Detector fabrication was completed through the pre-MBE step; and 4) Initial testing of the MBE doping process was performed on monitoring wafers, with detailed quality assessments. Early results suggest that potential challenges in optimizing the UV-sensitivity of silicon PIN type CMOS devices, compared with similar UV enhancement methods established for CCDs, have been mitigated through our newly developed methods. We will discuss the potential advantages of our approach and briefly describe future development steps.

Correlations Between Ratings on the Resident Annual Evaluation Summary and the Internal Medicine Milestones and Association With ABIM Certification Examination Scores Among US Internal Medicine Residents, 2013-2014.

PubMed

Hauer, Karen E; Vandergrift, Jonathan; Hess, Brian; Lipner, Rebecca S; Holmboe, Eric S; Hood, Sarah; Iobst, William; Hamstra, Stanley J; McDonald, Furman S

2016-12-06

US internal medicine residency programs are now required to rate residents using milestones. Evidence of validity of milestone ratings is needed. To compare ratings of internal medicine residents using the pre-2015 resident annual evaluation summary (RAES), a nondevelopmental rating scale, with developmental milestone ratings. Cross-sectional study of US internal medicine residency programs in the 2013-2014 academic year, including 21 284 internal medicine residents (7048 postgraduate-year 1 [PGY-1], 7233 PGY-2, and 7003 PGY-3). Program director ratings on the RAES and milestone ratings. Correlations of RAES and milestone ratings by training year; correlations of medical knowledge ratings with American Board of Internal Medicine (ABIM) certification examination scores; rating of unprofessional behavior using the 2 systems. Corresponding RAES ratings and milestone ratings showed progressively higher correlations across training years, ranging among competencies from 0.31 (95% CI, 0.29 to 0.33) to 0.35 (95% CI, 0.33 to 0.37) for PGY-1 residents to 0.43 (95% CI, 0.41 to 0.45) to 0.52 (95% CI, 0.50 to 0.54) for PGY-3 residents (all P values <.05). Linear regression showed ratings differed more between PGY-1 and PGY-3 years using milestone ratings than the RAES (all P values <.001). Of the 6260 residents who attempted the certification examination, the 618 who failed had lower ratings using both systems for medical knowledge than did those who passed (RAES difference, -0.9; 95% CI, -1.0 to -0.8; P < .001; milestone medical knowledge 1 difference, -0.3; 95% CI, -0.3 to -0.3; P < .001; and medical knowledge 2 difference, -0.2; 95% CI, -0.3 to -0.2; P < .001). Of the 26 PGY-3 residents with milestone ratings indicating deficiencies on either of the 2 medical knowledge subcompetencies, 12 failed the certification examination. Correlation of RAES ratings for professionalism with residents' lowest professionalism milestone ratings was 0.44 (95% CI, 0.43 to 0.45; P < .001). Among US internal medicine residents in the 2013-2014 academic year, milestone-based ratings correlated with RAES ratings but with a greater difference across training years. Both rating systems for medical knowledge correlated with ABIM certification examination scores. Milestone ratings may better detect problems with professionalism. These preliminary findings may inform establishment of the validity of milestone-based assessment.

The Joint Committee for Traceability in Laboratory Medicine (JCTLM) - its history and operation.

PubMed

Jones, Graham R D; Jackson, Craig

2016-01-30

The Joint Committee for Traceability in Laboratory Medicine (JCTLM) was formed to bring together the sciences of metrology, laboratory medicine and laboratory quality management. The aim of this collaboration is to support worldwide comparability and equivalence of measurement results in clinical laboratories for the purpose of improving healthcare. The JCTLM has its origins in the activities of international metrology treaty organizations, professional societies and federations devoted to improving measurement quality in physical, chemical and medical sciences. The three founding organizations, the International Committee for Weights and Measures (CIPM), the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the International Laboratory Accreditation Cooperation (ILAC) are the leaders of this activity. The main service of the JCTLM is a web-based database with a list of reference materials, reference methods and reference measurement services meeting appropriate international standards. This database allows manufacturers to select references for assay traceability and provides support for suppliers of these services. As of mid 2015 the database lists 295 reference materials for 162 analytes, 170 reference measurement procedures for 79 analytes and 130 reference measurement services for 39 analytes. There remains a need for the development and implementation of metrological traceability in many areas of laboratory medicine and the JCTLM will continue to promote these activities into the future. Copyright © 2015 Elsevier B.V. All rights reserved.

Training in neurology.

PubMed

Aminoff, Michael J

2008-05-13

The training of clinical neurologists is undergoing profound change. Increasing subspecialization within neurology, the widening separation of clinical neurology from other branches of internal medicine, limitations of exposure to training in internal medicine, mandated restrictions in working hours, and attempts to shorten the training period are likely to have adverse effects on the next generation of clinical neurologists. Despite the need for a broad base in general medicine, discussed here, the exposure of neurology trainees to general medical disorders is diminishing. An emphasis on an algorithmic approach to patient management rather than on educating residents to use their reasoning faculties when applying new techniques and knowledge to clinical practice may adversely affect patient care. Neurologists require broad-based training in neurology, internal medicine, and psychiatry, to ensure excellence in clinical practice. It is time to question again whether they are receiving the training that they need.

Management of prediabetes: a comparison of the treatment approaches utilized by a family practice clinic and an internal medicine/endocrinology practice.

PubMed

Anderson, Zachary L; Scopelliti, Emily M; Trompeter, Jessica M; Havrda, Dawn E

2015-02-01

To compare the management of prediabetes between a family practice clinic and internal medicine/endocrinology practice. A randomized, retrospective evaluation of the medical history in 168 eligible patients with a diagnosis of prediabetes or abnormal blood glucose (BG) at a family practice clinic (n = 78) and an internal medicine/endocrinology practice (n = 90). The internal medicine/endocrinology practice provided more counseling regarding lifestyle modifications (91.1% vs 76.9%, P = .039), specific physical activity recommendations (26.7% vs 7.7%, P = .003), and recommended more patients receive 150 minutes/week of moderate exercise (8.9% vs 1.3%, P = .038). The family practice clinic provided more written dietary information (16.9% vs 13.3%, P = .044) and specific weight loss goals (20.5% vs 6.7%, P = .015). The internal medicine/endocrinology practice initiated pharmacological therapy in more patients (51.1% vs 3.8%, P< .001) and had a significant decrease in fasting BG from baseline compared to the family practice clinic (-9.0 vs -5.6 mg/dL, P< .001). Providers are likely to initiate nonpharmacological therapy but may not provide specific education recommended by the American Diabetes Association. The integration of a multidisciplinary team to provide guideline-based nonpharmacologic counseling may be beneficial in improving outcomes in the management of prediabetes. © The Author(s) 2013.

Applying the Chronic Care Model to Homeless Veterans: Effect of a Population Approach to Primary Care on Utilization and Clinical Outcomes

PubMed Central

Buckel, Lauren; Bourgault, Claire; Blumen, Jonathan; Redihan, Stephen G.; Jiang, Lan; Friedmann, Peter

2010-01-01

Objectives. We compared a population-tailored approach to primary care for homeless veterans with a usual care approach. Methods. We conducted a retrospective prolective cohort study of homeless veterans enrolled in a population-tailored primary care clinic matched to a historical sample in general internal medicine clinics. Overall, 177 patients were enrolled: 79 in the Homeless-Oriented Primary Care Clinic and 98 in general internal medicine primary care. Results. Homeless-oriented primary care–enrolled patients had greater improvements in hypertension, diabetes, and lipid control, and primary care use was higher during the first 6 months (5.96 visits per person vs 1.63 for general internal medicine) but stabilized to comparable rates during the second 6 months (2.01 vs 1.31, respectively). Emergency department (ED) use was also higher (2.59 vs 1.89 visits), although with 40% lower odds for nonacute ED visits than for the general internal medicine group (95% confidence interval = 0.2, 0.8). Excluding substance abuse and mental health admissions, hospitalizations were reduced among the homeless veterans between the 2 periods (28.6% vs 10.8%; P < .01) compared with the general internal medicine group (48.2% vs 44.4%; P = .6; difference of differences, P < .01). Conclusions. Tailoring primary care to homeless veterans can decrease unnecessary ED use and medical admissions and improve chronic disease management. PMID:20966377

Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world.

PubMed

Arya, Neil; Dahlman, Bruce; Gibson, Christine; Ponka, David; Haq, Cynthia; Rouleau, Katherine; Hansel, Stephanie

2017-08-01

To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally. Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts. With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world. Copyright© the College of Family Physicians of Canada.

Development of laser technology in Poland: 2016

NASA Astrophysics Data System (ADS)

Jankiewicz, Zdzisław; Jabczyński, Jan K.; Romaniuk, Ryszard S.

2016-12-01

The paper is an introduction to the volume of proceedings and a concise digest of works presented during the XIth National Symposium on Laser Technology (SLT2016) [1]. The Symposium is organized since 1984 every three years [2-8]. SLT2016 was organized by the Institute of Optoelectronics, Military University of Technology (IO, WAT) [9], Warsaw, with cooperation of Warsaw University of Technology (WUT) [10], in Jastarnia on 27-30 September 2016. Symposium Proceedings are traditionally published by SPIE [11-19]. The meeting has gathered around 150 participants who presented around 120 research and technical papers. The Symposium, organized every 3 years is a good portrait of laser technology and laser applications development in Poland at university laboratories, governmental institutes, company R&D laboratories, etc. The SLT also presents the current technical projects under realization by the national research, development and industrial teams. Topical tracks of the Symposium, traditionally divided to two large areas - sources and applications, were: laser sources in near and medium infrared, picosecond and femtosecond lasers, optical fiber lasers and amplifiers, semiconductor lasers, high power and high energy lasers and their applications, new materials and components for laser technology, applications of laser technology in measurements, metrology and science, military applications of laser technology, laser applications in environment protection and remote detection of trace substances, laser applications in medicine and biomedical engineering, laser applications in industry, technologies and material engineering.

Standardization and future directions in pattern identification research: International brainstorming session.

PubMed

Jung, Jeeyoun; Park, Bongki; Lee, Ju Ah; You, Sooseong; Alraek, Terje; Bian, Zhao-Xiang; Birch, Stephen; Kim, Tae-Hun; Xu, Hao; Zaslawski, Chris; Kang, Byoung-Kab; Lee, Myeong Soo

2016-09-01

An international brainstorming session on standardizing pattern identification (PI) was held at the Korea Institute of Oriental Medicine on October 1, 2013 in Daejeon, South Korea. This brainstorming session was convened to gather insights from international traditional East Asian medicine specialists regarding PI standardization. With eight presentations and discussion sessions, the meeting allowed participants to discuss research methods and diagnostic systems used in traditional medicine for PI. One speaker presented a talk titled "The diagnostic criteria for blood stasis syndrome: implications for standardization of PI". Four speakers presented on future strategies and objective measurement tools that could be used in PI research. Later, participants shared information and methodology for accurate diagnosis and PI. They also discussed the necessity for standardizing PI and methods for international collaborations in pattern research.

Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

PubMed

Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

2009-10-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

PubMed

Laube, Justin G R; Shapiro, Martin F

2017-05-01

Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p < 0.01), 3.2 (SD, 2.1) for naturopathic medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive health goals of general internal medicine, family medicine, integrative medicine, and CAM practices.

Appropriate Measures and Consistent Standard for High Energy Laser Beam Quality (Postprint)

DTIC Science & Technology

2006-08-01

another. a We follow the 99% criteria [ Siegman , Lasers , chapter 17.1] which corresponds to a... Siegman , “ Lasers ” University Science Books, 1986. • A.E. Siegman , “New developments in laser resonators”, SPIE Vol. 1224, Optical Resonators, 1990...pp. 1-14. • Anthony E. Siegman & Steven W. Townsend, “Output Beam Propagation and Beam Quality from a Multimode Stable-Cavity Laser ”, IEEE Journal

Terahertz Imaging of Subjects With Concealed Weapons

DTIC Science & Technology

2006-05-01

pulsed imaging", Advanced Characterization, Therapeutics, and Systems XIV, Proceedings of SPIE, Vol. 5318: 23-33 6. Anthony E. Siegman , Lasers , p667...imagery. Both methods made use of in-house transceivers, consisting of two ultra-stable far-infrared lasers , terahertz heterodyne detection systems...SYSTEM The 1.56THz transceiver system at STL uses two carbon dioxide lasers paired individually with two far-infrared lasers . All four units are

Phase Fluctuation Enhanced Adaptive Processor

DTIC Science & Technology

2000-02-04

Serial Number Filing Date Inventor 09/498.348 4 February 2000 Ronald A. Wagstaff Jackson A. Mobbs NOTICE The above identified patent...phase angle, as describedin Phase Variations in a Fluctuation Based Processor, Ronald A. Wagstaff and Jacob George, SPIE Vol. 2751, April 1996, pages...16 17 18 19 20 21 22 Docket No.: N.C. 79,518 PATENT APPT TPATT™ Inventor’s Name: Wagstaff , et al APPLICATION 1 have medium phase fluctuations

76 FR 8748 - Loan Repayment Program for Repayment of Health Professions Educational Loans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

... Nurse Anesthetists.). (l) Podiatry: D.P.M. (m) Physical Rehabilitation Services: Physical Therapy... program site determined by the Secretary. Loan repayment sites are characterized by physical, cultural... allopathic medicine, family medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and...

Performance of International Medical Students In psychosocial medicine.

PubMed

Huhn, D; Lauter, J; Roesch Ely, D; Koch, E; Möltner, A; Herzog, W; Resch, F; Herpertz, S C; Nikendei, C

2017-07-10

Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. International medical students scored significantly poorer than their local peers (p < .001; η 2  = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η 2  = .053). No differences emerged within the multiple-choice examination (p = .127). International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

ERIC Educational Resources Information Center

Jones, Roger; Panda, Mukta; Desbiens, Norman

2008-01-01

Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

Item Analysis to Improve Reliability for an Internal Medicine Undergraduate OSCE

ERIC Educational Resources Information Center

Auewarakul, Chirayu; Downing, Steven M.; Praditsuwan, Rungnirand; Jaturatamrong, Uapong

2005-01-01

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical…

Documentation of quality improvement exposure by internal medicine residency applicants.

PubMed

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

General internal medicine at the crossroads of prosperity and despair: caring for patients with chronic diseases in an aging society.

PubMed

Larson, E B

2001-05-15

During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.

77 FR 3269 - Loan Repayment Program for Repayment of Health Professions Educational Loans; Announcement Type...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Anesthetists.). (o) Podiatry: D.P.M. (p) Physical Rehabilitation Services: Physical Therapy, Occupational... by the Secretary. Loan repayment sites are characterized by physical, cultural, and professional... medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric medicine...

Resource Manual for Alcohol and Other Drug Abuse Education in Internal Medicine.

ERIC Educational Resources Information Center

Bigby, JudyAnn, Ed.; England, Susan, Ed.

The resource manual provides guidelines and resources for individuals interested in integrating a substance abuse curriculum into existing programs for medical students and residents in internal medicine. Materials and resources appropriate for practicing physicians are also included. Three sections are: (1) a statement of minimum knowledge and…

76 FR 57060 - International Cooperation on Harmonisation of Technical Requirements for Registration of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0588] International Cooperation on Harmonisation of Technical Requirements for Registration of Veterinary Medicinal Products; Draft Guidance for Industry on Pharmacovigilance of Veterinary Medicinal Products: Electronic...

