Medical schools can cooperate: a new joint venture to provide medical education in the Northern Rivers region of New South Wales.

PubMed

Page, Sue L; Birden, Hudson H; Hudson, J Nicky; Thistlethwaite, Jill E; Roberts, Chris; Wilson, Ian; Bushnell, John; Hogg, John; Freedman, S Ben; Yeomans, Neville

2008-02-04

The medical schools at the University of Western Sydney, University of Wollongong and University of Sydney have developed a joint program for training medical students through placements of up to 40 weeks on the New South Wales North Coast. The new partnership agency - the North Coast Medical Education Collaboration - builds on the experience of regional doctors and their academic partners. A steering committee has identified the availability and support requirements of local practitioners to provide training, and has undertaken a comparative mapping of learning objectives and assessments from the courses of the three universities. The goals of the program include preparing doctors who can perform effectively in rural settings and multidisciplinary health care teams, and to advance research in medical education.

Do we pay our community preceptors? Results from a CERA clerkship directors' survey.

PubMed

Anthony, David; Jerpbak, Christine M; Margo, Katherine L; Power, David V; Slatt, Lisa M; Tarn, Derjung M

2014-03-01

Family medicine clerkships depend heavily on community-based family physician preceptors to teach medical students. These preceptors have traditionally been unpaid, but in recent years some clerkships have started to pay preceptors. This study determines trends in the number and geographic region of programs that pay their community preceptors, identifies reasons programs pay or do not pay, and investigates perceived advantages and disadvantages of payment. We conducted a cross-sectional, electronic survey of 134 family medicine clerkship directors at allopathic US medical schools. The response rate was 62% (83/132 clerkship directors). Nineteen of these (23%) currently pay community preceptors, 11 of whom are located in either New England or the South Atlantic region. Sixty-three percent of programs who pay report that their community preceptors are also paid for teaching other learners, compared to 32% of those programs who do not pay. Paying respondents displayed more positive attitudes toward paying community preceptors, though a majority of non-paying respondents indicated they would pay if they had the financial resources. The majority of clerkships do not pay their community preceptors to teach medical students, but competition from other learners may drive more medical schools to consider payment to help with preceptor recruitment and retention. Medical schools located in regions where there is competition for community preceptors from other medical and non-medical schools may need to consider paying preceptors as part of recruitment and retention efforts.

The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Argentina.

PubMed

Kairiyama, Eulogia; Morales Pedraza, Jorge

2009-05-01

Tissue banking activities in Argentina started in 1993. The regulatory and controlling national authority on organ, tissue and cells for transplantation activity is the National Unique Coordinating Central Institute for Ablation and Implant (INCUCAI). Three tissue banks were established under the IAEA program and nine other banks participated actively in the implementation of this program. As result of the implementation of the IAEA program in Argentina and the work done by the established tissue banks, more and more hospitals are now using, in a routine manner, radiation sterilised tissues processed by these banks. During the period 1992-2005, more than 21 016 tissues were produced and irradiated in the tissue banks participating in the IAEA program. Within the framework of the training component of the IAEA program, Argentina has been selected to host the Regional Training Centre for Latin American. In this centre, tissue bank operators and medical personal from Latin American countries were trained. Since 1999, Argentina has organised four regular regional training courses and two virtual regional training courses. More than twenty (20) tissue bank operators and medical personnel from Argentina were trained under the IAEA program in the six courses organised in the country. In general, ninety (96) tissue bank operators and medical personnel from eight Latin-American countries were trained in the Buenos Aires regional training centre. From Argentina 16 students graduated in these courses.

Challenges and opportunities in building a sustainable rural primary care workforce in alignment with the Affordable Care Act: the WWAMI program as a case study.

PubMed

Allen, Suzanne M; Ballweg, Ruth A; Cosgrove, Ellen M; Engle, Kellie A; Robinson, Lawrence R; Rosenblatt, Roger A; Skillman, Susan M; Wenrich, Marjorie D

2013-12-01

The authors examine the potential impact of the Patient Protection and Affordable Care Act (ACA) on a large medical education program in the Northwest United States that builds the primary care workforce for its largely rural region. The 42-year-old Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, hosted by the University of Washington School of Medicine, is one of the nation's most successful models for rural health training. The program has expanded training and retention of primary care health professionals for the region through medical school education, graduate medical education, a physician assistant training program, and support for practicing health professionals.The ACA and resulting accountable care organizations (ACOs) present potential challenges for rural settings and health training programs like WWAMI that focus on building the health workforce for rural and underserved populations. As more Americans acquire health coverage, more health professionals will be needed, especially in primary care. Rural locations may face increased competition for these professionals. Medical schools are expanding their positions to meet the need, but limits on graduate medical education expansion may result in a bottleneck, with insufficient residency positions for graduating students. The development of ACOs may further challenge building a rural workforce by limiting training opportunities for health professionals because of competing demands and concerns about cost, efficiency, and safety associated with training. Medical education programs like WWAMI will need to increase efforts to train primary care physicians and increase their advocacy for student programs and additional graduate medical education for rural constituents.

Expanding Clinical Medical Training Opportunities at the University of Nairobi: Adapting a Regional Medical Education Model from the WWAMI Program at the University of Washington

PubMed Central

Child, Mara J.; Kiarie, James N.; Allen, Suzanne M.; Nduati, Ruth; Wasserheit, Judith N.; Kibore, Minnie W.; John-Stewart, Grace; Njiri, Francis J.; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E.; Farquhar, Carey

2014-01-01

A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa. PMID:25072575

[Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

PubMed

Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

2016-05-01

Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

PEPFAR/DOD/Pharmaccess/Tanzania Peoples Defence Forces HIV/AIDS Program

DTIC Science & Technology

2009-09-01

NACP National AIDS Control Program NGO Non Governmental Organization NLTP National Leprosy and TB Program NS National Service OIS...have an ongoing DOT-TB program monitored by the Regional Medical Officer, in line with the guidelines of the National Tuberculosis and Leprosy ...and treatment, according to the guidelines of the NACP TB Unit and the National TB and Leprosy Programme (NTLP). 48 48 C Train medical officers

Accreditation of undergraduate medical education in the Caribbean: report on the Caribbean accreditation authority for education in medicine and other health professions.

PubMed

van Zanten, Marta; Parkins, Lorna M; Karle, Hans; Hallock, James A

2009-06-01

Medical education in the Caribbean has undergone significant change and growth in the past decades. Currently, approximately 60 medical schools in the Caribbean provide medical training to a combination of domestic and international students. External quality assurance of these institutions has varied in effectiveness and scope throughout the region. The Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) was established by governments of the Caribbean Community as a way to fulfill regional and local needs for a governmentally recognized quality assurance agency. To examine efficient and effective options for maintaining and improving established accreditation systems such as CAAM-HP, the Invitational Conference on Accreditation of Medical Education Programs in the Caribbean took place in May 2007 in Jamaica. The conference was hosted by CAAM-HP and the World Federation for Medical Education, with assistance from the Educational Commission for Foreign Medical Graduates. The evaluation and monitoring of undergraduate medical education programs in the Caribbean by a regional accrediting system such as CAAM-HP can help ensure the quality of the education delivered at these diverse institutions.

Do otolaryngology residency applicants relocate for training?

PubMed

Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

2016-04-01

To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

NERMLS: The First Year *

PubMed Central

Colby, Charles C.; Bloomquist, Harold; Hodges, T. Mark

1969-01-01

The Countway Library, Boston, was the nation's first Regional Medical Library under the Regional Medical Library Program of the NLM. New England Regional Medical Library Service (NERMLS) began in October 1967 and is the outgrowth of traditional extramural services of the Harvard and Boston Medical Libraries (constituents of the Countway). During the first year over 27,000 requests were received of which 84 percent were filled. Some problems of document delivery (and their solution) are recounted. Other activities were: a limited amount of reference work; distribution of a Serials List; and planning for a region-wide medical library service. Proposals call for consultation and education, regional reference service, and improved document delivery service. Emphasis is placed on the role of the Community Hospital as a center for continuing education and the need to strengthen and assist hospital medical libraries. With the Postgraduate Medical Institute, Boston, NERMLS assisted in the compilation of a small physician-selected medical Core Collection which would serve as a minimum standard collection for community hospital libraries. PMID:5823504

Creating a state medical response system for medical disaster management: the North Carolina experience.

PubMed

Kearns, Randy D; Skarote, Mary Beth; Peterson, Jeff; Hubble, Michael W; Winslow, James E

2014-09-01

The purpose of this work was to examine the creation and evolution of the North Carolina state medical response system (SMRS). During the past 30 years, states and local communities have developed a somewhat incongruent patchwork of medical disaster response systems. Several local or regional programs participated in the National Disaster Medical System; however, aside from the Disaster Medical Assistance Teams, most of these local resources lacked national standards and national direction. The September 11, 2001 terrorist attacks in Washington, DC and New York, and the anthrax-laced letters mailed to prominent individuals in the US media and others (bioterrorism) in the months that followed were tragic, but they served as both a tipping point and a unifying factor to drive preparedness activities on a national level. Each state responded to the September 11, 2001 attacks by escalating planning and preparedness efforts for a medical disaster response. The North Carolina SMRS was created based on the overall national direction and was tailored to meet local needs such as hurricane response. This article reviews the accomplishments to date and examines future aims. From regional medical response teams to specialty programs such as ambulance strike teams, burn surge planning, electronic inventory and tracking systems, and mobile pharmacy resources, the North Carolina SMRS has emerged as a national leader. Each regional coalition, working with state leadership, has developed resources and has used those resources while responding to disasters in North Carolina. The program is an example of how national leadership can work with state and local agencies to develop a comprehensive and effective medical disaster response system.

Applicant Characteristics Associated With Selection for Ranking at Independent Surgery Residency Programs.

PubMed

Dort, Jonathan M; Trickey, Amber W; Kallies, Kara J; Joshi, Amit R T; Sidwell, Richard A; Jarman, Benjamin T

2015-01-01

This study evaluated characteristics of applicants selected for interview and ranked by independent general surgery residency programs and assessed independent program application volumes, interview selection, rank list formation, and match success. Demographic and academic information was analyzed for 2014-2015 applicants. Applicant characteristics were compared by ranking status using univariate and multivariable statistical techniques. Characteristics independently associated with whether or not an applicant was ranked were identified using multivariable logistic regression modeling with backward stepwise variable selection and cluster-correlated robust variance estimates to account for correlations among individuals who applied to multiple programs. The Electronic Residency Application Service was used to obtain applicant data and program match outcomes at 33 independent surgery programs. All applicants selected to interview at 33 participating independent general surgery residency programs were included in the study. Applicants were 60% male with median age of 26 years. Birthplace was well distributed. Most applicants (73%) had ≥1 academic publication. Median United States Medical Licensing Exams (USMLE) Step 1 score was 228 (interquartile range: 218-240), and median USMLE Step 2 clinical knowledge score was 241 (interquartile range: 231-250). Residency programs in some regions more often ranked applicants who attended medical school within the same region. On multivariable analysis, significant predictors of ranking by an independent residency program were: USMLE scores, medical school region, and birth region. Independent programs received an average of 764 applications (range: 307-1704). On average, 12% interviews, and 81% of interviewed applicants were ranked. Most programs (84%) matched at least 1 applicant ranked in their top 10. Participating independent programs attract a large volume of applicants and have high standards in the selection process. This information can be used by surgery residency applicants to gauge their candidacy at independent programs. Independent programs offer a select number of interviews, rank most applicants that they interview, and successfully match competitive applicants. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Teaching Evidence-Based Medicine: A Regional Dissemination Model.

ERIC Educational Resources Information Center

Leipzig, Rosanne M.; Wallace, Eleanor Z.; Smith, Lawrence G.; Sullivant, Jean; Dunn, Kathel; McGinn, Thomas

2003-01-01

Described and evaluated an interactive course designed to create a cadre of medical school faculty in New York who could integrate evidence-based medicine into their training programs. Findings for representatives of 30 internal medicine residency programs show the usefulness of the regional dissemination model used. (SLD)

Developing the Master Educator: Cross Disciplinary Teaching Scholars Program for Human and Veterinary Medical Faculty

ERIC Educational Resources Information Center

Srinivasan, Malathi; Pratt, Daniel D.; Collins, John; Bowe, Constance M.; Stevenson, Frazier T.; Pinney, Stephen J.; Wilkes, Michael S.

2007-01-01

Objective: At the University of California, Davis (UCD), the authors sought to develop an institutional network of reflective educational leaders. The authors wanted to enhance faculty understanding of medical education's complexity, and improve educators' effectiveness as regional/national leaders. Methods: The UCD Teaching Scholars Program is a…

Impact of Community College of Philadelphia Allied Health Programs on the Philadelphia Region. Report #117.

ERIC Educational Resources Information Center

Philadelphia Community Coll., PA.

This report discusses the Allied Health programs at Community College of Philadelphia (CCP): (1) Clinical Laboratory Technician; (2) Dental Assisting Hygiene; (3) Dental Assisting Certificate; (4) Diagnostic Medical Imaging; (5) Dietetic Technician; (6) Health Information Technology; (7) Medical Assisting and Office Management; (8) Nursing; and…

Changes, trends and challenges of medical education in Latin America.

PubMed

Pulido M, Pablo A; Cravioto, Alejandro; Pereda, Ana; Rondón, Roberto; Pereira, Gloria

2006-02-01

This paper briefly reviews the current situation of Latin American medical schools and the search to improve the quality and professionalism of medical education through the region. Institutional evaluation and accreditation programs based on nationally ongoing developing standards have been accepted, now optimized and complemented by the framework of the Global & International Standards of Medical Education working jointly with the WFME. More recently, the process has evolved to look into the quality of the outcomes of the medicals as seen by examinations implemented at the end of medical studies and the initiation of medical practice. In addition, there is vision for the application of new programs such as the global minimum essential requirements advanced by the Institute for International Medical Education (IIME). The PanAmerican Federation of Associations of Medical Schools (PAFAMS), an academic, non-governmental organization, is fostering the exchange of ideas and experiences among members, associations and affiliated medical schools geared to focus on the quality and professionalism of the graduates of medical schools in Latin America. These actions also aim to consolidate databases of information on medical education and innovative endeavors in continuing professional education and development through e-learning projects in the region.

Implementing a Swedish regionalized medical program supported by digital technologies: possibilities and challenges from a management perspective.

PubMed

Pettersson, Fanny L M

2013-01-01

In 2011, Umeå University in Sweden was facing its first attempt to transform the existing medical program into a regionalized medical program (RMP), supported by the use of digital technologies. The Swedish RMP means that students are distributed in geographically separated groups while doing their five clinical clerkship semesters. To provide medical students with ways of undertaking their theoretical studies when geographically distributed, digital technologies are used for educational and administrative purposes. In this article, the Swedish RMP will be described and related to previous international research on educating medical students in rural settings. The aim of this article was, from a management perspective, to understand if and how contradictions arise during the implementation process of the Swedish RMP, supported by digital technologies. Based on this analysis, a further aim was to discuss, from a management perspective, the possibilities and challenges for improvement of this medical educational practice, as well as to provide implications for other similar changes in medical programs internationally. To identify possible contradictions during the implementation process, ethnographically inspired observations were made during management work meetings, before and during the first regionalized semester. In addition, in-depth follow-up interviews were held in May and June 2011 with six management executives of the Swedish RMP, concerning their expectations and experiences of the implementation process. The qualitative and activity theory (AT)-inspired analysis resulted in the emergence of two main themes and seven sub-themes. The analysis suggests that a number of contradictions arose during the implementation process of the Swedish RMP. For instance, a contradiction constituted as a conflict between the university management and some teachers concerning how digital technologies and technology enhanced learning (TEL) could and should be used when educating medical students. In addition, due to the use of digital technologies the implementation process helped to reveal existing problems and tensions in educational practice, not previously visible to management. These included contradictions such as a lack of alignment in how course goals, teaching practices, and examinations should be carried out. Further, obsolete course content and overlap between courses and subjects were identified, leading to an overhaul of all semesters, not only those regionalized. This study showed how contradictions in educational practice arose when the Swedish RMP, supported by digital technologies, was implemented. These contradictions involve both possibilities and challenges for management to improve how and with what quality the Swedish RMP is conducted. A challenge for management is to find the most effective way to enhance up-take and use of the more interactive and innovative TEL-solutions. However, a possibility is that the regionalization process and implemented improvements may also influence non-regionalized semesters, with the potential to eventually increase the quality of the entire program.

Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

PubMed

Metz, Anneke M

2017-01-01

Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating from medical school, choosing primary care specialties, and working in medically underserved areas. MEDPREP may therefore serve as a model for increasing physician diversity and addressing the needs of medically underserved communities.

The Effect of Regional Medical Education on Physician Distribution in Illinois.

ERIC Educational Resources Information Center

Spencer, David L.; D'Elia, Gabrielle

1983-01-01

A study of physician distribution in Illinois counties from 1969-1979 showed smallest increases in low-population counties and largest in middle-sized cities. The major result of establishment of regional medical education centers is not a general diffusion of physicians but concentration in tertiary care centers with the new educational programs.…

The Association Between Residency Training and Internists’ Ability to Practice Conservatively

PubMed Central

Sirovich, Brenda E.; Lipner, Rebecca S.; Johnston, Mary; Holmboe, Eric S.

2014-01-01

IMPORTANCE Growing concern about rising costs and potential harms of medical care has stimulated interest in assessing physicians’ ability to minimize the provision of unnecessary care. OBJECTIVE To assess whether graduates of residency programs characterized by low-intensity practice patterns are more capable of managing patients’ care conservatively, when appropriate, and whether graduates of these programs are less capable of providing appropriately aggressive care. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional comparison of 6639 first-time takers of the 2007 American Board of Internal Medicine certifying examination, aggregated by residency program (n = 357). EXPOSURES Intensity of practice, measured using the End-of-Life Visit Index, which is the mean number of physician visits within the last 6 months of life among Medicare beneficiaries 65 years and older in the residency program’s hospital referral region. MAIN OUTCOMES AND MEASURES The mean score by program on the Appropriately Conservative Management (ACM) (and Appropriately Aggressive Management [AAM]) subscales, comprising all American Board of Internal Medicine certifying examination questions for which the correct response represented the least (or most, respectively) aggressive management strategy. Mean scores on the remainder of the examination were used to stratify programs into 4 knowledge tiers. Data were analyzed by linear regression of ACM(or AAM) scores on the End-of-Life Visit Index, stratified by knowledge tier. RESULTS Within each knowledge tier, the lower the intensity of health care practice in the hospital referral region, the better residency program graduates scored on the ACM subscale (P < .001 for the linear trend in each tier). In knowledge tier 4 (poorest), for example, graduates of programs in the lowest-intensity regions had a mean ACM score in the 38th percentile compared with the 22nd percentile for programs in the highest-intensity regions; in tier 2, ACM scores ranged from the 75th to the 48th percentile in regions from lowest to highest intensity. Graduates of programs in low-intensity regions tended, more weakly, to score better on the AAM subscale (in 3 of 4 knowledge tiers). CONCLUSIONS AND RELEVANCE Regardless of overall medical knowledge, internists trained at programs in hospital referral regions with lower-intensity medical practice are more likely to recognize when conservative management is appropriate. These internists remain capable of choosing an aggressive approach when indicated. PMID:25179515

The APA/HRSA Faculty Development Scholars Program: introduction to the supplement.

PubMed

Osborn, Lucy M; Roberts, Kenneth B; Greenberg, Larrie; DeWitt, Tom; Devries, Jeffrey M; Wilson, Modena; Simpson, Deborah E

2004-01-01

The purpose of this project was to improve pediatric primary care medical education by providing faculty development for full-time and community-based faculty who teach general pediatrics to medical students and/or residents in ambulatory pediatric community-based settings. Funding for the program came through an interagency agreement with the Health Resources and Services Administration (HRSA) and the Agency for Healthcare Research and Quality (AHRQ). A train-the-trainer model was used to train 112 scholars who could teach skills to general pediatric faculty across the nation. The three scholar groups focused on community-based ambulatory teaching; educational scholarship; and executive leadership. Scholars felt well prepared to deliver faculty development programs in their home institutions and regions. They presented 599 workshops to 7989 participants during the course of the contract. More than 50% of scholars assumed positions of leadership, and most reported increased support for medical education in their local and regional environments. This national pediatric faculty development program pioneered in the development of a new training model and should guide training of new scholars and advanced and continuing training for those who complete a basic program.

Technology complementing military psychology programs and services in the Pacific Regional Medical Command.

PubMed

Stetz, Melba C; Folen, Raymond A; Van Horn, Sandra; Ruseborn, Daniel; Samuel, Kevin M

2013-08-01

The Tripler Army Medical Center is the only federal tertiary care hospital serving the Pacific Regional Medical Command. Due to Tripler's large area of responsibility, many behavioral health professionals are starting to employ more technology during their sessions. As explained in this article, virtual reality and telepsychology efforts are proving to benefit military service members and their families in the Pacific Rim. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Global cardiovascular device innovation: Japan-USA synergies: Harmonization by Doing (HBD) program, a consortium of regulatory agencies, medical device industry, and academic institutions.

PubMed

Uchida, Takahiro; Ikeno, Fumiaki; Ikeda, Koji; Suzuki, Yuka; Todaka, Koji; Yokoi, Hiroyoshi; Thompson, Gary; Krucoff, Mitchel; Saito, Shigeru

2013-01-01

Global medical devices have become more popular, but investment money for medical device development is not easily available in the market. Worldwide health-care budget constraints mean that efficient medical device development has become essential. To achieve efficient development, globalization is a key to success. Spending large amounts of money in different regions for medical device development is no longer feasible. In order to streamline processes of global medical device development, an academic, governmental, and industrial consortium, called the Harmonization by Doing program, has been set up. The program has been operating between Japan and the USA since 2003. The program has 4 working groups: (1) Global Cardiovascular Device Trials; (2) Study on Post-Market Registry; (3) Clinical Trials; and (4) Infrastructure and Methodology Regulatory Convergence and Communication. Each working group has as its goals the achievement of speedy and efficient medical device development in Japan and the USA. The program has held multiple international meetings to deal with obstacles against efficient medical device development. This kind of program is very important to deliver novel medical devices. Involvement of physicians in this type of activity is also very helpful to achieve these goals.

A Multistate Program to Educate Physicians: Successful, Economical, but Endangered.

ERIC Educational Resources Information Center

Roberts, Allan; And Others

1995-01-01

The West Virginia School of Osteopathic Medicine's successful interstate educational exchange program through the Southern Regional Education Board is described, and concerns are expressed for the program's future. Suggestions are offered for establishing similar multistate programs that promote education in medical specialties and encourage…

Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

PubMed

Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

2015-03-01

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

Making Healthy Minds Healthy Bodies: An Activity-Theoretical Analysis of the Development and Organizational Adaptation of a Medical Service-Learning Program

ERIC Educational Resources Information Center

Powell, Tamara J.

2013-01-01

Physician workforce shortages in California are projected to grow rapidly in the next ten years, particularly in inner-city and rural regions. In response to this anticipated need, the University of California's medical schools are increasing enrollment and working to implement and evaluate new programs and curricula to prepare graduates to work…

[The German program for disease management guidelines. Results and perspectives].

PubMed

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

Joint Curriculum Development of the Training Program for Five-Year, Rural-Oriented, Tuition-Waived Medical Students

ERIC Educational Resources Information Center

Che, Xiang-Xin; Niu, Li; Xia, Xiu-Long; Wang, Xin

2014-01-01

To alleviate the shortage of competent undergraduate-level medical professionals in the central and western rural regions of China, from 2010 to 2012, the Chinese government mandated 100 medical colleges to recruit 30,000 rural-oriented, tuition-waived medical students (RTMS) for the township and village hospitals. But no educational curriculum is…

Following Their Dreams: Native American Students Pursuing Medical School.

ERIC Educational Resources Information Center

Boswell, Evelyn

1997-01-01

Four Native American first-year medical school students from Montana discuss their career choice and their goals for establishing medical practices in Native American communities. A regional program has enabled the students to take their first year of classes at Montana State University-Bozeman and to complete their studies at the University of…

Survey and analysis of the current state of residency training in medical-school-affiliated hospitals in China

PubMed Central

2014-01-01

Background Since the global standards for postgraduate medical education (PGME) were published in January 2003, they have gained worldwide attention. The current state of residency training programs in medical-school-affiliated hospitals throughout China was assessed in this study. Methods Based on the internationally recognized global standards for PGME, residents undergoing residency training at that time and the relevant residency training instructors and management personnel from 15 medical-school-affiliated hospitals throughout China were recruited and surveyed regarding the current state of residency training programs. A total of 938 questionnaire surveys were distributed between June 30, 2006 and July 30, 2006; of 892 surveys collected, 841 were valid. Results For six items, the total proportions of “basically meets standards” and “completely meets standards” were <70% for the basic standards. These items were identified in the fields of “training settings and educational resources”, “evaluation of training process”, and “trainees”. In all fields other than “continuous updates”, the average scores of the western regions were significantly lower than those of the eastern regions for both the basic and target standards. Specifically, the average scores for the basic standards on as many as 25 of the 38 items in the nine fields were significantly lower in the western regions. There were significant differences in the basic standards scores on 13 of the 38 items among trainees, instructors, and managers. Conclusions The residency training programs have achieved satisfactory outcomes in the hospitals affiliated with various medical schools in China. However, overall, the programs remain inadequate in certain areas. For the governments, organizations, and institutions responsible for PGME, such global standards for PGME are a very useful self-assessment tool and can help identify problems, promote reform, and ultimately standardize PGME. PMID:24885865

Medical education and research environment in Qatar: a new epoch for translational research in the Middle East

PubMed Central

2011-01-01

Recent advances in medical technology and key discoveries in biomedical research have the potential to improve human health in an unprecedented fashion. As a result, many of the Arab Gulf countries, particularly Qatar are devoting increasing resources toward establishing centers of excellence in biomedical research. However, there are challenges that must be overcome. The low profile of private medical institutions and their negligible endowments in the region are examples of such challenges. Business-type government controlled universities are not the solution for overcoming the challenges facing higher education and research programs in the Middle East. During the last decade, Qatar Foundation for Education, Science and Community Development has attracted six branch campuses of American Institutions of higher learning to the Education City in Qatar, a 2500-acre area, which is rapidly becoming a model of integrating higher education and research in the region. Not-for profit, time-tested education institutions from abroad in public-private partnership with local organizations offer favorable conditions to build robust research programs in the region. Weill Cornell Medical College in Qatar (WCMC-Q) of Cornell University is an example such an institution. It is the first and only medical school in Qatar. WCMC-Q's interwoven education, research and public health based framework lays a sturdy foundation for developing and implementing translational medicine research programs of importance to the State of Qatar and Middle Eastern nations. This approach is yielding positive results. Discoveries from this program should influence public policy in a positive fashion toward reducing premature mortality and morbidity due to diabetes, obesity, heart disease and cancer, examples of health conditions commonly encountered in Qatar. PMID:21272322

Medical education and research environment in Qatar: a new epoch for translational research in the Middle East.

PubMed

Chouchane, Lotfi; Mamtani, Ravinder; Al-Thani, Mohammed H; Al-Thani, Al-Anoud M; Ameduri, Marco; Sheikh, Javaid I

2011-01-27

Recent advances in medical technology and key discoveries in biomedical research have the potential to improve human health in an unprecedented fashion. As a result, many of the Arab Gulf countries, particularly Qatar are devoting increasing resources toward establishing centers of excellence in biomedical research. However, there are challenges that must be overcome. The low profile of private medical institutions and their negligible endowments in the region are examples of such challenges. Business-type government controlled universities are not the solution for overcoming the challenges facing higher education and research programs in the Middle East.During the last decade, Qatar Foundation for Education, Science and Community Development has attracted six branch campuses of American Institutions of higher learning to the Education City in Qatar, a 2500-acre area, which is rapidly becoming a model of integrating higher education and research in the region. Not-for profit, time-tested education institutions from abroad in public-private partnership with local organizations offer favorable conditions to build robust research programs in the region. Weill Cornell Medical College in Qatar (WCMC-Q) of Cornell University is an example such an institution. It is the first and only medical school in Qatar.WCMC-Q's interwoven education, research and public health based framework lays a sturdy foundation for developing and implementing translational medicine research programs of importance to the State of Qatar and Middle Eastern nations. This approach is yielding positive results. Discoveries from this program should influence public policy in a positive fashion toward reducing premature mortality and morbidity due to diabetes, obesity, heart disease and cancer, examples of health conditions commonly encountered in Qatar.

Assessing the impact of faculty development fellowship in Shiraz University of Medical Sciences.

PubMed

Ebrahimi, Sedigheh; Kojuri, Javad

2012-02-01

Changing concepts of education have led many medical schools to design educational programs to enhance teaching skills, as traditional approaches cannot fulfill the current students' needs. The educational development of medical faculty members has recently received impetus in Iran and the Eastern Mediterranean region. The aim of this study was to investigate whether participation in a faculty development program reinforced new teaching skills. A teacher-training program was designed at Shiraz University of Medical Sciences to help medical instructors improve their teaching skills. The program, imparted in workshop format, covered effective teaching methods, feedback, knowledge assessment, and time management. Program sessions lasted four hours, four days each week for one month. Instruction was in the form of lectures, group discussions, case simulations, video presentations, and role-playing. All participants in the study (n = 219) belonged to the academic staff of Shiraz University of Medical Sciences. The participants highly rated the quality of the program. They felt that the educational intervention was appropriate and had a positive impact on their knowledge (P < 0.001). Assessment of the effectiveness of the program in strengthening the participants' teaching ability showed that students noticed significant improvements in the participants' teaching abilities (P < 0.05). Our faculty development program appears to have a significant positive effect on medical teachers' competencies, and we suggest that our educational intervention is effective in achieving its aims. Further research should investigate whether this faculty development program actually results in improved teaching performance.

OCLC book interlibrary loan in a basic-unit hospital library: one year's experience.

PubMed

Landwirth, T K

1983-04-01

Methodist Medical Center of Illinois Medical Library, a "basic-unit" medical library (i.e., not a resource library) in the Regional Medical Library Program recently completed one year of borrowing and lending books using OCLC. Of the books successfully borrowed through OCLC, 79% were obtained from nonmedical libraries. Forming cost-sharing OCLC clusters among basic units makes OCLC an affordable alternative to borrowing books from overburdened medical resource libraries.

The Concept of Fit in Contingency Theory.

DTIC Science & Technology

1984-11-01

Research Center San Diego, CA 92152 Psychology Department Naval Regional Medical Center San Diego, CA 92134 Com~’arding Officer - Naval Submarine Medical ...Research Laboratory Naval Submarine Base New London, Box 900 Grotcn, CT 06249 Co~anding Officer :;ava! Aerospace Medical Resea-:ch’ Lab Naval Air...Station Pen~sacola, FEL 32508 Program Manager for Human 44 Performance (Code 44) Naval Medical R&D Command National Naval Medical Center Bethesda, MD 20014A

New study program: Interdisciplinary Postgraduate Specialist Study in Medical Informatics.

PubMed

Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra

2014-01-01

Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.

Cultural competence springs up in the desert: the story of the center for cultural competence in health care at Weill Cornell Medical College in Qatar.

PubMed

Elnashar, Maha; Abdelrahim, Huda; Fetters, Michael D

2012-06-01

The authors describe the factors that led Weill Cornell Medical College in Qatar (WCMC-Q) to establish the Center for Cultural Competence in Health Care from the ground up, and they explore challenges and successes in implementing cultural competence training.Qatar's capital, Doha, is an extremely high-density multicultural setting. When WCMC-Q's first class of medical students began their clinical clerkships at the affiliated teaching hospital Hamad Medical Corporation in 2006, the complicated nature of training in a multicultural and multilingual setting became apparent immediately. In response, initiatives to improve students' cultural competence were undertaken. Initiatives included launching a medical interpretation program in 2007; surveying the patients' spoken languages, examining the effect of an orientation program on interpretation requests, and surveying faculty using the Tool for Assessing Cultural Competence Training in 2008; implementing cultural competence training for students and securing research funding in 2009; and expanding awareness to the Qatar community in 2010. These types of initiatives, which are generally highly valued in U.S. and Canadian settings, are also apropos in the Arabian Gulf region.The authors report on their initial efforts, which can serve as a resource for other programs in the Arabian Gulf region.

Operations of the Biblioteca Regional de Medicina (BIREME).

PubMed

Neghme, A

1975-04-01

The operations and accomplishments of the Biblioteca Regional de Medicina (BIREME), the regional medical library of the Pan American Health Organization, are summarized. Aspects of BIREME's program which are described include: strengthening biomedical collections in Latin America, network organization, international cooperation, document and information delivery, bibliographic services, and educational efforts.

42 CFR 438.6 - Contract requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE General Provisions § 438.6 Contract requirements. (a) Regional...) Terminology. As used in this paragraph, the following terms have the indicated meanings: (i) Actuarially sound... adjustments to account for factors such as medical trend inflation, incomplete data, MCO, PIHP, or PAHP...

42 CFR 438.6 - Contract requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE General Provisions § 438.6 Contract requirements. (a) Regional...) Terminology. As used in this paragraph, the following terms have the indicated meanings: (i) Actuarially sound... adjustments to account for factors such as medical trend inflation, incomplete data, MCO, PIHP, or PAHP...

42 CFR 438.6 - Contract requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE General Provisions § 438.6 Contract requirements. (a) Regional...) Terminology. As used in this paragraph, the following terms have the indicated meanings: (i) Actuarially sound... adjustments to account for factors such as medical trend inflation, incomplete data, MCO, PIHP, or PAHP...

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1).

PubMed

Hamdy, H; Telmesani, A W; Al Wardy, N; Abdel-Khalek, N; Carruthers, G; Hassan, F; Kassab, S; Abu-Hijleh, M; Al-Roomi, K; O'malley, K; El Din Ahmed, M G; Raj, G A; Rao, G M; Sheikh, K

2010-01-01

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates (UAE), two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait, and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education, particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 2).

PubMed

Hamdy, H; Telmesani, A W; Wardy, N Al; Abdel-Khalek, N; Carruthers, G; Hassan, F; Kassab, S; Abu-Hijleh, M; Al-Roomi, K; O'Malley, K; El Din Ahmed, M G; Raj, G A; Rao, G M; Sheikh, J

2010-01-01

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates, two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities, and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Tactical emergency medical support programs: a comprehensive statewide survey.

PubMed

Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

2012-01-01

Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

OCLC book interlibrary loan in a basic-unit hospital library: one year's experience.

PubMed Central

Landwirth, T K

1983-01-01

Methodist Medical Center of Illinois Medical Library, a "basic-unit" medical library (i.e., not a resource library) in the Regional Medical Library Program recently completed one year of borrowing and lending books using OCLC. Of the books successfully borrowed through OCLC, 79% were obtained from nonmedical libraries. Forming cost-sharing OCLC clusters among basic units makes OCLC an affordable alternative to borrowing books from overburdened medical resource libraries. PMID:6860829

Outcomes and lessons learned from evaluating TRICARE's disease management programs.

PubMed

Dall, Timothy M; Askarinam Wagner, Rachel C; Zhang, Yiduo; Yang, Wenya; Arday, David R; Gantt, Cynthia J

2010-06-01

To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients. Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program. Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services. Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services. Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

PubMed

Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

2014-06-01

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

Varicella epidemiology in Latin America and the Caribbean.

PubMed

Ávila-Agüero, Maria L; Beltrán, Sandra; Castillo, José Brea Del; Castillo Díaz, María Esther; Chaparro, Luis Eduardo; Deseda, Carmen; Debbag, Roberto; Espinal, Carlos; Falleiros-Arlant, Luiza Helena; González Mata, Antonio José; Macías Parra, Mercedes; Marques-Rosa, Fabiano; Catalina Pírez, María; Vázquez-Rivera, Mirella

2018-02-01

The Latin American Society of Pediatric Infectious Diseases (SLIPE), with the support of the Americas Health Foundation (AHF), has developed a position paper on varicella prevention in Latin America and Caribbean countries (LAC). This article summarizes the most relevant aspects of varicella in LAC, and emphasizes the need to include the varicella vaccine in the national immunization programs in the Region and evaluate its impact disease burden. Areas covered: A systematic review was conducted of the medical evidence published and presented at various regional medical conferences on the disease burden in LAC, the advances made by prevention programs, the available vaccines in the Region, and their immunogenicity, efficacy, effectiveness, and safety. The different national varicella-prevention vaccination programs were reviewed, as was available information regarding the impact of these programs on the epidemiology of varicella in those countries implementing a varicella vaccine strategy. Following that initial publication, an update was conducted, including data from additional countries in the Region. Expert commentary: Varicella is a vaccine-preventable infectious disease, considered a 'benign disease' because of lower complication rates when compared with measles, pertussis. The incorporation of a two-dose varicella vaccine in national immunization schedules in all countries throughout LAC would be of great benefit to the health of the children.

Utilization of the medical librarian in a state Medicaid program to provide information services geared to health policy and health disparities

PubMed Central

Droese, Peter; Peterson, Nancy

2006-01-01

Objective: The role of two solo medical librarians in supporting Medicaid programs by functioning as information specialists at regional and state levels is examined. Setting: A solo librarian for the Massachusetts Medicaid (MassHealth) program and a solo librarian for the New England States Consortium Systems Organization (NESCSO) functioned as information specialists in context to support Medicaid policy development and clinical, administrative, and program staff for state Medicaid programs. Brief Description: The librarian for MassHealth initially focused on acquiring library materials and providing research support on culturally competent health care and outreach, as part of the United States Department of Health and Human Services Culturally and Linguistically Appropriate Services in Health Care Standards. The NESCSO librarian focused on state Medicaid system issues surrounding the implementation of the Health Insurance Portability and Accountability Act. The research focus expanded for both the librarians, shaping their roles to more directly support clinical and administrative policy development. Of note, the availability and dissemination of information to policy leaders facilitated efforts to reduce health disparities. In Massachusetts, this led to a state legislative special commission to eliminate health disparities, which released a report in November 2005. On a regional level, the NESCSO librarian provided opportunities for states in New England to share ideas and Medicaid program information. The Centers for Medicaid and Medicare are working with NESCSO to explore the potential for using the NESCSO model for collaboration for other regions of the United States. Results/Outcomes: With the increased attention on evidence-based health care and reduction of health disparities, medical librarians are called on to support a variety of health care information needs. Nationally, state Medicaid programs are being called on to provide coverage and make complex medical decisions regarding the delivery of benefits. Increasing numbers of beneficiaries and shrinking Medicaid budgets demand effective and proactive decision making to provide quality care and to accomplish the missions of state Medicaid programs. In this environment, the opportunities for information professionals to provide value and knowledge management are increasing. PMID:16636710

Operations of the Biblioteca Regional de Medicina (BIREME).

PubMed Central

Neghme, A

1975-01-01

The operations and accomplishments of the Biblioteca Regional de Medicina (BIREME), the regional medical library of the Pan American Health Organization, are summarized. Aspects of BIREME's program which are described include: strengthening biomedical collections in Latin America, network organization, international cooperation, document and information delivery, bibliographic services, and educational efforts. Images PMID:1139061

US medical specialty global health training and the global burden of disease

PubMed Central

Kerry, Vanessa B.; Walensky, Rochelle P.; Tsai, Alexander C.; Bergmark, Regan W.; Bergmark, Brian A.; Rouse, Chaturia; Bangsberg, David R.

2013-01-01

Background Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled. Methods Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate the association between programmatic activity and country–level disease burden. Results Of the 1856 programs assessed between January and June 2011, there were 380 global health residency training programs (20%) working in 141 countries. 529 individual programmatic activities (elective–based rotations, research programs, extended curriculum–based field training, or other) occurred at 1337 specific sites. The majority of the activities consisted of elective–based rotations. At the country level, disease burden had a statistically significant association with programmatic activity (Spearman's ρ = 0.17) but only explained 3% of the total variation between countries. Conclusions There were a substantial number of US medical specialty global health programs, but a relative paucity of surgical and mental health programs. Elective–based programs were more common than programs that offer longitudinal experiences. Despite heterogeneity, there was a small but statistically significant association between program location and the global burden of disease. Areas for further study include the degree to which US–based programs develop partnerships with their program sites, the significance of this activity for training, and number and breadth of programs in medical specialty global health education in other countries around the world. PMID:24363924

Army National Guard: Regionally Aligned Brigade Force of First Choice

DTIC Science & Technology

2012-03-16

include Access to the National Guard; Training, Transient, Holding, and School (TTHS); Medical/ Dental Readiness; and Full Time Manning. Finally...Another policy that merits revision is the Medical and Dental Readiness Management Policies and Programs. One of the greatest challenges to the...Reserve Components’ ability to establish itself as an operational force is medical and dental readiness. Currently, RC members incur a cost to

The Impact of a Model Partnership in a Medical Postgraduate Program in North-South and South-South Collaboration on Trainee Retention, Program Sustainability and Regional Collaboration

ERIC Educational Resources Information Center

Amare, Beede Lemma; Lutale, Janet; Derbew, Miliard; Mathai, Dilip; Langeland, Nina

2017-01-01

North-South educational partnerships can potentially alleviate the scarcity of health work force in the South. A model program with the objectives of sustainability, high trainee retention, quality education, and capacity building is the goal of many similar programs. To achieve these goals a program of postgraduate clinical specialty training was…

Association between proportion of US medical graduates and program characteristics in gastroenterology fellowships.

PubMed

Atsawarungruangkit, Amporn

2017-01-01

Gastroenterology is one of the most competitive internal medicine fellowship. However, factors that associated with program competitiveness have not been documented. The objective of this study was to evaluate associations between characteristics of gastroenterology fellowship programs and their competitiveness through the proportion of US medical graduates for the academic year 2016/17. This study used a retrospective, cross-sectional design with data obtained from the American Medical Association. The proportion of US medical graduates in gastroenterology fellowships was used as an indicator of program competitiveness. Using both univariate and multivariate linear regression analyses, we analyzed the association between the proportion of medical graduates in each program and 27 program characteristics based on a significance level of 0.05. In total, 153 out of 171 gastroenterology fellowship programs satisfied the inclusion criteria. A multivariate analysis revealed that a higher proportion of US medical graduates was significantly associated with five program characteristics: that it was a university-based program (p < 0.001), the ratio of full-time paid faculty to fellow positions (p < 0.001), the proportion of females in the program (p = 0.002), location in the Pacific region (p = 0.039), and a non-smoker hiring policy (p = 0.042). Among the five significant factors, being university based, located in the Pacific, and having a non-smoker hiring policy were likely to remain unchanged over a long period. However, program directors and candidates should pay attention to equivalence between full-time paid faculty and fellowship positions, and the proportion of women in the program. The former indicates the level of supervision while the latter has become increasingly important owing to the higher proportion of women in medicine.

[On the approaches enhancing the structural effectiveness of regional public health system].

PubMed

Uahakova, E I

2009-01-01

The particular technique of assessment of total extent of population consumption of medical care is discussed. The approach is based on the calculation of the sum of monetary equivalent units of rendering of medical care to population. The additional analysis of its structure according to the forms of medical care is specified. The approaches to the comparison between the existing structure of financing and factual cost criteria of unit of medical care provision on a particular territory are discussed. The example is given of calculation of possible economic benefit in the process of bring the ratio of medical care forms to conformity with the structure of its consumption recommended in the federal program of state guarantees of medical care in Russia. The recommendations are proposed how to reallocate the volumes of financing according the forms of medical care which will become the foundation of more balanced development of regional health care system.

Epidemiology of chronic obstructive pulmonary disease: a population-based study in Krasnoyarsk region, Russia.

PubMed

Artyukhov, Ivan P; Arshukova, Irina L; Dobretsova, Elena A; Dugina, Tatyana A; Shulmin, Andrey V; Demko, Irina V

2015-01-01

Krasnoyarsk region is a territory with the widespread risk factors for chronic obstructive pulmonary disease (COPD) such as tobacco smoke, air pollution, and occupational exposure. An assessment of COPD prevalence based on medical diagnosis statistics underestimates the true COPD prevalence. This study aims to evaluate how medical examinations may increase the accuracy of estimates of COPD prevalence. True COPD prevalence was estimated as a number of patients with the established disease diagnosis supplemented by the additional disease cases detected during medical examinations per 1,000 inhabitants of the region. Official medical statistics data and the data collected from the Global Alliance against Chronic Respiratory Diseases program 2011 among 15,000 inhabitants of the region aged 18 years and older were analyzed. This study revealed the COPD cases without official medical diagnosis. The true prevalence of COPD is estimated to be two times higher than the prevalence estimates based on medical diagnosis statistics. Undiagnosed and untreated cases of COPD result in severe COPD forms as well as addition of severe comorbidities. Because of this, there is an increase in the index of potential years of life lost. Conducting special medical examinations may increase the number of COPD cases detected at the early stages of the disease. This, in turn, may reduce the overall burden of the disease for the population of the region.

Specification and evaluation of a regional PACS in the SaxTeleMed project

NASA Astrophysics Data System (ADS)

Lemke, Heinz U.; Niederlag, W.; Heuser, H.

2002-05-01

During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

Charles W. Dohner, PhD: an evaluator and mentor in medical education.

PubMed

Irby, David M; Wilkerson, Luann

2003-01-01

As one of the first generation medical education pioneers, Charles W. Dohner, PhD established the ninth office of medical education at the University of Washington (UW) where he served as chairman from 1967-1996. With a background in education and measurement, he focused his work on evaluation of educational programs and faculty development. The Department of Medical Education went through three distinct stages of development: pathfinding 1967-1972 focused on developing working relationships with the faculty and clarifying identity, integration into academic affairs 1972-1980, and direct leadership by department faculty 1980-1996. Dohner helped to create and evaluate the WAMI program, a regional medical education program for the states of Washington, Alaska, Montana, and Idaho. He served as a consultant to a specialty board, the founding president of the Society of Directors of Research in Medical Education, and a frequent consultant in international medical education. Dohner identified three important innovations in medical education: educators in academic medicine, simulations and performance assessment, and community-based medical education. Success factors for professional education include technical competence in education, interpersonal communication and collaboration skills, a plan for personal growth, and use of mentors. Future trends in medical education will involve information technology, professionalism, wellness and complementary medicine, and performance assessment. He has been a passionate spokesman for excellence in medical education and most noted for his roles as an evaluator, program developer, and mentor of academic leaders.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

PubMed Central

Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

2016-01-01

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups. PMID:27895218

Resident away rotations allow adaptive neurosurgical training.

PubMed

Gephart, Melanie Hayden; Derstine, Pamela; Oyesiku, Nelson M; Grady, M Sean; Burchiel, Kim; Batjer, H Hunt; Popp, A John; Barbaro, Nicholas M

2015-04-01

Subspecialization of physicians and regional centers concentrate the volume of certain rare cases into fewer hospitals. Consequently, the primary institution of a neurological surgery training program may not have sufficient case volume to meet the current Residency Review Committee case minimum requirements in some areas. To ensure the competency of graduating residents through a comprehensive neurosurgical education, programs may need for residents to travel to outside institutions for exposure to cases that are either less common or more regionally focused. We sought to evaluate off-site rotations to better understand the changing demographics and needs of resident education. This would also allow prospective monitoring of modifications to the neurosurgery training landscape. We completed a survey of neurosurgery program directors and query of data from the Accreditation Council of Graduate Medical Education to characterize the current use of away rotations in neurosurgical education of residents. We found that 20% of programs have mandatory away rotations, most commonly for exposure to pediatric, functional, peripheral nerve, or trauma cases. Most of these rotations are done during postgraduate year 3 to 6, lasting 1 to 15 months. Twenty-six programs have 2 to 3 participating sites and 41 have 4 to 6 sites distinct from the host program. Programs frequently offset potential financial harm to residents rotating at a distant site by support of housing and transportation costs. As medical systems experience fluctuating treatment paradigms and demographics, over time, more residency programs may adapt to meet the Accreditation Council of Graduate Medical Education case minimum requirements through the implementation of away rotations.

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

PubMed

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

2015-01-01

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

Instructional Methods for Human Anatomy and Cell Biology in Nurse Anesthesia Graduate Programs: A Survey With a Focus on Regional Anesthesia

DTIC Science & Technology

1997-07-14

and Wieland (1995) examined Anatomy and Physiology as a predictor of success in undergraduate nursing students . They concluded that students who did... Student Registered Nurse Anesthetist (SRNA). 1991 -1995 1 st Medical Group, Langley Air Force Base, Virginia. Clinical Nurse, Special Care Unit...anesthetic techniques in situ, and 3 (4%) of the programs afford the students the opportunity to practice regional anesthetic techniques on the specimens

Project REACH. Regional Education To Achieve with Company Help. Performance Report.

ERIC Educational Resources Information Center

Parkway School District, Chesterfield, MO.

Parkway Area Adult Basic Education Program formed a partnership with St. John's Mercy Medical Center, St. Luke's Hospital, Watlow Electric, Missouri Department of Elementary and Secondary Education, and Literacy Council of Greater St. Louis to develop a model National Workplace Literacy Program. The instructional model developed under Project…

Four Characteristics for Regional Continuing Education in Medical Allied Health

ERIC Educational Resources Information Center

Koewing, J. Robert; And Others

1976-01-01

The Area Health Education Centers (AHEC) Program (created under the Comprehensive Health Manpower Act of 1971) is briefly described followed by a discussion of the University of North Carolina's regional planning efforts for continuing education. Major planning problems--aggregate numbers, continuing education suppliers, geographic distribution,…

Regional Meeting of Pacific Islands Women's Non-Governmental Organizations.

ERIC Educational Resources Information Center

South Pacific Commission, Noumea (New Caledonia).

Papers presented at a 1985 regional conference of the Pacific Islands Women's Non-Governmental Organizations are provided in this document. Each paper reports on a different country and discusses developmental issues relating to women's role, such as medical programs, health, social status and welfare, education, employment, and other subjects.…

Supporting international medical graduates in rural Australia: a mixed methods evaluation.

PubMed

Wright, Alistair; Regan, Melanie; Haigh, Cathy; Sunderji, Irum; Vijayakumar, Priyanga; Smith, Cathy; Nestel, Debra

2012-01-01

In Australia, international medical graduates (IMGs) make a substantial contribution to rural medical workforces. They often face significant communication, language, professional and cultural barriers, in addition to the other challenges of rural clinical practice. The Gippsland Inspiring Professional Standards among International Experts (GIPSIE) program was designed to provide educational support to IMGs across a large geographical region using innovative educational methods to ultimately build capacity in the provision of rural medical education. GIPSIE offered 5 sessions over 3 months. Simulation-based training was a prominent theme and addressed clinical knowledge, attitudes and skills and included a range of activities (eg procedural skills training with benchtop models, management of the acutely ill patient with SimMan, patient assessment skills with simulated patients). Diverse clinical communication skills were explored (eg teamwork, handover, telephone, critical information). Audiovisual review of performance was enabled through the use of iPod nano devices. GIPSIE was underpinned by a website offering diverse learning resources. Content experts were invited to lead sessions that integrated knowledge and skills reflecting local practice. IMGs were recruited from hospitals (n = 15) and general practices (n = 2) across the region. It was aimed to evaluate the impact of GIPSIE on the clinical practice of IMG participants. Evaluation measures included pre- and post-program 15 item multisource feedback (MSF), post-program questionnaires and, in order to address retention, telephone interviews exploring participants' responses 3 months after the program finished. Fifteen participants completed GIPSIE and rated the program highly, especially the simulation-based activities with feedback and later audiovisual review on iPods and the GIPSIE website. Suggestions were made to improve several aspects of the program. Participants reported increased knowledge, skills and professionalism after the program. Although overall MSF scores showed no statistically significant changes, there were positive directional changes for the items 'technical skills appropriate to current practice', 'willingness and effectiveness when teaching/training colleagues' and 'communication with carers and family'. These developments were also supported in free-text comments. Learning was reported to be sustained 3 months after the program. GIPSIE was highly valued by participants who reported improvements in clinical knowledge and skills. A range of professional issues were raised and addressed. GIPSIE seemed to provide a platform for further development. Although new to many participants, simulation was embraced as an educational method. The relationship between regional clinicians and the medical school was pivotal to success. A feature of the study was tracking improvements in clinical practice as a consequence of participating in the GIPSIE program. Future work needs to focus on further promoting the transfer of learning to the workplace. However the sustainability of these programs requires significant commitment.

Telemedicine Enables Broader Access to Movement Disorders Curricula for Medical Students.

PubMed

Cubo, Esther; Doumbe, Jacques; López, Emiliano; Lopez, Guadalupe A; Gatto, Emilia; Persi, Gabriel; Guttman, Mark

2017-01-01

The impact of tele-education for movement disorders on medical students is unknown. The present study had three objectives. First, to create a tele-education program for medical students in regions with limited access to movement disorders curricula. Second, to analyze the feasibility, satisfaction, and improvement of medical knowledge. Third, to assess the main reasons of medical students for attending this course. In 2016, a program was piloted in a low-middle income (Cameroon) and a middle-high income (Argentina) country. Medical students were offered a free movement disorder tele-education program (four medical schools in Argentina, and 1 medical school in Cameroon). Six real-time videoconferences covering hyperkinetic and hypokinetic movement disorders were included. Evaluations included attendance, pre- and post-medical knowledge, and satisfaction questionnaires. The study included 151 undergraduate medical students (79.4% from Argentina, 20.6% from Cameroon). Feasibility was acceptable with 100% and 85.7% of the videoconferences completed in Argentina and Cameroon, respectively. Attendance was higher in Argentina compared to Cameroon (75% vs. 33.1%). According to student reports, the topics and innovative educational environment were the main reasons for attendance. Both groups ranked satisfaction as moderate to high, and medical knowledge improved similarly in both countries. Tele-education can improve movement disorders knowledge in medical schools in high-middle and low-middle income countries lacking access to other educational opportunities.

Governance and assessment in a widely distributed medical education program in Australia.

PubMed

Solarsh, Geoff; Lindley, Jennifer; Whyte, Gordon; Fahey, Michael; Walker, Amanda

2012-06-01

The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes.

IMPGSS - International Medical Program Global Satellite System

DTIC Science & Technology

2004-02-01

additional comments regarding the significance of working with Tachyon and NASK under this Contract). 5.2.5 Requirements - Country/Region Assessments...services on a tentative exploratory basis by Tachyon ]. 5.2.7 Program Development Deliverable A 007 This is currently summarized in the Program Content...based satellite transmissions and transmission pricing based on segmented, limited use data volumes via Tachyon . " A more involved use of evaluation

The impact of HTA and procurement practices on the selection and prices of medical devices.

PubMed

Callea, Giuditta; Armeni, Patrizio; Marsilio, Marta; Jommi, Claudio; Tarricone, Rosanna

2017-02-01

Technological innovation in healthcare yields better health outcomes but also drives healthcare expenditure, and governments are struggling to maintain an appropriate balance between patient access to modern care and the economic sustainability of healthcare systems. Health Technology Assessment (HTA) and centralized procurement are increasingly used to govern the introduction and diffusion of new technologies in an effort to make access to innovation financially sustainable. However, little empirical evidence is available to determine how they affect the selection of new technologies and unit prices. This paper focuses on medical devices (MDs) and investigates the combined effect of various HTA governance models and procurement practices on the two steps of the MD purchasing process (i.e., selecting the product and setting the unit price). Our analyses are based on primary data collected through a national survey of Italian public hospitals. The Italian National Health Service is an ideal case study because it is highly decentralized and because regions have adopted different HTA governance models (i.e., regional, hospital-based, double-level or no HTA), often in combination with centralized regional procurement programs. Hence, the Italian case allows us to test the impact of different combinations of HTA models and procurement programs in the various regions. The results show that regional HTA increases the probability of purchasing the costliest devices, whereas hospital-based HTA functions more like a cost-containment unit. Centralized regional procurement does not significantly affect MD selection and is associated with a reduction in the MD unit price: on average, hospitals located in regions with centralized procurement pay 10.1% less for the same product. Hospitals located in regions with active regional HTA programs pay higher prices for the same device (+23.2% for inexpensive products), whereas hospitals that have developed internal HTA programs pay 8.3% on average more for the same product. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Transition from Tube to Oral Feeding in the School Setting

ERIC Educational Resources Information Center

McKirdy, Laura S.; Sheppard, Justine J.; Osborne, Mary L.; Payne, Pamela

2008-01-01

Purpose: A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills. Method: The program combined educational and therapeutic goals. It was implemented in a regional public school for children with…

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan.

PubMed

Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

2016-01-01

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs' fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups. © The Author(s) 2016.

Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

PubMed Central

Wham, George S.; Saunders, Ruth; Mensch, James

2010-01-01

Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r  =  0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R2  =  0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget. Conclusions: The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes. PMID:20064052

Problem-based learning in regional anatomy education at Peking University.

PubMed

Wang, Jun; Zhang, Weiguang; Qin, Lihua; Zhao, Jing; Zhang, Shuyong; Gu, Jin; Zhou, Changman

2010-01-01

Problem-based learning (PBL) has been introduced to medical schools around the world and has increasingly become a popular pedagogical technique in Asian countries since 1990. Gross anatomy is a fundamental basic science course in virtually all medical training programs, and the methods used to teach it are under frequent scrutiny and revision. Students often struggle with the vast collection of new terms and complex relationships between structures that they must learn. To help students with this process, our department teaches separate systemic and regional anatomy courses, the latter in a PBL format. After three years of using PBL in our regional anatomy course, we have worked out a set of effective instructions that we would like to share with other medical schools. We report here evidence that our clinical PBL approach stimulates students' interest in learning and enhances anatomy education in a way that can foster better practices in our future medical work force. (c) 2010 American Association of Anatomists.

SU-E-E-04: Building and Strengthening the First Master's Program in Medical Physics in The Gulf Region.