Advancing Women's Health and Women's Leadership With Endowed Chairs in Women's Health.

PubMed

Carnes, Molly; Johnson, Paula; Klein, Wendy; Jenkins, Marjorie; Bairey Merz, C Noel

2017-02-01

Gender-based bias and conflation of gender and status are root causes of disparities in women's health care and the slow advancement of women to leadership in academic medicine. More than a quarter of women physicians train in internal medicine and its subspecialties, and women physicians almost exclusively constitute the women's health focus within internal medicine. Thus, internal medicine has considerable opportunity to develop women leaders in academic medicine and promote women's health equity.To probe whether holding an endowed chair-which confers status-in women's health may be an effective way to advance women leaders in academic medicine and women's health, the authors explored the current status of endowed chairs in women's health in internal medicine. They found that the number of these endowed chairs in North America increased from 7 in 2013 to 19 in 2015, and all were held by women. The perceptions of incumbents and other women's health leaders supported the premise that an endowed chair in women's health would increase women's leadership, the institutional stature of women's health, and activities in women's health research, education, and clinical care.Going forward, it will be important to explore why not all recipients perceived that the endowed chair enhanced their own academic leadership, whether providing women's health leaders with fundraising expertise fosters future success in increasing the number of women's health endowed chairs, and how the conflation of gender and status play out (e.g., salary differences between endowed chairs) as the number of endowed chairs in women's health increases.

A Comparison of Students' Clinical Experience in Family Medicine and Traditional Clerkships.

ERIC Educational Resources Information Center

Parkerson, George R., Jr.; And Others

1984-01-01

Experience on the traditional internal medicine, surgery, pediatrics, obstetrics-gynecology, and psychiatry clerkships was compared with the experience on a family medicine clerkship. The family medicine clerkship offered the most experience with circulatory, respiratory, digestive, neurological, musculoskeletal, and skin problems and with…

Internationalization of traditional Chinese medicine: current international market, internationalization challenges and prospective suggestions.

PubMed

Lin, Annie Xianghong; Chan, Ging; Hu, Yuanjia; Ouyang, Defang; Ung, Carolina Oi Lam; Shi, Luwen; Hu, Hao

2018-01-01

Through reviewing the current international market for traditional Chinese medicine (TCM), this paper identified the internationalization challenges for TCM, including unclear therapeutic material basis and mechanism, difficulty of quality control, low preparation level, registration/policy barriers, and shortage of intellectual property. To deal with these challenges, suggestions were given including: (1) product innovation of TCM (study the TCM by using the methods and means of western medicine; innovate the basic theory of TCM; develop TCM health product); (2) standard innovation of TCM; (3) building big data platform of Chinese medicine (big data platform of TCM preparation; big data platform on the quality of TCM).

A commitment to high-value care education from the internal medicine community.

PubMed

Smith, Cynthia D; Levinson, Wendy S

2015-05-05

The Alliance for Academic Internal Medicine, American Board of Internal Medicine (ABIM), ABIM Foundation, and American College of Physicians are collaborating to enhance the education of physicians in high-value care (HVC) and make its practice an essential competency in undergraduate and postgraduate education by 2017. This article serves as the organizations' formal commitment to providing a foundation of HVC education on which others may build. The 5 key targets for HVC education are experiential learning and curriculum, environment and culture, clinical support, regulatory requirements, and sustainability. The goal is to train future health care professionals for whom HVC is part of normal practice, thus providing patients with improved clinical outcomes at a lower cost.

The Effect of a CD-ROM Multimedia Tool on the Cardiac Auscultation Ability of Internal Medicine Residents

PubMed Central

Mangrulkar, Rajesh S.; Watt, John M.; Chapman, Chris M.; Judge, Richard D.; Stern, David T.

2001-01-01

In order to test the hypothesis that self study with a CD-ROM based cardiac auscultation tool would enhance knowledge and skills, we conducted a controlled trial of internal medicine residents and evaluated their performance on a test before and after exposure to the tool. Both intervention and control groups improved their auscultation knowledge and skills scores. However, subjects in the CD-ROM group had significantly higher improvements in skills, knowledge, and total scores than those not exposed to the intervention (all p<0.001). Therefore, protected time for internal medicine residents to use this multimedia computer program enhanced both facets of cardiac auscultation.

Predictors of yoga use among internal medicine patients.

PubMed

Cramer, Holger; Lauche, Romy; Langhorst, Jost; Paul, Anna; Michalsen, Andreas; Dobos, Gustav

2013-07-13

Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.

Design and Development of Electrically Pumped Coaxial Nanoscale Laser for On-chip Optical Communication - TOPIC STIR

DTIC Science & Technology

2015-08-31

Hodaei, M. A. Miri, M. Heinrich, D. Christodoulides, M. Khajavikhan, “ PT - symmetric microring lasers ”, SPIE Photonics West San Francisco CA (2015...Broad Area PT - Symmetric Microring Lasers , CLEO: QELS_Fundamental Science. 07-JUN-15, San Jose, California. : , Hossein Hodaei, William Hayenga...Mohammad-Ali Miri, Absar Ulhassan, Demetrios N. Christodoulides, Mercedeh Khajavikhan. Tunable Parity-Time- Symmetric Microring Lasers , CLEO: Science and

Isolating and Discriminating Overlapping Signatures in Cluttered Environments

DTIC Science & Technology

2011-05-11

Lin-Ping Song, Douglas W. Oldenburg, Leonard R. Pasion , and Stephen D. Billings. Transient electromagnetic inversion for multiple targets. SPIE...and Remote Sensing, 39(6):1294 – 1298, 2001. ISSN 0196-2892. 33, 34 [52] L. R. Pasion and D. W. Oldenburg. A discrimination algorithm for UXO using...R. Pasion , Douglas W. Oldenburg, and Stephen D. Billings. Com- puting transient electromagnetic response of a metallic object with a spheroidal

Ultrafast Laser Interaction Processes for Libs and Other Sensing Technologies

DTIC Science & Technology

2013-04-05

Wang. Propagation of ultrashort pulses through water, Optics Express, (02 2007): . doi: 12/02/2009 8.00 Z. Chen, S. Mao. Femtosecond laser -induced...Richardson, "Nd:YAG-CO2 double- pulse laser -induced breakdown spectroscopy for explosive residues detection" SPIE Defense, Security, Sensing; Orlando, FL... Ultrashort Pulse Laser Workshop, Directed Energy Professional Society; Newton, MA, USA; 06/29,2009. 63. Martin C. Richardson, Michael Sigman

Ultrafast Laser Interaction Processes for LIBS and Other Sensing Technologies

DTIC Science & Technology

2013-04-05

Propagation of ultrashort pulses through water, Optics Express, (02 2007): . doi: 12/02/2009 8.00 Z. Chen, S. Mao. Femtosecond laser -induced electronic...CO2 double- pulse laser -induced breakdown spectroscopy for explosive residues detection" SPIE Defense, Security, Sensing; Orlando, FL, USA; 04/07...Matthieu Baudelet, Michael Sigman, Paul J Dagdigian, Martin C. Richardson, "Nd:YAG-CO2 Double- Pulse Laser Induced Breakdown Spectroscopy for Explosive

Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

PubMed

Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

2015-06-01

The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

International textbook of family medicine: the application of EURACT teaching agenda.

PubMed

Švab, Igor; Katić, Milica

2014-01-01

The paper describes experiences in the development of an international textbook of family medicine. The process of its development has started in Slovenia, where the Slovenian authors have written a textbook, adhering strictly to the European definition of family medicine and its core competencies. The format and the approach were also adopted by Croatian authors, who have used most of the material from the Slovenian book, but have modified some of the chapters according to the situation in the country and have added some of their own. This activity has created an opportunity for a truly international collaboration in the area of education of family medicine, with a creation of an international consortium, which would be responsible for the core content of the book and local adaptations of the book according to the specificities and needs of different countries. This innovative approach in the development of teaching material may be interesting for a variety of smaller countries in Europe and worldwide. Copyright © 2014 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Genomic Diversity and the Microenvironment as Drivers of Progression in DCIS

DTIC Science & Technology

2016-10-01

been acquiring new skills in medical image analysis and learning about the complexities of breast cancer diagnosis. How were the results...database and medical record searching at Duke, 2) Development of methods for isolating DNA from archival DCIS lesions, 3) Deep and comprehensive...on the Aim 3 results to the SPIE Medical Imaging Conference to be held in February 2017. If accepted, those will each be published in the form of a

Internal medicine residency redesign: proposal of the Internal Medicine Working Group.

PubMed

Horwitz, Ralph I; Kassirer, Jerome P; Holmboe, Eric S; Humphrey, Holly J; Verghese, Abraham; Croft, Carol; Kwok, Minjung; Loscalzo, Joseph

2011-09-01

Concerned with the quality of internal medicine training, many leaders in the field assembled to assess the state of the residency, evaluate the decline in interest in the specialty, and create a framework for invigorating the discipline. Although many external factors are responsible, we also found ourselves culpable: allowing senior role models to opt out of important training activities, ignoring a progressive atrophy of bedside skills, and focusing on lock-step curricula, lectures, and compiled diagnostic and therapeutic strategies. The group affirmed its commitment to a vision of internal medicine rooted in science and learned with mentors at the bedside. Key factors for new emphasis include patient-centered small group teaching, greater incorporation of clinical epidemiology and health services research, and better schedule control for trainees. Because previous proposals were weakened by lack of evidence, we propose to organize the Cooperative Educational Studies Group, a pool of training programs that will collect a common data set describing their programs, design interventions to be tested rigorously in multi-methodological approaches, and at the same time produce knowledge about high-quality practice. Copyright © 2011 Elsevier Inc. All rights reserved.

[Day hospital in internal medicine: A chance for ambulatory care].

PubMed

Grasland, A; Mortier, E

2018-04-16

Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Promoting Success: A Professional Development Coaching Program for Interns in Medicine.

PubMed

Palamara, Kerri; Kauffman, Carol; Stone, Valerie E; Bazari, Hasan; Donelan, Karen

2015-12-01

Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported. Design, implement, and evaluate a program to support intern professional development through positive psychology coaching. We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews. Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94%) rated the coaching program as good or excellent, and 96% would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort. There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout.

Development and Implementation of a Web-based Evaluation System for an Internal Medicine Residency Program.

ERIC Educational Resources Information Center

Rosenberg, Mark E.; Watson, Kathleen; Paul, Jeevan; Miller, Wesley; Harris, Ilene; Valdivia, Tomas D.

2001-01-01

Describes the development and implementation of a World Wide Web-based electronic evaluation system for the internal medicine residency program at the University of Minnesota. Features include automatic entry of evaluations by faculty or students into a database, compliance tracking, reminders, extensive reporting capabilities, automatic…

RESIDENT IMPLEMENTATION OF THE 2007 ACC/AHA GUIDELINES ON PREOPERATIVE CARDIAC EVALUATION IN NON-CARDIAC SURGERY PATIENTS: IS CLINICAL EXPERIENCE ENOUGH?

PubMed

Amhaz, Hassan H; Kuo, Ruth; Chidiac, Elie J; Pallekonda, Vinay; Fuleihan, Samir F; McKelvey, George; Kaddoum, Romeo N

2015-06-01

Preoperative evaluation of surgical patients is important, as perioperative complications are associated with increased mortality. Specialties including anesthesiology, internal medicine, cardiology, and surgery are involved in the evaluation and management of these patients. This institutional study investigated the residents' knowledge of the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on perioperative evaluation of patients undergoing non-cardiac surgery. This pilot study used a web-based survey questionnaire to assess resident's knowledge of the 2007 ACC/AHA guidelines through individual steps and corresponding branch point(s) in twelve clinical scenarios. Additionally, residents were asked if they were aware of, or if they had received lectures on ACC/AHA guidelines. Staff anesthesiologists with training in cardiac and intensive care medicine validated the scenarios. A total of 104 resident participants were surveyed including 35 anesthesiology residents, 41 internal medicine residents, 20 surgery residents, and 8 cardiology fellows. Awareness of the 2007 ACC/AHA guidelines by specialty was: anesthesiology (85%), internal medicine (97.6%), cardiology (100%), and surgery (70%). Only 54.3% of anesthesiology, 31.7% of internal medicine, 100% of cardiology, and 10% of surgery residents stated they received lectures. The overall mean score achieved on the eleven scenarios was 50.4% for anesthesiology, 47.0% for internal medicine, 55.7% for cardiology, and 42.3% for surgery. Although the majority of residents were aware of the 2007 ACC/AHA guidelines, fewer received lectures and regardless of specialty, implementation of these guidelines was poor. There exists significant room for improvement in the understanding of preoperative assessment of non-cardiac surgery patients.

Design and Fabrication of NxN Optical Couplers Based on Organic Polymer Opti al WaveGuides

DTIC Science & Technology

1994-08-01

lOxlO optical coupler utilizing photopolymerizable organic polymers. Background information on the theory of operation of the coupler culminating in a...Channel Waveguides Based on Photopolymerizable Di/Tri Acrylates," in Optoelecwonic Interconnects Ii, Ray T. Chen, John A. Neff, Editors, Proc. SPIE 2153, pp...demonstrated that acrylic polymers can be used to fabricate single-mode optical wavguides. The resins that we have formulated are photopolymerizable

Nanocomposites for Electronic Applications. Volume 1

DTIC Science & Technology

1993-06-14

for a PZT thin film micro- motor using a rotating flexure wave generated in a PZT film on a silicon oxynitride diaphragm. The rotating wave has been...Solid State Science, The Pennsylvania State University (May 1992). 6. Jayne R. Giniewicz. "An Investigation of the Lead Scandium Tantalate-Lead...Materials and Structures, SPIE, Albuquerque, NM (February 1-4, 1993). 24. G. Harshe, J. P. Dougherty, and R. E. Newnham. "Theoretical Modelling of 3-0/0-3

The Systems Integration of Autonomous Behavior Analysis to Create a Maritime Smart Environment for the Enhancement of Maritime Domain Awareness

DTIC Science & Technology

2010-06-01

173 Figure 68. MATLAB "inpolygon" function depiction....................................................174...Kollmorgen AN/BVS-1 photonic mast. The sensors mounted on this mast include LLTV (low-light TV), thermal imager and laser rangefinder. To facilitate...Robert Tillson, SeeCoast Port Surveillance, Proceedings of SPIE Vol. 6204: Photonics for Port and Harbor Security II Orlando, FL, April 18–19, 2006. 70

Control Demonstration of a Thin Deformable In-Plane Actuated Mirror

DTIC Science & Technology

2006-03-01

where a four-quadrant electrode grid sitting behind a pre-shaped membrane mirror uses electrostatic forces to deform the surface. Any manufacturing...to receive the Wavescope data due to its MATLAB and Simulink capa- bilities. The dSPACE computer system is stocked with a UART (Universal Asynchronous...cations,” SPIE Smart Structures and Materials Symposium, EAPAD Conference, Vol. 5051-45 (2003). 6. Bennet, H. E. and others, . “Development of

Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training: A Mixed-Methods Approach.

PubMed

Taylor, David R; Park, Yoon Soo; Smith, Christopher A; Karpinski, Jolanta; Coke, William; Tekian, Ara

2018-05-15

Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem"). A modified Delphi process involving clinical experts followed by a conference of educational experts. The Royal College of Physicians and Surgeons of Canada. In phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results. Phase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and assigned activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education. The project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents. These activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada. Identification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks. Southeastern Ontario Academic Medical Organization Endowed Scholarship and Education Fund and Queen's University Department of Medicine Innovation Fund.

Training Internists to Meet Critical Care Needs in the United States: A Consensus Statement from the Critical Care Societies Collaborative (CCSC)

PubMed Central

Pastores, Stephen M.; Martin, Greg S.; Baumann, Michael H.; Curtis, J. Randall; Farmer, J. Christopher; Fessler, Henry E.; Gupta, Rakesh; Hill, Nicholas S.; Hyzy, Robert C.; Kvetan, Vladimir; MacGregor, Drew A.; O’Grady, Naomi P.; Ognibene, Frederick P.; Rubenfeld, Gordon D.; Sessler, Curtis N.; Siegal, Eric; Simpson, Steven Q.; Spevetz, Antoinette; Ward, Nicholas S.; Zimmerman, Janice L.

2014-01-01

Objectives Multiple training pathways are recognized by the Accreditation Council for Graduate Medical Education (ACGME) for internal medicine (IM) physicians to certify in critical care medicine (CCM) via the American Board of Internal Medicine. While each involves 1 year of clinical fellowship training in CCM, substantive differences in training requirements exist among the various pathways. The Critical Care Societies Collaborative convened a task force to review these CCM pathways and to provide recommendations for unified and coordinated training requirements for IM-based physicians. Participants A group of CCM professionals certified in pulmonary-CCM and/or IM-CCM from ACGME-accredited training programs who have expertise in education, administration, research, and clinical practice. Data Sources and Synthesis Relevant published literature was accessed through a MEDLINE search and references provided by all task force members. Material published by the ACGME, American Board of Internal Medicine, and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force reached consensus using a roundtable meeting, electronic mail, and conference calls. Main Results Internal medicine-CCM–based fellowships have disparate program requirements compared to other internal medicine subspecialties and adult CCM fellowships. Differences between IM-CCM and pulmonary-CCM programs include the ratio of key clinical faculty to fellows and a requirement to perform 50 therapeutic bronchoscopies. Competency-based training was considered uniformly desirable for all CCM training pathways. Conclusions The task force concluded that requesting competency-based training and minimizing variations in the requirements for IM-based CCM fellowship programs will facilitate effective CCM training for both programs and trainees. PMID:24637881

Philosophy and concepts of modern spine surgery.

PubMed

José-Antonio, Soriano-Sánchez; Baabor-Aqueveque, Marcos; Silva-Morales, Francisco

2011-01-01

The main goal of improving pain and neurological deficit in the practice of spine surgery is changing for a more ambitious goal, namely to improve the overall quality of life and the future of patients through three major actions (1) preserving the vertebral anatomical structures; (2) preserving the paravertebral anatomical structures; and (3) preserving the functionality of the segment. Thus, three new concepts have emerged (a) minimal surgery; (b) minimal access surgery; and (c) motion preservation surgery. These concepts are covered in a new term, minimally invasive spine surgery (MISS) The term "MISS" is not about one or several particular surgical techniques, but a new way of thinking, a new philosophy. Although the development of minimally invasive spine surgery is recent, its application includes all spine segments and almost all the existing conditions, including deformities.Evidence-based medicine (EBM), a term coined by Alvan Feinstein in the 1960s (Feinstein A (1964) Annals of Internal Medicine 61: 564-579; Feinstein A (1964) Annals of Internal Medicine 61: 757-781; Feinstein A (1964) Annals of Internal Medicine 61: 944-965; Feinstein A (1964) Annals of Internal Medicine 61: 1162-1193.), emphasizes the possibility of combining art and science following the strict application of scientific methods in the treatment of patients (Feinstein A (1964) Annals of Internal Medicine 61: 944-965; Feinstein A (1964) Annals of Internal Medicine 61: 1162-1193.), which may represent the advantages of objectivity and rationality in the use of different treatments (Fig. 11). However, EBM has many obvious defects, especially in spine surgery it is almost impossible to develop double-blind protocols (Andersson G, Bridwell K, Danielsson A, et al (2007) Spine 32: S64-S65.). In most cases, the only evidence one can find in the literature is the lack of evidence (Resnick D (2007) Spine 32:S15-S19.), however, the lack of evidence does not mean its absence. Only then, with a rigorous self-analysis, we may take a clear path towards a new philosophy in spine surgery. Of course, feedback from patients through satisfaction and clinical scales can guide our direction and provide the energy needed to maintain the enthusiasm (Fig. 12).

The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives.

PubMed

Oristrell, J; Oliva, J C; Casanovas, A; Comet, R; Jordana, R; Navarro, M

2014-01-01

The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents. To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction. All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis. An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction. Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine. Copyright © 2013 Elsevier España, S.L. All rights reserved.

How is organ transplantation depicted in internal medicine and transplantation journals.

PubMed

Durand, Céline; Duplantie, Andrée; Chabot, Yves; Doucet, Hubert; Fortin, Marie-Chantal

2013-10-02

In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey's critiques of organ transplantation were still relevant. Using the PubMed database, we retrieved 1,120 articles from the top ten internal medicine journals and 4,644 articles from the two main transplantation journals (Transplantation and American Journal of Transplantation). Out of the internal medicine journal articles, we analyzed those in which organ transplantation was the main topic (349 articles). A total of 349 articles were randomly selected from the transplantation journals for content analysis. In our sample, organ transplantation was described in positive terms and was presented as a routine treatment. Few articles addressed ethical issues, patients' experiences and uncertainties related to organ transplantation. The internal medicine journals reported on more ethical issues than the transplantation journals. The most important ethical issues discussed were related to the justice principle: organ allocation, differential access to transplantation, and the organ shortage. Our study provides insight into representations of organ transplantation in the transplant and general medical communities, as reflected in medical journals. The various portrayals of organ transplantation in our sample of articles suggest that Fox and Swazey's critiques of the procedure are still relevant.

Optimizing the use of intravenous therapy in internal medicine.

PubMed

Champion, Karine; Mouly, Stéphane; Lloret-Linares, Celia; Lopes, Amanda; Vicaut, Eric; Bergmann, Jean-François

2013-10-01

We aimed to evaluate the impact of physicians' educational programs in the reduction of inappropriate intravenous lines in internal medicine. Fifty-six French internal medicine units were enrolled in a nationwide, prospective, blinded, randomized controlled trial. Forms describing the patients with an intravenous line and internal medicine department characteristics were filled out on 2 separate days in January and April 2007. Following the first visit, all units were randomly assigned to either a specific education program on the appropriate indications of an intravenous line, during February and March 2007, or no training (control group). The Investigators' Committee then blindly evaluated the clinical relevance of the intravenous line according to pre-established criteria. The primary outcome was the percentage of inappropriate intravenous lines. During January 2007, intravenous lines were used in 475 (24.9%) of the 1910 hospitalized patients. Of these, 80 (16.8%) were considered inappropriate. In April 2007, 416 (22.8%) of the 1823 hospitalized patients received an intravenous line, which was considered in 10.2% (21/205) of patients managed by trained physicians, versus 16.6% (35/211) of patients in the control group (relative difference 39%; 95% confidence interval, -0.6-13.3; P = .05). Reduced intravenous administration of fluids, antibiotics, and analgesics accounted for the observed decrease. The use of a simple education program reduced the rate of inappropriate intravenous lines by almost 40% in an internal medicine setting (NCT01633307). Copyright © 2013 Elsevier Inc. All rights reserved.

Ultrasound for internal medicine physicians: the future of the physical examination.

PubMed

Dulohery, Megan M; Stoven, Samantha; Kurklinsky, Andrew K; Kurklinksy, Andrew; Halvorsen, Andrew; McDonald, Furman S; Bhagra, Anjali

2014-06-01

With the advent of compact ultrasound (US) devices, it is easier for physicians to enhance their physical examinations through the use of US. However, although this new tool is widely available, few internal medicine physicians have US training. This study sought to understand physicians' baseline knowledge and skill, provide education in US principles, and demonstrate that proper use of compact US devices is a skill that can be quickly learned. Training was performed at the Mayo Clinic in June 2010 and June 2011. The participants consisted of internal medicine residents. The workshop included didactics and hands-on US experiences with human and cadaver models in a simulation center. Pretests and posttests of residents' knowledge, attitudes, and skills with US were completed. We reassessed the 2010 group in the spring of 2012 with a long-term retention survey for knowledge and confidence in viewing images. A total of 136 interns completed the workshop. Thirty-nine residents completed the long-term retention survey. Posttest assessments showed a statistically significant improvement in the knowledge of US imaging, confidence in identifying structures, image identification, and image acquisition (P < .0001). In the long-term retention study, knowledge of US imaging and confidence in identifying structures did decline. This educational intervention resulted in improvement in US knowledge and image acquisition. However, the knowledge diminished over time, suggesting that further education is needed if US is to become an important component of internal medicine training and practice. © 2014 by the American Institute of Ultrasound in Medicine.

Incidence of refeeding syndrome in internal medicine patients.

PubMed

Kraaijenbrink, B V C; Lambers, W M; Mathus-Vliegen, E M H; Siegert, C E H

2016-03-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to a department of internal medicine. All patients acutely admitted to the department of internal medicine of a teaching community hospital in Amsterdam, the Netherlands, between 22 February 2011 and 29 April 2011, were included. We applied the National Institute for Health and Care Excellence (NICE) criteria for determining people at risk of refeeding syndrome and took hypophosphataemia as the main indicator for the presence of this syndrome. Of 178 patients included in the study, 97 (54%) were considered to be at risk of developing refeeding syndrome and 14 patients actually developed the syndrome (14% of patients at risk and 8% of study population). Patients with a malignancy or previous malignancy were at increased risk of developing refeeding syndrome (p < 0.05). Measurement of muscle strength over time was not associated with the occurrence of refeeding syndrome. The Short Nutritional Assessment Questionnaire score had a positive and negative predictive value of 13% and 95% respectively. The incidence of refeeding syndrome was relatively high in patients acutely admitted to the department of internal medicine. Oncology patients are at increased risk of developing refeeding syndrome. When taking the occurrence of hypophosphataemia as a hallmark, no other single clinical or composite parameter could be identified that accurately predicts the development of refeeding syndrome.

Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

PubMed

Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

2017-06-01

While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

Calibration and Compensation of Instrumental Errors in Imaging Polarimeters

DTIC Science & Technology

2007-04-01

procedures for polarimeters 3. Examine impact of focal plane nonuniformity on polarimeters 4. Understand the role of bandwidth in broadband polarimetry. 5... nonuniformity (NU) noise. NU noise is a results from pixel-to-pixel variations in the photodetector response. NU noise is a persistent problem for all... nonuniformity noise in imaging polarimeters," Proc SPIE Vol. 5888: Polarization Science and Remote Sensing 11, pp. 58880J 1 - 10, J. A. Shaw and J. S

Polarimetric Wavelet Fractal Remote Sensing Principles for Space Materials (Preprint)

DTIC Science & Technology

2012-06-04

previously introduced 9-10, 28. The combination of polarimetry and wavelet-fractal analysis yields enhanced knowledge of the spatial-temporal-frequency...applications in situations that require analysis over very short time durations or where information is localized, and have been combined with polarimetry ...and D.B. Chenault, “Near Infrared Imaging Polarimetry ”, Proc. SPIE 4481, pp. 30-31, 2001. [8] A.B. Mahler, P. Smith, R. Chipman, G. Smith, N

Dual Mode Thin Film Bulk Acoustic Resonators (FBARs) Based on AlN, ZnO and GaN Films with Tilted c-Axis Orientation

DTIC Science & Technology

2010-01-01

TERMS MEMS , acoustic wave devices, acoustic wave sensors Qing-Ming Wang University of Pittsburgh 123 University Place University Club Pittsburgh, PA...resonators,” Proc. SPIE Vol. 6223, 62230I, Micro ( MEMS ) and Nanotechnologies for Space Applications; Thomas George, Zhong-Yang Cheng; Eds. (May...microelectromechanical resonators has been recognized as a technological challenge in the current microelectronics and MEMS development. The

Thermal-Polarimetric and Visible Data Collection for Face Recognition

DTIC Science & Technology

2016-09-01

pixels • Spectral range: 7.5–13 μm • Analog image output: NTSC analog video • Digital image output: Firewire radiometric, 14-bit digital video to...PC The analog video was not used for this study. The radiometric, 14-bit digital data provided temperature measurement information for comparison...distribution unlimited. 18 9. References 1. Choi J, Hu S, Young SS, Davis LS. Thermal to visible face recognition. Proc. SPIE 8371, Sensing

Parallel-Computing Architecture for JWST Wavefront-Sensing Algorithms

DTIC Science & Technology

2011-09-01

results due to the increasing cost and complexity of each test. 2. ALGORITHM OVERVIEW Phase retrieval is an image-based wavefront-sensing...broadband illumination problems we have found that hand-tuning the right matrix sizes can account for a speedup of 86x faster. This comes from hand-picking...Wavefront Sensing and Control”. Proceedings of SPIE (2007) vol. 6687 (08). [5] Greenhouse, M. A., Drury , M. P., Dunn, J. L., Glazer, S. D., Greville, E

Sepsis in Internal Medicine wards: current knowledge, uncertainties and new approaches for management optimization.

PubMed

Zaccone, Vincenzo; Tosoni, Alberto; Passaro, Giovanna; Vallone, Carla Vincenza; Impagnatiello, Michele; Li Puma, Domenica Donatella; De Cosmo, Salvatore; Landolfi, Raffaele; Mirijello, Antonio

2017-11-01

Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving. This is due to Internists' increased adherence to guidelines and "bundles". The routine use of SOFA score helps physicians in the definition of septic patients, even if the optimal score has still to come. Point-of-care ultrasonography, lactates, procalcitonin and beta-d-glucan are of help for treatment optimization. The purpose of this narrative review is to focus on the management of sepsis in Internal Medicine departments, particularly on crucial concepts regarding diagnosis, risk assessment and treatment. Key Messages Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The prevalence of sepsis is constantly increasing, affecting more hospital patients than any other disease. At least half of patients affected by sepsis are admitted to Internal Medicine wards. Adherence to guidelines, routine use of clinical and lab scores and point-of-care ultrasonography are of help for early recognition of septic patients and treatment optimization.

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

PubMed

Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

2018-04-01

Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

Clinical Features, Short-Term Mortality, and Prognostic Risk Factors of Septic Patients Admitted to Internal Medicine Units

PubMed Central

Mazzone, Antonino; Dentali, Francesco; La Regina, Micaela; Foglia, Emanuela; Gambacorta, Maurizia; Garagiola, Elisabetta; Bonardi, Giorgio; Clerici, Pierangelo; Concia, Ercole; Colombo, Fabrizio; Campanini, Mauro

2016-01-01

Abstract Only a few studies provided data on the clinical history of sepsis within internal Medicine units. The aim of the study was to assess the short-term mortality and to evaluate the prognostic risk factors in a large cohort of septic patients treated in internal medicine units. Thirty-one internal medicine units participated to the study. Within each participating unit, all admitted patients were screened for the presence of sepsis. A total of 533 patients were included; 78 patients (14.6%, 95%CI 11.9, 18.0%) died during hospitalization; mortality rate was 5.5% (95% CI 3.1, 9.6%) in patients with nonsevere sepsis and 20.1% (95%CI 16.2, 28.8%) in patients with severe sepsis or septic shock. Severe sepsis or septic shock (OR 4.41, 95%CI 1.93, 10.05), immune system weakening (OR 2.10, 95%CI 1.12, 3.94), active solid cancer (OR 2.14, 95% CI 1.16, 3.94), and age (OR 1.03 per year, 95% CI 1.01, 1.06) were significantly associated with an increased mortality risk, whereas blood culture positive for Escherichia coli was significantly associated with a reduced mortality risk (OR 0.46, 95%CI 0.24, 0.88). In-hospital mortality of septic patients treated in internal medicine units appeared similar to the mortality rate obtained in recent studies conducted in the ICU setting. PMID:26825876

Clinical Features, Short-Term Mortality, and Prognostic Risk Factors of Septic Patients Admitted to Internal Medicine Units: Results of an Italian Multicenter Prospective Study.