PubMed

Maalej, N; Al-Karmi, A; Al-Sadah, J; Abdel-Rahman, W

2012-06-01

The first medical physics Master's program in the Arabian Gulf region was started in 2002 at King Fahd University of Petroleum & Minerals (KFUPM), Dhahran, Saudi Arabia. After consulting with national and international representatives from the AAPM, IOMP, the University of Wisconsin-Madison and King Faisal Specialist Hospital and Research Center (KFSHRC) we constructed a versatile and rigorous curriculum. The program requires the completion of 7 core courses, 7 required labs, a minimum of 3 elective courses, a research project, a four-month clinical rotation and passing and a comprehensive examination. The success of the program required very close collaboration with national hospitals such as King Fahad Specialist Hospital in Dammam (KFSH-D), KFSHRC, and Riyadh Military Hospital. We cemented the collaboration with a formal agreement between KFUPM and KFSH-D, whereby the clinical medical physicists are actively involved in teaching lectures and labs, evaluating students' performance and co-supervising their clinical rotation and research projects. In order to prepare our graduates for their medical physics careers, we emphasize innovative learning methods such as students centered learning, execution of course projects, experiential learning and acquiring research skills and tools such as Monte Carlo simulations. Our graduates have succeeded in securing clinical positions in some of the best hospitals in the region and achieved high employer satisfaction. Some students have gone to pursue their PhD's in North America and Europe. Many of our students succeeded in publishing their projects in international journals and international conferences. One of our students was instrumental in obtaining a US patent (US Patent # 785298) for an innovative x-ray tube design. We have achieved national recognition through the excellence of our graduates. In order to maintain high education quality standards and achieve international recognition, we are presently working to acquire IAEA approval and CAMPEP accreditation. © 2012 American Association of Physicists in Medicine.

Does medical student membership in the gold humanism honor society influence selection for residency?

PubMed

Rosenthal, Susan; Howard, Brian; Schlussel, Yvette R; Lazarus, Cathy J; Wong, Jeffrey G; Moutier, Christine; Savoia, Maria; Trooskin, Stanley; Wagoner, Norma

2009-01-01

With the creation of the Gold Humanism Honor Society (GHHS) in 2002, the Arnold P. Gold Foundation established a mechanism for recognizing medical students who demonstrate exemplary humanism/professionalism/communication skills. Currently, 80 medical schools have GHHS chapters. Selection is based on peer nomination using a validated tool. The objective of this survey was to assess the percentage of residency program directors (PDs) who are aware of and are using GHHS membership as a residency selection tool. Surgery (SURG) and internal medicine (IM) PDs in 4 United States regions were surveyed for familiarity with GHHS and perceived rank of GHHS membership relative to Alpha Omega Alpha (AOA) membership, class rank, medical student performance evaluation (MSPE), clerkship grade, and United States Medical Licensing Examination (USMLE) score, in evaluating an applicant's humanism/professionalism, service orientation, and fit with their program. Program demographics and familiarity with GHHS were also surveyed. The response rate was 56% (149 respondents). IM PDs rated GHHS membership higher than did SURG PDs when evaluating professionalism/humanism and service orientation. PDs familiar with GHHS ranked membership higher when considering professionalism/humanism (4.1 vs 3.2; p < 0.05) and service orientation (4.1 vs 2.9; p < 0.01). Familiarity with GHHS correlated with being an IM PD, residency based at teaching hospital, large residency program, knowledge of residents who were GHHS members, and having a GHHS chapter at their school (p < 0.01). Familiarity with GHHS was related to rankings of GHHS (professionalism/humanism F = 3.36; p < 0.05; service orientation F = 3.86; p < 0.05) more than the PDs' specialty was. In all, 157 GHHS students (from all 4 United States regions) were also surveyed about the 1197 interviews they had with residency PDs. They reported that although a few PDs were aware of GHHS, PDs of core medical specialties were more aware of GHHS than SURG PDs. IM PDs were more aware of GHHS (70%) than SURG PDs (30%). Awareness was related to the favorable ranking of GHHS as a selection criterion for humanism/professionalism/service orientation. PDs familiar with GHHS were from larger programs, were likely to know residents who were members, and were likely to think that GHHS membership predicted humanistic care. Membership in GHHS may set candidates apart from their peers and allow PDs to distinguish objectively the candidates who demonstrate compassionate medical care. Increased knowledge about the GHHS may therefore serve to be a useful adjunct for PDs when selecting medical students for their residency programs.

Forecasting future needs and optimal allocation of medical residency positions: the Emilia-Romagna Region case study.

PubMed

Senese, Francesca; Tubertini, Paolo; Mazzocchetti, Angelina; Lodi, Andrea; Ruozi, Corrado; Grilli, Roberto

2015-01-30

Italian regional health authorities annually negotiate the number of residency grants to be financed by the National government and the number and mix of supplementary grants to be funded by the regional budget. This study provides regional decision-makers with a requirement model to forecast the future demand of specialists at the regional level. We have developed a system dynamics (SD) model that projects the evolution of the supply of medical specialists and three demand scenarios across the planning horizon (2030). Demand scenarios account for different drivers: demography, service utilization rates (ambulatory care and hospital discharges) and hospital beds. Based on the SD outputs (occupational and training gaps), a mixed integer programming (MIP) model computes potentially effective assignments of medical specialization grants for each year of the projection. To simulate the allocation of grants, we have compared how regional and national grants can be managed in order to reduce future gaps with respect to current training patterns. The allocation of 25 supplementary grants per year does not appear as effective in reducing expected occupational gaps as the re-modulation of all regional training vacancies.

Value of systematic intervention for chronic obstructive pulmonary disease in a regional Japanese city based on case detection rate and medical cost.

PubMed

Tawara, Yuichi; Senjyu, Hideaki; Tanaka, Kenichiro; Tanaka, Takako; Asai, Masaharu; Kozu, Ryo; Tabusadani, Mitsuru; Honda, Sumihisa; Sawai, Terumitsu

2015-01-01

We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs. We distributed a questionnaire to all 8,878 inhabitants aged 50-89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change. As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time. The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The success of this program suggests that a similar program could reduce the economic and human costs of COPD morbidity throughout Japan.

TRICARE: the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services (STS) program--DoD. Notice.

PubMed

1998-11-16

This notice is to advise interested parties that Brooke Army Medical Center (BAMC) and Wilford Hall Medical Center (WHMC), hereinafter referred to as Destination San Antonio, have been designated the Regional Specialized Treatment Service facilities (STSFs) for DRGs 1, 3, 4, 49, 104-107, 110-111, 191, 209, 491, 286, and 357. The application for the STSF designation was submitted by the Lead Agency for TRICARE Region 6 and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent will oversee that the STSFs maintain the quality and standards required for specialized treatment services. DoD beneficiaries residing within a 200-mile radius of Destination San Antonio facilities falling into the above patient category must be evaluated by Destination San Antonio staff before receiving care for these DRGs under direct military care or TRICARE/CHAMPUS cost sharing. Travel and lodging for the patient and, if stated to be medically necessary by a referring physician, for a nonmedical attendant, will be reimbursed by Destination San Antonio facility in accordance with the provisions of the Joint Federal Travel Regulation. Although evaluation in person is preferred, it is possible to conduct the evaluation telephonically if the patient is unable to travel to a Destination San Antonio facility. If the care for these DRGs cannot be performed at the Destination San Antonio facilities, the TRICARE Managed Care Support Contractor for Region 6 will provide a medical necessity review prior to issuance of an Inpatient Care Authorization or Non-availability Statement.

77 FR 71179 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... with high TRICARE volume) and regional-specific rates for psychiatric hospitals and units with low...

Challenges Facing Medical Residents' Satisfaction in the Middle East: A Report From United Arab Emirates.

PubMed

Abdulrahman, Mahera; Qayed, Khalil I; AlHammadi, Hisham H; Julfar, Adnan; Griffiths, Jane L; Carrick, Frederick R

2015-01-01

PHENOMENON: Medical residents' satisfaction with the quality of training for medical residency training specialists is one of the core measures of training program success. It will also therefore contribute to the integrity of healthcare in the long run. Yet there is a paucity of research describing medical residents' satisfaction in the Middle East, and there are no published studies that measure the satisfaction of medical residents trained within the United Arab Emirates (UAE). This makes it difficult to develop a quality residency training program that might meet the needs of both physicians and society. The authors designed a questionnaire to assess medical residents' satisfaction with the Dubai residency training program in order to identify insufficiencies in the training, clinical, and educational aspects. The survey was a self-report questionnaire composed of different subscales covering sociodemographic and educational/academic profile of the residents along with their overall satisfaction of their training, curriculum, work environment, peer teamwork, and their personal opinion on their medical career. Respondents showed a substantial level of satisfaction with the residency training. The vast majority of residents (80%, N = 88) believe that their residency program curriculum and rotation was "good," "very good," or "excellent." Areas of dissatisfaction included salary, excessive paperwork during rotations, and harassment. INSIGHTS: This is the first report that studies the satisfaction of medical residents in all specialties in Dubai, UAE. Our findings provide preliminary evidence on the efficiency of different modifications applied to the residency program in UAE. To our knowledge, there has not been any previous study in the Middle East that has analyzed this aspect of medical residents from different specialties. The authors believe that this report can be used as a baseline to monitor the effectiveness of interventions applied in the future toward improving residency training programs in this region.

AMIDE: a free software tool for multimodality medical image analysis.

PubMed

Loening, Andreas Markus; Gambhir, Sanjiv Sam

2003-07-01

Amide's a Medical Image Data Examiner (AMIDE) has been developed as a user-friendly, open-source software tool for displaying and analyzing multimodality volumetric medical images. Central to the package's abilities to simultaneously display multiple data sets (e.g., PET, CT, MRI) and regions of interest is the on-demand data reslicing implemented within the program. Data sets can be freely shifted, rotated, viewed, and analyzed with the program automatically handling interpolation as needed from the original data. Validation has been performed by comparing the output of AMIDE with that of several existing software packages. AMIDE runs on UNIX, Macintosh OS X, and Microsoft Windows platforms, and it is freely available with source code under the terms of the GNU General Public License.

Instructional Methods for Human Anatomy and Cell Biology in Nurse Anesthesia Graduate Programs: A Survey with a Focus on Regional Anesthesia

DTIC Science & Technology

1997-09-01

undergraduate nursing students . They concluded that students who did well in this course tended to perform better in nursing school overall...curriculum for the medical student of the 21st century: Gross anatomy. Clinical Anatomy. 9 (2), 71-99. Fitzgerald, M.J.T. (1992). Undergraduate medical...Road, Bethesda, MD 20814-4799. Student Registered Nurse Anesthetist (SRNA). 1991 -1995 1 st Medical Group, Langley Air Force Base, Virginia

Networking Matters: A Social Network Analysis of the Association of Program Directors of Internal Medicine.

PubMed

Warm, Eric; Arora, Vineet M; Chaudhry, Saima; Halvorsen, Andrew; Schauer, Daniel; Thomas, Kris; McDonald, Furman S

2018-03-22

Networking has positive effects on career development; however, personal characteristics of group members such as gender or diversity may foster or hinder member connectedness. Social network analysis explores interrelationships between people in groups by measuring the strength of connection between all possible pairs in a given network. Social network analysis has rarely been used to examine network connections among members in an academic medical society. This study seeks to ascertain the strength of connection between program directors in the Association of Program Directors in Internal Medicine (APDIM) and its Education Innovations Project subgroup and to examine possible associations between connectedness and characteristics of program directors and programs. We hypothesize that connectedness will be measurable within a large academic medical society and will vary significantly for program directors with certain measurable characteristics (e.g., age, gender, rank, location, burnout levels, desire to resign). APDIM program directors described levels of connectedness to one another on the 2012 APDIM survey. Using social network analysis, we ascertained program director connectedness by measuring out-degree centrality, in-degree centrality, and eigenvector centrality, all common measures of connectedness. Higher centrality was associated with completion of the APDIM survey, being in a university-based program, Educational Innovations Project participation, and higher academic rank. Centrality did not vary by gender; international medical graduate status; previous chief resident status; program region; or levels of reported program director burnout, callousness, or desire to resign. In this social network analysis of program directors within a large academic medical society, we found that connectedness was related to higher academic rank and certain program characteristics but not to other program director characteristics like gender or international medical graduate status. Further research is needed to optimize our understanding of connection in organizations such as these and to determine which strategies promote valuable connections.

Characteristics of nontrauma scene flights for air medical transport.

PubMed

Krebs, Margaret G; Fletcher, Erica N; Werman, Howard; McKenzie, Lara B

2014-01-01

Little is known about the use of air medical transport for patients with medical, rather than traumatic, emergencies. This study describes the practices of air transport programs, with respect to nontrauma scene responses, in several areas throughout the United States and Canada. A descriptive, retrospective study was conducted of all nontrauma scene flights from 2008 and 2009. Flight information and patient demographic data were collected from 5 air transport programs. Descriptive statistics were used to examine indications for transport, Glasgow Coma Scale Scores, and loaded miles traveled. A total of 1,785 nontrauma scene flights were evaluated. The percentage of scene flights contributed by nontraumatic emergencies varied between programs, ranging from 0% to 44.3%. The most common indication for transport was cardiac, nonST-segment elevation myocardial infarction (22.9%). Cardiac arrest was the indication for transport in 2.5% of flights. One air transport program reported a high percentage (49.4) of neurologic, stroke, flights. The use of air transport for nontraumatic emergencies varied considerably between various air transport programs and regions. More research is needed to evaluate which nontraumatic emergencies benefit from air transport. National guidelines regarding the use of air transport for nontraumatic emergencies are needed. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Patient-centered health care using pharmacist-delivered medication therapy management in rural Mississippi.

PubMed

Ross, Leigh Ann; Bloodworth, Lauren S

2012-01-01

To describe and provide preliminary clinical and economic outcomes from a pharmacist-delivered patient-centered health care (PCHC) model implemented in the Mississippi Delta. Mississippi between July 2008 and June 2010. 13 community pharmacies in nine Mississippi Delta counties. This PCHC model implements a comprehensive medication therapy management (MTM) program with pharmacist training, individualized patient encounters and group education, provider outreach, integration of pharmacists into health information technology, and on-site support in community pharmacies in a medically underserved region with a large burden of chronic disease and health disparities. The program also expands on traditional MTM services through initiatives in health literacy/cultural competency and efforts to increase the provider network and improve access to care. Criteria-based clinical outcomes, quality indicator reports, cost avoidance. PCHC services have been implemented in 13 pharmacies in nine counties in this underserved region, and 78 pharmacists and 177 students have completed the American Pharmacists Association's MTM Certificate Training Program. Preliminary data from 468 patients showed 681 encounters in which 1,471 drug therapy problems were identified and resolved. Preliminary data for clinical indicators and economic outcome measures are trending in a positive direction. Preliminary data analyses suggest that pharmacist-provided PCHC is beneficial and has the potential to be replicated in similar rural communities that are plagued with chronic disease and traditional primary care provider shortages. This effort aligns with national priorities to reduce medication errors, improve health outcomes, and reduce health care costs in underserved communities.

Special Deliveries: Certified Nurse-Midwifery Programs Lacking in New England

ERIC Educational Resources Information Center

Franzosa, Alyssa

2012-01-01

With Boston serving as a hub of both educational and medical excellence, it's no wonder that New England has a high reputation to uphold in both of these areas. However, Boston and the rest of the region lack a specific degree program that is putting New England below the radars of potential midwives. Certified nurse-midwifery is a popular field…

A Model Vocational High Technology in Health Care Demonstration Project. Final Performance Report.

ERIC Educational Resources Information Center

Valencia Community Coll., Orlando, FL.

A unique training program in high tech obstetrical, neonatal, and pediatric nursing care areas was designed to be offered on site at Orlando (Florida) Regional Medical/Arnold Palmer Hospital for Children and Women. The training program offered 16 different courses to 355 employees over the 18-month period of the project. A needs assessment was…

Undergraduate Education in Cancer in the European Region. Report on a UICC/WHO Meeting (Geneva, Switzerland, April 6-8, 1981).

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

The progress of undergraduate education in cancer in European countries was assessed, and recommendations were offered for further development according to the EURO program. Based on a survey of undergraduate education in medical schools of the European region, the following areas were evaluated: goals and objectives of teaching, tasks a general…

Program Capacity to Eliminate Outcome Disparities in Addiction Health Services

PubMed Central

Guerrero, Erick G.; Aarons, Gregory; Grella, Christine; Garner, Bryan R.; Cook, Benjamin; Vega, William A.

2014-01-01

We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010–2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed. PMID:25450596

Program Capacity to Eliminate Outcome Disparities in Addiction Health Services.

PubMed

Guerrero, Erick G; Aarons, Gregory A; Grella, Christine E; Garner, Bryan R; Cook, Benjamin; Vega, William A

2016-01-01

We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed.

Close to Home: Employment Outcomes for Recent Radiation Oncology Graduates

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

Ahmed, Awad A.; Holliday, Emma B.; Ileto, Jan

Purpose: To characterize the practice type and location of radiation oncology (RO) residents graduating in 2013. Methods and Materials: Graduates completing RO residency in 2013 were identified, and for each, postgraduate practice setting (academic vs private practice) and location were identified. Characteristics of the graduates, including details regarding their institutions of medical school and residency education, were collected and analyzed. Results: Data were obtained from 146 of the 154 RO graduates from the class of 2013. Employment data were available for 142 graduates. Approximately one-third of graduates were employed in the same state as residency (36.6%), approximately two-thirds (62.0%) in themore » same region as residency, and nearly three-fourths (73.9%) in the same region as medical school or residency completion. Of the 66 graduates (46.5%) working in academics, 40.9% were at the same institution where they completed residency. Most trainees (82.4%) attended medical schools with RO residency programs. Conclusions: Although personal factors may attract students to train in a particular area, the location of medical school and residency experiences may influence RO graduate practice location choice. Trends in the geographic distribution of graduating radiation oncologists can help identify and better understand disparities in access to RO care. Steps to improve access to RO care may include interventions at the medical student or resident level, such as targeting students at medical schools without associated residency programs and greater resident exposure to underserved areas.« less

Close to Home: Employment Outcomes for Recent Radiation Oncology Graduates.

PubMed

Ahmed, Awad A; Holliday, Emma B; Ileto, Jan; Yoo, Stella K; Green, Michael; Orman, Amber; Deville, Curtiland; Jagsi, Reshma; Haffty, Bruce G; Wilson, Lynn D

2016-07-01

To characterize the practice type and location of radiation oncology (RO) residents graduating in 2013. Graduates completing RO residency in 2013 were identified, and for each, postgraduate practice setting (academic vs private practice) and location were identified. Characteristics of the graduates, including details regarding their institutions of medical school and residency education, were collected and analyzed. Data were obtained from 146 of the 154 RO graduates from the class of 2013. Employment data were available for 142 graduates. Approximately one-third of graduates were employed in the same state as residency (36.6%), approximately two-thirds (62.0%) in the same region as residency, and nearly three-fourths (73.9%) in the same region as medical school or residency completion. Of the 66 graduates (46.5%) working in academics, 40.9% were at the same institution where they completed residency. Most trainees (82.4%) attended medical schools with RO residency programs. Although personal factors may attract students to train in a particular area, the location of medical school and residency experiences may influence RO graduate practice location choice. Trends in the geographic distribution of graduating radiation oncologists can help identify and better understand disparities in access to RO care. Steps to improve access to RO care may include interventions at the medical student or resident level, such as targeting students at medical schools without associated residency programs and greater resident exposure to underserved areas. Copyright © 2016 Elsevier Inc. All rights reserved.

Preparedness for practice: a systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice.

PubMed

Dijkstra, Ids S; Pols, Jan; Remmelts, Pine; Brand, Paul L P

2015-02-01

Postgraduate medical education training programs strive to prepare their trainees optimally for independent practice. Several studies have shown, however, that new consultants feel inadequately prepared for practice, and that this increases the risk of stress and burnout. To analyze across specialties for which tasks and themes new consultants feel inadequately prepared. And, to identify themes that need improved attention in postgraduate medical education programs or after registration. 330 New consultants from all hospital specialities with accredited training programs who completed their training in the north-eastern educational region of The Netherlands between 2004 and 2010 received a questionnaire which was based on a previously validated generic task inventory. 143 respondents (43%) returned the questionnaire. They felt excellently prepared for 40 tasks, well prepared for 25 tasks, marginally sufficiently prepared for 18 tasks and insufficiently prepared for 8 tasks. Preparedness scores were lowest for tasks concerning management administration and leadership, research, end-of-life care, and patient safety-related communication. Surgical specialists felt better prepared for practice than medical specialists, which could not be explained by differences in general self-efficacy. Although new consultants felt well prepared for medical tasks, the scores of more generic tasks indicate that the alignment between the different phases of the medical education continuum and independent practice needs improvement.

Association of Rapid Care Process Implementation on Reperfusion Times Across Multiple ST-Segment-Elevation Myocardial Infarction Networks.

PubMed

Fordyce, Christopher B; Al-Khalidi, Hussein R; Jollis, James G; Roettig, Mayme L; Gu, Joan; Bagai, Akshay; Berger, Peter B; Corbett, Claire C; Dauerman, Harold L; Fox, Kathleen; Garvey, J Lee; Henry, Timothy D; Rokos, Ivan C; Sherwood, Matthew W; Wilson, B Hadley; Granger, Christopher B

2017-01-01

The Mission: Lifeline STEMI Systems Accelerator program, implemented in 16 US metropolitan regions, resulted in more patients receiving timely reperfusion. We assessed whether implementing key care processes was associated with system performance improvement. Hospitals (n=167 with 23 498 ST-segment-elevation myocardial infarction patients) were surveyed before (March 2012) and after (July 2014) program intervention. Data were merged with patient-level clinical data over the same period. For reperfusion, hospitals were grouped by whether a specific process of care was implemented, preexisting, or never implemented. Uptake of 4 key care processes increased after intervention: prehospital catheterization laboratory activation (62%-91%; P<0.001), single call transfer protocol from an outside facility (45%-70%; P<0.001), and emergency department bypass for emergency medical services direct presenters (48%-59%; P=0.002) and transfers (56%-79%; P=0.001). There were significant differences in median first medical contact-to-device times among groups implementing prehospital activation (88 minutes implementers versus 89 minutes preexisting versus 98 minutes nonimplementers; P<0.001 for comparisons). Similarly, patients treated at hospitals implementing single call transfer protocols had shorter median first medical contact-to-device times (112 versus 128 versus 152 minutes; P<0.001). Emergency department bypass was also associated with shorter median first medical contact-to-device times for emergency medical services direct presenters (84 versus 88 versus 94 minutes; P<0.001) and transfers (123 versus 127 versus 167 minutes; P<0.001). The Accelerator program increased uptake of key care processes, which were associated with improved system performance. These findings support efforts to implement regional ST-segment-elevation myocardial infarction networks focused on prehospital catheterization laboratory activation, single call transfer protocols, and emergency department bypass. © 2017 American Heart Association, Inc.

The Central American Network for Disaster and Health Information.

PubMed

Arnesen, Stacey J; Cid, Victor H; Scott, John C; Perez, Ricardo; Zervaas, Dave

2007-07-01

This paper describes an international outreach program to support rebuilding Central America's health information infrastructure after several natural disasters in the region, including Hurricane Mitch in 1998 and two major earthquakes in 2001. The National Library of Medicine joined forces with the Pan American Health Organization/World Health Organization, the United Nations International Strategy for Disaster Reduction, and the Regional Center of Disaster Information for Latin America and the Caribbean (CRID) to strengthen libraries and information centers in Central America and improve the availability of and access to health and disaster information in the region by developing the Central American Network for Disaster and Health Information (CANDHI). Through CRID, the program created ten disaster health information centers in medical libraries and disaster-related organizations in six countries. This project served as a catalyst for the modernization of several medical libraries in Central America. The resulting CANDHI provides much needed electronic access to public health "gray literature" on disasters, as well as access to numerous health information resources. CANDHI members assist their institutions and countries in a variety of disaster preparedness activities through collecting and disseminating information.

Aviation and the delivery of medical care in remote regions: the Lesotho HIV experience.

PubMed

Furin, Jennifer; Shutts, Mike; Keshavjee, Salmaan

2008-02-01

In many regions of the world plagued by high burdens of disease, there is difficulty in accessing basic medical care. This is often due to logistical constraints and a lack of infrastructure such as roads. Medical aviation can play a major role in addressing some of these crucial issues as it allows for the rapid transport of patients, personnel, and medications to remote-and sometimes otherwise inaccessible-areas. Lesotho is a mountainous nation of 2 million people that provides a good example of medical aviation as a cornerstone in the delivery of health care. The population has a reported HIV seroprevalence of 25%, and many patients live in rural areas that are inaccessible by road. Mission Aviation Fellowship has joined forces with a medical team from the nongovernmental organization Partners In Health in an effort to launch a comprehensive program to address HIV and related problems in rural Lesotho. This medical aviation partnership has allowed for the provision of HIV prevention and treatment services to thousands of people living in the mountains. This commentary describes how medical aviation has been crucial in developing models to address complex, serious health problems in remote settings.

Vertical integration of medical education: Riverland experience, South Australia.

PubMed

Rosenthal, D R; Worley, P S; Mugford, B; Stagg, P

2004-01-01

Vertical integration of medical education is currently a prominent international topic, resulting from recent strategic initiatives to improve medical education and service delivery in areas of poorly met medical need. In this article, vertical integration of medical education is defined as 'a grouping of curricular content and delivery mechanisms, traversing the traditional boundaries of undergraduate, postgraduate and continuing medical education, with the intent of enhancing the transfer of knowledge and skills between those involved in the learning-teaching process'. Educators closely involved with vertically integrated teaching in the Riverland of South Australia present an analytical description of the educational dynamics of this system. From this analysis, five elements are identified which underpin the process of successful vertical integration: (1) raised educational stakes; (2) local ownership; (3) broad university role; (4) longer attachments; and (5) shared workforce vision. Given the benefits to the Riverland medical education programs described in this paper, it is not surprising that vertical integration of medical education is a popular goal in many rural regions throughout the world. Although different contexts will result in different functional arrangements, it could be argued that the five principles outlined in this article can be applied in any region.

Assessment of medical practitioners' knowledge of fibromyalgia in Saudi Arabia.

PubMed

Kaki, Abdullah Mohammad; Hazazi, Abdulaziz A

2018-01-01

Fibromyalgia (FM), a relatively common disease, is difficult to diagnose owing to its subjective symptoms and poor knowledge among medical practitioners. The purpose of this study was to assess the knowledge regarding FM among medical practitioners in Saudi Arabia and the need for educational programs at the undergraduate level. An online survey was administered to physicians, nurses, and technologist/technicians in different regions of the country. Responses were obtained from 104 medical practitioners. Knowledge regarding FM including clinical symptoms, diagnosis, and treatment was assessed. Only 26% of the respondents reported that FM was part of their undergraduate curriculum, and only 8.7% attended educational programs about FM. (Approximately 50% of the medical practitioners either referred FM patients to unrelated specialty or did not know whom to refer these patients to). Only 33.7% of the respondents were familiar with the diagnostic criteria. Physiotherapy (69.4%) and pharmacological treatment (63.9%) were predominantly reported as the appropriate treatment. Knowledge regarding FM among medical practitioners in Saudi Arabia is poor. Further education at the undergraduate level is needed to improve knowledge and avoid delays in diagnosis and treatment.

Neurology Training Worldwide.

PubMed

Hillis, James M; Berkowitz, Aaron L

2018-04-01

Neurology training is essential for providing neurologic care globally. Large disparities in availability of neurology training exist between higher- and lower-income countries. This review explores the worldwide distribution of neurology training programs and trainees, the characteristics of training programs in different parts of the world, and initiatives aimed at increasing access to neurology training in under-resourced regions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Entrepreneurial ventures and whole-body donations: a regional perspective from the United States.

PubMed

Anteby, Michel; Hyman, Mikell

2008-02-01

Human cadavers are crucial to medical science. While the debate on how to secure sufficient cadavers has focused primarily on donors' behaviors, procuring organizations' roles in increasing donations remain less explored. The United States offers a unique setting in which to examine this question since entrepreneurial ventures supplying cadavers for medical science have recently emerged alongside traditional academic-housed programs, raising both hopes and fears about their impact on whole-body donations. To assess their potential impact, an archival survey of voluntary, in-state whole-body donors to two programs procuring in the same U.S. state was conducted. The programs' specimen recipients were also analyzed. One program is academic-housed and the other is an entrepreneurial venture. Both offered equal levels of financial support to donating parties. Eighty donations and 120 specimen shipping invoices from 2005 were analyzed in each program. Donations to the two programs did not significantly differ in terms of donors' sex, marital status, maximum educational level, and estimated hourly wage. The entrepreneurial venture's donors were, however, significantly younger, more likely to be from a minority group, and more likely to have died from cancer. For-profit organizations, continuing medical training organizations, and medical device companies were more likely recipients of the entrepreneurial venture's specimens. Non-profit and academic organizations were more likely recipients of the academic-housed program's specimens. These findings suggest that although the programs procured from a somewhat similar pool of donors, they also complemented one another. The entrepreneurial program procured donations that the academic-housed program often did not attract. Specimen recipients' distinct demands partly explain these procurement behaviors. Thus, organizational efforts to meet demands seem to shape the supply. Examining organizations alongside donors might provide new answers to secure donations.