PubMed

Mazzone, Antonino; Dentali, Francesco; La Regina, Micaela; Foglia, Emanuela; Gambacorta, Maurizia; Garagiola, Elisabetta; Bonardi, Giorgio; Clerici, Pierangelo; Concia, Ercole; Colombo, Fabrizio; Campanini, Mauro

2016-01-01

Only a few studies provided data on the clinical history of sepsis within internal Medicine units. The aim of the study was to assess the short-term mortality and to evaluate the prognostic risk factors in a large cohort of septic patients treated in internal medicine units. Thirty-one internal medicine units participated to the study. Within each participating unit, all admitted patients were screened for the presence of sepsis. A total of 533 patients were included; 78 patients (14.6%, 95%CI 11.9, 18.0%) died during hospitalization; mortality rate was 5.5% (95% CI 3.1, 9.6%) in patients with nonsevere sepsis and 20.1% (95%CI 16.2, 28.8%) in patients with severe sepsis or septic shock. Severe sepsis or septic shock (OR 4.41, 95%CI 1.93, 10.05), immune system weakening (OR 2.10, 95%CI 1.12, 3.94), active solid cancer (OR 2.14, 95% CI 1.16, 3.94), and age (OR 1.03 per year, 95% CI 1.01, 1.06) were significantly associated with an increased mortality risk, whereas blood culture positive for Escherichia coli was significantly associated with a reduced mortality risk (OR 0.46, 95%CI 0.24, 0.88). In-hospital mortality of septic patients treated in internal medicine units appeared similar to the mortality rate obtained in recent studies conducted in the ICU setting.

Is the Brazilian pharmaceutical policy ensuring population access to essential medicines?

PubMed

Bertoldi, Andréa Dâmaso; Helfer, Ana Paula; Camargo, Aline L; Tavares, Noêmia U L; Kanavos, Panos

2012-03-21

To evaluate medicine prices, availability and affordability in Brazil, considering the differences across three types of medicines (originator brands, generics and similar medicines) and different types of facilities (private pharmacies, public sector pharmacies and "popular pharmacies"). Data on prices and availability of 50 medicines were collected in 56 pharmacies across six cities in Southern Brazil using the World Health Organization / Health Action International methodology. Median prices obtained were divided by international reference prices to derive the median price ratio (MPR). In the private sector, prices were 8.6 MPR for similar medicines, 11.3 MRP for generics and 18.7 MRP for originator brands, respectively. Mean availability was 65%, 74% and 48% for originator brands, generics and similar medicines, respectively. In the public sector, mean availability of similar medicines was 2-7 times higher than that of generics. Mean overall availability in the public sector ranged from 68.8% to 81.7%. In "popular pharmacies", mean availability was greater than 90% in all cities. Availability of medicines in the public sector does not meet the challenge of supplying essential medicines to the entire population, as stated in the Brazilian constitution. This has unavoidable repercussions for affordability, particularly amongst the lower socio-economic strata.

Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation.

PubMed

Van Puymbroeck, Rudolf V

2010-01-01

"Access to medicines" is a broad concept. After a review of three authoritative frameworks that help to identify its constitutive components, this essay summarizes the actual situation on the ground in low- and middle-income countries on the basis of recent empirical work. An analysis of survey data from 36 countries concluded that developing countries should promote generic medicines as a key policy option for improving access to medicines. Taking an international perspective to that recommendation, this essay reviews the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and, particularly, how this agreement has been applied in practice. As shown by the experience of Thailand, Brazil, and the Philippines, in order to deal effectively with international pressures for an excessive application of the TRIPS Agreement, some sort of conversion experience appears to be required, which then leads to a switch from a private enterprise, supply-driven approach to a public health vision that insists on universal and affordable access. But moral conviction is not sufficient. In order to muster and sustain the political will to face down international forces, civil society and government offices must be able and ready to show the costs and other adverse consequences of the TRIPS-based model for medicines. This calculation needs to reach beyond the health sector and calls for new alliances, nationally as well as internationally. © 2010 American Society of Law, Medicine & Ethics, Inc.

Internal medicine board certification and career pathways in Japan.

PubMed

Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kawaguchi, Hideaki; Shimpo, Masahisa; Yasunaga, Hideo

2017-05-08

Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

Gender differences in salary of internal medicine residency directors: a national survey.

PubMed

Willett, Lisa L; Halvorsen, Andrew J; McDonald, Furman S; Chaudhry, Saima I; Arora, Vineet M

2015-06-01

Whether salary disparities exist between men and women in medical education leadership roles is not known. The study objective was to determine whether salary disparities exist between male and female Internal Medicine residency program directors, and if so, to identify factors associated with the disparities and explore historical trends. The annual Association of Program Directors in Internal Medicine (APDIM) survey in August 2012 included items to assess the salary and demographic characteristics of program directors, which were merged with publically available program data. To assess historical trends, we used similarly obtained survey data from 2008 to 2011. The study included program directors of 370 APDIM member programs, representing 95.6% of the 387 accredited Internal Medicine training programs in the United States and Puerto Rico. Of the 370 APDIM member programs, 241 (65.1%) completed the survey, of whom 169 (70.1%) were men and 72 (29.9%) were women. Program directors' total annual salary, measured in $25,000 increments, ranged from $75,000 or less to more than $400,000. Historical trends of mode salary by gender from 2008 to 2012 were assessed. The mode salary was $200,000 to 225,000 for men and $175,000 to $200,000 for women (P = .0005). After controlling for academic rank, career in general internal medicine, and program director age, the distribution of salary remained different by gender (P = .004). Historical trends show that the difference in mode salary has persisted since 2008. Leaders in academic medical centers, residency and fellowship directors, and all faculty in medical education need to be aware that salary disparities cited decades ago persist in this sample of medical educators. Closing the gender gap will require continued advocacy for measuring and reporting salary gaps, and changing the culture of academic medical centers. Copyright © 2015 Alliance for Academic Internal Medicine. Published by Elsevier Inc. All rights reserved.

78 FR 79465 - International Drug Scheduling; Convention on Psychotropic Substances; Single Convention on...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

... Essential Medicines and Health Products (EMP): http://www.who.int/medicines/areas/quality_safety/ECDD/en... medicine: --Please mention other, if any, medical use not included in the approved indications (off label...: (Controlled substances act/ Medicines law/Poisons acts/Consumer protection acts/Generic legislation/Analogue...

Does Research Training During Residency Promote Scholarship and Influence Career Choice? A Cross-Sectional Analysis of a 10-Year Cohort of the UCSF-PRIME Internal Medicine Residency Program.

PubMed

Kohlwes, Jeffrey; O'Brien, Bridget; Stanley, Marion; Grant, Ross; Shunk, Rebecca; Connor, Denise; Cornett, Patricia; Hollander, Harry

2016-01-01

The Association of Program Directors in Internal Medicine, the Accreditation Council for Graduate Medical Education, the Alliance for Academic Internal Medicine, and the Carnegie Foundation report on medical education recommend creating individualized learning pathways during medical training so that learners can experience broader professional roles beyond patient care. Little data exist to support the success of these specialized pathways in graduate medical education. We present the 10-year experience of the Primary Care Medicine Education (PRIME) track, a clinical-outcomes research pathway for internal medicine residents at the University of California San Francisco (UCSF). We hypothesized that participation in an individualized learning track, PRIME, would lead to a greater likelihood of publishing research from residency and accessing adequate career mentorship and would be influential on subsequent alumni careers. We performed a cross-sectional survey of internal medicine residency alumni from UCSF who graduated in 2001 through 2010. We compared responses of PRIME and non-PRIME categorical alumni. We used Pearson's chi-square and Student's t test to compare PRIME and non-PRIME alumni on categorical and continuous variables. Sixty-six percent (211/319) of alumni responded to the survey. A higher percentage of PRIME alumni published residency research projects compared to non-PRIME alumni (64% vs. 40%; p = .002). The number of PRIME alumni identifying research as their primary career role was not significantly different from non-PRIME internal medicine residency graduates (35% of PRIME vs. 29% non-PRIME). Process measures that could explain these findings include adequate access to mentors (M 4.4 for PRIME vs. 3.6 for non-PRIME alumni, p < .001, on a 5-point Likert scale) and agreeing that mentoring relationships affected career choice (M 4.2 for PRIME vs. 3.7 for categorical alumni, p = .001). Finally, 63% of PRIME alumni agreed that their research experience during residency influenced their subsequent career choice versus 46% of non-PRIME alumni (p = .023). Our results support the concept that providing residents with an individualized learning pathway focusing on clinical outcomes research during residency enables them to successfully publish manuscripts and access mentorship, and may influence subsequent career choice. Implementation of individualized residency program tracks that nurture academic interests along with clinical skills can support career development within medicine residency programs.

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

PubMed

Daniels, Michael N; Maynard, Sharon; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

2017-01-01

Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice.

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

PubMed Central

Daniels, Michael N.; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

2017-01-01

Background Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. Methods This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. Results 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). Conclusions The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice. PMID:28207893

Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

ERIC Educational Resources Information Center

Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

2001-01-01

Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

Generalism in modern subspecializing medicine.

PubMed

Levi, Marcel

2017-04-01

Medicine is currently developing at a breath holding pace. Diseases and medical conditions for which no remedy was available only a few years ago, can now be treated or even completely cured. However, this advancement of medicine comes with increasing complexity in many situations. This article discusses how we have to adapt our health care organization and our work as physicians to better cope with the new challenges of the enormous advancement of medicine, with a specific focus on internal medicine. If we want our patients to obtain maximal benefit of the progress in biomedical knowledge and the ensuing improved clinical outcomes in many areas we need to further focus and concentrate complex medical care in a team-based approach. In addition, we need to match increasing subspecialization with an attitude of generalism, both in our clinical work and in our teaching and training programs. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Polarization Orientation Dependence of the Far Infrared Spectra of Oriented Single Crystals of 1,3,5-trinitro-S-triazine (RDX) using Terahertz Time-Domain Spectroscopy

DTIC Science & Technology

2009-01-01

BE, Hogbin MR, Kemp MC (2007) Proc IEEE 95:1559 14. Laman N, Sree Harsha S, Grischkowsky D, Melinger JS (2008) Opt Express 16:4094 15. Melinger JS... Laman N, Grischkowsky D (2008) Appl Phy Lett 93:011102 16. Tribe WR, Newnham DA, Taday PF, Kemp MC (2004) Proc SPIE 5354:168 17. Watters DG, Falconer DG

Diamond as an Optical Materials

DTIC Science & Technology

1992-02-20

method, a rotating polishing plate of iron (of low carbon content) or nickel is held at an elevated temperature inside an environmental chamber...produced the highest polishing rate and nickel produced nearly as high a polishina rate. No polishing action was observed with molybdenum plates or with...Diamond Films," Diamond Optics III, A. Feldman and S. Holly, Editors, Proc. SPIE 1325, 240-252 (1990). (9] W.D. Partlow, R.E. Witkowski, and J.P. McHugh in

Federating heterogeneous datasets to enhance data sharing and experiment reproducibility

NASA Astrophysics Data System (ADS)

Prieto, Juan C.; Paniagua, Beatriz; Yatabe, Marilia S.; Ruellas, Antonio C. O.; Fattori, Liana; Muniz, Luciana; Styner, Martin; Cevidanes, Lucia

2017-03-01

Recent studies have demonstrated the difficulties to replicate scientific findings and/or experiments published in past.1 The effects seen in the replicated experiments were smaller than previously reported. Some of the explanations for these findings include the complexity of the experimental design and the pressure on researches to report positive findings. The International Committee of Medical Journal Editors (ICMJE) suggests that every study considered for publication must submit a plan to share the de-identified patient data no later than 6 months after publication. There is a growing demand to enhance the management of clinical data, facilitate data sharing across institutions and also to keep track of the data from previous experiments. The ultimate goal is to assure the reproducibility of experiments in the future. This paper describes Shiny-tooth, a web based application created to improve clinical data acquisition during the clinical trial; data federation of such data as well as morphological data derived from medical images; Currently, this application is being used to store clinical data from an osteoarthritis (OA) study. This work is submitted to the SPIE Biomedical Applications in Molecular, Structural, and Functional Imaging conference.

[Profile of heart failure according to the department of admission. Implications for multidisciplinary management].

PubMed

Vicent, Lourdes; Ayesta, Ana; Vidán, María Teresa; Miguel-Yanes, José María de; García, Jorge; Tamargo, María; Gómez, Víctor; Véliz, Samuel; Fernández-Avilés, Francisco; Martínez-Sellés, Manuel

Population aging has led to notable changes in heart failure admissions. The aim of this study was to analyse the characteristics, comorbidity, management, and outcomes of this patient population in three hospital departments. An analysis was made of a prospective register that included all patients admitted due to heart failure in Internal Medicine, Cardiology, and Geriatrics over a period of 45 days. Of a total of 235 patients, 124 (52.7%) were admitted to Internal Medicine, 83 (35.3%) to Cardiology, and 28 (11.9%) to Geriatrics. Mean age was 77.0±20.2 years (Cardiology 71.5±13.5; Internal Medicine 79.2±21.1; Geriatrics 89.9±5.1; p<.001). Preserved ejection fraction was found in 121 (51.5%) patients, and this rate was higher in Internal Medicine (62.5%) and Geriatrics (70.0%) than in Cardiology (31.3%), p<.001. Comorbidity was frequent, especially atrial fibrillation (126; 53.6%), renal disease (89; 37.8%), and chronic obstructive pulmonary disease (65; 27.6%). Infections were the most common decompensating trigger in Internal Medicine (56; 45.2%), and there was often no trigger in Cardiology (45; 54.2%) and Geriatrics (14; 50.0%), p<.0001. The use of renin-angiotensin system inhibitors, beta-blockers, and spironolactone in patients with systolic dysfunction was higher in Cardiology. During the 45 days follow-up, 23 patients (9.9%) were readmitted, which was more frequent in Internal Medicine than in Cardiology (odds ratio 3.0 [95% confidence interval: 1.1 - 8.6], p=.03), with no other significant comparisons. Patients admitted due to decompensated heart failure are elderly and often have comorbidities. There are major differences between departments as regards age and clinical profile. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Moving beyond the language barrier: the communication strategies used by international medical graduates in intercultural medical encounters.