Continuing Medical Education

PubMed Central

Cameron, Douglas G.

1965-01-01

The proper role of departments of continuing medical education in the medical faculties of universities needs to be more clearly defined. Much of the initiative for the development of extramural postgraduate instruction in this country came from organized medicine. The individual practising doctor has traditionally made his needs known most effectively through his professional organizations and should be encouraged to continue to do so. The individual doctor, professional organizations, hospitals and medical schools are all vital elements in any successful program of continuing medical education. A variety of administrative patterns may well emerge, each adapted specially to the region it serves. With a sense of urgency and the co-operation of all concerned, rapid progress in this important field is clearly possible. PMID:14278032

Commentary: discovering a different model of medical student education.

PubMed

Watson, Robert T

2012-12-01

Traditional medical schools in modern academic health centers make discoveries, create new knowledge and technology, provide innovative care to the sickest patients, and educate future academic and practicing physicians. Unfortunately, the growth of the research and clinical care missions has sometimes resulted in a loss of emphasis on the general professional education of medical students. The author concludes that it may not be practical for many established medical schools to functionally return to the reason they were created: for the education of medical students.He had the opportunity to discover a different model of medical student education at the first new MD-granting medical school created in the United States in 25 years (in 2000), the Florida State University College of Medicine. He was initially skeptical about how its distributed regional campuses model, using practicing primary care physicians to help medical students learn in mainly ambulatory settings, could be effective. But his experience as a faculty member at the school convinced him that the model works very well.He proposes a better alignment of form and function for many established medical schools and an extension of the regional community-based model to the formation of community-based primary care graduate medical education programs determined by physician workforce needs and available resources.

75 FR 2515 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

...: This notice provides the updated regional per diem rates for low volume mental health providers; the... beneficiary per-diem cost-share amount for low-volume providers; and the updated per- [[Page 2516

The Arabian Gulf University College of Medicine and Medical Sciences: a successful model of a multinational medical school.

PubMed

Hamdy, Hossam; Anderson, M Brownell

2006-12-01

In the late 1970s, leaders of the Arabian [corrected] Gulf countries proposed a novel idea of a joint educational and cultural venture: establishing a new regional university based in the Kingdom of Bahrain that would be managed as a multinational consortium of Gulf countries including Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain. It was intended to promote higher education and research in the Gulf region; to serve the development needs of the region; to reflect the unique economic, social, and cultural attributes of the Gulf communities and their environments; and to respond to the health care needs of the member countries. Since its inception in 1982, the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU) has adopted the educational philosophy of problem-based learning (PBL) and self-directed, student-centered education. The curriculum is integrated, with early introduction of education to foster clinical skills and professional competencies. The strategic alliance with the health care systems in Bahrain and other Gulf regions has created a successful model of efficient and effective initialization of health care resources in the community. The experience that has accumulated at the AGU-CMMS from introducing innovative medical education has allowed it to take a leadership position in medical education in the Gulf region. The original goals of this unique experiment have been realized along with unanticipated outcomes of spearheading changes in medical education in the Gulf region. Old and new medical schools have adopted several characteristics of the AGU educational program. Several elements contributed to its success: a clear vision of providing quality medical education and realizing and sustaining this vision by a supportive leadership at the university and college levels; an alliance with the regional health care systems; a dedicated faculty who have been able to work as a team while continually developing themselves; proper student selection and the creation of a culture of student/faculty partnerships in education and in building an international reputation and credibility by cooperating with reputable international universities and organizations.

Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.

PubMed

Falcone, John L; Middleton, Donald B

2013-01-01

The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location. In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05. Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P < .001). The median pass rate per state was 86.4% (interquartile range, 82.0-90.8. χ(2) Tests showed that states in the West performed higher than the other 3 US Census Bureau Regions (all P < .001). Approximately half of the family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.

Needs assessment and evaluation of a short course to improve faculties teaching skills at a former World Health Organization regional teacher training center

PubMed Central

KOJURI, JAVAD; AMINI, MITRA; KARIMIAN, ZAHRA; DEHGHANI, MOHAMMAD REZA; SABER, MAHBOOBEH; BAZRAFCAN, LEILA; EBRAHIMI, SEDIGHEH; REZAEE, RITA

2015-01-01

Introduction: In the design of educational programs, much attention has been paid to teaching methods, needs assessment, an important part of the development of educational programs, generally is neglected. Another important aspect in educational program design is assessing effectiveness. The aims of this study were to design a formal needs assessment program to define the core contents of a faculty development program, and to determine whether participation in the faculty development program reinforced new teaching skills. Methods: A teacher-training program was designed at Shiraz University of Medical Sciences to help medical instructors boost their teaching skills. Needs assessment was done with nominal group technique followed by a 5-point Likert scale questionnaire. The program, imparted in workshop format, covered effective teaching methods, feedback, assessing knowledge and time management. Instruction was in the form of lectures, group discussions, case simulations, video presentations and role-plays. The program was evaluated in several phases using data triangulation and multi-item assessments of overall program quality in three major dimensions: Kirkpatrick program evaluation model, evaluation of the educational environment and qualitative analysis with open-ended questions. All participants in the study belonged to the academic staff of Shiraz University of Medical Sciences (n=396). Results: Seven main categories were derived from nominal group techniques and questionnaires. After the program, participants rated the quality of the program highly. They felt that the educational intervention was appropriate and had a positive impact on their knowledge of effective teaching methods, feedback, knowledge assessment and time management. Assessment of the effectiveness of the program showed that participants reported significant improvements in their teaching abilities. Conclusions: Our faculty development program  have a significant positive effect on medical university teaching staff members’ competencies. Further research is needed to investigate whether the faculty development program actually results in improved teaching performance. PMID:25587548

Regional group purchasing of vaccines: review of the Pan American Health Organization EPI revolving fund and the Gulf Cooperation Council group purchasing program.

PubMed

DeRoeck, Denise; Bawazir, Saleh A; Carrasco, Peter; Kaddar, Miloud; Brooks, Alan; Fitzsimmons, John; Andrus, Jon

2006-01-01

This paper reviews the key design features, accomplishments of and lessons learned from two regional group procurement mechanisms dealing with vaccines that have been in operation for more than 25 years. The Pan American Health Organization (PAHO) EPI Revolving Fund purchases vaccines and immunization supplies on behalf of more than 35 countries in the Latin American and Caribbean region. Based on a 'central contracting' model, the program handles most aspects of procurement-from tendering to contracting with and paying producers--using a common fund to pay producers before being reimbursed by countries once goods are received in-country. The Gulf Cooperation Council (GCC) Group Purchasing Program among seven Persian Gulf States issues joint tenders for vaccines, as well as drugs and other medical goods. Through this 'group contracting' program, countries are responsible for contracting with and paying producers on their own, once the group has selected winning bids. Both programs have experienced substantial growth in the past two decades and are considered to have contributed to or accelerated achievements of immunization programs in both regions, including the introduction of new vaccines. The paper identifies several features of both programs--both those designed to attract country participation and those designed to ensure the programs' financial viability--which help explain their success and longevity.

Virtual rapid response: the next evolution of tele-ICU.

PubMed

Hawkins, Carrie L

2012-01-01

The first of its kind in the Veterans Affairs (VA) system, the Denver VA Medical Center's tele-intensive care unit (ICU) program is unique because it is entirely nurse driven. A nontraditional tele-ICU model, the program was tailored to meet the needs of rural veterans by using critical care nursing expertise in Denver, Colorado. An experienced CCRN-certified nurse manages the system 24 hours a day, 7 days a week, from Eastern Colorado Health Care System. The virtual ICU provides rapid response interventions through virtual technology. This tele-ICU technology allows for a "virtual handshake" by nursing staff at the start of the shift and a report on potential patient issues. Clinical relationships have been strengthened between all 5 VA facilities in the Rocky Mountain Region, increasing the likelihood of early consultation at the onset of clinical decline of a patient. In addition, the tele-ICU nurse is available for immediate nursing consultation and support, coordinates point-to-point virtual consultation between physicians at the rural sites and specialists in Denver, and assists in expediting critical care transfers. The primary objectives for the tele-ICU program include improving quality and access of care to critical care services in rural sites, reducing community fee basis costs and frequency of transfers, and increasing collaboration and collegiality among nursing and medical staff in all Region 19's medical centers.

Training physicians for community-oriented primary care in Latin America: model programs in Mexico, Nicaragua, and Costa Rica.

PubMed Central

Braveman, P A; Mora, F

1987-01-01

Under the rubrics of preventive and social medicine, public health, and family and community medicine, medical educators in Latin America have developed programs to train physicians for community-oriented health care (COPC). The historical background for such programs in Latin America is reviewed. Three relevant examples of programs in Mexico, Nicaragua, and Costa Rica are highlighted, drawing on the author's direct experience with and in these faculties. The paper addresses the relation between these programs and national and regional trends in education and services. PMID:3826469

Assessing the risk of work-related international travel.

PubMed

Druckman, Myles; Harber, Philip; Liu, Yihang; Quigley, Robert L

2014-11-01

To identify factors affecting the likelihood of requiring medical services during international business trips. Data from more than 800,000 international trips and medical assistance cases provided to 48 multinational corporations in 2009. Travel destination countries were grouped into four a priori risk-related categories. Travel to "low" medical risk countries in aggregate accounted for more hospitalizations and medical evacuations than travel to "high" medical risk countries. Nevertheless, the risk per trip was much higher for travel to higher medical risk countries. Corporations with employees on international travel should allocate sufficient resources to manage and ideally prevent medical issues during business travel. Travel medicine must focus on more than infectious diseases, and programs are necessary for both high- and low-risk regions. Improved understanding of travel-related needs determines resource allocation and risk mitigation efforts.

Restructuring VA ambulatory care and medical education: the PACE model of primary care.

PubMed

Cope, D W; Sherman, S; Robbins, A S

1996-07-01

The Veterans Health Administration (VHA) Western Region and associated medical schools formulated a set of recommendations for an improved ambulatory health care delivery system during a 1988 strategic planning conference. As a result, the Department of Veterans Affairs (VA) Medical Center in Sepulveda, California, initiated the Pilot (now Primary) Ambulatory Care and Education (PACE) program in 1990 to implement and evaluate a model program. The PACE program represents a significant departure from traditional VA and non-VA academic medical center care, shifting the focus of care from the inpatient to the outpatient setting. From its inception, the PACE program has used an interdisciplinary team approach with three independent global care firms. Each firm is interdisciplinary in composition, with a matrix management structure that expands role function and empowers team members. Emphasis is on managed primary care, stressing a biopsychosocial approach and cost-effective comprehensive care emphasizing prevention and health maintenance. Information management is provided through a network of personal computers that serve as a front end to the VHA Decentralized Hospital Computer Program (DHCP) mainframe. In addition to providing comprehensive and cost-effective care, the PACE program educates trainees in all health care disciplines, conducts research, and disseminates information about important procedures and outcomes. Undergraduate and graduate trainees from 11 health care disciplines rotate through the PACE program to learn an integrated approach to managed ambulatory care delivery. All trainees are involved in a problem-based approach to learning that emphasizes shared training experiences among health care disciplines. This paper describes the transitional phases of the PACE program (strategic planning, reorganization, and quality improvement) that are relevant for other institutions that are shifting to training programs emphasizing primary and ambulatory care.

Canada's new medical school: The Northern Ontario School of Medicine: social accountability through distributed community engaged learning.

PubMed

Strasser, Roger P; Lanphear, Joel H; McCready, William G; Topps, Maureen H; Hunt, D Dan; Matte, Marie C

2009-10-01

Like many rural regions around the world, Northern Ontario has a chronic shortage of doctors. Recognizing that medical graduates who have grown up in a rural area are more likely to practice in the rural setting, the Government of Ontario, Canada, decided in 2001 to establish a new medical school in the region with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM) is a joint initiative of Laurentian University and Lakehead University, which are located 700 miles apart. This paper outlines the development and implementation of NOSM, Canada's first new medical school in more than 30 years. NOSM is a rural distributed community-based medical school which actively seeks to recruit students into its MD program who come from Northern Ontario or from similar northern, rural, remote, Aboriginal, Francophone backgrounds. The holistic, cohesive curriculum for the MD program relies heavily on electronic communications to support distributed community engaged learning. In the classroom and in clinical settings, students explore cases from the perspective of physicians in Northern Ontario. Clinical education takes place in a wide range of community and health service settings, so that the students experience the diversity of communities and cultures in Northern Ontario. NOSM graduates will be skilled physicians ready and able to undertake postgraduate training anywhere, but with a special affinity for and comfort with pursuing postgraduate training and clinical practice in Northern Ontario.

Risk factors associated with academic difficulty in an Australian regionally located medical school.

PubMed

Malau-Aduli, Bunmi S; O'Connor, Teresa; Ray, Robin A; van der Kruk, Yolanda; Bellingan, Michelle; Teague, Peta-Ann

2017-12-28

Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal. This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated. The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them. This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

Successes, challenges and needs regarding rural health medical education in continental Central America: a literature review and narrative synthesis.

PubMed

Colon-Gonzalez, Maria C; El Rayess, Fadya; Guevara, Sara; Anandarajah, Gowri

2015-01-01

Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. A comprehensive literature review was conducted between December 2013 and May 2014. The stepwise, reproducible search process included English and Spanish language resources from both data-based web search engines (PubMed, Web of Science/Web of Knowledge, ERIC and Google Scholar) and the grey literature. Search criteria included MeSH terms: 'medical education', 'rural health', 'primary care', 'community medicine', 'social service', in conjunction with 'Central America', 'Latin America', 'Mexico', 'Guatemala', 'Belize', 'El Salvador', 'Nicaragua', 'Honduras', 'Costa Rica' and 'Panama'. Articles were included in the review if they (1) were published after 1984; (2) focused on medical education for rural health, primary care, community health; and (3) involved the countries of interest. A narrative synthesis of the content of resources meeting inclusion criteria was done using qualitative research methods to identify common themes pertaining to the study goals. The search revealed 20 resources that met inclusion criteria. Only four of the 20 were research articles; therefore, information about this subject was primarily derived from expert opinion. Thematic analysis revealed the historical existence of several innovative programs that directly address rural medicine training needs, suggesting that expertise is present in this region. However, numerous challenges limit sustainability or expansion of successful programs. Common challenges include: (a) physicians' exposure to rural medicine primarily takes place during social service commitment time, rather than during formal medical training; (b) innovative educational programs are often not sustainable due to financial and leadership challenges; (c) the majority of physician manpower is in urban areas, resulting in few rural physician role models and teachers; and (d) there is insufficient collaboration to establish clinical and educational systems to meet rural health needs. Recurring suggestions for curricular changes include: (a) making primary care training a core component of medical school education; and (b) expanding medical school curricula in cross-cultural communication and social determinants of disease. Suggestions for health system changes include: (a) improving living and working conditions for rural physicians; and (b) establishing partnerships between educational, governmental and non-governmental organizations and rural community leadership, to promote rural health training and systems. Expertise in rural medicine and training exists in continental Central America. However, there are numerous challenges to improving medical education to meet the needs of rural communities. Overcoming these challenges will require creative solutions, new partnerships, and evaluation and dissemination of successful educational programs. There is a great need for further research on this topic.

Evaluation of the national health surveillance program of workers previously exposed to asbestos in Spain (2008).

PubMed

Gómez, Montserrat García; Castañeda, Rosario; López, Vega García; Vidal, Manuel Martínez; Villanueva, Vicent; Espinosa, Mercedes Elvira

2012-01-01

Although asbestos was banned in Spain in 2001, monitoring the health of previously-exposed workers is required. In 2002 the Ministry of Health and the autonomous regions of Spain planned a health surveillance program for workers exposed to asbestos (Programa de Vigilancia de la Salud de los Trabajadores Expuestos al Amianto [PIVISTEA]) with employers' organizations, trade unions and scientific societies. The aim of this study was to evaluate the PIVISTEA to improve its effectiveness. A questionnaire with indicators for the year 2008 was sent to Spain's 17 autonomous regions, as well as to the autonomous cities of Ceuta and Melilla. The results were analyzed by evaluating the compliance of each program with the activities established by the PIVISTEA. In December 2008, a total of 22,158 workers from 14 autonomous regions and 306 companies were included in the program. The program had been started in 88% of the regions but surveillance activities remained scarce in 24%. Fifty-seven percent of the autonomous regions (69% of the total number of workers) provided the information requested. Seven autonomous regions provided data on the relationship between the diseases found and asbestos exposure. Only 5% of these diseases entitled affected individuals to receive compensation for occupational diseases. The health surveillance of workers previously exposed to asbestos in Spain, as well as medical-legal recognition of diseases caused by exposure at work, remain in adequate. Although the trend is positive, the effectiveness of many regional programs is limited, and inter-regional inequalities among affected workers have been detected. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study.

PubMed

Yoo, Jae Hyun; Oh, Yunhye; Jang, Byongsu; Song, Jihye; Kim, Jiwon; Kim, Seonwoo; Lee, Jiyoung; Shin, Hye-Yeon; Kwon, Jeong-Yi; Kim, Yun-Hee; Jeong, Bumseok; Joung, Yoo-Sook

2016-11-30

Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates. Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals. After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul's ADHD Rating Scale-Korean version. Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.

The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study

PubMed Central

Yoo, Jae Hyun; Oh, Yunhye; Jang, Byongsu; Song, Jihye; Kim, Jiwon; Kim, Seonwoo; Lee, Jiyoung; Shin, Hye-Yeon; Kwon, Jeong-Yi; Kim, Yun-Hee; Jeong, Bumseok; Joung, Yoo-Sook

2016-01-01

Objective Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates. Methods Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals. Results After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul’s ADHD Rating Scale-Korean version. Conclusion Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement. PMID:27776388

76 FR 5407 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... Antarctica and to certain regions of the Arctic under the auspices of the United States Antarctic Program are.... National Science Foundation--Polar Physical Examination (Antarctica/Arctic/Official Visitors) Medical... disqualified, the reasons. 2. Polar Physical Examination--Antarctica/Arctic, will be used by the individual's...

Nationwide survey of cancer center programs in Korea

PubMed Central

Kim, Ji-Youn; Yi, Eun-Surk

2017-01-01

This study was conducted to investigate cancer centers established for the purpose of satisfying various needs about cancer, improving the cancer treatment environment, and subdividing services ranging from diagnosis, treatment, and rehabilitation to palliative care. To this end, the authors have surveyed programs in 17 cancer centers representing Korea, including 12 national cancer centers and five major hospitals. As a result, it was found that the most common type of lecture program was disease management, followed by health care and hospitalization, while the most common type of participation program was psychological relief, followed by physical activity. The most frequently operated type of program was found to be psychological relief, followed by physical activity and health care in the regional cancer centers, while the most frequently operated type was disease management, followed by psychological relief and health care in the five major hospitals. The proportion of physical activity was very high in two regional cancer centers, whereas five regional cancer centers did not offer physical activity programs at all. In the five major hospitals, physical activity programs were conducted regularly at least once a month or at least once a week. In addition, further studies are required to provide professional and detailed medical services for the establishment and operation of programs for cancer patient management and the environmental aspects of the hospital. PMID:28702441

The View Behind and Ahead: Implications of Certification *

PubMed Central

Darling, Louise

1973-01-01

The Medical Library Association's certification plan, never of real significance in employment and promotion practices in health sciences librarianship, does not reflect the many changes which have occurred in swift progression since adoption of the code in 1949. Solutions to the problems which have accumulated since then are sought in a brief examination of trends in credentialing and certification in the health professions and in the library field, both general and special. Emphasis is given to the historical development of provisions in the MLA Code for the Training and Certification of Medical Librarians, the limited opportunity for practical implementation of most of the provisions, the importance of the code in stimulating the Association's educational programs, the impact of the Medical Library Assistance Act, Regional Medical Programs, and increases in demand for health information on manpower requirements for health science libraries, the specific dissatisfactions MLA members have expressed over certification, and the role of the Ad Hoc Committee to Develop a New Certification Code. PMID:4744343

Telemedicine as an innovative model for rebuilding medical systems in developing countries through multipartnership collaboration: the case of Albania.

PubMed

Latifi, Rifat; Dasho, Erion; Shatri, Zhaneta; Tilley, Elizabeth; Osmani, Kalterina L; Doarn, Charles R; Dogjani, Agron; Olldashi, Fatos; Koçiraj, Agim; Merrell, Ronald C

2015-06-01

The U.S. Government and other developed nations provide billions of dollars annually in relief assistance to countries around the world. The long-term benefits of this aid, however, are often difficult to elucidate. The aim of this article is to present a model of a multipartnership collaboration among U.S. governmental, nongovernmental organizations, and academia to rebuild medical systems using telemedicine as a sustainable model of foreign aid. The International Virtual e-Hospital implemented the "initiate-build-operate-transfer" strategy to establish an effective telemedicine system in Albania that includes the National Telemedicine Center and 12 regional telemedicine centers. This nationwide telemedicine network has active clinical programs, virtual educational programs, and an electronic library that has substantially improved the access to care while advancing medical education. We propose that telemedicine is an optimal, sustainable, low-cost model for rebuilding medical systems of developing countries when implemented through a multipartnership approach.

James Cook University's rurally orientated medical school selection process: quality graduates and positive workforce outcomes.

PubMed

Ray, Robin A; Woolley, Torres; Sen Gupta, Tarun

2015-01-01

The regionally based James Cook University (JCU) College of Medicine and Dentistry aims to meet its mission to address the health needs of the region by using a selection policy favouring rural origin applicants and providing students with early and repeated exposure to rural experiences during training. This study seeks to determine if the JCU medical school's policy of preferentially selecting rural and remote background students is associated with differing patterns of undergraduate performance or graduate practice location. Data at application to medical school and during the undergraduate years was retrieved from administrative databases held by the university and the medical school. Postgraduate location data were obtained either from personal contact via email, telephone or Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (ASGC-RA) categories, with 1 being a major city and 5 being a very remote location. The 856 Australian-based students accepted into the JCU medical program between 2000 and 2008 came from all geographical regions across Australia: 20% metropolitan (ASGC-RA 1), 20% inner regional (ASGC-RA 2), 56% outer regional (ASGC-RA 3), and 5% from remote or very remote locations (ASGC-RA 4 and 5). Having a rural or remote hometown at application (ASGC-RA 3-5) was significantly associated with a lower tertiary entrance score (p<0.001), a lower interview score in the medical school selection process (p<0.001), being less likely to be admitted into the Honours program (p=0.001), being an advanced standing student (p=0.025), being awarded a Medical Rural Bonded Scholarship (p=0.005), taking longer to complete the 6-year course (p=<0.009) and having a lower academic achievement across years 1 to 3 (p=0.002, p=0.005 and p=0.025, respectively). Graduates having either a rural or a remote home town at application were more likely to practise in rural (RA 3-5) towns than graduates from metropolitan/inner regional centre across all postgraduate years. For example, the prevalence odds ratios (POR) for graduates practising in a rural town at postgraduate year 1 (PGY 1) having either a rural or remote hometown were 2.6 and 1.8, respectively, times that of graduates having a metropolitan/inner regional hometown, while at PGY 9 the PORs had increased to 4.2 and 9.5, respectively. Bonded medical place students showed many similar trends to rural students in both their pre-medical school and undergraduate performance indicators but lower engagement in rural practice in the 5 years of data available. Some significant differences were noted between rural and remote origin students and metropolitan or inner regional origin students in terms of academic achievement in the first 3 years of the course and length of time taken to complete the course. However, this group of rural and remote-origin students seems to do just as well in the exams in the clinical years (years 4-6) and are much more likely to practise in rural and remote areas. These data suggest that JCU's selection process favouring rural origin applicants does not compromise academic standards, but does produce graduates whose patterns of practice accord with the mission of the school.

State of the art in telemedicine - concepts, management, monitoring and evaluation of the telemedicine programme in Alentejo (Portugal).

PubMed

Oliveira, Tiago Cravo; Branquinho, Maria José; Gonçalves, Luís

2012-01-01

Alentejo - one of five Portuguese continental regions - faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program. From 1998 until 2000, the program developed in an experimental fashion, with teleconsultations involving a number of providers: primary health care centers, regional hospitals, and central hospitals. Between 2000 and 2010, there were a total of 135,000 telemedicine acts including teleconsultations, teleradiology (computerised tomography and x-rays), ultrasound telemedicine and telepathology. Presently, the network comprises 20 health centers and 6 hospitals, covering 4 districts. The platform is composed of high resolution videoconferencing equipment, software with patients' clinical records, an image archive, and a number of peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are provided by fifteen medical specialties, across 3 district hospitals, ranging from neurology to pediatric surgery. In 2008, health authorities started the telelearning program, initially using point to point videoconferencing, and by the end of 2010, 848 healthcare professionals, across 52 locations, had participated in remote learning sessions, covering topics from chronic wound treatment, to infection control, to medical error. As of 2011, point to multipoint telelearning is also in operation. This paper provides an overview of the telemedicine program in Alentejo, including both infrastructure and operations. Preliminary results of an ongoing evaluation of the impact of teleconsultations on key indicators of the regional healthcare system are also presented (including current utilization and plans for future expansion). This article builds on the experience acquired throughout a decade of using telemedicine on an everyday basis, in a context of remarkable challenges in the delivery of accessible, equitable and quality healthcare services.

New regulations regarding Postgraduate Medical Training in Spain: perception of the tutor's role in the Murcia Region

PubMed Central

2010-01-01

Background Recently introduced regulatory changes have expanded the Tutor role to include their primary responsibility for Postgraduate Medical Training (PMT). However, accreditation and recognition of that role has been devolved to the autonomic regions. The opinions of the RT may be relevant to future decisions; Methods A comprehensive questionnaire, including demographic characteristics, academic and research achievement and personal views about their role, was sent to 201 RTs in the Murcia Region of Spain. The responses are described using median and interquartile ranges (IQR); Results There were 147 replies (response rate 73%), 69% male, mean age 45 ± 7 yrs. RTs perception of the residents' initial knowledge and commitment throughout the program was 5 (IQR 4-6) and 7 (IQR 5-8), respectively. As regards their impact on the PMT program, RTs considered that their own contribution was similar to that of senior residents. RTs perception of how their role was recognised was 5 (IQR 3-6). Only 16% did not encounter difficulties in accessing specific RT training programs. Regarding the RTs view of their various duties, supervision of patient care was accorded the greatest importance (64%) while the satisfactory completion of the PMT program and supervision of day-to-day activities were also considered important (61% and 59% respectively). The main RT requirements were: a greater professional recognition (97%), protected time (95%), specific RT training programs (95%) and financial recognition (86%); Conclusions This comprehensive study, reflecting the feelings of our RTs, provides a useful insight into the reality of their work and the findings ought to be taken into consideration in the imminent definitive regulatory document on PMT. PMID:20540814

The Central American Network for Disaster and Health Information

PubMed Central

Arnesen, Stacey J.; Cid, Victor H.; Scott, John C.; Perez, Ricardo; Zervaas, Dave

2007-01-01

Purpose: This paper describes an international outreach program to support rebuilding Central America's health information infrastructure after several natural disasters in the region, including Hurricane Mitch in 1998 and two major earthquakes in 2001. Setting, Participants, and Description: The National Library of Medicine joined forces with the Pan American Health Organization/World Health Organization, the United Nations International Strategy for Disaster Reduction, and the Regional Center of Disaster Information for Latin America and the Caribbean (CRID) to strengthen libraries and information centers in Central America and improve the availability of and access to health and disaster information in the region by developing the Central American Network for Disaster and Health Information (CANDHI). Through CRID, the program created ten disaster health information centers in medical libraries and disaster-related organizations in six countries. Results/Outcome: This project served as a catalyst for the modernization of several medical libraries in Central America. The resulting CANDHI provides much needed electronic access to public health “gray literature” on disasters, as well as access to numerous health information resources. CANDHI members assist their institutions and countries in a variety of disaster preparedness activities through collecting and disseminating information. PMID:17641767

A regional prehospital electrocardiogram network with a single telecardiology "hub" for public emergency medical service: technical requirements, logistics, manpower, and preliminary results.

PubMed

Brunetti, Natale Daniele; De Gennaro, Luisa; Dellegrottaglie, Giulia; Amoruso, Daniele; Antonelli, Gianfranco; Di Biase, Matteo

2011-11-01

In patients with a major cardiac event, the first priority is to minimize time-to-treatment. For many patients, the first and fastest contact with the health system is through emergency medical services (EMS). However, delay to treatment is still significant in developed countries, and international guidelines therefore recommend that EMS use prehospital electrocardiogram (ECG). Many communities are implementing prehospital ECG programs, with different technical solutions. We report on a region-wide prehospital ECG telecardiology program that involved 233,657 patients from all over Apulia (4 million inhabitants), Italy, who called the public regional free EMS telephone number "118." Prehospital ECG was transmitted by mobile phone to a single regional telecardiology "hub" where a cardiologist available 24/7 promptly reported the ECG, having a briefing with on-scene EMS personnel and EMS district central; patients were then directed to fibrinolysis or primary percutaneous coronary intervention (PCI) as appropriate. Patients were >70 years in 51% of cases, and 55% of prehospital ECGs were unremarkable; the remaining 45% showed signs suggesting acute coronary syndrome (ACS) in 18%, arrhythmias in 20%, and minor findings in 62%. In cases of suspected ACS (chest pain), ECG findings were normal in 77% of patients; 74% of subjects with suspected ACS were screened within 30' from the onset of symptoms. A regional single telecardiology hub providing prehospital ECG for a sole regional public EMS provides an example of a prehospital ECG network optimizing quality of ECG report and uniformity of EMS assistance in a large region-wide network.

The Use of Market Analysis in Determining Resource Allocations for the Exceptional Family Member Program in USAREUR Landstuhl Army Regional Medical Center, Landsthul, Germany

DTIC Science & Technology

1984-08-01

tests, interviews, and behavioral evaluations. (5) Planning and managing a program of psychological services, including psychological counseling for...Establish capability to provide health related services at realistic levels at OCONUS locations consistent with prevalence rates of manageable ...Health Care Delivery in the United States, New Yori: Springer Publishing Ccmpany, 1981. Kotler , Philip. varketing NLaagement, Ne Jersey: Prentice-Hall

Naval Medical R and D News

DTIC Science & Technology

2017-01-01

person- days were lost among U.S. military personnel due to malaria than to bullets during every military campaign fought in malaria-endemic regions...is Hospital Corpsman Second Class Alison Heads, and the Blue Jacket of the Year award is Hospital Corpsman Third Class Justin L. Heads. Chief...Every Day Is World AIDS Day for the DoD HIV/AIDS Prevention Program SAN DIEGO — The DoD HIV/AIDS Prevention Program (DHAPP), which is

Using Volunteers to Help Expectant Mothers and Their Infants.

ERIC Educational Resources Information Center

Landolt, Terry

1985-01-01

Describes new Appalachian Regional Commission model health care program linking expectant mothers/infants with volunteers familiar with available resources to provide prenatal medical care, assistance in modifying personal habits potentially harmful to unborn infants, nutritional supplements and advice, and social service assistance. Includes 1982…

Internships | NREL

Science.gov Websites

Apply here Contact: nrel.education@nrel.gov Benefits and Opportunities at a Glance NREL Undergraduate NREL's sponsored internships. Learn more Benefits Option to enroll in medical benefits (if working 30 undergraduate education and research program. Learn more SULI Benefits Salary - $625 per week Regional

76 FR 5405 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... Antarctica and to certain regions of the Arctic under the auspices of the United States Antarctic Program are... Science Foundation--Polar Physical Examination (Antarctica/Arctic/Official Visitors) Medical History, will... disqualified, the reasons. 2. Polar Physical Examination--Antarctica/Arctic, will be used by the individual's...

Classification and disease prediction via mathematical programming

NASA Astrophysics Data System (ADS)

Lee, Eva K.; Wu, Tsung-Lin

2007-11-01

In this chapter, we present classification models based on mathematical programming approaches. We first provide an overview on various mathematical programming approaches, including linear programming, mixed integer programming, nonlinear programming and support vector machines. Next, we present our effort of novel optimization-based classification models that are general purpose and suitable for developing predictive rules for large heterogeneous biological and medical data sets. Our predictive model simultaneously incorporates (1) the ability to classify any number of distinct groups; (2) the ability to incorporate heterogeneous types of attributes as input; (3) a high-dimensional data transformation that eliminates noise and errors in biological data; (4) the ability to incorporate constraints to limit the rate of misclassification, and a reserved-judgment region that provides a safeguard against over-training (which tends to lead to high misclassification rates from the resulting predictive rule) and (5) successive multi-stage classification capability to handle data points placed in the reserved judgment region. To illustrate the power and flexibility of the classification model and solution engine, and its multigroup prediction capability, application of the predictive model to a broad class of biological and medical problems is described. Applications include: the differential diagnosis of the type of erythemato-squamous diseases; predicting presence/absence of heart disease; genomic analysis and prediction of aberrant CpG island meythlation in human cancer; discriminant analysis of motility and morphology data in human lung carcinoma; prediction of ultrasonic cell disruption for drug delivery; identification of tumor shape and volume in treatment of sarcoma; multistage discriminant analysis of biomarkers for prediction of early atherosclerois; fingerprinting of native and angiogenic microvascular networks for early diagnosis of diabetes, aging, macular degeneracy and tumor metastasis; prediction of protein localization sites; and pattern recognition of satellite images in classification of soil types. In all these applications, the predictive model yields correct classification rates ranging from 80% to 100%. This provides motivation for pursuing its use as a medical diagnostic, monitoring and decision-making tool.

Establishing a composite tissue allotransplantation program.

PubMed

Pomahac, Bohdan

2012-01-01

Composite tissue allotransplantation (CTA) has emerged as a promising surgical option to restore the form and function of missing or severely damaged structures such as the face, hands, or trachea. Currently, there are four active CTA programs in the United States and numerous others under development. The process of development of a CTA program in the United States involves successful collaboration between a strong project leader with vested clinical research interest, a multidisciplinary team of investigators, an Institutional Review Board, a regional Organ Processing Organization (PO), and the hospital's administration. The process of establishment of a CTA program can be slow and lengthy, therefore the project leader must strive to maintain the enthusiasm alive and drive the project forward. At all phases of development, the project must remain focused on the patients, must recognize and address all potential patient safety issues, must take into account the concerns, issues and logistic hurdles faced by the OPO, and must be financially responsible by ensuring that postoperative costs related to medical care and life-long immunosuppression are covered by medical insurance. This article describes the process of establishment of a CTA program at Brigham and Women's Hospital, Boston, MA with special emphasis on strategy and planning. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

PubMed

Hu, Guijie; Yi, Yanhua

2016-01-01

Rural health professionals in township health centers (THCs) tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME) program to upgrade their educational levels. A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor's degree and who rated themselves as "partially capable" in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. A decentralized CME program was perceived feasible to upgrade rural health workers' education level to a bachelor's degree and improve their clinical competency.

Training Australian Defence Force Medical Officers to civilian general practice training standards--reflections on military medicine and its links to general practice education and training.

PubMed

Kitchener, Scott J; Rushbrook, Elizabeth; Brennan, Leonard; Davis, Stephen

2011-06-06

This article examines military medicine and its links to civilian general practice education and training, drawing attention to the variations and difficulties in, and successful approaches for, training Australian Defence Force (ADF) Medical Officers. Military medicine has been an area of change over the 10 years of the Australian General Practice Training (AGPT) program. Crisis situations like those in Timor Leste and Afghanistan have focused attention and recognition on the importance of primary health care in the work of the ADF. To train doctors in military medicine, there are several different models at different locations around Australia, as well as large variations in military course and experience recognition and approvals between AGPT regional training providers. At times, the lack of standardisation in training delays the progress of ADF registrars moving through the AGPT program and becoming independently deployable Medical Officers.

Brazilian infectious diseases specialists: who and where are they?

PubMed

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas. Copyright © 2016. Published by Elsevier Editora Ltda.

Evaluation of the impact of collaborative work by teams from the National Medical Residency Committee and the Brazilian Society of Neurosurgery. Retrospective and prospective study.

PubMed

Santos, Renato Antunes Dos; Snell, Linda; Nunes, Maria do Patrocínio Tenório

2016-04-01

Training for specialist physicians in Brazil can take place in different ways. Closer liaison between institutions providing this training and assessment and health care services may improve qualifications. This article analyzes the impact of closer links and joint work by teams from the National Medical Residency Committee (Comissão Nacional de Residência Médica, CNRM) and the Brazilian Society of Neurosurgery (Sociedade Brasileira de Neurocirurgia, SBN) towards evaluating these programs. Retrospective and prospective study, conducted in a public university on a pilot project developed between CNRM and SBN for joint assessment of training programs across Brazil. The literature in the most relevant databases was reviewed. Documents and legislation produced by official government bodies were evaluated. Training locations were visited. Reports produced about residency programs were analyzed. Only 26% of the programs were immediately approved. The joint assessments found problems relating to teaching and to functioning of clinical service in 35% of the programs. The distribution of programs in this country has a strong relationship with the Human Development Index (HDI) of the regions and is very similar to the distribution of specialists. Closer collaboration between the SBN and CNRM had a positive impact on assessment of neurosurgery medical residency across the country. The low rates of direct approval have produced modifications and improvements to the quality of teaching and care (services). Closer links between the CNRM and other medical specialties have the capability to positively change the structure and function of specialty training in Brazil.

Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

PubMed

Share, David A; Mason, Margaret H

2012-09-01

Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

Outcomes of Australian rural clinical schools: a decade of success building the rural medical workforce through the education and training continuum.

PubMed

Greenhill, Jennene A; Walker, Judi; Playford, Denese

2015-01-01

The establishment of the rural clinical schools funded through the Commonwealth Department of Health and Ageing (now Department of Health) Rural Clinical Training and Support program over a decade ago has been a significant policy initiative in Australian rural health. This article explores the impacts of this policy initiative and presents the wide range of educational innovations contextualised to each rural community they serve. This article reviews the achievements of the Australian rural clinical and regional medical schools (RCS/RMS) through semi-structured interviews with the program directors or other key informants. The questions and responses were analysed according to the funding parameters to ascertain the numbers of students, types of student placements and range of activities undertaken by each university program. Sixteen university medical schools have established 18 rural programs, creating an extensive national network of RCS and RMS in every state and territory. The findings reveal extensive positive impacts on rural and regional communities, curriculum innovation in medical education programs and community engagement activities. Teaching facilities, information technology, video-conferencing and student accommodation have brought new infrastructure to small rural towns. Rural clinicians are thriving on new opportunities for education and research. Clinicians continue to deliver clinical services and some have taken on formal academic positions, reducing professional isolation, improving the quality of care and their job satisfaction. This strategy has created many new clinical academics in rural areas, which has retained and expanded the clinical workforce. A total of 1224 students are provided with high-quality learning experiences for long-term clinical placements. These placements consist of a year or more in primary care, community and hospital settings across hundreds of rural and remote areas. Many programs offer longitudinal integrated clerkships; others offer block rotations in general practice and specialist clinics. Nine universities established programs prior to 2004, and these well-established programs are finding graduates who are returning to rural practice. Universities are required to have 25% of the students from a rural background. University admission policies have changed to encourage more applications from rural students. This aspect of the policy implements the extensive research evidence that rural-origin students are more likely to become rural practitioners. Additional capacity for research in RCS has influenced the rural health agenda in fields including epidemiology, population health, Aboriginal health, aged care, mental health and suicide prevention, farming families and climate change. There are strong research partnerships with rural workforce agencies, research centres for early career researchers and PhD students. The RCS policy initiative has vastly increased opportunities for medical students to have long-term clinical placements in rural health services. Over a decade since the policy has been implemented, graduates are being attracted to rural practice because they have positive learning experiences, good infrastructure and support within rural areas. The study shows the RCS initiative sets the stage for a sustainable future Australian rural medical workforce now requiring the development of a seamless rural clinical training pipeline linking undergraduate and postgraduate medical education.

Impact of Physician Asthma Care Education on Patient Outcomes

ERIC Educational Resources Information Center

Cabana, Michael D.; Slish, Kathryn K.; Evans, David; Mellins, Robert B.; Brown, Randall W.; Lin, Xihong; Kaciroti, Niko; Clark, Noreen M.

2014-01-01

Objective: We evaluated the effectiveness of a continuing medical education program, Physician Asthma Care Education, in improving pediatricians' asthma therapeutic and communication skills and patients' health care utilization for asthma. Methods: We conducted a randomized trial in 10 regions in the United States. Primary care providers were…

Anatomy for Biomedical Engineers

ERIC Educational Resources Information Center

Carmichael, Stephen W.; Robb, Richard A.

2008-01-01

There is a perceived need for anatomy instruction for graduate students enrolled in a biomedical engineering program. This appeared especially important for students interested in and using medical images. These students typically did not have a strong background in biology. The authors arranged for students to dissect regions of the body that…

Comparative Analysis of Monographic Collections in Nursing.

ERIC Educational Resources Information Center

Bowden, Virginia M.; And Others

The results of a project comparing the nursing monograph collections of academic health science center libraries in the Southwest are reported. Records for nursing monographs from the TALON (South Central Regional Medical Library Program) Union Catalog of Monographs from 1977-1983 were analyzed to reveal the distribution by year, publisher, and…

An Evaluation of the Navy Family Advocacy Program at Naval Regional Medical Center, Camp Pendleton, California.

DTIC Science & Technology

1982-08-01

to d suggest that health system intervention varies from simply providing initial physical examination to coordinating long term care and follow-up...developed with item numbers 3, 4, and 6 utilized to score the local program in terms of professional awareness. The cover 1 49 letter and questionnaire...Congress. HARM: Includes, but not limited to: ( 1 ) Physical , emo- tional, or mental injury, including physical injury resulting from otherwise lawful

Dialectics of a medical provision policy in priority areas in Brazil.

PubMed

Weber, César Augusto Trinta

2017-03-01

The people living in vulnerable areas that are difficult to access in Brazil represent a portion of the population that has proven very sensitive to lack of medical and health services. The government, seeking to solve the situation urgently, implemented the More Doctors Program [Programa Mais Médicos, in the Portuguese original] in 2013. To discuss the More Doctors Program, with the purpose of contributing to the debate on the provision of medical policies in Brazil. Study based on the review of official documents: Programa Mais Médicos - dois anos: mais saúde para os brasileiros, 2015 [More Doctors Program - two years: more health for Brazilians, 2015]; Operational Audit Report, TC Nº 005391/2014-8, the Court of Auditors of Brazil; and Medical Demography in Brazil 2015. The import of exchange physicians without diploma revalidation has cast a shadow on the technical quality of services offered to the population. In terms of infrastructure, the reduction of resources paralyzed works and made the care network maintenance projects impossible. The creation of new medical schools has created uncertainty about the possibility of quality education being offered, with minimum and sufficient structure including laboratories, clinics and teaching hospitals indispensable to medical training. The regional inequalities of concentration and dispersion of physicians, showed by studies on medical demography in Brazil, stem from several factors, including the lack of a career path and working conditions. There is no point in having physicians if they do not have safe and ethical conditions to establish the diagnosis and a treatment plan, as well as to monitor the rehabilitation of the patient.

Senior Resident Training on Educational Principles (STEP): A Proposed Innovative Step from a Developing Nation.

PubMed

Singh, Satendra

2010-12-01

Resident-as-teacher courses are pretty common in Western medical schools however they are a rarity in Asian and developing countries. The current report is a scholarly analysis of a three day orientation program for senior residents in order to improve their functioning by providing new template either for supplementing basic workshops for faculty or to advocate a change in system. The experience gained by Medical Education Unit of University College of Medical Sciences can be used to conduct training breeding grounds at national or regional levels. Resident as teachers educational interventions need to be designed taking into account their impact on education system.

General surgery vs fellowship: the role of the Independent Academic Medical Center.

PubMed

Adra, Souheil W; Trickey, Amber W; Crosby, Moira E; Kurtzman, Scott H; Friedell, Mark L; Reines, H David

2012-01-01

To compare career choices of residency graduates from Independent Academic Medical Center (IAMC) and University Academic Medical Center (UAMC) programs and evaluate program directors' perceptions of residents' motivations for pursuing general surgery or fellowships. From May to August 2011, an electronic survey collected information on program characteristics, graduates' career pursuits, and career motivations. Fisher's exact tests were calculated to compare responses by program type. Multivariate logistic regression was used to identify independent program characteristics associated with graduates pursuing general surgery. Data were collected on graduates over 3 years (2009-2011). Surgery residency program directors. Seventy-four program directors completed the survey; 42% represented IAMCs. IAMCs reported more graduates choosing general surgery. Over one-quarter of graduates pursued general surgery from 52% of IAMC vs 37% of UAMC programs (p = 0.243). Career choices varied significantly by region: over one-quarter of graduates pursue general surgery from 78% of Western, 60% of Midwestern, 40% of Southern, and 24% of Northeastern programs (p = 0.018). On multivariate analysis, IAMC programs were independently associated with more graduates choosing general surgery (p = 0.017), after adjustment for other program characteristics. Seventy-five percent of UAMC programs reported over three-fourths of graduates receive first choice fellowship, compared with only 52% of IAMC programs (p = 0.067). Fellowships were comparable among IAMC and UAMC programs, most commonly MIS/Bariatric (16%), Critical Care/Trauma (16%), and Vascular (14%). IAMC and UAMC program directors cite similar reasons for graduate career choices. Most general surgery residents undergo fellowship training. Graduates from IAMC and UAMC programs pursue similar specialties, but UAMC programs report more first choice acceptance. IAMC programs may graduate proportionately more general surgeons. Further studies directly evaluating surgical residents' career choices are warranted to understand the influence of independent and university programs in shaping these choices and to develop strategies for reducing the general surgeon shortage. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Screening of diseases associated with asbestos. On-going activities, synthesis].

PubMed

Frimat, P; Paris, C; Letourneux, M; Catilina, P; Sobaszek, A

1999-12-01

Medical screening requires always assessment. On the basis of ongoing studies on occupational health asbestos programs, we suggest some recommendations for asbestos screening after occupational exposure. The proposal for asbestos workers post-exposure surveillance should take into account the medical but also the social aspects of the problem. Post-exposure screening of asbestos workers includes an evaluation of occupational exposure, compulsory basis medical check-up, the characteristics of the radiological investigations and schedule of the medical surveillance. In conclusion, we suggest some general recommendations for asbestos screening after occupational exposure, particularly the necessity to obtain a concerted approach of asbestos screening with regional and national networks, the concern of their assessment and the implementation of specific research studies.

Exploring the role of social capital in supporting a regional medical education campus.

PubMed

Toomey, Patricia; Hanlon, Neil; Bates, Joanna; Poole, Gary; Lovato, Chris Y

2011-01-01

To help address physician shortages in the underserved community of Prince George, Canada, the University of British Columbia (UBC) and various partners created the Northern Medical Program (NMP), a regional distributed site of UBC's medical doctor undergraduate program. Early research on the impacts of the NMP revealed a high degree of social connectedness. The objective of the present study was to explore the role of social capital in supporting the regional training site and the benefits accrued to a broad range of stakeholders and network partners. In this qualitative study, 23 semi-structured interviews were conducted with community leaders in 2007. A descriptive content analysis based on analytic induction technique was employed. Carpiano's Bourdieu-based framework of 'neighbourhood' social capital was adapted to empirically describe how social capital was produced and mobilized within and among networks during the planning and implementation of the NMP. Results from this study reveal that the operation of social capital and the related concept of social cohesion are multifaceted, and that benefits extend in many directions, resulting in somewhat unanticipated benefits for other key stakeholders and network partners of this medical education program. Participants described four aspects of social capital: (i) social cohesion; (ii) social capital resources; (iii) access to social capital; and (iv) outcomes of social capital. The findings of this study suggest that the partnerships and networks formed in the NMP planning and implementation phases were the foundation for social capital mobilization. The use of Carpiano's spatially-bounded model of social capital was useful in this context because it permitted the characterization of relations and networks of a tight-knit community body. The students, faculty and administrators of the NMP have benefitted greatly from access to the social capital mobilized to make the NMP operational. Taking account of the dynamic and multifaceted operation of social capital helps one move beyond a view of geographic communities as simply containers or sinks of capital investment, and to appreciate the degree to which they may act as a platform for productive network formation and expansion.

Implementing an advance care planning program in German nursing homes: results of an inter-regionally controlled intervention trial.

PubMed

In der Schmitten, Jürgen; Lex, Katharina; Mellert, Christine; Rothärmel, Sonja; Wegscheider, Karl; Marckmann, Georg

2014-01-24

Advance Care Planning (ACP) is a systematic approach to ensure that effective advance directives (ADs) are developed and respected. We studied the effects of implementing a regional ACP program in Germany. In a prospective, inter-regionally controlled trial focusing on nursing homes (n/hs), we compared the number, relevance and validity of new ADs completed in the intervention region versus the control region. Intervention n/h residents and their families were offered professional facilitation including standardized documentation. Data from 136 residents of three intervention n/hs were compared with data from 439 residents of 10 control n/hs over a study period of 16.5 months. In the intervention region, 49 (36.0%) participating residents completed a new AD over the period of the study, compared to 18 (4.1%) in the control region; these ADs included 30 ADs by proxy in the intervention region versus 10 in the control region. Proxies were designated in 94.7% versus 50.0% of cases, the AD was signed by a physician in 93.9% versus 16.7%, and an emergency order was included in 98.0% versus 44.4%. Resuscitation status was addressed in 95.9% versus 38.9% of cases (p<0.01 for all of the differences mentioned above). In the intervention region, new ADs were preceded by an average of 2.5 facilitated conversations (range, 2–5) with a mean total duration of 100 minutes (range, 60–240 minutes). The implementation of an ACP program in German nursing homes led, much more frequently than previously reported, to the creation of advance directives with potential relevance to medical decision-making. Future research should assess the effect of such programs on clinical and structural outcomes.

Cost-benefit analysis on the use of telemedicine program of Kosova for continuous medical education: a sustainable and efficient model to rebuild medical systems in developing countries.

PubMed

Latifi, Kalterina; Lecaj, Ismet; Bekteshi, Flamur; Dasho, Erion; Doarn, Charles R; Merrell, Ronald C; Latifi, Rifat

2011-12-01

The Ministry of Health of Kosova has recently announced the Telemedicine Program of Kosova (TMPK) as the official institution responsible for managing and coordinating the nation's Long-Distance Continuous Medical Education (CME) program. There are a lack of studies on cost-benefit analysis (CBA) and other economic evaluations of telemedicine programs (TMP), in particular the financial value of CME offered through such a service. In addition, there is lack of prospective studies on Monitoring & Evaluation (M&E) of TMP. The goal of this study was to conduct a retrospective CBA of prospective data collected at TMPK over a 5-year period (2005-2010) in order to determine the cost benefit as opposed to the alternative method of delivery of this model for developing countries whose healthcare systems are in disarray. We reviewed data on the number of participants in virtual lectures both at the Telemedicine Center of Kosova (TCK) as well as the number of participants at six Regional Telemedicine Centers throughout Kosova, the number of lectures broadcasted, the clinical cases reviewed and transmitted for international consultation, and other quantitative data. Only in 2009, approximately 2,000 CME certificates were awarded to physicians and nurses of Kosova, 18 international teleconsultations were conducted, 138 videoconferences, lectures, and seminars were held, and there were over 9,000 visitors at the TCK e-library. Data analysis shows that the TMPK has been an efficient mechanism for CME and sustainable model for rebuilding the medical system. TMPK has been successful in offering physicians, nurses, and other medical professions access to electronic information. TMP is an efficient mechanism to ensure CME and rebuilding medical systems in developing countries. There is a need for prospective CBA of any TMP and the establishment of M&E programs in any future telemedicine initiatives in developing countries.

Reimbursing Live Organ Donors for Incurred Non-Medical Expenses: A Global Perspective on Policies and Programs

PubMed Central

Sickand, M.; Cuerden, M. S.; Klarenbach, S. W.; Ojo, A. O.; Parikh, C. R.; Boudville, N.; Garg, A. X.

2015-01-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support. PMID:19788503

Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs.

PubMed

Sickand, M; Cuerden, M S; Klarenbach, S W; Ojo, A O; Parikh, C R; Boudville, N; Garg, A X

2009-12-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support.

Strengthening Faculty Recruitment for Health Professions Training in Basic Sciences in Zambia

PubMed Central

Simuyemba, Moses; Talib, Zohray; Michelo, Charles; Mutale, Wilbroad; Zulu, Joseph; Andrews, Ben; Katubulushi, Max; Njelesani, Evariste; Bowa, Kasonde; Maimbolwa, Margaret; Mudenda, John; Mulla, Yakub

2014-01-01

Zambia is facing a crisis in its human resources for health (HRH), with deficits in the number and skill mix of health workers. The University of Zambia School of Medicine (UNZA SOM) was the only medical school in the country for decades, but recently it was joined by three new medical schools—two private and one public. In addition to expanding medical education, the government has also approved several allied health programs, including pharmacy, physiotherapy, biomedical sciences, and environmental health. This expansion has been constrained by insufficient numbers of faculty. Through a grant from the Medical Education Partnership Initiative (MEPI), UNZA SOM has been investing in ways to address faculty recruitment, training, and retention. The MEPI-funded strategy involves directly sponsoring a cohort of faculty at UNZA SOM during the five-year grant, as well as establishing more than a dozen new master’s programs, with the goal that all sponsored faculty are locally trained and retained. Because the issue of limited basic science faculty plagues medical schools throughout Sub-Saharan Africa, this strategy of using seed funding to build sustainable local capacity to recruit, train, and retain faculty could be a model for the region. PMID:25072591

Strengthening faculty recruitment for health professions training in basic sciences in Zambia.

PubMed

Simuyemba, Moses; Talib, Zohray; Michelo, Charles; Mutale, Wilbroad; Zulu, Joseph; Andrews, Ben; Nzala, Selestine; Katubulushi, Max; Njelesani, Evariste; Bowa, Kasonde; Maimbolwa, Margaret; Mudenda, John; Mulla, Yakub

2014-08-01

Zambia is facing a crisis in its human resources for health, with deficits in the number and skill mix of health workers. The University of Zambia School of Medicine (UNZA SOM) was the only medical school in the country for decades, but recently it was joined by three new medical schools--two private and one public. In addition to expanding medical education, the government has also approved several allied health programs, including pharmacy, physiotherapy, biomedical sciences, and environmental health. This expansion has been constrained by insufficient numbers of faculty. Through a grant from the Medical Education Partnership Initiative (MEPI), UNZA SOM has been investing in ways to address faculty recruitment, training, and retention. The MEPI-funded strategy involves directly sponsoring a cohort of faculty at UNZA SOM during the five-year grant, as well as establishing more than a dozen new master's programs, with the goal that all sponsored faculty are locally trained and retained. Because the issue of limited basic science faculty plagues medical schools throughout Sub-Saharan Africa, this strategy of using seed funding to build sustainable local capacity to recruit, train, and retain faculty could be a model for the region.

Seasonal influenza vaccination in China: Landscape of diverse regional reimbursement policy, and budget impact analysis.

PubMed

Yang, Juan; Atkins, Katherine E; Feng, Luzhao; Pang, Mingfan; Zheng, Yaming; Liu, Xinxin; Cowling, Benjamin J; Yu, Hongjie

2016-11-11

To explore the current landscape of seasonal influenza vaccination across China, and estimate the budget of implementing a national "free-at-the-point-of-care" vaccination program for priority populations recommended by the World Health Organization. In 2014 and 2016, we conducted a survey across provincial Centers for Disease Control and Prevention to collect information on regional reimbursement policies for influenza vaccination, estimated the national uptake using distributed doses of influenza vaccines, and evaluated the budget using population size and vaccine cost obtained from official websites and literatures. Regular reimbursement policies for influenza vaccination are available in 61 mutually exclusive regions, comprising 8 provinces, 45 prefectures, and 8 counties, which were reimbursed by the local Government Financial Department or Basic Social Medical Insurance (BSMI). Finance-reimbursed vaccination was offered mainly for the elderly, and school children for free in Beijing, Dongli district in Tianjin, Karamay, Shenzhen and Xinxiang cities. BSMI-reimbursement policies were limited to specific medical insurance beneficiaries with distinct differences in the reimbursement fractions. The average national vaccination coverage was just 1.5-2.2% between 2004 and 2014. A free national vaccination program for priority populations (n=416million), would cost government US$ 757million (95% CI 726-789) annually (uptake rate=20%). An increasing number of regional governments have begun to pay, partially or fully, for influenza vaccination for selected groups. However, this small-scale policy approach has failed to increase national uptake. A free, nationwide vaccination program would require a substantial annual investment. A cost-effectiveness analysis is needed to identify the most efficient methods to improve coverage. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

75 FR 80762 - Medicare Program; Emergency Medical Treatment and Labor Act: Applicability to Hospital and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... intensive care units or with respect to rural areas, regional referral centers as identified by the... care for an EMC. Therefore, we stated that we believed the EMTALA requirements did not extend to..., and professional obligations with respect to the continued proper care and treatment of its patients...

Survey on Continuing Education Needs for Health Professionals: Report.

ERIC Educational Resources Information Center

System Development Corp., Santa Monica, CA.

The report documents the results of a 1967 survey of health professionals in the four-State Western Interstate Commission for Higher Education (WICHE) Mountain States Regional Medical Program (MS/RMP). Addressed to health professionals in each of the four States--Idaho, Montana, Nevada, and Wyoming--the survey focuses primarily on the…

Implementation and Modification of an Anatomy-Based Integrated Curriculum

ERIC Educational Resources Information Center

Klement, Brenda J.; Paulsen, Douglas F.; Wineski, Lawrence E.