PubMed

Jain, Parul; Krieger, Janice L

2011-07-01

To understand the communication strategies international medical graduates use in medical interactions to overcome language and cultural barriers. In-depth interviews were conducted with 12 international physicians completing their residency training in internal medicine in a large hospital in Midwestern Ohio. The interview explored (a) barriers participants encountered while communicating with their patients regarding language, affect, and culture, and (b) communication convergence strategies used to make the interaction meaningful. International physicians use multiple convergence strategies when interacting with their patients to account for the intercultural and intergroup differences, including repeating information, changing speaking styles, and using non-verbal communication. Understanding barriers to communication faced by international physicians and recognizing accommodation strategies they employ in the interaction could help in training of future international doctors who come to the U.S. to practice medicine. Early intervention could reduce the time international physicians spend navigating through the system and trying to learn by experimenting with different strategies which will allow these physicians to devote more time to patient care. We recommend developing a training manual that is instructive of the socio-cultural practices of the region where international physician will start practicing medicine. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

JWST Full-Scale Model on Display in Orlando

NASA Image and Video Library

2017-12-08

JWST Full-Scale Model on Display. A full-scale model of the James Webb Space Telescope was built by the prime contractor, Northrop Grumman, to provide a better understanding of the size, scale and complexity of this satellite. The model is constructed mainly of aluminum and steel, weighs 12,000 lb., and is approximately 80 feet long, 40 feet wide and 40 feet tall. The model requires 2 trucks to ship it and assembly takes a crew of 12 approximately four days. This model has traveled to a few sites since 2005. The photographs below were taken at some of its destinations. The model was on display at The International Society for Optical Engineering's (SPIE) week-long Astronomical Telescopes and Instrumentations conference,May 25 - 30, 2006. Credit: NASA/Goddard Space Flight Center/Dr Mark Clampin NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Roles of the International Council for Laboratory Animal Science (ICLAS) and International Association of Colleges of Laboratory Animal Medicine (IACLAM) in the Global Organization and Support of 3Rs Advances in Laboratory Animal Science

PubMed Central

Turner, Patricia V; Pekow, Cynthia; Clark, Judy MacArthur; Vergara, Patri; Bayne, Kathryn; White, William J; Kurosawa, Tsutomu Miki; Seok, Seung-Hyeok; Baneux, Philippe

2015-01-01

Practical implementation of the 3Rs at national and regional levels around the world requires long-term commitment, backing, and coordinated efforts by international associations for laboratory animal medicine and science, including the International Association of Colleges of Laboratory Animal Medicine (IACLAM) and the International Council for Laboratory Animal Science (ICLAS). Together these organizations support the efforts of regional organization and communities of laboratory animal science professionals as well as the development of local associations and professional colleges that promote the training and continuing education of research facility personnel and veterinary specialists. The recent formation of a World Organization for Animal Health (OIE) Collaborating Center for Laboratory Animal Science and Welfare emphasizes the need for research into initiatives promoting laboratory animal welfare, particularly in emerging economies and regions with nascent associations of laboratory animal science. PMID:25836964

Roles of the International Council for Laboratory Animal Science (ICLAS) and International Association of Colleges of Laboratory Animal Medicine (IACLAM) in the Global Organization and Support of 3Rs Advances in Laboratory Animal Science.

PubMed

Turner, Patricia V; Pekow, Cynthia; Clark, Judy MacArthur; Vergara, Patri; Bayne, Kathryn; White, William J; Kurosawa, Tsutomu Miki; Seok, Seung-Hyeok; Baneux, Philippe

2015-03-01

Practical implementation of the 3Rs at national and regional levels around the world requires long-term commitment, backing, and coordinated efforts by international associations for laboratory animal medicine and science, including the International Association of Colleges of Laboratory Animal Medicine (IACLAM) and the International Council for Laboratory Animal Science (ICLAS). Together these organizations support the efforts of regional organization and communities of laboratory animal science professionals as well as the development of local associations and professional colleges that promote the training and continuing education of research facility personnel and veterinary specialists. The recent formation of a World Organization for Animal Health (OIE) Collaborating Center for Laboratory Animal Science and Welfare emphasizes the need for research into initiatives promoting laboratory animal welfare, particularly in emerging economies and regions with nascent associations of laboratory animal science.

The Effect of Reducing Maximum Shift Lengths to 16 Hours on Internal Medicine Interns’ Educational Opportunities

PubMed Central

Theobald, Cecelia N.; Stover, Daniel G.; Choma, Neesha N.; Hathaway, Jacob; Green, Jennifer K.; Peterson, Neeraja B.; Sponsler, Kelly C.; Vasilevskis, Eduard E.; Kripalani, Sunil; Sergent, John; Brown, Nancy J.; Denny, Joshua C.

2013-01-01

Purpose To evaluate educational experiences of internal medicine interns before and after maximum shift lengths were decreased from 30 hours to 16 hours. Method The authors compared educational experiences of internal medicine interns at Vanderbilt University Medical Center before (2010, 47 interns) and after (2011, 50 interns) duty hour restrictions were implemented in July 2011. The authors compared number of inpatient encounters, breadth of concepts in notes, exposure to five common presenting problems, procedural experience, and attendance at teaching conferences. Results Following the duty hour restrictions, interns cared for more unique patients (mean 118 versus 140 patients per intern, P = .005) and wrote more history and physicals (mean 73 versus 88, P = .005). Documentation included more total concepts after the 16-hour maximum shift implementation, with a 14% increase for history and physicals (338 versus 387, P < .001) and a 10% increase for progress notes (316 versus 349, P < .001). There was no difference in the median number of selected procedures performed (6 versus 6, P = .94). Attendance was higher at the weekly chief resident conference (60% versus 68% of expected attendees, P < .001) but unchanged at morning report conferences (79% versus 78%, P = .49). Conclusions Intern clinical exposure did not decrease after implementation of the 16-hour shift length restriction. In fact, interns saw more patients, produced more detailed notes, and attended more conferences following duty hour restrictions. PMID:23425987

Global payment contract attitudes and comprehension among internal medicine physicians.

PubMed

Allen-Dicker, Joshua; Herzig, Shoshana J; Kerbel, Russell

2015-08-01

Global payment contracts (GPCs) are increasingly common agreements between insurance payers and healthcare providers that incorporate aspects of risk adjustment, capitation, and pay-for-performance. Physicians are often viewed as potential barriers to implementation of organizational change, but little is known about internist opinion on GPC involvement or specific internist attributes that might predict GPC support. We aimed to investigate internist and internal medicine subspecialist support of GPC involvement, and to identify associations among physician attributes, GPC knowledge, and GPC support. Cross-sectional. General medicine and internal medicine subspecialist physicians within the Beth Israel Deaconess Department of Medicine in Boston, Massachusetts, were surveyed 4 years after care organization entry into a GPC. Measurements collected included reported support for GPC involvement, reason for support, and demonstrated comprehension of key GPC details. Of the 281 respondents (49% response rate), 85% reported supporting involvement in a GPC. In a multivariate ordinal logistic regression model, exposure to prior information about GPCs, demonstrated comprehension of key GPC details, longer time since completion of residency, and lower clinical time commitment were all independently associated with higher levels of GPC involvement support. Four years since first engaging in a global payment contract, a majority of internal medicine physician respondents support this decision. Understanding predictors of physician support for GPC involvement within our care organization may help other health systems to approach organizational change. Health system leaders debating GPC involvement should consider engaging physicians via educational interventions geared toward improving GPC support.

Medicine prices, availability, and affordability in the Shaanxi Province in China: implications for the future.

PubMed

Jiang, Minghuan; Zhou, Zhongliang; Wu, Lina; Shen, Qian; Lv, Bing; Wang, Xiao; Yang, Shimin; Fang, Yu

2015-02-01

In 2009, China implemented the National Essential Medicines System (NEMS) to improve access to high-quality low-cost essential medicines. To measure the prices, availability and affordability of medicines in China following the implementation of the NEMS. 120 public hospitals and 120 private pharmacies in ten cities in Shaanxi Province, Western China. The standardized methodology developed by the World Health Organization and Health Action International was used to collect data on prices and availability of 49 medicines. Median price ratio; availability as a percentage; cost of course of treatment in days' wages of the lowest-paid government workers. In the public hospitals, originator brands (OBs) were procured at 8.89 times the international reference price, more than seven times higher than the lowest-priced generics (LPGs). Patients paid 11.83 and 1.69 times the international reference prices for OBs and generics respectively. A similar result was observed in the private pharmacies. The mean availabilities of OBs and LPGs were 7.1 and 20.0 % in the public hospitals, and 12.6 and 29.2 % in the private pharmacies. Treatment with OBs is therefore largely unaffordable, but the affordability of the LPGs is generally good. High prices and low availability of survey medicines were observed. The affordability of generics, but not OBs, is reasonable. Effective measures should be taken to reduce medicine prices and improve availability and affordability in Shaanxi Province.

Proceedings of the Strategy Meeting for the Development of an International Consortium for Chinese Medicine and Cancer

PubMed Central

White, Jeffrey D.; Lin, Hongsheng; Wu, Roy S.; Lam, Stephen; Li, Jie; Dou, Jinhui; Kumar, Nagi; Lin, Lizhu; Lao, Lixing

2017-01-01

On November 3, 2014, in Bethesda, MD, the Office of Cancer Complementary and Alternative Medicine of the National Cancer Institute held a meeting to examine the potential utility and feasibility of establishing an international consortium for Chinese medicine and cancer. There is significant interest in the West in using components of Chinese medicine (CM) —such as botanicals and herbal medicines, acupuncture and acupressure, and qigong—in the field of oncology, as potential anticancer agents, for symptom management, and to improve quality of life. The proposal for a consortium on CM came from the Chinese Academy of Chinese Medical Sciences, with the aims of improving scientific communications and collaborations and modernizing the studies of CM for cancer. The US National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine agreed to work with Chinese Academy of Chinese Medical Sciences to explore the feasibility of establishing an international consortium for Chinese medicine and cancer. At the meeting, participants from the United States, China, Canada, Australia, and Korea discussed issues in CM and cancer research, treatment, and management, including potential mechanisms of action, proof of efficacy, adverse effects, regulatory issues, and the need for improving the quality of randomized clinical trials of CM treatments and supportive care interventions. Presented in these proceedings are some of the main issues and opportunities discussed by workshop participants. PMID:29244995

Sports medicine clinical trial research publications in academic medical journals between 1996 and 2005: an audit of the PubMed MEDLINE database.

PubMed

Nichols, A W

2008-11-01

To identify sports medicine-related clinical trial research articles in the PubMed MEDLINE database published between 1996 and 2005 and conduct a review and analysis of topics of research, experimental designs, journals of publication and the internationality of authorships. Sports medicine research is international in scope with improving study methodology and an evolution of topics. Structured review of articles identified in a search of a large electronic medical database. PubMed MEDLINE database. Sports medicine-related clinical research trials published between 1996 and 2005. Review and analysis of articles that meet inclusion criteria. Articles were examined for study topics, research methods, experimental subject characteristics, journal of publication, lead authors and journal countries of origin and language of publication. The search retrieved 414 articles, of which 379 (345 English language and 34 non-English language) met the inclusion criteria. The number of publications increased steadily during the study period. Randomised clinical trials were the most common study type and the "diagnosis, management and treatment of sports-related injuries and conditions" was the most popular study topic. The knee, ankle/foot and shoulder were the most frequent anatomical sites of study. Soccer players and runners were the favourite study subjects. The American Journal of Sports Medicine had the highest number of publications and shared the greatest international diversity of authorships with the British Journal of Sports Medicine. The USA, Australia, Germany and the UK produced a good number of the lead authorships. In all, 91% of articles and 88% of journals were published in English. Sports medicine-related research is internationally diverse, clinical trial publications are increasing and the sophistication of research design may be improving.

Brief report: Multiprogram evaluation of reading habits of primary care internal medicine residents on ambulatory rotations.

PubMed

Lai, Cindy J; Aagaard, Eva; Brandenburg, Suzanne; Nadkarni, Mohan; Wei, Henry G; Baron, Robert

2006-05-01

To assess the reading habits and educational resources of primary care internal medicine residents for their ambulatory medicine education. Cross-sectional, multiprogram survey of primary care internal medicine residents. Second- and third-year residents on ambulatory care rotations at 9 primary care medicine programs (124 eligible residents; 71% response rate). Participants were asked open-ended and 5-point Likert-scaled questions about reading habits: time spent reading, preferred resources, and motivating and inhibiting factors. Participants reported reading medical topics for a mean of 4.3+/-3.0 SD hours weekly. Online-only sources were the most frequently utilized medical resource (mean Likert response 4.16+/-0.87). Respondents most commonly cited specific patients' cases (4.38+/-0.65) and preparation for talks (4.08+/-0.89) as motivating factors, and family responsibilities (3.99+/-0.65) and lack of motivation (3.93+/-0.81) as inhibiting factors. To stimulate residents' reading, residency programs should encourage patient- and case-based learning; require teaching assignments; and provide easy access to online curricula.

[Community pharmacy and general internal medicine are at the same crossroads: some opportunities should be seized].

PubMed

Bugnon, O; Buchmann, M

2012-11-28

The medicines give some symptoms relief and save lives every day. However, the responsible use of medicines is not definitively attained for the modern health systems. The shortcomings in this area are the cause of major negative clinical outcomes for the patients and the cause of additional cost for the health financing system. The two centenarians, as the International Pharmaceutical Federation (FIP) and the "Policlinique Médicale Universitaire (PMU)" in Lausanne, preview the solutions from now on for reversing this trend, such as the interdisciplinary collaborative approaches, the introduction of adequate financial incentives and the strengthening of education and research in community medicine, pharmacy and health.

Academic Relationships and Teaching Resources. Fogarty International Center Series on the Teaching of Preventive Medicine, Volume 6.

ERIC Educational Resources Information Center

Clark, Duncan W., Ed.

The monograph is one of the Fogarty International Center Series on the Teaching of Preventive Medicine, undertaken to: (1) review and evaluate the state of the art of prevention and control of human diseases; (2) identify deficiences in knowledge requiring further research (including analysis of financial resources, preventive techniques, and…

[A list and analysis of reproductive medicine periodicals indexed in MEDLINE in 2006].

PubMed

Xia, Xin-yi; Huang, Yu-feng; Pan, Lian-jun; Shang, Xue-jun

2006-07-01

MEDLINE established by National Library of Medicine (NLM), USA, is the most commonly used biomedical literature retrieval system, whose indexed literature generally represents the top of the medical world. Of the total number of 4959 journals listed in the Lists of Journals Indexed in MEDLINE (2006) published by NLM, 46 are periodicals of reproductive medicine, mainly including andrology, fertility, and sterility. Researchers of reproductive medicine should be familiar with the journals indexed in MEDLINE, closely follow their published frontier researches in this field, and consciously contribute to them in English. Editors of reproductive medicine journals should endeavour to have their journals included in such internationally authoritative systems as MEDLINE, SCI, etc by publishing them in English in compliance with international standards. This article presents a list of the reproductive medicine periodicals indexed in MEDLINE (2006) together with a brief analysis, which is meant to help researchers in reproductive medicine, andrology and other relevant fields with their contribution, subscription, reading and retrieving, as well as to share some more knowledge about MEDLINE and its indexed journals with Chinese editors of reproductive medicine journals.

Arbuscular mycorrhizal symbiosis for sustainable cultivation of Chinese medicinal plants: a promising research direction.