2017-01-01

Morehouse School of Medicine elected to restructure its first-year medical curriculum by transitioning from a discipline-based to an integrated program. The anatomy course, with regional dissection at its core, served as the backbone for this integration by weaving the content from prior traditional courses into the curriculum around the anatomy…

A Model for Health Professional Education in South Texas

ERIC Educational Resources Information Center

Ramirez, Amelie; Vela, Leonel; Cigarroa, Francisco G.

2008-01-01

In 1997, The University of Texas Health Science Center at San Antonio established the Regional Academic Health Center (RAHC) for the Lower Rio Grande Valley in south Texas. Through medical education programs, research facilities, and partnerships with health-care providers, the RAHC aims to improve the health status and access to health services…

Creating an Academic and Rural Community Network To Improve Diabetes Care.

ERIC Educational Resources Information Center

Smith, Carol A.; Kennedy, Diane M.; Lahoz, Monina Rasay; Hislop, David A.; Erkel, Elizabeth E.

The South Carolina Rural Interdisciplinary Program in Training (SCRIPT) provides practical educational experiences for students from multiple health care majors in rural communities in the Low Country (Southern region) of South Carolina. Faculty from the Medical University of South Carolina joined with staff from the Low Country Area Health…

VISIONS for Greater Employment Opportunities. Final Report.

ERIC Educational Resources Information Center

Orangeburg-Calhoun Technical Coll., Orangeburg, SC.

The VISIONS project, a workplace literacy program held in two manufacturing plants and a regional medical center, was conducted during an 18-month period from July 1, 1993 to December 31, 1994. During the project, staff were hired and trained, task analyses and orientation sessions were held, and tests and curricula were developed. Employees were…

Interview with David Tauben: University of Washington, Chief of the Division of Pain Medicine.

PubMed

Tauben, David

2017-07-01

Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers. He served as a member of the NIH National Pain Strategy task force on pain education and is principal investigator for the UW's prestigious NIH Pain Consortium Center of Excellence for Pain Education, leading curriculum development to extend the pain proficiency qualifications of interprofessional primary care providers. Dr Tauben is a member of the American Pain Society and the International Association for the Study of Pain special interest study groups on Pain Education. He is a founding member of the State of Washington Agency Medical Directors panel of medical experts developing opioid prescription guidelines for the state, and a regular clinical and content expert for regulatory and legislative bodies involved in public policy regarding pain medicine practice and standards. He speaks as a clinical expert in medical management of chronic pain, especially as it applies to primary care practices. Dr Tauben served as an expert for several US Centers for Disease Control clinical outreach programs and policy reviews advising primary care providers on how to prescribe opioids for chronic noncancer pain. He is annually recognized by his peers as recipient of regional awards in care of pain patients, and brings decades of clinical experience of best practice medication management of acute and chronic pain. Dr Tauben received his bachelors degree in philosophy from Yale University, medical degree from Tufts University School of Medicine and completed his residency training at the UW, in Seattle. He is a fellow of the American College of Physicians.

TRICARE: the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services (STS) program--DoD. Notice.

PubMed

1998-11-16

This notice is to advise interested parties that Naval Hospital Jacksonville (NAVHOSPJAX), Florida, has been designated a regional Specialized Treatment Services facility (STSF) for total joint replacement. The application for this STSF designation was submitted by NAVHOSPJAX and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent for TRICARE Region 3 will oversee that the STSF maintains the quality and standards required for specialized treatment services. This designation covers the following Diagnostic Related Groups: 209--Major Joint and Limb Reattachment Procedures of Lower Extremity 491--Major Joint and Limb Reattachment Procedures of Upper Extremity DoD beneficiaries who reside in the NAVHOSPJAX STS Catchment Area must be evaluated by NAVHOSPJAX before receiving TRICARE/CHAMPUS cost sharing for procedures that fall under the above Diagnostic Related Groups, in accordance with TRICARE/CHAMPUS Nonavailability Statement policy. Travel and lodging for the patient and, if stated to be medically necessary by a referring physician, for a nonmedical attendant, will be reimbursed by NAVHOSPJAX in accordance with the provision of the Joint Federal Travel Regulation. Although evaluation in person is preferred, it is possible to conduct the evaluation telephonically if the patient is unable to travel to NAVHOSPJAX. If the procedures cannot be performed at NAVHOSPJAX, Humana Military Healthcare Services will provide a medical necessity review prior to issuance of a Nonavailability Statement or other similar authorizations. The NAVHOSPJAX STSF Catchment Area includes zip codes within TRICARE Region 3 that fall within a 200-mile radius South and West of NAVHOSPJAX.

Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

PubMed Central

2016-01-01

Purpose: Rural health professionals in township health centers (THCs) tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME) program to upgrade their educational levels. Methods: A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. Results: The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor’s degree and who rated themselves as “partially capable” in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. Conclusion: A decentralized CME program was perceived feasible to upgrade rural health workers’ education level to a bachelor’s degree and improve their clinical competency. PMID:27134005

Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia.

PubMed

Devi, B C R; Tang, T S; Corbex, M

2008-12-01

The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from <200 g in 1993 to >1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population.

Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.

PubMed

Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel

2016-09-01

Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery.

Carnegie Mellon University's MMM program: management education for 21st-century physicians.

PubMed

Korevaar, W C; Pearson, R W

2001-01-01

The number and types of executive and graduate-level management programs for physicians have exploded in recent years. These programs take on a variety of formats, ranging from executive seminars to master's-level degree programs. Options for physicians obtaining the master's degree tend to be either regionally based programs in traditional evening classes or nationally based programs that combine executive education formats with distance education. This paper examines a nationally based program - the Master of Medical Management (MMM) - from the perspectives of an administrator and a graduate of the program. It offers reasons for the growth of similar programs and data from students enrolled in the Carnegie Mellon University MMM program. The paper also examines educational outcomes in the form of behavioral competencies that the physicians acquired in the program. It concludes with reflections on the future of the MMM and related programs for physician executives in the 21st century.

Making an impact: an adventure into international pharmacy.

PubMed

Hitch, William; Ransom, Matthew

2009-01-01

To support a medical team, organized by Shoulder to Shoulder, with pharmacy services in an effort to expand ongoing health care to a rural community in Honduras. Pharmacy services in a temporary medical clinic in a schoolhouse in Colomarigua, a small mountain village in Honduras. Pharmacy services and medical care to address acute care needs of the people of Colomarigua, Honduras, during a week-long clinic. Interpreters assisted with patient counseling. Medication labels with pictures that connected doses to mealtimes increased patient understanding and the potential for medications to be dosed correctly. Fill lines were drawn on delivery devices for pediatric suspensions. An effort was made to avoid polypharmacy by communicating with physicians about the different prescriptions that were being prescribed in each household. Not applicable. Not applicable. We created a temporary clinic with a pharmacy and provided medical care to more than 600 children and adults in the surrounding regions. The medical team identified need for a feeding program, and local Shoulder to Shoulder teams began activities to support the community's development. Education programs were initiated to allow promising local children access to higher education. Challenges to providing optimal pharmaceutical care included language barriers, space and flow of the pharmacy, and a limited formulary. Benefits included gaining a whole new perspective on pharmacotherapy, health, and the importance of service to those in need whether abroad or at home.

[Research of regional medical consumables reagent logistics system in the modern hospital].

PubMed

Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

2013-09-01

To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

What is the financial state of medical students from rural backgrounds during tuition fee deregulation?

PubMed

Woloschuk, Wayne; Lemay, Jean-François; Wright, Bruce

2010-01-01

We sought to examine the financial state of medical students from rural backgrounds during a time of tuition fee deregulation. We surveyed incoming classes from 2007 to 2011 at the University of Calgary. Community background, expected educational debt at graduation, educational debt at entry to medical school and parental income were collected for analysis. Data were analyzed using the Χ² test, analysis of variance and the Newman-Keuls multiple comparison test. The overall response rate was 95.3%. Of the 571 (93.5%) respondents who supplied data on their background and debt, 94.4% expected to have educational debt at graduation. The mean projected educational debt at graduation by medical students from both rural ($107 226 [95% confidence interval (CI) $98 030-$116 423]) and regional ($99 456 [95% CI $91 905-$107 006]) backgrounds was significantly greater than the debt projected by students from metropolitan ($88 565 [95% CI $83 607-$93 524]) backgrounds. Medical students who came from rural backgrounds had the highest mean debt at entry to medical school ($33 053 [95% CI $25 715-$40 391]) compared with their peers from regional ($23 253 [95% CI $16 621-$29 885]) and metropolitan ($22 053 [95% CI $17 344-$26 762]) backgrounds. Students of rural origin also had parents whose mean income ($104 024 [95% CI $75 976-$132 173]) was significantly lower than the mean parental income of their peers who originated from regional ($143 167 [95% CI $119 898-$166 435]) and metropolitan ($150 339 [95% CI $135 241-165 438]) centres. Rising tuition and subsequent debt may be affecting the diversity of medical students' backgrounds. Financial programs dedicated to rural-background students and their interest in medicine may become necessary.

Proposal for a unified selection to medical residency programs.

PubMed

Toffoli, Sônia Ferreira Lopes; Ferreira Filho, Olavo Franco; Andrade, Dalton Francisco de

2013-01-01

This paper proposes the unification of entrance exams to medical residency programs (MRP) in Brazil. Problems related to MRP and its interface with public health problems in Brazil are highlighted and how this proposal are able to help solving these problems. The proposal is to create a database to be applied in MRP unified exams. Some advantages of using the Item Response Theory (IRT) in this database are highlighted. The MRP entrance exams are developed and applied decentralized where each school is responsible for its examination. These exams quality are questionable. Reviews about items quality, validity and reliability of appliances are not common disclosed. Evaluation is important in every education system bringing on required changes and control of teaching and learning. The proposal of MRP entrance exams unification, besides offering high quality exams to institutions participants, could be as an extra source to rate medical school and cause improvements, provide studies with a database and allow a regional mobility. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

Behavior Risk Factors Among Russian Students.

PubMed

Anischenko, Aleksander; Arhangelskaya, Anna; Klenov, Michael; Burdukova, Ekaterina; Ogarev, Valrii; Ignatov, Nikolay; Osadchenko, Irina; Gurevich, Konstantin

2017-01-01

Purpose To analyze the prevalence of risk factors among Russian students. Methods In this study, 834 students were included from five Federal universities which were localized in four Federal regions of Russian Federation. Future doctors, school teachers, and wellness trainers were included in this study. Students were specifically asked about smoking, physical activity International Physical Activity Questionnaire (IPAQ), and food preference. Waist, hip, weight, and height were measured. Results The region of study and ethnic group were not influenced with respect to age and body mass index ( p > .1), while all other factors had a significant influence ( p < .05). High levels of smoking, hypodynamia, and motivation to intake of unhealthy food were found in medical students in comparison with those in future teachers and wellness instructors ( p < .05). The indicators of central obesity (due to levels of body mass index and waist-hip ratio) were found in medical students. Perspective Special programs to prevent the most common behavior risk factors in future medical doctors have to be designed.

PACS: implementation in the U.S. Department of Defense

NASA Astrophysics Data System (ADS)

Chacko, Anna K.; Wider, Ronald; Romlein, John R.; Cawthon, Michael A.; Richardson, Ronald R., Jr.; Lollar, H. William; Cook, Jay F.; Timboe, Harold L.; Johnson, Thomas G.; Fellows, Douglas W.

2000-05-01

The Department of Defense has been a leader in Radiology re- engineering for the past decade. Efforts have included the development of two landmark PACS specifications (MDIS and DIN- PACS), respective vendor selection and implementation programs. A Tri-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, PACS and teleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematic adjustment of procurement process for radiological imaging equipment included a focus on specifying PACS-capable-digital imaging modalities and mini- PACS as stepping stones to make the hospitals and health clinics PACS-ready. The success of the PACS and teleradiology program in the DOD is evidenced by the near filmless operation of most Army and Air Force Medical Centers, several community hospitals and several operational teleradiology constellations. Additionally, the MDIS PACSystem has become the commercial PACS product for General Electric Medical Systems. The DOD continues to forge ahead in the PACS arena by implementing advanced configurations and operational concepts such as the VRE (Virtual Radiology Environment), the negotiation of Regional Archiving and Regional PACS Maintenance Programs. Newer regulations (HIPAA, the FDA approval of digital mammography) have been promulgated impacting the culture and conduct of our business. Incorporating their requirements at the very outset will enable us to streamline the delivery of radiology. The DOD community has embraced the information age at multiple levels. The Healthcare portion of this community with these initiatives is integrating itself into DOD's future. The future holds great possibilities, promises and challenges for the DOD PACS programs.

The Alberta Hereditary Diseases Program: a regional model for delivery of genetic services.

PubMed Central

Lowry, R B; Bowen, P

1990-01-01

Genetic counselling and related services are generally provided at major university medical centres because they are very specialized. The need for rurally based genetic services prompted the inclusion of an outreached program in the Alberta Hereditary Diseases Program (AHDP), which was established in 1979; the AHDP was designed to provide services to the entire province through two regional centres and seven outreach clinics. There is a community health nurse in almost every health unit whose duties are either totally or partially devoted to the AHDP; thus, genetic help and information are as close as a rural health unit. The AHDP is designed to provide complete clinical (diagnostic, counselling and some management) services and laboratory (cytogenetic, biochemical and molecular) services for genetic disorders. In addition, the program emphasizes education and publishes a quarterly bulletin, which is sent free of charge to all physicians, hospitals, public health units, social service units, major radio and television stations, newspapers and public libraries and to selected individuals and groups in Alberta. PMID:2302614

Sustainability of vector control strategies in the Gran Chaco Region: current challenges and possible approaches

PubMed Central

Gürtler, Ricardo E

2011-01-01

Sustainability has become a focal point of the international agenda. At the heart of its range of distribution in the Gran Chaco Region, the elimination of Triatoma infestans has failed, even in areas subject to intensive professional vector control efforts. Chagas disease control programs traditionally have been composed of two divorced entities: a vector control program in charge of routine field operations (bug detection and insecticide spraying) and a disease control program in charge of screening blood donors, diagnosis, etiologic treatment and providing medical care to chronic patients. The challenge of sustainable suppression of bug infestation and Trypanosoma cruzi transmission can be met through integrated disease management, in which vector control is combined with active case detection and treatment to increase impact, cost-effectiveness and public acceptance in resource-limited settings. Multi-stakeholder involvement may add sustainability and resilience to the surveillance system. Chagas vector control and disease management must remain a regional effort within the frame of sustainable development rather than being viewed exclusively as a matter of health pertinent to the health sector. Sustained and continuous coordination between governments, agencies, control programs, academia and the affected communities is critical. PMID:19753458

78 FR 68853 - International Medical Device Regulators Forum; Medical Device Single Audit Program International...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

...] International Medical Device Regulators Forum; Medical Device Single Audit Program International Coalition Pilot... Drug Administration (FDA) is announcing participation in the Medical Device Single Audit Program International Coalition Pilot Program. The Medical Device Single Audit Program (MDSAP) was designed and...

Gastroenterology training in Latin America

PubMed Central

Cohen, Henry; Saenz, Roque; de Almeida Troncon, Luiz E; Lizarzabal, Maribel; Olano, Carolina

2011-01-01

Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent’s medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients’ needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors’ needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved. PMID:21633594

Short-Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program.

PubMed

McCormick, Zachary L; Gagnon, Christine M; Caldwell, Mary; Patel, Jaymin; Kornfeld, Sarah; Atchison, James; Stanos, Steven; Harden, R Norman; Calisoff, Randy

2015-12-01

Complex regional pain syndrome (CRPS) is difficult to effectively treat with unimodal approaches. To investigate whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program. Observational cohort study of 49 patients aged 18-89 who fulfilled 'Budapest Criteria' for CRPS and completed an interdisciplinary pain management program. Preprogram to postprogram changes in physical functioning, perceived disability, emotional functioning, acceptance, coping, and pain were assessed. The measures used included: Pain Disability Index, Six minute walk test, 2-minute sit-to-stand, Numerical Rating Scale, Center for Epidemiologic Studies Depression Scale, Pain Anxiety Symptoms Scale, Chronic Pain Acceptance Questionnaire, Coping Strategies Questionnaire-Revised, RIC- Multidimensional Patient Global Impression of Change (RIC-MPGIC), and Medication Quantification Scale. For worker's compensation patients, the rate of successful release to work at the end of the program was calculated. Results indicated significant improvements in physical functioning and perceived disability (P's<0.001). Patients reported increased usage of an adaptive coping strategy, distraction (P = 0.010), and decreased usage of maladaptive and passive strategies (P's < 0.001). Patients showed greater chronic pain acceptance (P's ≤ 0.010) and reductions in emotional distress (P's < 0.001). Medication usage at 1-month follow-up was significantly reduced compared to program start (P < 0.001) and discharge (P = 0.004). Patients reported "much improvement" in overall functioning, physical functioning, mood, and their ability to cope with pain and flare-ups (RIC-MPGIC). Patient report of pain was not significantly reduced at discharge (P =0.078). Fourteen (88%) of 16 total worker's compensation patients were successfully released to work at the end of the program. This study demonstrates short-term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well-being as of equal value and relevance to pain reduction. © 2015 Wiley Periodicals, Inc.

CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) Reform: Will It Work? An Analysis of the CHAMPUS Reform Initiative.

DTIC Science & Technology

1987-12-01

eterinarians, optometrists, podiatrists, pharmacists , psycologists, nurse practitioners, rhvsician assistants, and others. In addition, over 146,000 enlisted...and the uti -lization data needed for ood resource C. CONTROL OF HEALTH CARE COSTS 1-,- la c ot- regional fixed-price contracts is set forth by the fram

Fostering the Growing Need to Learn: Designs for the Continuing Education of Health Manpower. Part One, Volume One.

ERIC Educational Resources Information Center

Syracuse Univ., NY.

This publication is one of four parts of the Project Continuing Education for Health Manpower performed by Syracuse University for the Regional Medical Programs Service. Continuing education is defined as systematic efforts to acquire, maintain, and develop the abilities, skills, knowledge, and attitudes of persons already engaged in providing…

Characterizing customers at medical center farmers’ markets1

PubMed Central

Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

2014-01-01

Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

Characterizing customers at medical center farmers' markets.

PubMed

Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

2014-08-01

Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

PubMed

Cheek, Colleen; Hays, Richard; Allen, Penny; Walker, Gary; Shires, Lizzi

2017-01-01

Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania but most left for specialty training. All 15 interview participants intended to remain in Australia for at least their intern year, although at enrolment only six had planned to remain. Factors influencing workplace location decisions were (1) 'professional': greater appeal of Australian medical workplaces, intention to pursue a speciality, and to complete this at an Australian metropolitan hospital; (2) 'social': proximity to family/partner or opportunity to meet a prospective partner, family obligations, positive rural experiences; and (3) 'location': direct travel access to family. IFP graduates from the Tasmanian medical program make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context. Most IFPs do not choose to work rurally. Rurally focused medical programs need to consider how they place IFP students to meet both the learning and career needs of IFP students and the goal of the rural medical programs in developing a rural workforce.

[Implementation of a proactive integrated primary care program for frail older people: from science to evidence-based practice].

PubMed

Bleijenberg, Nienke; de Jonge, Artine; Brand, Morris P; O'Flynn, Caitriona; Schuurmans, Marieke J; de Wit, Niek J

2016-12-01

Multimorbidity, functional impairment and frailty among community-dwelling older people are causing increasing complexity in primary care. A proactive integrated primary care approach is therefore essential. Between October 2014-2015, an evidence-based proactive care program for frail older people was implemented in the region Noord-West Veluwe en Zeewolde, the Netherlands. This study evaluated the feasibility of the implementation, having a strong focus on the collaboration between the medical and social domain. Using a mixed-methods design we evaluated several process indicators. Data were obtained from electronic routine medical record data within primary care, questionnaires, and interviews with older adults. The questionnaires provided information regarding the expectations and experiences towards the program and were sent to health care professionals at baseline and six months follow-up. Stakeholders from various domains were asked to fill in the questionnaire at baseline and twelve months follow-up. Interviews were conducted to explore the experiences of older adults with the program. Regional work groups were set up in each municipality to enhance the interdisciplinary and domain transcending collaboration. The proactive primary care program was implemented in 42 general practices who provided care to 7904 older adults aged 75 years or older. A total of 101 health care professionals and 44 stakeholders filled in the questionnaires. The need for better structure and interdisciplinary cooperation seemed widespread among the participants. The implementation resulted in a positive significant change in the demand for a better regional healthcare-framework (34% p ≤ .001) among health care professionals, and the needs for transparency regarding the possibilities for referral improved (27% , p = .009). Half of the participants reported that the regional collaboration has been improved after the implementation. Health care professionals and stakeholders gained increased attention and awareness of frail elderly in their area compared to before the implementation. Older people and their caregivers were positive about the proactive approach. The nurses reported that the screenings questionnaire was too lengthy and therefore time consuming. The implementation of the proactive primary care approach in daily practice was feasible. A strong interdisciplinary collaboration was realized. The program was easily adapted to the local context.

Domestic Travel and Regional Migration for Parathyroid Surgery Among Patients Receiving Care at Academic Medical Centers in the United States, 2012-2014.

PubMed

Hinson, Andrew M; Hohmann, Samuel F; Stack, Brendan C

2016-07-01

To improve outcomes after parathyroidectomy, several organizations advocate for selective referral of patients to high-volume academic medical centers with dedicated endocrine surgery programs. The major factors that influence whether patients travel away from their local community and support system for perceived better care remain elusive. To assess how race/ethnicity and insurance status influence domestic travel patterns and selection of high- vs low-volume hospitals in different regions of the United States for parathyroid surgery. A retrospective study was conducted of 36 750 inpatients and outpatients discharged after undergoing parathyroidectomy identified in the University HealthSystem Consortium database from January 1, 2012, to December 31, 2014 (12 quarters total). Each US region (Northeast, Mid-Atlantic, Great Lakes, Central Plains, Southeast, Gulf Coast, and West) contained 20 or more low-volume hospitals (1-49 cases annually), 5 or more mid-volume hospitals (50-99 cases annually), and multiple high-volume hospitals (≥100 cases annually). Domestic medical travelers were defined as patients who underwent parathyroidectomy at a hospital in a different US region from which they resided and traveled more than 150 miles to the hospital. Distance traveled, regional destination, and relative use of high- vs low-volume hospitals. A total of 23 268 of the 36 750 patients (63.3%) had parathyroidectomy performed at high-volume hospitals. The mean (SD) age of the study cohort was 71.5 (16.2) years (95% CI, 71.4-71.7 years). The female to male ratio was 3:1. Throughout the study period, mean (SD) distance traveled was directly proportional to hospital volume (high-volume hospitals, 208.4 [455.1] miles; medium-volume hospitals, 50.5 [168.4] miles; low-volume hospitals, 27.7 [89.5] miles; P < .001). From 2012 to 2014, the annual volume of domestic medical travelers increased by 15.0% (from 961 to 1105), while overall volume increased by 4.9% (from 11 681 to 12 252; P = .03). Nearly all (2982 of 3113 [95.8%]) domestic medical travelers had surgery at high-volume hospitals, and most of these patients (2595 of 3113 [83.4%]) migrated to hospitals in the Southeast. Domestic medical travelers were significantly more likely to be white (2888 of 3113 [92.8%]; P < .001) and have private insurance (1934 of 3113 [62.1%]; P < .001). Most patients with private insurance (12 137 of 17 822 [68.1%]) and Medicare (9433 of 15 121 [62.4%]) had surgery at high-volume hospitals, while the largest proportion of patients with Medicaid and those who were uninsured had surgery at low-volume hospitals (1059 of 2715 [39.0%]). Centralization of parathyroid surgery is a reality in the United States. Significant disparities based on race and insurance coverage exist and may hamper access to the highest-volume surgeons and hospitals. Academic medical centers with dedicated endocrine surgery programs should consider strategic initiatives to reduce disparities within their respective regions.

TRICARE; the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services (STS) program--DoD. Notice.

PubMed

1998-11-16

This notice is to advise interested parties that Dwight D. Eisenhower Army Medical Center (EAMC), Fort Gordon, Georgia, has been designated a regional Specialized Treatment Services facility (STSF) for Neurosurgery, Orthopedic Surgery, General Surgery, Peripheral Vascular Surgery, and Head and Neck Surgery. The application for this STSF designation was submitted by the Lead Agent for TRICARE Region 3 and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent will oversee that the STSF maintains the quality and standards required for specialized treatment services. This designation covers the following Diagnostic Related Groups: 001--Craniotomy, Age Greater than 17, Except for Trauma 004--Spinal Procedures 049--Major Head and Neck Procedures 191--Pancreas, Liver and Shunt Procedures with CC 110--Major Cardiovascular Procedures with CC 111--Major Cardiovascular Procedures without CC 286--Adrenal and Pituitary Procedures 209--Major Joint and Limb Reattachment Procedures of Lower Extremity 491--Major Joint and Limb Reattachment of Upper Extremity DoD beneficiaries who reside in the EAMC STS Catchment Area must be evaluated by EAMC before receiving TRICARE/CHAMPUS cost sharing for procedures that fall under the above Diagnostic Related Groups, in accordance with TRICARE/CHAMPUS Nonavailability Statement policy. Travel and lodging for the patient and, if stated to be medically necessary by a referring physician, for a nonmedical attendant, will be reimbursed by EAMC in accordance with the provisions of the Joint Federal Travel Regulation. Although evaluation in person is preferred, it is possible to conduct the evaluation telephonically if the patient is unable to travel to EAMC. If the procedure cannot be performed at EAMC, Humana Military Healthcare Services will provide a medical necessity review prior to issuance of a Nonavailability Statement or other similar authorizations. The EAMC STSF Catchment Area is defined by zip codes in the Defense Medical Information System STS Facilities Catchment Area Directory. The Catchment Area includes zip codes within TRICARE Region 3 that fall within a 200-mile radius of EAMC.

Medication Use among Veterans across Health Care Systems.

PubMed

Nguyen, Khoa A; Haggstrom, David A; Ofner, Susan; Perkins, Susan M; French, Dustin D; Myers, Laura J; Rosenman, Marc; Weiner, Michael; Dixon, Brian E; Zillich, Alan J

2017-03-08

Dual healthcare system use can create gaps and fragments of information for patient care. The Department of Veteran Affairs is implementing a health information exchange (HIE) program called the Virtual Lifetime Electronic Record (VLER), which allows providers to access and share information across healthcare systems. HIE has the potential to improve the safety of medication use. However, data regarding the pattern of outpatient medication use across systems of care is largely unknown. Therefore, the objective of this study is to describe the prevalence of medication dispensing across VA and non-VA health care systems among a cohort Veteran population. This study included all Veterans who had two outpatient visits or one inpatient visit at the Indianapolis VA during a 1-year period prior to VLER enrollment. Source of medication data was assessed at the subject level, and categorized as VA, INPC (non-VA), or both. The primary target was identification of sources for medication data. Then, we compared the mean number of prescriptions, as well as overall and pairwise differences in medication dispensing. Out of 52,444 Veterans, 17.4% of subjects had medication data available in a regional HIE. On average, 40 prescriptions per year were prescribed for Veterans who used both sources compared to 29 prescriptions per year from VA only and 25 prescriptions per year from INPC only sources. The annualized prescription rate of Veterans in the dual use group was 36% higher than those who had only VA data available and 61% higher than those who had only INPC data available. Our data demonstrated that 17.4% of subjects had medication use identified from non-VA sources, including prescriptions for antibiotics, antineoplastics, and anticoagulants. These data support the need for HIE programs to improve coordination of information, with the potential to reduce adverse medication interactions and improve medication safety.

EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

Determinants of geographic inequalities in HPV vaccination in the most populated region of France.

PubMed

Héquet, Delphine; Rouzier, Roman

2017-01-01

In France, there are recommendations and reimbursements for human papillomavirus (HPV) vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents' initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France. The data of this study were obtained from the National Health Insurance between 2011 and 2013. Correlations between vaccination initiation rate (at least 1 dose reimbursed) and socio-demographic/cultural factors were assessed using Pearson's product-moment correlation coefficient. Multivariate analyses were performed using logistic regression. In total, 121,636 girls received at least one HPV vaccine dose. The vaccination rate for girls born from 1996 to 1999 was 18.7%. Disparities in vaccination coverage rates were observed between the 8 departments of the region, ranging from 12.9% to 22.6%. At the department level, unemployment, proportion of immigrants and foreigners, and coverage by CMU health insurance ("Couverture Maladie Universelle", a health insurance plan for those who are not otherwise covered through business or employment and who have a low income) were significantly inversely correlated with vaccination rates, whereas urban residence, medical density, income and use of medical services were not related to coverage. In the multivariate model, only the percentage of foreigners remained independently associated with lower vaccination coverage. At the individual level, the use of medical services was a strong driver of HPV vaccination initiation. We observed geographic disparities in HPV vaccination initiation coverage. Even if no clear factor was identified as a vaccination determinant, we observed a failure of vaccination only based on parents' initiative. Therefore, an organized policy on HPV vaccination, such as school-based programs, can help improve coverage rates.