PubMed

Zeng, Yan; Guo, Lan-Ping; Chen, Bao-Dong; Hao, Zhi-Peng; Wang, Ji-Yong; Huang, Lu-Qi; Yang, Guang; Cui, Xiu-Ming; Yang, Li; Wu, Zhao-Xiang; Chen, Mei-Lan; Zhang, Yan

2013-01-01

Arbuscular mycorrhizal (AM) are symbiotic systems in nature and have great significance in promoting the growth and stress resistance of medicinal plants. During our literature search from the Chinese Scientific Information Database (Chinese National Knowledge Infrastructure, CNKI) we obtained 65 articles with "AM fungi" and "medicinal plant" as the key words, which indicates that in China, research efforts on these topics have been increasing. The main purposes of this review are to discuss the effects of mycorrhiza on the active ingredients of Chinese medicinal plants in comparison with results obtained in other plants in studies conducted by the international research community, and to introduce works published in Chinese journals to international colleagues.

Color universal design: analysis of color category dependency on color vision type (4)

NASA Astrophysics Data System (ADS)

Ikeda, Tomohiro; Ichihara, Yasuyo G.; Kojima, Natsuki; Tanaka, Hisaya; Ito, Kei

2013-02-01

This report is af ollow-up to SPIE-IS+T / Vol. 7528 7528051-8, SPIE-IS+T / Vol. 7866 78660J-1-8 and SPIE-IS+T / Vol. 8292 829206-1-8. Colors are used to communicate information in various situations, not just for design and apparel. However, visual information given only by color may be perceived differently by individuals with different color vision types. Human color vision is non-uniform and the variation in most cases is genetically linked to L-cones and M-cones. Therefore, color appearance is not the same for all color vision types. Color Universal Design is an easy-to-understand system that was created to convey color-coded information accurately to most people, taking color vision types into consideration. In the present research, we studied trichromat (C-type), prolan (P-type), and deutan (D-type) forms of color vision. We here report the result of two experiments. The first was the validation of the confusion colors using the color chart on CIELAB uniform color space. We made an experimental color chart (total of color cells is 622, the color difference between color cells is 2.5) for fhis experiment, and subjects have P-type or D-type color vision. From the data we were able to determine "the limits with high probability of confusion" and "the limits with possible confusion" around various basing points. The direction of the former matched with the theoretical confusion locus, but the range did not extend across the entire a* range. The latter formed a belt-like zone above and below the theoretical confusion locus. This way we re-analyzed a part of the theoretical confusion locus suggested by Pitt-Judd. The second was an experiment in color classification of the subjects with C-type, P-type, or D-type color vision. The color caps of fhe 100 Hue Test were classified into seven categories for each color vision type. The common and different points of color sensation were compared for each color vision type, and we were able to find a group of color caps fhat people with C-, P-, and D-types could all recognize as distinguishable color categories. The result could be used as the basis of a color scheme for future Color Universal Design.

Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

ERIC Educational Resources Information Center

Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

2013-01-01

Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

Once upon a Time. . . at the Tenth SOBRAMFA International and Academic Meeting--S. Paulo--Brazil

ERIC Educational Resources Information Center

De Benedetto, Maria Auxiliadora C.; Blasco, Pablo G.; de Castro, Ariane G.; de Carvalho, Elsi

2006-01-01

In Brazil, medical practice and the predominant medical education model are based on specialization. Methodologies such as patient-centered medicine and narrative medicine are either unknown or not applied in a systematic way. In order to draw students' and doctors' attention to these approaches during the TENTH SOBRAMFA INTERNATIONAL AND ACADEMIC…

A national survey on availability, price and affordability of selected essential medicines for non communicable diseases in Sri Lanka.

PubMed

Dabare, Panthihage Ruvini L; Wanigatunge, Chandanie A; Beneragama, Bvs Hemantha

2014-08-08

Access to medicines is a universal right. Low availability and low affordability of medicines are issues that deny this right to a significant proportion of the world population. The objective of this study was to determine the availability, price and affordability of essential medicines prescribed to treat non communicable diseases in Sri Lanka. Methodology was based on the 2nd edition of the World Health Organization Health Action International Manual. A country survey was conducted and facilities representing both public and private pharmacies were selected. A total of 109 facilities was surveyed. At each facility data on the availability and prices of 50 essential medicines for non communicable diseases were collected. Percentage availability, median price of originator brand and lowest priced generic, median price ratio to the International Reference Price were calculated for surveyed medicines. Affordability was determined using the daily incomes of the lowest--paid unskilled government worker. Semi government community pharmacies had the highest (>80%) availability while outdoor pharmacies of public health care facilities, private pharmacies and outdoor pharmacies of private hospital showed a fairly high availability (50 - 80%) of surveyed medicines.Unit price of 76% of selected individual medicines was less than ten Sri Lankan rupees. Out of these 28% of medicines cost less than one Sri Lanka rupee. For 21 of the surveyed medicines the median price ratio to the international reference price was less than one. The prices of originator brands for 14 surveyed medicines were more than five times that of the lowest price generics.Less than a single day's wages was adequate to purchase a month's supply of the lowest priced generic of more than 67% of surveyed medicines. The availability of selected essential medicines was fairly high in both public and private sectors in Sri Lanka. Most medicines are affordable to the lowest income earners in the community. There were many generic brands and generics available for most of the medicines in private and semi government community pharmacies increasing both availability and affordability.

The development of pain medicine in Italy and the rest of Europe 40 years after the first International Association for the Study of Pain Congress.

PubMed

Varrassi, Giustino; Paladini, Antonella

2017-01-01

Professor Giustino Varrassi and Antonella Paladini speak to Jade Parker, Commissioning Editor: Professor Giustino Varrassi is Full Professor of Anesthesiology and Pain Medicine in the LUdeS University, Valletta, Malta. He graduated at the Medical School of the University 'La Sapienza' (Rome, Italy) in 1973, and became board certified in Anesthesiology and Intensive Care in 1976 and in Pneumology in 1978, both in the same Medical School. He is currently President of the European League Against Pain and of the Paolo Procacci Foundation, and is a founding member of both of these. He is also a member of the World Institute of Pain, and a member of the Board of the Associazione Italiana per lo Studio del Dolore. He has been an invited speaker at more than 500 congresses (national and international), mainly in obstetric anesthesia and pain medicine. He is also the author of approximately 500 papers, published in international and national scientific journals, and 46 book chapters, mainly on obstetric anesthesia and pain medicine. He is the editor of 31 books and congress proceedings, including a textbook on obstetric anesthesia. He has also been the organizer of around 40 congresses, including European and World congresses on Pain Medicine. Professor Antonella Paladini is an Assistant Professor of Anesthesiology and Pain Medicine at the L'Aquila University, Italy. She has recently been nominated as Associate Professor of Anesthesiology in the LUdeS University, in Valletta, Malta. She graduated in medicine at L'Aquila University in 1989, and has got her Board Certification with laude in Anesthesia in 1992 and served as anesthetist in few teaching hospitals, mainly in cardiac surgery departments. Since 2000, she is in charge of the L'Aquila University, and has addressed her interests toward pain medicine. In 2004, she got the Board Certificate in Pain Medicine, with laude, in the University of Verona. She has a huge scientific production, with over 60 papers published in international and national journals. She is especially interested in the phenomenon of neuroinflammation and pain, and has published interesting review articles and meta-analysis on the topic. She has also co-authored few chapters of international books.

19 CFR 191.101 - Drawback allowance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TREASURY (CONTINUED) DRAWBACK Internal Revenue Tax on Flavoring Extracts and Medicinal or Toilet... revenue tax upon the exportation of flavoring extracts and medicinal or toilet preparations (including... tax on flavoring extracts or medicinal or toilet preparations (including perfumery) manufactured or...

Internal Medicine Residents' Preferences regarding Medical Ethics Education.

ERIC Educational Resources Information Center

Jacobson, Jay A.; And Others

1989-01-01

A survey of residents (N=323) in 6 internal medicine programs investigated the topics students wanted included in the medical ethics curriculum and by which of 17 methods they would prefer to be taught. About three-fourths had previous medical ethics instruction, and most wanted more on specific topics, especially legal and end-of-life issues.…

Minimizing the Threat of Light Pollution on Observatories through Education: the Quality Lighting Teaching Kit

NASA Astrophysics Data System (ADS)

Walker, Constance E.; M, Pompea, Stephen

2018-01-01

Poor quality lighting impedes astronomy research and our right to see a starry night sky. It creates safety issues, affects human circadian sensitivities, disrupts ecosystems, and wastes billions of dollars/year in energy consumption. It also leads to excess carbon emissions. How do you change the mindset of society that is used to turning night into day? You educate the next generation on quality lighting.As an outcome of the International Year of Light 2015, the National Optical Astronomy Observatory’s Education and Public Outreach group has produced a Quality Lighting Teaching (QLT) Kit. The kits are designed around problem-based learning scenarios. The kit’s six activities allow students to address real lighting problems that relate to wildlife, sky glow, aging eyes, energy consumption, safety, and light trespass. The activities are optimized for 11-14 year olds but can be expanded to younger and older. All materials are in both English and Spanish. Most of the activities can be done within in a few minutes during class or afterschool and as stations or as stand-alones. Everything you need for the six activities is included in the kit. Tutorial videos on how to do the activities can be found at www.noao.edu/education/qltkit.php. Ninety-two out of one hundred kits have been distributed in thirty-two countries through SPIE (the International Society for Optical Engineering), CIE (the International Commission on Illuminations), OSA (the Optical Society), IDA (the International Dark Sky Association), and the IAU OAD–Office of Astronomy Development. Successful feedback is promoting a choice between commercializing the kit or gaining further grants to build more kits. A plan is being considered to distribute kits to observatories around the world, hence helping to reduce the effects of one of the three threats to observational astronomy through awareness and action.

The Quality Lighting Teaching Kit: Educating the Public about the Dark Side of IYL2015

NASA Astrophysics Data System (ADS)

Walker, Constance Elaine; Pompea, Stephen M.; Levy, Rebecca

2015-08-01

The UN-sanctioned International Year of Light in 2015 (IYL2015) is providing an opportunity to increase public awareness of dark skies preservation, quality lighting and energy conservation. The Education and Public Outreach (EPO) group at the U.S. National Optical Astronomy Observatory (NOAO) has received a grant through the IAU to produce official “Quality Lighting Teaching Kits” for the IYL2015 cornerstone theme, “Cosmic Light”. These kits will emphasize the use of proper optical design in achieving quality lighting that promotes both energy efficiency and energy conservation of an endangered natural resource: our dark skies. Poor quality lighting not only impedes astronomy research, but creates safety issues, affects human circadian sensitivities, disrupts ecosystems, and wastes billions of dollars/year in energy consumption and carbon emissions.The concepts and practices of “quality lighting” will be explored through problem-based learning (e.g., engineering design), hands-on/minds-on activities, demonstrations, and formative and summative assessment probes. The impact of the kits will be amplified by providing professional development using tutorial videos created at NOAO and conducting question and answer sessions via Google+ Hangouts for program participants. The Quality Lighting Teaching Kit will leverage ten years of work by NOAO’s EPO team in developing programs on lighting and optics education (e.g., the NSF-funded “Hands on Optics”, IAU “Dark Skies Africa” and Arizona Public Service Foundation’s “Dark Skies Yuma” programs).NOAO’s partners are the International Society for Optics and Photonics (SPIE), International Commission on Illumination (CIE), International Dark-Sky Association (IDA), and IAU Office of Astronomy for Development, with sponsorship from the IAU and The Optical Society (OSA). Along with astronomy education centers (NUCLIO and Universe Awareness), the networks will disseminate kits to formal and informal audiences worldwide. The impact sought is a change in knowledge, attitude, and behavior in each community by learning how to light responsibly, improving the quality of life in “illuminating” ways.

75 FR 13137 - National Center For Complementary and Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... Complementary and Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... Alternative Medicine Special Emphasis Panel; International Center for Research in CAM. Date: April 12, 2010... Complementary and Alternative Medicine, NIH, 6707 Democracy Blvd., Suite 401, Bethesda, MD 20892, (301) 451-6570...

19 CFR 191.102 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) DRAWBACK Internal Revenue Tax on Flavoring Extracts and Medicinal or Toilet Preparations... medicinal or toilet preparations on which drawback is claimed shall record the products manufactured, the... than 5 percent. If the percentage of alcohol contained in a medicinal preparation, flavoring extract or...

Tip-over Prevention Through Heuristic Reactive Behaviors for Unmanned Ground Vehicles

DTIC Science & Technology

2014-05-01

Systems Center Pacific Unmanned Systems Group 53406 Woodward Road San Diego, CA 92152 ABSTRACT Skid-steer teleoperated robots are commonly used by...Reactive Behaviors Further author information: (Send correspondence to K.T.) K.T.: E-mail: kurt.talke@navy.mil, SPIE Proc. 9084: Unmanned Systems ...5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Space and Naval Warfare Systems Center

Associations between quality indicators of internal medicine residency training programs

PubMed Central

2011-01-01

Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p < 0.05). PGY3 IM-ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

Screening for Cancer by Residents in an Internal Medicine Program.

ERIC Educational Resources Information Center

Lynch, Garrett R.; Prout, Marianne N.

1986-01-01

A study of cancer screening by internal medicine residents in an inner-city clinic revealed that screening was more frequent for male patients, and breast examinations and Pap smears were performed on less than a third of female patients, suggesting a need for more intensive early-detection education of residents. (MSE)

Research on Free Electron Lasers

DTIC Science & Technology

1989-01-01

<exp(Aa)vo) >A = exp((YG -o/2) (67) For the exponential distribution function is another example that results from a symmetric angular spread in the...vo = 47 when there is an angular spread. This indicates that the actual peak moves to the right when 00 increases. The last term term decreases the...value of the gain at vo = F7 when either the angular spread ag or energy spread OG increases. 10. SPIE FEL Review Paper During the contracting period

Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.

PubMed

Kogelman, Laura; Barnett, Elizabeth D; Chen, Lin H; Quinn, Emily; Yanni, Emad; Wilson, Mary E; Benoit, Christine; Karchmer, Adolf W; Ooi, Winnie W; Jentes, Emily S; Hamer, Davidson H

2014-01-01

As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists. We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses. Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw <50 travelers per year whereas 30% of travel medicine specialists saw <50 travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients. Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers. © 2014 International Society of Travel Medicine.

Promoting Success: A Professional Development Coaching Program for Interns in Medicine

PubMed Central

Palamara, Kerri; Kauffman, Carol; Stone, Valerie E.; Bazari, Hasan; Donelan, Karen

2015-01-01

Background Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported. Objective Design, implement, and evaluate a program to support intern professional development through positive psychology coaching. Methods We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews. Results Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94%) rated the coaching program as good or excellent, and 96% would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort. Conclusions There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout. PMID:26692977

19 CFR 191.103 - Additional requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TREASURY (CONTINUED) DRAWBACK Internal Revenue Tax on Flavoring Extracts and Medicinal or Toilet... requirements. (a) Manufacturer claims domestic drawback. In the case of medicinal preparations and flavoring... filed with the Bureau of Alcohol, Tobacco and Firearms for domestic drawback on medicinal preparations...