Bringing space technology down to earth

NASA Technical Reports Server (NTRS)

Gray, E. Z.

1974-01-01

The direct transfer of space technology to terrestial applications is demonstrated by the use of fuel cells to augment existing electric power-generation facilities. The role of NASA's Technology Utilization Program is discussed in regard to indirect transfer of technology. The Tech Brief program for identifying and reporting innovations, the regional dissemination centers, and the Applications Teams working with other government agencies and the medical community are described. Projects discussed include the development of a lightweight breathing apparatus for firemen, a practical method for separating nonferrous metals from automobile scrap, and a rechargeable heart pacemaker.

[Physical activity during cancer: Can we define participants' profiles?

PubMed

Villaron, Charlène; Marqueste, Tanguy; Eisinger, François; Cappiello, Maria Antonietta; Cury, François

2017-03-01

Benefits of physical activity during cancer treatment are widely demonstrated, however, most of patients are not active enough. Several studies have analyzed the different variables that would affect the participation to physical activity programs. The aim of our study was to define profiles of patients who agree to participate in a physical activity program in the medical setting according to the hospital structure in which they receive their care, their past and present habits in sports and their temporal perspectives. Forty-six patients treated from two different hospitals (regional hospital denoted CLCC; and local hospital denoted CH), completed a survey consisting of a questionnaire on their past and present habits in physical activity, ZTPI and a demographic questionnaire. Patients could decide to participate or not in a physical activity program in the medical community. T-tests and Chi 2 were performed to compare the two groups. Chi 2 tests have shown that patients cared in CH are significantly more involved in physical activity program than patients cared in CLCC. Our study points out that the past and present patient PA (physical activity) has no influence on their accession to a physical activity program, however the type of hospital providing patient care could influence their participation. These results should lead us to rethink about the different forms of communication made around the physical activity programs in medical contexts, and about different practical arrangements proposed according to each health facility. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Prevalence of Low-Cost Generic Program Use in a Nationally Representative Cohort of Privately Insured Adults.

PubMed

Pauly, Nathan James; Brown, Joshua David

2015-12-01

Administrative claims data are used for a wide variety of research and quality assurance purposes. Despite their utility, they are prone to medication exposure misclassification if medications are purchased without utilizing an insurance benefit. Low-cost generic programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. Since they were implemented in 2006, LCGPs are now available at 8 of the 10 largest pharmacy chains and include a wide variety of medication classes. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted and exposure may go unobserved in claims data. There are little data regarding the utilization of these programs, and estimates of their use can provide important insights into the potential impact LCGPs may have on exposure misclassification in claims data. To (a) quantify the prevalence of LCGP users in a privately insured adult population, (b) assess patterns of LCGP use, and (c) compare clinical and demographic characteristics associated with LCGP users and nonusers. The study cohort consisted of 19,037 privately insured adults aged 18-64 who participated in the Medical Expenditure Panel Survey (MEPS) from 2007-2011. MEPS captures medication utilization at the pharmacy level, so prescription fills can be observed irrespective of a claim being filed. Pharmaceutical utilization was assessed at the individual level for each year of the study period, and LCGP use was recorded as a binary variable for each individual. An LCGP medication fill was identified if the total cost of the drug was paid out of pocket and matched the cost of medications listed on LCGP formularies available from Target, Walmart, CVS, or other major pharmacy retailers during these years. Cohort demographics and characteristics of interest included age, gender, race, employment status, marital status, family income, education level, residence in a metropolitan statistical area (MSA), prescription drug coverage, geographic region, comorbidities, and number of unique medications and medication fills. Comparisons were made between users and nonusers using chi-square and t-tests. Multivariable logistic regression was used to identify factors associated with LCGP use. Out of the entire study cohort (N = 19,037), 6,921 (36.4%) individuals were identified as LCGP users, representing 34 million LCGP users annually. Users tended to be older, had higher Charlson Comorbidity Index scores, filled more prescriptions per person, and used more unique medications. Proportions of LCGP users and uses nearly doubled from 2007-2011, while total prescription utilization per person remained relatively stable. Over 10% of all prescription fills were filled through LCGPs. Of all LCGP fills, approximately 42% were for cardiovascular medications, 12% for antidiabetics, and 14% for levothyroxine. Greater than 30% of fills for antigout, metronidazole, angiotensin-converting enzyme inhibitors, levothyroxine, metformin, and diuretics were obtained through LCGPs, as were 18.9% of all warfarin fills. Compared with the reference category aged 18-34, adults aged 35-54 had an adjusted odds ratio (AOR) of being an LCGP user of 1.39 (95% CI = 1.29-1.50) and adults aged 55-64 had an AOR of 1.86 (95% CI = 1.70-2.04). Additionally, those with prescription drug coverage were nearly twice as likely to be LCGP users (AOR = 1.96; 95% CI = 1.64-2.35) compared with those without. Gender, income, comorbidity burden, region, year of panel entry, and number of unique medications also significantly predicted LCGP use. There is a high rate of LCGP use in the privately insured adult population. Users of LCGPs tend to be older, have more chronic comorbidities, and use more medications than nonusers. Claims-based research and quality assurance programs focusing on the benefits and harms of medications available through these programs are at risk of greatly underestimating the true medication exposure in this population and should account for this in sensitivity analyses. Managed care organizations should incentivize the reporting of LCGP medication use or make adjustments to generic medication benefit structures to more effectively capture true medication exposure.

Training and professional profile of retinologists in Spain: Retina 2 project, Report 4.

PubMed

Pastor, J Carlos; Fernández, Itziar; Rojas, Jimena; Coco, Rosa; Sanabria, Maria R; Rodríguez-de la Rúa, Enrique; Sánchez, Diego; Valverde, Carmen; Sala-Puigdollers, Anna

2011-01-01

Uniform postresidency systems to train medical specialists have not been developed in most European countries. Before developing a framework for such a system, we established the learning and professional profiles of Spanish ophthalmologists dedicated to medical retina and vitreoretina subspecialties. After identification of presumed subspecialists by experts from different autonomous regions, a self-administered questionnaire was mailed in 2006. A reminder was sent three weeks later. Postal mail was used. Nonresponder bias was determined. Of 492 possible retina subspecialists, 261 replied to the questionnaires. While about 86% received specific retinal training, standardized fellowship programs were uncommon for both medical retina and vitreoretina (around 10%). Of the responders, 24.5% performed only medical retina, 11.8% vitreoretina, and 63.6% both. Most (60.5%) practiced anterior segment surgery, and 78.7% declared skills in vitrectomy. We have developed a database of Spanish ophthalmologists dedicated to retinal pathologies and identified some characteristics of their professional profile. Although most of them have received specific retinal training, standardized mastership programs are still uncommon. These data will be useful in creating a standardized Retina Mastership, an important goal of the European Higher Education Area.

Reforming Cardiovascular Care in the United States towards High-Quality Care at Lower Cost with Examples from Model Programs in the State of Michigan.

PubMed

Alyeshmerni, Daniel; Froehlich, James B; Lewin, Jack; Eagle, Kim A

2014-07-01

Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA), and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act.

An historical overview of the National Network of Libraries of Medicine, 1985–2015

PubMed Central

Speaker, Susan L.

2018-01-01

The National Network of Libraries of Medicine (NNLM), established as the Regional Medical Library Program in 1965, has a rich and remarkable history. The network’s first twenty years were documented in a detailed 1987 history by Alison Bunting, AHIP, FMLA. This article traces the major trends in the network’s development since then: reconceiving the Regional Medical Library staff as a “field force” for developing, marketing, and distributing a growing number of National Library of Medicine (NLM) products and services; subsequent expansion of outreach to health professionals who are unaffiliated with academic medical centers, particularly those in public health; the advent of the Internet during the 1990s, which brought the migration of NLM and NNLM resources and services to the World Wide Web, and a mandate to encourage and facilitate Internet connectivity in the network; and the further expansion of the NLM and NNLM mission to include providing consumer health resources to satisfy growing public demand. The concluding section discusses the many challenges that NNLM staff faced as they transformed the network from a system that served mainly academic medical researchers to a larger, denser organization that offers health information resources to everyone. PMID:29632439

An historical overview of the National Network of Libraries of Medicine, 1985-2015.

PubMed

Speaker, Susan L

2018-04-01

The National Network of Libraries of Medicine (NNLM), established as the Regional Medical Library Program in 1965, has a rich and remarkable history. The network's first twenty years were documented in a detailed 1987 history by Alison Bunting, AHIP, FMLA. This article traces the major trends in the network's development since then: reconceiving the Regional Medical Library staff as a "field force" for developing, marketing, and distributing a growing number of National Library of Medicine (NLM) products and services; subsequent expansion of outreach to health professionals who are unaffiliated with academic medical centers, particularly those in public health; the advent of the Internet during the 1990s, which brought the migration of NLM and NNLM resources and services to the World Wide Web, and a mandate to encourage and facilitate Internet connectivity in the network; and the further expansion of the NLM and NNLM mission to include providing consumer health resources to satisfy growing public demand. The concluding section discusses the many challenges that NNLM staff faced as they transformed the network from a system that served mainly academic medical researchers to a larger, denser organization that offers health information resources to everyone.

Mentoring program design and implementation in new medical schools

PubMed Central

Fornari, Alice; Murray, Thomas S.; Menzin, Andrew W.; Woo, Vivian A.; Clifton, Maurice; Lombardi, Marion; Shelov, Steven

2014-01-01

Purpose Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established. PMID:24962112

Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey.

PubMed

Sun, Xiaoming; Li, Yanting; Liu, Shanshan; Lou, Jiquan; Ding, Ye; Liang, Hong; Gu, Jianjun; Jing, Yuan; Fu, Hua; Zhang, Yimin

2015-01-01

The performance of community health service centers (CHSCs) has not been well monitored and analysed since China's latest community health reforms in 2009. The aim of the current investigation was to evaluate the performing trends of the CHSCs and to analyze the main factors that could affect the performance in Pudong new district of Shanghai, China. A regional performance assessment indicator system was applied to the evaluation of Pudong CHSCs' performance from 2011 to 2013. All of the data were sorted out by a panel, and analyzed using descriptive statistics and a generalized estimating equation model. We found that the overall performance increased annually, with a growing number of CHSCs achieving high scores. Significant differences were observed in institutional management, public health services, basic medical services and comprehensive satisfaction during the period of three years. However, we found no differences in the service scores of Chinese traditional medicine (CTM). The investigation also demonstrated that the key factors affecting performance were the location, information system level, family GP program and medical association program rather than the size of the center. However, the medical association participation appeared to have a significant negative effect on performance. It can be concluded from the three-year investigation that the overall performance was improved, but that it could have been further enhanced, especially in institutional management and basic medical service; therefore, it is imperative that CHSCs undertake approaches such as optimizing the resource allocation and utilization, reinforcing the establishment of the information system level, extending the family GP program to more local communities, and promoting the medical association initiative.

SADC establishes a regional action plan.

PubMed

Klouda, T

1997-02-01

The regional meeting held on AIDS strategy in Lilongwe, Malawi, in December, 1996, made important advances. The 12 countries of the SADC (Southern Africa Development Community) joined the European Union to institute a regional action plan for the reduction of susceptibility of people to HIV because of social, cultural, and environmental factors; the vulnerability of people with HIV infection to social and other difficulties; and the vulnerability of institutions because of the foregoing impacts. At the conference the issues explored were employment, mining, medical drugs, education, and tourism. An employment charter was seen as crucial for the success of AIDS and workplace activities. Facilitation of travel across borders was important for the reduction of susceptibility to HIV infection. Enhancement of regional policies for essential drugs was vital for drugs for the treatment of AIDS. The clarification of the regional role was critical for regional support of national action (strengthening technical and institutional capacities) and for regional joint action such as studies on research, harmonization of data collection on HIV/AIDS; organization of training; development of information and education on HIV/AIDS; facilitation of manufacturing of drugs and condoms; and the development of a regional information and education program about HIV/AIDS. The conference also clarified HIV/AIDS programs in relation to other health and socioeconomic problems.

Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia

PubMed Central

Devi, B. C. R.; Corbex, M.

2008-01-01

Background: The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. Methods: The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. Results: The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from <200 g in 1993 to >1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. Conclusion: The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population. PMID:18641007

SDC DOCUMENTS APPLICABLE TO STATE AND LOCAL GOVERNMENT PROBLEMS.

DTIC Science & Technology

Public administration , Urban and regional planning, The administration of justice, Bio-medical systems, Educational systems, Computer program systems, The development and management of computer-based systems, Information retrieval, Simulation. AD numbers are provided for those documents which can be obtained from the Defense Documentation Center or the Department of Commerce’s Clearinghouse for Federal Scientific and Technical Information.

76 FR 12074 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... psychiatric hospitals and units with low TRICARE volume will have their TRICARE rates for Fiscal Year 2011...

1995-1996 SAEM emergency medicine faculty salary/benefits survey.

PubMed

Kristal, S L; Thompson, B M; Marx, J A

1998-12-01

The Society for Academic Emergency Medicine (SAEM) commissioned an emergency medicine (EM) faculty salary and benefit survey for all 1995 Residency Review Committee in Emergency Medicine (RRC-EM)-accredited programs using the SAEM third-generation survey instrument. Responses were collected by SAEM and blinded from the investigators. Seventy-six of 112 (68%) accredited programs responded, yielding data for 1,032 full-time faculty among the four Association of American Medical Colleges (AAMC) regions. Blinded program and individual faculty data were entered into a customized version of Filemaker Pro, a relational database program with a built-in statistical package. Salary data were sorted by 115 separate criteria such as program regions, faculty title, American Board of Emergency Medicine (ABEM) certification, academic rank, years postresidency, program size, and whether data were reported to AAMC. Demographic data from 132 categories were analyzed and included number of staff and residents per shift, number of intensive care unit (ICU) beds, obstacles to hiring new staff, and specific type and value of fringe benefits offered. Data were compared with those from the 1990 and 1992 SAEM and the 1995-96 AAMC studies. Mean salaries were reported as follows: all faculty, $158,100; first-year faculty, $131,074; programs reporting data to AAMC, $152,198; programs not reporting data to AAMC, $169,251. Mean salaries as reported by AAMC region: northeast, $155,909; south, $155,403; midwest, $172,260; west, $139,930. Mean salaries as reported by program financial source: community, $175,599; university, $152,878; municipal, $141,566. Reported salaries for full-time EM residency faculty continue to rise. Salaries in programs reporting data to the AAMC are considerably lower than those not reporting. The gap between ABEM-certified and non-ABEM-certified faculty continues to widen. Residency-trained faculty are now shown to earn more than non-residency-trained faculty. Significant regional differences in salaries have been present in all three SAEM surveys.

Using a medical volunteer program to motivate medical freshmen.

PubMed

Na, Beag Ju; Hur, Yera; Yun, Jungmin; Kang, Jaegu; Han, Seungyeon; Whang, Wonmin; Lee, Keumho; Lee, Jungmin

2013-09-01

A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students' motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.

Prevalence of risk and protective factors associated with heat-related outcomes in Southern Quebec: A secondary analysis of the NuAge study.

PubMed

Laverdière, Émélie; Généreux, Mélissa; Gaudreau, Pierrette; Morais, José A; Shatenstein, Bryna; Payette, Hélène

2015-06-18

Heat vulnerability is increasing owing to climate change, aging and urbanization. This vulnerability may vary geographically. Our study examined the prevalence and distribution of risk and protective factors of heat-related outcomes among older adults across three health regions of Southern Quebec (Canada). This secondary cross-sectional study used data from the 1st follow-up of the NuAge longitudinal study, a cohort of community-dwelling older adults, aged 68-82 years at baseline, of three health regions: Eastern Townships, Montreal and Laval. Prevalence of factors, identified in Health Canada guidelines, was measured. An Older Adult Heat Vulnerability Index (OAHVI) simultaneously considering medical, social and environmental factors was constructed. The distribution of each factor and OAHVI was examined across the three regions. Results were weighted for age, sex (overall and region-specific analyses) and region (overall analyses). Ninety percent of participants had ≥1 risk factor, the most prevalent being: cardiovascular medication (50.8%), hypertension (46.7%), living alone (39.2%), cardiovascular disease (36.9%), living in an urban heat island (34.7%) and needing help in activities of daily living (26.5%). Two thirds of participants had ≥1 protective factor, the most prevalent being talking on the phone daily (70.9%). Heat vulnerability varied greatly by region and this variation was mainly attributable to social and environmental rather than medical factors. According to the OAHVI, 87.2% of participants cumulated ≥2 factors (median = 3.0 factors/participant). Our results support the need for small-scale assessment of heat vulnerability. This study could help stakeholders tackle heat-related illness and develop regionally tailored prevention programs.

Impact of managed MediCal on California family practice programs.

PubMed

Zweifler, J A

2001-05-01

An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

Social accountability of medical schools and academic primary care training in Latin America: principles but not practice.

PubMed

Puschel, Klaus; Rojas, Paulina; Erazo, Alvaro; Thompson, Beti; Lopez, Jorge; Barros, Jorge

2014-08-01

Latin America has one of the highest rates of health disparities in the world and is experiencing a steep increase in its number of medical schools. It is not clear if medical school authorities consider social responsibility, defined as the institutional commitment to contribute to the improvement of community well-being, as a priority and if there are any organizational strategies that could reduce health disparities. To study the significance and relevance of social responsibility in the academic training of medical schools in Latin America. The study combined a qualitative thematic literature review of three databases with a quantitative design based on a sample of nine Latin American and non-Latin American countries. The thematic analysis showed high agreement among academic groups on considering medical schools as 'moral agents', part of a 'social contract' and with an institutional responsibility to reduce health disparities mainly through the implementation of strong academic primary care programs. The quantitative analysis showed a significant association between higher development of academic primary care programs and lower level of health disparities by country (P = 0.028). However, the data showed that most Latin American medical schools did not prioritize graduate primary care training. The study shows a discrepancy between the importance given to social responsibility and academic primary care training in Latin America and the practices implemented by medical schools. It highlights the need to refocus medical education policies in the region. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Current status and problems of regional maternal and child health education in the curriculum of midwifery education].

PubMed

Murayama, I

1989-01-01

According to the evaluations made by medical Technical Junior Colleges in Japan, general objectives in midwifery education are met, but their curriculum does not cater to each region's health care needs sufficiently. Japanese midwifery students can either attend a 6 month training program offered at 80 different locations, or enroll in a 1 year special-major program at one of the 10 Medical Technical Junior Colleges affiliated with National Universities. According to the curriculum revised in 1971, midwifery students are required to take the following courses and hours in 6 months. Intro. to Maternal and Child Health (15 hours), Maternal and Child Health Medicine (60 hours), Lecture on Midwifery (105 hrs), Practice in Midwifery (135 hrs), Midwifery Business Administration (60 hrs), Maternal and Child Health Administration including internship (225 hrs), Regional Maternal and Child Health including internship (105 hrs) and Family Sociology (15 hours). Regional Maternal and Child Health course (RMCH) is effectively taught only if all the maternal and child health courses and lecture on midwifery are taken beforehand. Objectives for RMCH course are becoming able to assess the state of maternal and child health care in the region and give constructive criticism and suggestions for improvement including legal aspects, acquiring positive attitudes and necessary skills for advancing and having understanding of regional health care and that of midwives' role of it. While the curriculum prepares the students for meeting the patients' physical needs, the students are not ready to cope with their psychological and socio-physiological problems surrounding individuals, families and communities. Changes and diversification of regional communities should be taken into consideration also in the curriculum. Increase in nuclear families, increase in working wives, isolation and/or over-crowding of high rise apartment living are some of the examples. Midwifery activity is also expected to expand to include care for puberty and menopausal population.

Defining new aims for BME programs in Latin America: the case of UAM-Iztapalapa.

PubMed

Azpiroz-Leehan, J; Martinez, L F; Urbina, M E G; Cadena, M M; Sacristan, E

2016-08-01

The need for upkeep and management of medical technology has fostered the creation of a large number of under graduate programs in the field of biomedical Engineering. In Latin America alone, there are over 85 programs dedicated to this. This contrasts with programs in other regions where most of the undergraduates continue on to pursue graduate degrees or work as research and development engineers in the biomedical industry. In this work we analyze the situation regarding curricular design in the 48 BME programs in Mexico and compare this to suggestions and classifications of programs according to needs and possibilities. We then focus on a particular institution, Universidad Autónoma Metropolitana and due to its characteristics and performance we propose that it should redefine its aims from the undergraduate program on, in order to not only generate research but also to provide a nurturing environment for a budding biomedical industry in Mexico.

Designing anatomy program in modern medical curriculum: matter of balance.

PubMed

Grković, Ivica; Marinović Guić, Maja; Kosta, Vana; Poljicanin, Ana; Carić, Ana; Vilović, Katarina

2009-02-01

To evaluate the structure of the anatomy program in the first year medical curriculum of University of Split School of Medicine by comparing it with the recommendations by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) and the Terminologia Anatomica (TA); we also quantitatively evaluated the organization of teaching material in contemporary topographical anatomy textbooks and matched them with the AACA recommendations, TA, and the curriculum of the anatomy course taught at Medical School in Split, Croatia. TA, official recommendations of the AACA, 6 contemporary anatomy textbooks, and the structure of the anatomy course were analyzed for the proportion of the terms or text devoted to standard topographical regions of the body. The findings were correlated using Spearman rho test. The curriculum outline correlated both with the AACA recommendations (Spearman rho=0.83, P=0.015) and TA (Spearman rho=0.73, P=0.046). Textbooks contained 8 distinct sections, 7 allocated to topographic anatomy regions and 1 to general anatomy concepts and principles. The structure of all textbooks correlated significantly with the course curriculum. However, 4 out of 6 textbooks did not correlate with TA and only a single textbook showed significant correlation with the AACA recommendations. Anatomy textbooks vary in the amount of text dedicated to different parts of topographical anatomy and are not quite concordant with curriculum recommendations and standard anatomical terminology. Planning the structure of an anatomy course should not be based on a single book or recommendation but on evidence.

Clerkship maturity: does the idea of training clinical skills work?

PubMed

Stosch, Christoph; Joachim, Alexander; Ascher, Johannes

2011-01-01

With the reformed curriculum "4C", the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated. Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the concept of Clerkship Maturity. The Cologne training program Clerkship Maturity can be validated empirically overall through the activities of the students awaiting the clerkship framework and through the evaluation by the medical staff providing the training. The subjective ratings of the advantages of the training by the students leave room for improvement. Apart from minor improvements to the program, the most likely solution providing sustainable results will involve an over-regional strategy for establishing skills training planned as part of the curriculum.

Roadmap for creating an accelerated three-year medical education program

PubMed Central

Leong, Shou Ling; Cangiarella, Joan; Fancher, Tonya; Dodson, Lisa; Grochowski, Colleen; Harnik, Vicky; Hustedde, Carol; Jones, Betsy; Kelly, Christina; Macerollo, Allison; Reboli, Annette C.; Rosenfeld, Melvin; Rundell, Kristen; Thompson, Tina; Whyte, Robert; Pusic, Martin

2017-01-01

ABSTRACT Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development – meeting regulatory requirements, attaining institutional buy-in and resources necessary to support the programs, including student assessment and mentoring – and program evaluation. Accelerated programs offer opportunities to innovate and integrate a mission benefitting students and the public. Abbreviations: CAMPP: Consortium of accelerated medical pathway programs; GME: Graduate medical education; LCME: Liaison committee on medical education; NRMP: National residency matching program; UME: Undergraduate medical education PMID:29117817

Roadmap for creating an accelerated three-year medical education program.

PubMed

Leong, Shou Ling; Cangiarella, Joan; Fancher, Tonya; Dodson, Lisa; Grochowski, Colleen; Harnik, Vicky; Hustedde, Carol; Jones, Betsy; Kelly, Christina; Macerollo, Allison; Reboli, Annette C; Rosenfeld, Melvin; Rundell, Kristen; Thompson, Tina; Whyte, Robert; Pusic, Martin

2017-01-01

Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development - meeting regulatory requirements, attaining institutional buy-in and resources necessary to support the programs, including student assessment and mentoring - and program evaluation. Accelerated programs offer opportunities to innovate and integrate a mission benefitting students and the public. CAMPP: Consortium of accelerated medical pathway programs; GME: Graduate medical education; LCME: Liaison committee on medical education; NRMP: National residency matching program; UME: Undergraduate medical education.

A comprehensive health program in a manganese ore mining community in the Amazon region of Brazil.

PubMed

Gusmão, H H

1980-05-01

It is clear that organizations which conduct operations in undeveloped areas lacking medical and sanitary facilities must assume responsibilities in broad areas of health service and environmental control. These responsibilities go far beyond those of traditional occupational medicine. In addition, adequate provision must be made to counteract stresses which may be associated with radical cultural and situational change.

The current status of education and career paths of students after completion of medical physicist programs in Japan: a survey by the Japanese Board for Medical Physicist Qualification.

PubMed

Kadoya, Noriyuki; Karasawa, Kumiko; Sumida, Iori; Arimura, Hidetaka; Yamada, Syogo

2015-07-01

To standardize educational programs and clinical training for medical physics students, the Japanese Board for Medical Physicist Qualification (JBMP) began to accredit master's, doctorate, and residency programs for medical physicists in 2012. At present, 16 universities accredited by the JBMP offer 22 courses. In this study, we aimed to survey the current status of educational programs and career paths of students after completion of the medical physicist program in Japan. A questionnaire was sent in August 2014 to 32 universities offering medical physicist programs. The questionnaire was created and organized by the educational course certification committee of the JBMP and comprised two sections: the first collected information about the university attended, and the second collected information about characteristics and career paths of students after completion of medical physicist programs from 2008 to 2014. Thirty universities (16 accredited and 14 non-accredited) completed the survey (response rate 94 %). A total of 209, 40, and 3 students graduated from the master's, doctorate, and residency programs, respectively. Undergraduates entered the medical physicist program constantly, indicating an interest in medical physics among undergraduates. A large percentage of the students held a bachelor's degree in radiological technology (master's program 94 %; doctorate program 70 %); graduates obtained a national radiological technologist license. Regarding career paths, although the number of the graduates who work as medical physicist remains low, 7 % with a master's degree and 50 % with a doctorate degree worked as medical physicists. Our results could be helpful for improving the medical physicist program in Japan.

Readiness: observations and comments from a medical team deployment.

PubMed

Popper, S E; Noble, D E; Mason, L J; Schaffer, L A; Glover, J G; Barkley, M S

1997-02-01

The evolving strategy of the United States in dealing with the changing world order calls for a force structure capable of fighting and winning two nearly simultaneous major regional conflicts and conducting a range of other military operations. Readiness is a key factor in this new strategy. Consequently, major paradigm shifts are occurring within the Air Force Medical Service. Maintaining current and accurate medical records on personnel to meet deployment requirements is a significant challenge. Historically, time and resources are consumed determining the deployability of troops prior to a deployment. This adds to the cost of doing business and increases the time required to clear the deploying team, even though there is an established process to avoid these very problems. The experience of a recent medical team deployment to Bosnia is discussed. Future directions given the implementation of TRI-CARE, the Preventive Health Assessment Program, and the Strategic Health Resourcing Plan are also considered.

[Postgraduate training program in neurology at the regional hospitals in Hokkaido area].

PubMed

Matsumoto, Akihisa

2007-11-01

In the new post graduate training system, the 55% of interns in the Hokkaido area choosed the post graduate training at the general hospitals and 45% of them choosed the medical universities (Hokkaido university, Asahikawa medical university, Sapporo medical university). Furthermore, 23% of interns in Hokkaido area choosed the general hospitals and medical universities in Sapporo city. As to the post graduate training system in neurology, 5 hospitals included the neurology for at least 1 month to 3 months. On the other hand, in one general hospital in Sapporo city, the clinical training of neurology was not included in the post graduate training system. During 2 years of the new post graduate training system, only 25% of the interns could rotate the neurological department. Since the neurology training course is necessary for the post graduate training system, it is suggested to need to support the opportunity to rotate the neurology for the interns.

Public Health Education for Emergency Medicine Residents

PubMed Central

Betz, Marian E.; Bernstein, Steven L.; Gutman, Deborah; Tibbles, Carrie D.; Joyce, Nina; Lipton, Robert; Schweigler, Lisa; Fisher, Jonathan

2015-01-01

Emergency medicine (EM) has an important role in public health, but the ideal approach for teaching public health to EM residents is unclear. As part of the national regional public health–medicine education centers-graduate medical education (RPHMEC-GM) initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create public health curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine public health and EM clinical topics during usual residency didactics, one partnered with local public health organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health–oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward public health, and a majority of EM residents at that program believed public health training is important. Reliance on pre-existing community partnerships facilitated development of public health rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for public health education for EM residents has not been defined. PMID:21961671

Strengthening professionals: a chapter-level formative evaluation of the Medical Library Association mentoring initiative.