Active matrix organic light emitting diode (OLED)-XL life test results

NASA Astrophysics Data System (ADS)

Fellowes, David A.; Wood, Michael V.; Hastings, Arthur R., Jr.; Ghosh, Amalkumar P.; Prache, Olivier

2008-04-01

OLED displays have been known to exhibit high levels of performance with regards to contrast, response time, uniformity, and viewing angle, but a lifetime improvement has been perceived to be essential for broadening the applications of OLED's in the military and in the commercial market. As a result of this need, the US Army and eMagin Corporation established a Cooperative Research and Development Agreement (CRADA) to improve the lifetime of OLED displays. In 2006, eMagin Corporation developed long-life OLED-XL devices for use in their AMOLED microdisplays for head-worn applications, and RDECOM CERDEC NVESD ran life tests on these displays, finding over 200% lifetime improvement for the XL devices over the standard displays. Early results were published at the 2007 SPIE Defense and Security Symposium. Further life testing of XL and standard devices at ambient conditions and at high temperatures will be presented this year along with a recap of previous data. This should result in a better understanding of the applicability of AMOLEDs in military and commercial head mounted systems: where good fits are made, and where further development might be needed. This is a continuation of the paper "Life test results of OLED-XL long-life devices for use in active matrix organic light emitting diode (AMOLED) displays for head mounted applications" presented at SPIE DSS in 2007.

VizieR Online Data Catalog: PTF stellar rotation periods for Pleiades members (Covey+, 2016)

NASA Astrophysics Data System (ADS)

Covey, K. R.; Agueros, M. A.; Law, N. M.; Liu, J.; Ahmadi, A.; Laher, R.; Levitan, D.; Sesar, B.; Surace, J.

2018-02-01

We monitored the Pleiades using time allocated to two PTF Key Projects: the PTF/M-dwarfs survey (Law et al. 2011ASPC..448.1367L, 2012ApJ...757..133L) and the PTF Open Cluster Survey (POCS; Agueros et al. 2011ApJ...740..110A; Douglas et al. 2014, J/ApJ/795/161). PTF was a time-domain experiment using the robotic 48-inch Samuel Oschin (P48) telescope at Palomar Observatory, CA, and involved real-time data-reduction and transient-detection pipelines and a dedicated follow-up telescope. The PTF infrastructure is described in Law et al. (2009PASP..121.1395L); we focus here on the components associated with the P48, which we used to conduct our monitoring campaign. The P48 is equipped with the CFH12K mosaic camera, which was significantly modified to optimize its performance on this telescope. The camera has 11 working CCDs, which cover a 7.26 square degree field of view with 92 megapixels at 1" sampling (Rahmer et al. 2008SPIE.7014E..4YR). Under typical observing conditions (1.1" seeing), it delivers 2" full-width half-maximum images that reach a 5σ limiting R~21 mag in 60 s (Law et al. 2010SPIE.7735E..3ML). (2 data files).

The Solar Cycle Variation of Coronal Temperature and Density During Cycle 21-22

DTIC Science & Technology

1994-06-15

We notice that a dramatic change in the intensity ratio implies a small change in temperature and therefore the precise calibration of each...The higher temperature material of these zones tends to lie over regions where magnetograph observations indicate a change in polarity of weak large...SPIE, 331,442, 1982. 7. Altrock, LC., Clmate Impact of Solar Variability Greenbelt, MD, NASA Conf. Publ. 3086, p. 287, 1990. 8. Fisher, LRL., McCabe, M

The Internal Consistency and Validity of the Vaccination Attitudes Examination Scale: A Replication Study.

PubMed

Wood, Louise; Smith, Michael; Miller, Christopher B; O'Carroll, Ronan E

2018-06-19

Vaccinations are important preventative health behaviors. The recently developed Vaccination Attitudes Examination (VAX) Scale aims to measure the reasons behind refusal/hesitancy regarding vaccinations. The aim of this replication study is to conduct an independent test of the newly developed VAX Scale in the UK. We tested (a) internal consistency (Cronbach's α); (b) convergent validity by assessing its relationships with beliefs about medication, medical mistrust, and perceived sensitivity to medicines; and (c) construct validity by testing how well the VAX Scale discriminated between vaccinators and nonvaccinators. A sample of 243 UK adults completed the VAX Scale, the Beliefs About Medicines Questionnaire, the Perceived Sensitivity to Medicines Scale, and the Medical Mistrust Index, in addition to demographics of age, gender, education levels, and social deprivation. Participants were asked (a) whether they received an influenza vaccination in the past year and (b) if they had a young child, whether they had vaccinated the young child against influenza in the past year. The VAX (a) demonstrated high internal consistency (α = .92); (b) was positively correlated with medical mistrust and beliefs about medicines, and less strongly correlated with perceived sensitivity to medicines; and (c) successfully differentiated parental influenza vaccinators from nonvaccinators. The VAX demonstrated good internal consistency, convergent validity, and construct validity in an independent UK sample. It appears to be a useful measure to help us understand the health beliefs that promote or deter vaccination behavior.

A multimodal high-value curriculum affects drivers of utilization and performance on the high-value care component of the internal medicine in-training exam.

PubMed

Chau, Tom; Loertscher, Laura

2018-01-01

Background : Teaching the practice of high-value care (HVC) is an increasingly important function of graduate medical education but best practices and long-term outcomes remain unknown. Objective : Whether a multimodal curriculum designed to address specific drivers of low-value care would affect resident attitudes, skills, and performance of HVC as tested by the Internal Medicine In-Training Exam (ITE). Methods : In 2012, we performed a baseline needs assessment among internal medicine residents at a community program regarding drivers of healthcare utilization. We then created a multimodal curriculum with online interactive worksheets, lectures, and faculty buy-in to target specific skills, knowledge, and culture deficiencies. Perceived drivers of care and performance on the Internal Medicine ITE were assessed yearly through 2016. Results : Fourteen of 27 (52%) residents completed the initial needs assessment while the curriculum was eventually seen by at least 24 of 27 (89%). The ITE was taken by every resident every year. Long-term, 3-year follow-up demonstrated persistent improvement in many drivers of utilization (patient requests, reliance on subspecialists, defensive medicine, and academic curiosity) and improvement with sustained high performance on the high-value component of the ITE. Conclusion : A multimodal curriculum targeting specific drivers of low-value care can change culture and lead to sustained improvement in the practice of HVC.

Calculating the Vulnerability of Synthetic Polymers to Autoignition during Nuclear Flash.

DTIC Science & Technology

1985-03-01

Lawrence Livermore National Laboratory P.O. Box 808 2561C Livermore, California 94550 II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE~March...34Low Emissivity and Solar Control Coatings on Architectural Glass," Proc. SPIE 37, 324 (1982). 10. R. C. Weast, Ed., Handbook of Chemistry and Physics...Attn: Michael Frankel Chief of Engineers Washington, D.C. 20305 Department of the Army Attn: DAEN-RDZ-A Command and Control Technical Center Washington

Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum design

PubMed Central

2010-01-01

Background Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge. Discussion We review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula. Summary Given the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues. PMID:20230607

Shortening the Miles to the Milestones: Connecting EPA-Based Evaluations to ACGME Milestone Reports for Internal Medicine Residency Programs.

PubMed

Choe, John H; Knight, Christopher L; Stiling, Rebekah; Corning, Kelli; Lock, Keli; Steinberg, Kenneth P

2016-07-01

The Next Accreditation System requires internal medicine training programs to provide the Accreditation Council for Graduate Medical Education (ACGME) with semiannual information about each resident's progress in 22 subcompetency domains. Evaluation of resident "trustworthiness" in performing entrustable professional activities (EPAs) may offer a more tangible assessment construct than evaluations based on expectations of usual progression toward competence. However, translating results from EPA-based evaluations into ACGME milestone progress reports has proven to be challenging because the constructs that underlay these two systems differ.The authors describe a process to bridge the gap between rotation-specific EPA-based evaluations and ACGME milestone reporting. Developed at the University of Washington in 2012 and 2013, this method involves mapping EPA-based evaluation responses to "milestone elements," the narrative descriptions within the columns of each of the 22 internal medicine subcompetencies. As faculty members complete EPA-based evaluations, the mapped milestone elements are automatically marked as "confirmed." Programs can maintain a database that tallies the number of times each milestone element is confirmed for a resident; these data can be used to produce graphical displays of resident progress along the internal medicine milestones.Using this count of milestone elements allows programs to bridge the gap between faculty assessments of residents based on rotation-specific observed activities and semiannual ACGME reports based on the internal medicine milestones. Although potentially useful for all programs, this method is especially beneficial to large programs where clinical competency committee members may not have the opportunity for direct observation of all residents.

Knowledge of HIV Testing Guidelines Among US Internal Medicine Residents: A Decade After the Centers for Disease Control and Prevention's Routine HIV Testing Recommendations.

PubMed

Dandachi, Dima; Dang, Bich N; Wilson Dib, Rita; Friedman, Harvey; Giordano, Thomas

2018-05-01

Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records. Of the 192 residents surveyed, 130 (68%) completed the survey. Only 58% were aware of universal HIV screening and 49% were aware that Illinois law allows for an opt-out HIV testing strategy. Most of the residents (64%) ordered no more than 10 HIV tests in 6 months. The most frequently reported barriers to HIV testing were deferral because of urgent care issues, lack of time, and the perception that patients were uncomfortable discussing HIV testing. From July 2015 to February 2016, the average HIV testing adherence rate in the 35 health centers was 18.2%. More effort is needed to change HIV testing practices among internal medicine residents so that they will adopt this approach in their future clinical practice. Improving knowledge about HIV testing and addressing other HIV testing barriers are essential for such a successful change.

[Evolution of internal medicine and its specialties in the last decades: an outward view].

PubMed

Rosselot, E

1996-04-01

The development of the subspecialties of internal medicine in the western world is reviewed from a historical perspective, focusing on the case of the United States of America. During the last decades, changes both in society and in medicine as a whole have prompted a great dispersion of medical practice styles, not always well-defined in their contents and goals, and ranging from primary care to ultra specialization. The definition of the general internist and of the subspecialist together with the attributes of each category according to an American College of Physicians task force group are commented upon. Some of the possible reasons accounting for a decreased interest in general internal medicine during the eighties together with figures supporting a recent reversal of this trend are given. New proposals have originated in government as well as in medical circles to promote the development of general internists, conceived as physicians knowledgeable in the classic subspecialties but also skilled in clinical epidemiology, informatics, behavior medicine, decision-making, clinical economics, ethics, and problem solving. The American College of Physicians, on the other hand, considers that allowing the community-based general internists to disappear, strengthening the generalist's identity as a primary care-oriented physician who provides no subspecially care, becoming hospital-based generalists who act mainly as consultants, or becoming fully trained subspecialists who also provide primary care, are all rejectable options. These arguments illustrate the fact that even in highly developed societies a degree of indefinition remains as to the best balance between general internal medicine and its subspecialties.

External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón.

PubMed

Díez-Manglano, Jesús; Cabrerizo García, José Luis; García-Arilla Calvo, Ernesto; Jimeno Saínz, Araceli; Calvo Beguería, Eva; Martínez-Álvarez, Rosa M; Bejarano Tello, Esperanza; Caudevilla Martínez, Aránzazu

2015-12-01

The objective of the study was to validate externally and prospectively the PROFUND index to predict survival of polypathological patients after a year. An observational, prospective and multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data concerning age, gender, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs and number of admissions during the previous year were gathered for each patient. The PROFUND index was calculated. The follow-up lasted 1 year. A Cox proportional regression model was calculated, and was used to analyze the association of the variables to mortality and C-statistic. 465 polypathological patients, 333 from internal medicine and 132 from geriatrics, were included. One-year mortality is associated with age [hazard ratio (HR) 1.52 95 % CI 1.04-2.12; p = 0.01], presence of neoplasia [HR 2.68 95 % CI 1.71-4.18; p = 0.0001] and dependence for basic activities of daily living [HR 2.34 95 % CI 1.61-3.40; p = 0.0009]. In predicting mortality, the PROFUND index shows good discrimination in patients from internal medicine (C-statistics 0.725 95 % CI 0.670-0.781), but a poor one in those from geriatrics (0.546 95 % CI 0.448-0.644). The PROFUND index is a reliable tool for predicting mortality in internal medicine PP patients.

Factors influencing career decisions in internal medicine.

PubMed

Macdonald, C; Cawood, T

2012-08-01

Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Developing educators, investigators, and leaders during internal medicine residency: the area of distinction program.

PubMed

Kohlwes, R Jeffrey; Cornett, Patricia; Dandu, Madhavi; Julian, Katherine; Vidyarthi, Arpana; Minichiello, Tracy; Shunk, Rebecca; Jain, Sharad; Harleman, Elizabeth; Ranji, Sumant; Sharpe, Brad; O'Sullivan, Patricia; Hollander, Harry

2011-12-01

Professional organizations have called for individualized training approaches, as well as for opportunities for resident scholarship, to ensure that internal medicine residents have sufficient knowledge and experience to make informed career choices. To address these training issues within the University of California, San Francisco, internal medicine program, we created the Areas of Distinction (AoD) program to supplement regular clinical duties with specialized curricula designed to engage residents in clinical research, global health, health equities, medical education, molecular medicine, or physician leadership. We describe our AoD program and present this initiative's evaluation data. METHODS AND PROGRAM EVALUATION: We evaluated features of our AoD program, including program enrollment, resident satisfaction, recruitment surveys, quantity of scholarly products, and the results of our resident's certifying examination scores. Finally, we described the costs of implementing and maintaining the AoDs. AoD enrollment increased from 81% to 98% during the past 5 years. Both quantitative and qualitative data demonstrated a positive effect on recruitment and improved resident satisfaction with the program, and the number and breadth of scholarly presentations have increased without an adverse effect on our board certification pass rate. The AoD system led to favorable outcomes in the domains of resident recruitment, satisfaction, scholarship, and board performance. Our intervention showed that residents can successfully obtain clinical training while engaging in specialized education beyond the bounds of core medicine training. Nurturing these interests 5 empower residents to better shape their careers by providing earlier insight into internist roles that transcend classic internal medicine training.

Burnout, coping, and spirituality among internal medicine resident physicians.

PubMed

Doolittle, Benjamin R; Windish, Donna M; Seelig, Charles B

2013-06-01

Burnout in physicians is common, and studies show a prevalence of 30% to 78%. Identifying constructive coping strategies and personal characteristics that protect residents against burnout may be helpful for reducing errors and improving physician satisfaction. We explored the complex relationships between burnout, behaviors, emotional coping, and spirituality among internal medicine and internal medicine-pediatrics residents. We anonymously surveyed 173 internal medicine and medicine-pediatrics residents to explore burnout, coping, and spiritual attitudes. We used 3 validated survey instruments: the Maslach Burnout Inventory, the Carver Coping Orientation to Problems Experienced (COPE) Inventory, and the Hatch Spiritual Involvement and Beliefs Scale (SIBS). A total of 108 (63%) residents participated, with 31 (28%) reporting burnout. Residents who employed strategies of acceptance, active coping, and positive reframing had lower emotional exhaustion and depersonalization (all, P < .03). Residents who reported denial or disengagement had higher emotional exhaustion and depersonalization scores. Personal accomplishment was positively correlated with the SIBS total score (r  =  +.28, P  =  .003), as well as the internal/fluid domain (r  =  +.32, P  =  .001), existential axes (r  =  +.32, P  =  .001), and humility/personal application domain (r  =  +.23, P  =  .02). The humility/personal application domain also was negatively correlated with emotional exhaustion (r  =  -.20, P  =  .04) and depersonalization (r  =  -.25, P  =  .009). No activity or demographic factor affected any burnout domain. Burnout is a heterogeneous syndrome that affects many residents. We identified a range of emotional and spiritual coping strategies that may have protective benefit.

International Perspectives on Quality Assurance and New Techniques in Radiation Medicine: Outcomes of an IAEA Conference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon

2008-05-01

The International Atomic Energy Agency organized an international conference called, 'Quality Assurance and New Techniques in Radiation Medicine' (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging andmore » radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?.« less

International perspectives on quality assurance and new techniques in radiation medicine: outcomes of an IAEA conference.

PubMed

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon; Dondi, Maurizio; Andreo, Pedro

2008-01-01

The International Atomic Energy Agency organized an international conference called, "Quality Assurance and New Techniques in Radiation Medicine" (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging and radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?

Second International Electronic Conference on Medicinal Chemistry (ECMC-2)

PubMed Central

Mayence, Annie; Vanden Eynde, Jean Jacques

2017-01-01

The second International Electronic Conference on Medicinal Chemistry, organized and sponsored by the publisher MDPI AG and the Journal Pharmaceuticals, took place in November 2016 on the SciForum website (www.sciforum.net/conference/ecmc-12). More than 150 authors from 22 countries participated in the event. Selected works presented during the scientific meeting are disclosed in this report. PMID:28146112

The Concept of Travel Medicine and the Actual Situation of Travel-Related Illnesses.

PubMed

Tunalı, Varol; Turgay, Nevin

2017-06-01

Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels. Traveling plays an important role in transmitting infections such as Zika virus infection, Ebola, avian flu, severe acute respiratory syndrome, Chikungunya, and dengue fever and is the principal reason for the epidemics of these types of infections on a global scale. With this background, we suggest that travel medicine is an important but "neglected" medical discipline as the discipline of Parasitology itself like most parasitic diseases.

[Re-organization of internal medicine wing in hospitals: a last-ditch effort or the beginning of reform?].

PubMed

Sharabi, Yehonatan

2014-01-01

Over the last decade numerous publications have dealt with ongoing changes in the traditional practice of internal medicine. In general, in-hospital medicine has evolved into ambulatory or specialized care. In this volume of Harefuah, Yinon et al. discuss trends at Shaare-Zedek Medical Center, focusing on the challenge of attracting residents to general internal medicine. Their model addresses local problems, but they have laid the groundwork for a more radical change. They present an evolutionary process that would transform hospital practice to become both more patient-centered and integrative, with an interdisciplinary team that translates the strengths of in-hospital (in- and out-patient care) vs. ambulatory or over-specialized care. Such reform should also include changes in clinical medical education, coupled with research and academic activities that can only take place in hospitals. The health care system is waiting for the next academic medical center that will take the lead in accepting this challenge and spearhead much needed reform.

The management of pneumonia in internal medicine.

PubMed

Bouza, E; Giannella, M; Pinilla, B; Pujol, R; Capdevila, J A; Muñoz, P

2013-01-01

Pneumonia generates a high workload for internal medicine departments. Management of this disease is challenging, because patients are usually elderly and have multiple comorbid conditions. Furthermore, the interpretation and adherence to guidelines are far from clear in this setting. We report the opinion of 43 internists especially interested in infectious diseases that were questioned at the 2011 XXXII National Conference of Spanish Society of Internal Medicine about the main issues involved in the management of pneumonia in the internal medicine departments, namely, classification, admission criteria, microbiological workup, therapeutic management, discharge policy, and prevention of future episodes. Participants were asked to choose between 2 options for each statement by 4 investigators. Consensus could not be reached in many cases. The most controversial issues concerned recognition and management of healthcare-associated pneumonia (HCAP). Most participants were aware of the differences in terms of underlying diseases, etiological distribution, and outcome of HCAP compared with community-acquired pneumonia, but only a minority agreed to manage HCAP as hospital-acquired pneumonia, as suggested by some guidelines. A clinical patient-to-patient approach proved to be the option preferred by internists in the management of HCAP. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Is the Brazilian pharmaceutical policy ensuring population access to essential medicines?

PubMed Central

2012-01-01

Background To evaluate medicine prices, availability and affordability in Brazil, considering the differences across three types of medicines (originator brands, generics and similar medicines) and different types of facilities (private pharmacies, public sector pharmacies and “popular pharmacies”). Methods Data on prices and availability of 50 medicines were collected in 56 pharmacies across six cities in Southern Brazil using the World Health Organization / Health Action International methodology. Median prices obtained were divided by international reference prices to derive the median price ratio (MPR). Results In the private sector, prices were 8.6 MPR for similar medicines, 11.3 MRP for generics and 18.7 MRP for originator brands, respectively. Mean availability was 65%, 74% and 48% for originator brands, generics and similar medicines, respectively. In the public sector, mean availability of similar medicines was 2–7 times higher than that of generics. Mean overall availability in the public sector ranged from 68.8% to 81.7%. In “popular pharmacies”, mean availability was greater than 90% in all cities. Conclusions Availability of medicines in the public sector does not meet the challenge of supplying essential medicines to the entire population, as stated in the Brazilian constitution. This has unavoidable repercussions for affordability, particularly amongst the lower socio-economic strata. PMID:22436555

Availability, prices and affordability of the World Health Organization's essential medicines for children in Guatemala.

PubMed

Anson, Angela; Ramay, Brooke; de Esparza, Antonio Ruiz; Bero, Lisa

2012-07-02

Several World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of children's medicines in Guatemala. An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010. A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone. Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists.

Manufacturing Science of Improved Molded Optics

DTIC Science & Technology

2013-12-05

Forrer, “Interaction of N-FK5 and L- BAL35 optical glass with various carbide and other precision glass mold tooling”, SPIE Optifab 2013 Conference...Richardson, S. Mourad, M. Huber, A. Kunz, M. Forrer. Interaction of N-FK5 and L-BAL35 optical glass with various carbide and other precision glass mold...stoichiometric compounds. As an example, if silicon and oxygen are present in a material, then it was assumed that they are present in the form of

Low Power, Room Temperature Systems for the Detection and Identification of Radionuclides from Atmospheric Nuclear Test

DTIC Science & Technology

2013-07-01

3 2.0 TELLURIUM ANTISITES IN CdZnTe ...........................................................................•. 4 3.0 EFFECTS OF...five journals, reported in eleven presentations, and printed in four conference proceedings. 3 2.0 TELLURIUM ANTISITES IN CdZnTe 1. M. Ch~ S...Terterian, D. Ting, R.B. James, J.C. Erickson, R W. Yao, T.T. Lam. M. Szawlowski, and R. Sczeboitz, " Tellurium Antisites in CdZnTe," SPIE Proceedings

High Efficiency Large-Angle Pancharatnam Phase Deflector Based on Dual Twist Design

DTIC Science & Technology

2016-12-16

previous approaches have been reported, with an even wider range of potential applications8-13. Figure 1a shows the schematics of a thin- film beam...using a liquid crystal device. SID Symp. Dig. Tech. Papers 45, 739–742 (2014). 10. Gao, K., Cheng, H. H., Bhowmik, A. K. & Bos, P. J. Thin- film ...efficient thin- film polarizing beamsplitters for broadband light. Proc. SPIE 6682, 668211 (2007). Acknowledgements We express thanks for financial

Results from Mechanical Testing of Silicon Carbide for Space Applications: Non-Destructive Evalution Samples and MISSE-6 Experiment Samples

DTIC Science & Technology

2010-06-07

the materials properties of silicon carbide plates”, S. Kenderian et al., 2009 SPIE Proceedings, vol. 7425 • Materials – 10” x 16” SiC plates...CONFERENCE PROCEEDING 3. DATES COVERED (From - To) 2008-2010 4. TITLE AND SUBTITLE Results from Mechanical Testing of Silicon Carbide for Space...for silicon carbide optical systems that covers material verification through system development. Recent laboratory results for testing of materials

Near-infrared Compressive Line Sensing Imaging System using Individually Addressable Laser Diode Array

DTIC Science & Technology

2015-05-11

Micromirror Device (DMD) is a microelectromechanical (MEMS) device. A DMD consists of millions of electrostatically actuated micro- mirrors (or pixels...digital micromirror device) were analyzed. We discussed the effort of developing such a prototype by Proc. of SPIE Vol. 9484 94840I-11 Downloaded...to Digital Micromirror Device (DMD) Technology”, (n.d.) Retrieved May 1, 2011, from http://www.ti.com/lit/an/dlpa008a/dlpa008a.pdf. [16

Exploitation of Smart Materials and Sensors as Disruptive Technologies

DTIC Science & Technology

2010-03-01

commercially available SMA, with current work aimed at new NiTi–X (X = Fe, Nb, Cu) alloys to further extend their range of properties and potential...ultra-light and micro-air vehicles. However, in common with alloy systems challenges exist regarding the long-term properties of polymeric-based SM... properties of single crystals of Ni-Mn-Ga magnetic shape memory alloys ", in Proc. SPIE, 186–197 (2004). 41 Gharghouri, M. A., Elsawy, A., & Hyatt

Model Classes, Approximation, and Metrics for Dynamic Processing of Urban Terrain Data

DTIC Science & Technology

2013-01-01

Sensing,” DARPA IPTO Retreat, Annapolis, 2008. R. Baraniuk, “Compressive Sensing, Wavelets, and Sparsity,” SPIE Defense + Security (acceptance speech ... Speech and Signal Processing (ICASSP). 2011/05/22 00:00:00, Prague, Czech Republic. : , 08/31/2011 33.00 Sang-Mook Lee, Jeong Joon Im, Bo-Hee Lee... KNN ) points to define a local intrinsic coordinate system using PCA and to construct the manifold and function locally using least squares. Local

[Monitoring medication errors in an internal medicine service].

PubMed

Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A

2014-01-01

Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.

Development of emotional intelligence in a team-based learning internal medicine clerkship.

PubMed

Borges, Nicole J; Kirkham, Karen; Deardorff, Adam S; Moore, Jeremy A

2012-01-01

Although increasing number of articles have been published on team-based learning (TBL), none has explored team emotional intelligence. We extend the literature by examining changes in team emotional intelligence during a third year clerkship where TBL is a primary instructional strategy. We hypothesized that team emotional intelligence will change in a positive direction (i.e., increase) during the clerkship. With IRB approval, during the 2009-2010 academic year third-year students in their internal medicine clerkship (N = 105, 100% response rate) completed the Workgroup Emotional Intelligence Profile - Short Version (WEIP-S) at the beginning and at the end of their 12-week clerkship. TBL is an instructional strategy utilized during the internal medicine clerkship. Paired t-tests showed that team emotional intelligence increased significantly pre to post clerkship for three of the four areas: awareness of own emotions (p = 0.018), recognizing emotions in others (p = 0.031), and ability to manage other's emotions (p = 0.013). There was no change for ability to control own emotions (p = 0.570). In an internal medicine clerkship, where TBL is utilized as an instructional strategy, team emotional intelligence increases. This supports TBL as an adjunctive tool to traditional medical education pedagogy.

Competency-based education and training in internal medicine.

PubMed

Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S

2010-12-07

Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

Pneumonia

MedlinePlus

... 2015 Updated by: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Internal ...

Mapping regulatory models for medicinal cannabis: a matrix of options.

PubMed

Belackova, Vendula; Shanahan, Marian; Ritter, Alison

2017-05-30

Objective The aim of the present study was to develop a framework for assessing regulatory options for medicinal cannabis in Australia. Methods International regulatory regimes for medicinal cannabis were reviewed with a qualitative policy analysis approach and key policy features were synthesised, leading to a conceptual framework that facilitates decision making across multiple dimensions. Results Two central organising dimensions of medicinal cannabis regulation were identified: cannabis supply and patient authorisation (including patient access). A number of the different supply options can be matched with a number of different patient authorisation options, leading to a matrix of possible regulatory regimes. Conclusions The regulatory options, as used internationally, involve different forms of cannabis (synthetic and plant-based pharmaceutical preparations or herbal cannabis) and the varying extent to which patient authorisation policies and procedures are stringently or more loosely defined. The optimal combination of supply and patient authorisation options in any jurisdiction that chooses to make medicinal cannabis accessible will depend on policy goals. What is known about the topic? Internationally, regulation of medicinal cannabis has developed idiosyncratically, depending on formulations that were made available and local context. There has been no attempt to date in the scientific literature to systematically document the variety of regulatory possibilities for medicinal cannabis. What does this paper add? This paper presents a new conceptual schema for considering options for the regulation of medicinal cannabis, across both supply and patient authorisation aspects. What are the implications for practitioners? The design of regulatory systems in Australia, whether for pharmaceutical or herbal products, is a vital issue for policy makers right now as federal and state and territory governments grapple with the complexities of medicinal cannabis regulation. The conceptual schema presented herein provides a tool for more systematic thinking about the options.

Performances of U.S. Osteopathic and Canadian Medical School Graduates on the American Board of Internal Medicine Certifying Examinations, 1984-1988.

ERIC Educational Resources Information Center

Shea, Judy A.; And Others

1990-01-01

A study compared the 1984-88 test performances of United States osteopathic medical school graduates and Canadian medical school graduates with those of U.S. and foreign medical school graduates during the same period. Findings, limitations, and implications for recruitment and training of internal medicine specialists are discussed. (Author/MSE)

Failure of physicians to recognize functional disability in ambulatory patients.

PubMed

Calkins, D R; Rubenstein, L V; Cleary, P D; Davies, A R; Jette, A M; Fink, A; Kosecoff, J; Young, R T; Brook, R H; Delbanco, T L

1991-03-15

To assess the ability of internists to identify functional disabilities reported by their patients. Comparison of responses by physicians and a random sample of their patients to a 12-item questionnaire about physical and social function. A hospital-based internal medicine group practice in Boston, Massachusetts, and selected office-based internal medicine practices in Los Angeles, California. Five staff physicians, three general internal medicine fellows, and 34 internal medicine residents in the hospital-based practice and 178 of their patients. Seventy-six physicians in the office-based practices and 230 of their patients. Physicians underestimated or failed to recognize 66% of disabilities reported by patients. Patient-reported disabilities were underestimated or unrecognized more often in the hospital-based practice than in the office-based practices (75% compared with 60%, P less than 0.05). Physicians overstated functional impairment in 21% of paired responses in which patients reported no disability. Physicians often underestimate or fail to recognize functional disabilities that are reported by their patients. They overstate functional impairment to a lesser degree. Because these discrepancies may adversely affect patient care and well-being, medical educators and clinicians should pay more attention to the assessment of patient function.

Ratings of Students' Performances in a Third-Year Internal Medicine Clerkship: A Comparison between Problem-Based and Lecture-Based Curricula.

ERIC Educational Resources Information Center

Richards, Boyd F.; And Others

1996-01-01

A study compared the performances of Wake Forest University (North Carolina) medical students rotating through an internal medicine program, 88 in a problem-based curriculum and 364 in a lecture-based curriculum. Students in the problem-based curriculum received significantly higher ratings from house staff and faculty on four clinical rating…

The international translational regenerative medicine center.

PubMed

Alexis, Mardi de Veuve; Grinnemo, Karl-Henrik; Jove, Richard

2012-11-01

The International Translational Regenerative Medicine Center, an organizing sponsor of the World Stem Cell Summit 2012, is a global initiative established in 2011 by founding partners Karolinska Institutet (Stockholm, Sweden) and Beckman Research Institute at City of Hope (CA, USA) with a mission to facilitate the acceleration of translational research and medicine on a global scale. Karolinska Institutet, home of the Nobel Prize in Medicine or Physiology, is one of the most prestigious medical research institutions in the world. The Beckman Research Institute/City of Hope is ranked among the leading NIH-designated comprehensive cancer research and treatment institutions in the USA, has the largest academic GMP facility and advanced drug discovery capability, and is a pioneer in diabetes research and treatment.