PubMed

Kwasik, Hanna; Fulda, Pauline O

2006-01-01

The main objective was to determine to what extent the Medical Library Association (MLA) mentoring initiative was implemented in the South Central Chapter of the Medical Library Association (SCC/ MLA) and to identify the needs, improvements, and adjustments in mentoring services for the future to improve the practice of librarianship. The data were collected by administering an anonymous structured survey designed by the authors. The survey was mailed to all 335 chapter members. The authors elicited responses to determine the chapter members' mentoring needs, awareness of available resources, satisfaction with existing services and resources, needs for the future, and suggestions to meet those needs. Of the 335 delivered surveys, 184 were returned, yielding a return rate of 55%. Eighty percent had a mentor or mentors in their careers, and 74% were either very satisfied or satisfied with the relationship. The majority considered having a mentor a critical part of the professional experience. The mentoring activity chosen by respondents as the most important was improvement of job performance through skills development. Over 50% were aware of SCC/MLA's mentoring activities, and less than 50% were aware of MLA's mentoring Website. The rate of response and the wealth of comments provided by respondents document the high level of interest in mentoring by medical librarians in the region. The following mentoring services were equally important to SCC/MLA members and were recommended for improvement or development at the regional level: a formalized mentoring program in the region, Web-based mentoring resources on the SCC/MLA Website, and a continuing education course for mentors. Members are aware of mentoring activities in the region; however, participation levels need to be increased in activities that SCC/MLA and MLA provide. Mentoring continues to evolve as a service in the profession.

Training mid- to late-career health professionals for clinical work in low-income regions abroad.

PubMed

Harris, W Andrew; Spencer, Peter; Winthrop, Kevin; Kravitz, Jay

2014-01-01

Oregon Health & Science University (OHSU) Global Health Center has developed a unique training program-Professionals' Training in Global Health (PTGH)--for mid- and late-career health professionals wanting to perform clinical services overseas in low-income countries. A multidisciplinary, multifaceted, structured curriculum underpins the clinical retraining, with classes aimed to be practical for clinical settings in resource-poor regions of the world. Preceptorships in family medicine and emergency medicine offer specialists the opportunity to observe primary care physicians one-on-one. In addition, PTGH trainees volunteer at free medical clinics where they work under the guidance and supervision of a family physician. For those individuals who live at some distance from Portland, Oregon, the course offers live videoconferencing, as well as archived streaming for later review. As of November 2013, 79 health professionals have completed the course, with 45 graduates having subsequently volunteered on one or more overseas medical missions, for a total of 109 medical service visits to 36 countries. Pre- and post-course testing shows improvements in clinical skills and knowledge base. Professionals' Training in Global Health has a 6-year record of interprofessional training and service both overseas and at home. The course has trained physicians, nurses, nurse practitioners, physician assistants, midwives, paramedics and other health professionals. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

A sense of place: rural training at a regional medical school campus.

PubMed

Crump, William J; Barnett, Darel; Fricker, Steve

2004-01-01

Traditionally, rural students experience urban disruption during the many years of education and training in urban environments before choosing a practice site. Regional rural campuses that allow students to live and work in small towns during the last 2 years of medical school are one strategy to address this issue. To report the results of the first 10 years of a rural campus in western Kentucky, including response to difficulties filling openings for third- and fourth-year medical students at the campus. A survey was sent to all 76 students who had shown interest in the rural campus, asking them to prioritize the important issues in their campus choice. Students not choosing the rural campus placed a higher priority on large-city amenities, better opportunities for their spouse, and proximity to family in eastern and central Kentucky. Students who chose the rural campus placed a higher priority on one-on-one clinical training and interest in small town life. For the rural clinical campus to reach its potential, more rural students from the western part of the state must be admitted to medical school and then choose this campus. Strategies to reinforce the sense of place among rural students focus on experiential programs in rural areas. Initial results suggest that medical educators should consider geography more carefully when designing approaches to address physician maldistribution.

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

PubMed

Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

2017-01-01

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung plus Baden-Württemberg" (VWB plus BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice. Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB plus BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program's content closely on the needs of the target groups, scientifically based evaluations and research are carried out. Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung plus program was developed based on that of the VWB plus BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published. Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB plus BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB plus BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians - something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB plus BW program positively influences the number of general practitioners.

Development of regional extracorporeal life support system: The importance of innovative simulation training.

PubMed

Puślecki, Mateusz; Ligowski, Marcin; Dąbrowski, Marek; Stefaniak, Sebastian; Ładzińska, Małgorzata; Pawlak, Aleksander; Zieliński, Marcin; Szarpak, Łukasz; Perek, Bartłomiej; Jemielity, Marek

2018-04-18

Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS. The primary objective was to present an innovative approach for using high-fidelity medical simulation before setting ECMO program for reversible respiratory failure (RRF) in Poland's first unique regional program "ECMO for Greater Poland", covering a total population of 3.5 million inhabitants in the Greater Poland region (Wielkopolska). Because this organizational model is complex and expensive, we use advanced high-fidelity medical simulation to prepare for the real-life implementation. The algorithm was proposed for respiratory treatment by veno-venous (VV) Extracorporeal Membrane Oxygenation (ECMO). The scenario includes all critical stages: hospital identification (Regional Department of Intensive Care) - inclusion and exclusion criteria matching using an authorship protocol; ECMO team transport; therapy confirmation; veno-venous cannulation of mannequin's artificial vessels and implementation of perfusion therapy and transport with ECMO to another hospital in a provincial city (Clinical Department of Intensive Care), where the VV ECMO therapy was performed in the next 48 h, as training platform. The total time, by definition, means the time from the first contact with the mannequin to the cannulation of artificial vessels and starting VV perfusion on ECMO, did not exceed 3 h - including 75 min of transport (the total time of simulation with first call from provincial hospital to admission to the Clinical Intensive Care department was 5 h). The next 48 h for perfusion simulation "in situ" generated a specific learning platform for intensive care personnel. Shortly after this simulation, we performed, the first in the region: ECMO used for RRF treatment. The transport was successful and exceeded 120 km. During first year of Program duration we performed 6 successful ECMO transports (5 adult and 1 paediatric) with 60% of adult patient survival of ECMO therapies. Three patients in good condition were discharged to home. Two years old patient was successfully disconnected from ECMO and in stabile condition is treated in Paediatric Department. We discovered the important role of medical simulation, not only as an examination for testing the medical professional's skills, but also as a mechanism for creating non-existent procedures. During debriefing, it was found that the previous simulation-based training allowed to build a successful procedural chain, to eliminate errors at the stage of identification, notification, transportation and providing ECMO perfusion therapy. Copyright © 2018. Published by Elsevier Inc.

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis

PubMed Central

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

ABSTRACT Background: Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. Objective: We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. Design: I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Results: Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. Conclusions: The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. Abbreviations: AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship PMID:28789602

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis.

PubMed

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship.

Correlates of unequal access to preventive care in China: a multilevel analysis of national data from the 2011 China Health and Nutrition Survey.

PubMed

Huang, Chi; Liu, Chao-Jie; Pan, Xiong-Fei; Liu, Xiang; Li, Ning-Xiu

2016-05-12

Preventive care has an essential role in reducing income-related health inequalities. Despite a general consensus of the need of shifting focus from disease treatment to wellness and prevention, little is known about inequalities in access to preventive care in China. Our study aimed to explore the inequalities in preventive care usage and factors that were associated with such inequalities among Chinese adults. Multilevel logistic regression analyses were performed using national data from the 2011 Chinese Health and Nutrition Survey. The study sample comprised 13,483 adults who were covered by Basic Social Medical Insurance (BSMI). We analyzed individual socioeconomic status (marital status, education attainment, annual household income per capita, and medical insurance) and contextual factors for their influence on preventive care usage (region of residence and type of community) after controlling for health needs (age, sex, and health condition). Out of the participants, 6.9 % received preventive care services over the past four weeks and 3.9 % went for a general physical examination prior to the survey. We noted regional disparities in the overall use of preventive care and specific use of general physical examination, with residents from central and northeastern regions less likely to use preventive care including general physical examination than in the more affluent eastern region. Lower levels of education and income were associated with reduced use of preventive care. Subscriptions to less generous social medical insurance programs such as Urban Resident-based Medical Insurance Scheme or New Rural Cooperative Medical Scheme were associated with decreased specific use of general physical examinations, but not overall use of preventive care. Inequalities in preventive care usage were evident in China, and were associated with health needs and socioeconomic characteristics. Current health insurance arrangements may fail to reduce inequalities relating to preventive care. A fair and more coherent policy across all BSMI schemes is needed.

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors

PubMed Central

2012-01-01

Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of “breaking bad news,” the handling of negative emotions, discontinuities in participation, the hierarchical doctor-patient relationship, culture-specific syndromes and language barriers. In addition to practical skills for daily clinical practice, the participants wanted to learn more about didactic teaching methods. Half a year after the completion of the training program, the participants stated that the program had a great impact on their daily medical practice. Conclusions The training in psychosomatic medicine for postgraduate medical doctors resulted in a positive response and is an important step in addressing the barriers in providing psychosomatic primary care. The transferability of western concepts should be tested locally, and adaptations should be undertaken where necessary. The revised curriculum forms the basis of training in psychosomatic medicine and psychotherapy for medical students and postgraduate doctors in China, Vietnam and Laos. PMID:22929520

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors.

PubMed

Fritzsche, Kurt; Scheib, Peter; Ko, Nayeong; Wirsching, Michael; Kuhnert, Andrea; Hick, Jie; Schüßler, Gerhard; Wu, Wenyuan; Yuan, Shen; Cat, Nguyen Huu; Vongphrachanh, Sisouk; Linh, Ngo Tich; Viet, Ngyuen Kim

2012-08-29

With the "ASIA-LINK" program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of "breaking bad news," the handling of negative emotions, discontinuities in participation, the hierarchical doctor-patient relationship, culture-specific syndromes and language barriers. In addition to practical skills for daily clinical practice, the participants wanted to learn more about didactic teaching methods. Half a year after the completion of the training program, the participants stated that the program had a great impact on their daily medical practice. The training in psychosomatic medicine for postgraduate medical doctors resulted in a positive response and is an important step in addressing the barriers in providing psychosomatic primary care. The transferability of western concepts should be tested locally, and adaptations should be undertaken where necessary. The revised curriculum forms the basis of training in psychosomatic medicine and psychotherapy for medical students and postgraduate doctors in China, Vietnam and Laos.

Humanities for medical students? A qualitative study of a medical humanities curriculum in a medical school program

PubMed Central

Wachtler, Caroline; Lundin, Susanne; Troein, Margareta

2006-01-01

Background Today, there is a trend towards establishing the medical humanities as a component of medical education. However, medical humanities programs that exist within the context of a medical school can be problematic. The aim of this study was to explore problems that can arise with the establishment of a medical humanities curriculum in a medical school program. Methods Our theoretical approach in this study is informed by derridean deconstruction and by post-structuralist analysis. We examined the ideology of the Humanities and Medicine program at Lund University, Sweden, the practical implementation of the program, and how ideology and practice corresponded. Examination of the ideology driving the humanities and medicine program was based on a critical reading of all available written material concerning the Humanities and Medicine project. The practice of the program was examined by means of a participatory observation study of one course, and by in-depth interviews with five students who participated in the course. Data was analysed using a hermeneutic editing approach. Results The ideological language used to describe the program calls it an interdisciplinary learning environment but at the same time shows that the conditions of the program are established by the medical faculty's agenda. In practice, the "humanities" are constructed, defined and used within a medical frame of reference. Medical students have interesting discussions, acquire concepts and enjoy the program. But they come away lacking theoretical structure to understand what they have learned. There is no place for humanities students in the program. Conclusion A challenge facing cross-disciplinary programs is creating an environment where the disciplines have equal standing and contribution. PMID:16519815

How a south Florida hospital targeted Hispanic consumers.

PubMed

Weinstein, A

1988-02-01

Last month's "Case in Point" presented AMI Parkway Regional Medical Center, a 412-bed acute care hospital in North Miami Beach, Fla. The hospital's administration has recognized the ethnic make-up of the South Florida market (white, black and Hispanic) and wants to increase its penetration into the large and potentially lucrative Latin market. The hospital is one of six in South Florida that are owned by American Medical International Inc., Los Angeles. Parkway recently completed a modernization and development program that resulted in an expanded emergency department, state-of-the-art critical care units, a cost-saving ambulatory unit and facilities for outpatient and community education programs. Positioned in a fiercely competitive market, Parkway has adopted an aggressive marketing posture. The marketing function has been elevated to one of six hospital divisions, sharing equal footing with finance, professional services, administrative services, nursing and human resources. Given the hospital's reputation for action and the previous success of programs based on market research, the assistant administrator for marketing and business development secured support for research on the Latin market.

[The role of medical university in modern prevention of cardiovascular diseases. Examples from Medical University of Gdańsk].

PubMed

Zdrojewski, Tomasz; Wierucki, Lukasz; Ignaszewska-Wyrzykowska, Agata; Zarzeczna-Baran, Marzena; Wojdak-Haasa, Ewa; Mogilnaya, Irina; Narkiewicz, Krzysztof; Szczech, Radosław; Rutkowski, Marcin; Bandosz, Piotr; Januszko, Wiktor; Krupa-Wojciechowska, Barbara; Wyrzykowski, Bogdan

2005-01-01

Constant worsening of epidemiological situation in cardiovascular diseases in Poland in the 70's and 80's called for intensive measures in the field of preventive cardiology. Thus in 90's, in order to change this situation, among others, team from Department of Hypertension and Diabetology from Medical University of Gdańsk started, in cooperation with other medical universities, important regional and national research programs and preventive interventions. The aim of the educational program carried out in years 1999-2001 for Members of the Polish Parliament, opinion leaders and decision makers was to increase knowledge of the Polish elites about epidemic of cardiovascular diseases in our country. These actions made possible receiving greater support from the government for new epidemiological and preventive programs in this field. Thanks to NATPOL PLUS project, carried out on the representative sample of adults in 2002, we determined for the first time the prevalence and control of main cardiovascular risk factors in Poland. Results of this program helped planning preventive tasks in the National Cardiovascular Diseases Prevention and Treatment Program POLKARD 2003-2005. The aim of the preventive programmes: SOPKARD and Polish Four-Cities Project was to work out standards of modern, comprehensive interventions. They permitted planning and introduction of the largest preventive program: the Polish 400 Cities Project (PP400M). The PP400M is addressed to citizens of all small towns (to 8000 citizens) and surrounding villages in the whole country. All these accomplishments in the field of quickly expanded clinical epidemiology and cardiovascular prevention are directed mainly to Pomeranian and Polish citizens, especially those who are not aware of high risk of myocardial infarction or stroke. The main principle of our strategy is the role of university as an expert in preparation and supervision of the programs, which were carried out by the specialized organizations and firms such as PBS in Sopot. The second important component of our strategy was an intensive cooperation with other leading research centres in Poland that allowed taking advantage of the joint achievements.

5 CFR 339.205 - Medical evaluation programs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Medical evaluation programs. 339.205 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...

5 CFR 339.205 - Medical evaluation programs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Medical evaluation programs. 339.205 Section 339.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS MEDICAL QUALIFICATION DETERMINATIONS Physical and Medical Qualifications § 339.205 Medical evaluation programs. Agencies...

5 CFR 339.205 - Medical evaluation programs.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Voluntary medical male circumcision: translating research into the rapid expansion of services in Kenya, 2008-2011.

PubMed

Mwandi, Zebedee; Murphy, Anne; Reed, Jason; Chesang, Kipruto; Njeuhmeli, Emmanuel; Agot, Kawango; Llewellyn, Emma; Kirui, Charles; Serrem, Kennedy; Abuya, Isaac; Loolpapit, Mores; Mbayaki, Regina; Kiriro, Ndungu; Cherutich, Peter; Muraguri, Nicholas; Motoku, John; Kioko, Jack; Knight, Nancy; Bock, Naomi

2011-11-01

Since the World Health Organization and the Joint United Nations Programme on HIV/AIDS recommended implementation of medical male circumcision (MC) as part of HIV prevention in areas with low MC and high HIV prevalence rates in 2007, the government of Kenya has developed a strategy to circumcise 80% of uncircumcised men within five years. To facilitate the quick translation of research to practice, a national MC task force was formed in 2007, a medical MC policy was implemented in early 2008, and Nyanza Province, the region with the highest HIV burden and low rates of circumcision, was prioritized for services under the direction of a provincial voluntary medical male circumcision (VMMC) task force. The government's early and continuous engagement with community leaders/elders, politicians, youth, and women's groups has led to the rapid endorsement and acceptance of VMMC. In addition, several innovative approaches have helped to optimize VMMC scale-up. Since October 2008, the Kenyan VMMC program has circumcised approximately 290,000 men, mainly in Nyanza Province, an accomplishment made possible through a combination of governmental leadership, a documented implementation strategy, and the adoption of appropriate and innovative approaches. Kenya's success provides a model for others planning VMMC scale-up programs.

Comparative cost analysis of housing and case management program for chronically ill homeless adults compared to usual care.

PubMed

Basu, Anirban; Kee, Romina; Buchanan, David; Sadowski, Laura S

2012-02-01

To assess the costs of a housing and case management program in a novel sample-homeless adults with chronic medical illnesses. The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits. Total costs were estimated using unit costs for each service. Randomized controlled trial of 407 homeless adults with chronic medical illnesses enrolled at two hospitals in Chicago, Illinois, and followed for 18 months. Compared to usual care, the intervention group generated an average annual cost savings of (-)$6,307 per person (95 percent CI: -16,616, 4,002; p = .23). Subgroup analyses of chronically homeless and those with HIV showed higher per person, annual cost savings of (-)$9,809 and (-)$6,622, respectively. Results were robust to sensitivity analysis using unit costs. The findings of this comprehensive, comparative cost analyses demonstrated an important average annual savings, though in this underpowered study these savings did not achieve statistical significance. © Health Research and Educational Trust.

The geographic distribution of the otolaryngology workforce in the United States.

PubMed

Lango, Miriam N; Handorf, Elizabeth; Arjmand, Ellis

2017-01-01

To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. Cross-sectional study. The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files. Multiple linear regression tested the association of population, physician, and hospital factors on the supply of Medicare-enrolled otolaryngologists/HRR. Two methods of measuring the otolaryngology workforce were moderately correlated across hospital referral regions (Pearson coefficient 0.513, P = .0001); regardless, the supply of otolaryngology providers varies greatly over different geographic regions. Otolaryngologists concentrate in regions with many other physicians, particularly specialist physicians. The otolaryngology supply also increases with regional population income and education levels. Using AMA-derived data, there was no association between the supply of otolaryngologists and staffed acute-care hospital beds and the presence of an otolaryngology residency-training program. In contrast, the supply of otolaryngology providers enrolled in Medicare independently increases for each HRR by 0.8 per 100,000 for each unit increase in supply of hospital beds (P < .0001) and by 0.49 per 100,000 in regions with an otolaryngology residency-training program (P = .006), accounting for all other factors. Irrespective of methodology, the supply of otolaryngologists varies widely across geographic regions in the United States. For Medicare beneficiaries, regional hospital factors-including the presence of an otolaryngology residency program-may improve access to otolaryngology services. NA Laryngoscope, 127:95-101, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Impact of an educational program on the quality of life of patients with lymphedema: A preliminary evaluation.

PubMed

Blaise, Sophie; Satger, Bernadette; Pernod, Gilles; Richaud, Cécile; Villemur, Béatrice; Carpentier, Patrick H

2017-09-01

We report on the preliminary evaluation of a well-designed program, Living with Lymphedema. This longitudinal cohort study assessed patients' quality of life using questionnaires. Our main objective was to evaluate the satisfaction of the patients and their adherence to the program. This was done using a specific questionnaire of satisfaction as well as by noting patients' adherence to the program (number of patients attending all three consultations). The secondary objective was to assess the effect of the program on the patient's quality of life. The assessment criteria were the evolution of the Medical Outcomes Study 36-Item Short Form Health Survey and EuroQol questionnaire scores between the first (C1) and third (C3) consultations. The Living with Lymphedema program targeted all patients with lymphedema in the Grenoble (France) conurbation and within the GRANTED health care network that includes vascular medicine specialists, primary care physicians, physical therapists, and dietitians in the Alpine region of France. All studied patients were ambulatory patients. The GRANTED network took care only of the educational aspect of the disease. All patients with primary or secondary lymphedema were offered the Living with Lymphedema program, whatever their age and the location of the lymphedema (upper or lower limbs). The collection of patient data conformed to the ethical and administrative regulations of the regional health authority. Grenoble Institutional Review Board (CPP Sud-Est V; No. 5891) approval for the study was specifically obtained for this evaluation on December 24, 2012. The program was built around one-to-one consultations, group workshops, and more specialized appointments. It was complementary to the routine medical care received by the patient (not evaluated in this study). It proposed three individual "educational" consultations, seven group workshops, and two specialized consultations with a dietitian. All the consultations or workshops were led by certified professionals trained in therapeutic education. The cohort was the 34 patients included in the program. We found a significant improvement in the physical dimension of the Medical Outcomes Study 36-Item Short Form Health Survey score (P = .01) between C1 and C3 but not for the psychic dimension. Visual analog scale scores of the ability to cope with the lymphedema showed a statistically significant improvement between C1 and C3 (P = .05). No difference was observed in adherence to compression therapy. This therapeutic educational program showed a significant improvement in several criteria of quality of life and in the autonomy of patients with lymphedema. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The effect of dual accreditation on family medicine residency programs.

PubMed

Mims, Lisa D; Bressler, Lindsey C; Wannamaker, Louise R; Carek, Peter J

2015-04-01

In 1985, the American Osteopathic Association (AOA) Board of Trustees agreed to allow residency programs to become dually accredited by the AOA and Accreditation Council for Graduate Medical Education (ACGME). Despite the increase in such programs, there has been minimal research comparing these programs to exclusively ACGME-accredited residencies. This study examines the association between dual accreditation and suggested markers of quality. Standard characteristics such as regional location, program structure (community or university based), postgraduate year one (PGY-1) positions offered, and salary (PGY-1) were obtained for each residency program. In addition, the faculty to resident ratio in the family medicine clinic and the number of half days residents spent in the clinic each week were recorded. Initial Match rates and pass rates of new graduates on the ABFM examination from 2009 to 2013 were also obtained. Variables were analyzed using chi-square and Student's t test. Logistic regression models were then created to predict a program's 5-year aggregate initial Match rate and Board pass rate in the top tertile as compared to the lowest tertile. Dual accreditation was obtained by 117 (27.0%) of programs. Initial analyses revealed associations between dually accredited programs and mean year of initial ACGME program accreditation, regional location, program structure, tracks, and alternative medicine curriculum. When evaluated in logistic regression, dual accreditation status was not associated with Match rates or ABFM pass rates. By examining suggested markers of program quality for dually accredited programs in comparison to ACGME-only accredited programs, this study successfully established both differences and similarities among the two types.

Development of a Medical Humanities Program at Dalhousie University Faculty of Medicine, Nova Scotia, Canada, 1992-2003.

PubMed

Murray, Jock

2003-10-01

The Medical Humanities Program at Dalhousie University Faculty of Medicine in Nova Scotia, Canada, was initiated in 1992 to incorporate the medical humanities into the learning and experiences of medical students. The goal of the program was to gain acceptance as an integral part of the medical school. The program assumed a broad concept of the medical humanities that includes medical history, literature, music, art, multiculturalism, philosophy, epistemology, theology, anthropology, professionalism, history of alternative therapies, writing, storytelling, health law, international medicine, and ethics. Phase I of the program has provided the same elective and research opportunities in the medical humanities that are available to the students in clinical and basic sciences, and has encouraged and legitimized the involvement of the humanities in the life and learning of the medical student through a wide array of programs and activities. Phase II will focus on further incorporation of the humanities into the curriculum. Phase III will be the development of a graduate program in medical humanities to train more faculty who will incorporate the humanities into their teaching and into the development of education programs.

49 CFR 390.105 - Medical examiner training programs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Medical examiner training programs. 390.105... FEDERAL MOTOR CARRIER SAFETY REGULATIONS; GENERAL National Registry of Certified Medical Examiners § 390.105 Medical examiner training programs. An applicant for medical examiner certification must complete...

49 CFR 390.105 - Medical examiner training programs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false Medical examiner training programs. 390.105... FEDERAL MOTOR CARRIER SAFETY REGULATIONS; GENERAL National Registry of Certified Medical Examiners § 390.105 Medical examiner training programs. An applicant for medical examiner certification must complete...

Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study.

PubMed

Wellard, Sally Jane; Rasmussen, Bodil; Savage, Sally; Dunning, Trisha

2013-07-01

This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.

Effect of two Howard Hughes Medical Institute research training programs for medical students on the likelihood of pursuing research careers.

PubMed

Fang, Di; Meyer, Roger E

2003-12-01

To assess the effect of Howard Hughes Medical Institute's (HHMI) two one-year research training programs for medical students on the awardees' research careers. Awardees of the HHMI Cloister Program who graduated between 1987 and 1995 and awardees of the HHMI Medical Fellows Program who graduated between 1991 and 1995 were compared with unsuccessful applicants to the programs and MD-PhD students who graduated during the same periods. Logistic regression analyses were conducted to assess research career outcomes while controlling for academic and demographic variables that could affect selection to the programs. Participation in both HHMI programs increased the likelihood of receiving National Institutes of Health postdoctoral support. Participation in the Cloister Program also increased the likelihood of receiving a faculty appointment with research responsibility at a medical school. In addition, awardees of the Medical Fellows Program were not significantly less likely than Medical Scientist Training Program (MSTP) and non-MSTP MD-PhD program participants to receive a National Institutes of Health postdoctoral award, and awardees of the Cloister Program were not significantly less likely than non-MSTP MD-PhD students to receive a faculty appointment with research responsibility. Women and underrepresented minority students were proportionally represented among awardees of the two HHMI programs whereas they were relatively underrepresented in MD-PhD programs. The one-year intensive research training supported by the HHMI training programs appears to provide an effective imprinting experience on medical students' research careers and to be an attractive strategy for training physician-scientists.

Development of an interdisciplinary pre-matriculation program designed to promote medical students’ self efficacy

PubMed Central

Kosobuski, Anna Wirta; Whitney, Abigail; Skildum, Andrew; Prunuske, Amy

2017-01-01

ABSTRACT Background and objectives: A four-week interdisciplinary pre-matriculation program for Native American and rural medical students was created and its impact on students’ transition to medical school was assessed. The program extends the goals of many pre-matriculation programs by aiming to increase not only students’ understanding of basic science knowledge, but also to build student self-efficacy through practice with medical school curricular elements while developing their academic support networks. Design: A mixed method evaluation was used to determine whether the goals of the program were achieved (n = 22). Student knowledge gains and retention of the microbiology content were assessed using a microbiology concept inventory. Students participated in focus groups to identify the benefits of participating in the program as well as the key components of the program that benefitted the students. Results: Program participants showed retention of microbiology content and increased confidence about the overall medical school experience after participating in the summer program. Conclusions: By nurturing self-efficacy, participation in a pre-matriculation program supported medical students from Native American and rural backgrounds during their transition to medical school. Abbreviations: CAIMH: Center of American Indian and Minority Health; MCAT: Medical College Admission Test; PBL: Problem based learning; UM MSD: University of Minnesota Medical School Duluth PMID:28178916

General Medical Surveillance Program

NASA Technical Reports Server (NTRS)

1993-01-01

Background on the General Medical Surveillance Program at LeRC is presented. The purpose of the General Medical Surveillance Program at LeRC is outlined, and the specifics of the program are discussed.

The demise of Oregon's Medically Needy program: effects of losing prescription drug coverage.

PubMed

Zerzan, Judy; Edlund, Tina; Krois, Lisa; Smith, Jeanene

2007-06-01

In January 2003, people covered by Oregon's Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits. To describe the Medically Needy population and determine how benefit loss affected this population's health and prescription use. A 49-question telephone survey instrument created by the research team and administered by a research contractor. A random sample of 1,269 eligible enrollees in Oregon's Medically Needy Program. Response rate was 35% with 439 individuals, ages 21-91 and 64% women, completing the survey. Demographics, health information, and medication use at the time of the survey obtained from the interview. Medication use during the program obtained from administrative data. In the 6 months after the Medically Needy program ended, 75% had skipped or stopped medications. Sixty percent of the respondents had cut back on their food budget, 47% had borrowed money, and 49% had skipped paying other bills to pay for medications. By self-report, there was no significant difference in emergency department visits, but a significant decrease in hospitalizations comparing 6 months before and after losing the program. Two-thirds of respondents rated their current health as poor or fair. The Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered.

From primary care to public health: using Problem-based Learning and the ecological model to teach public health to first year medical students.

PubMed

Hoover, Cora R; Wong, Candice C; Azzam, Amin

2012-06-01

We investigated whether a public health-oriented Problem-Based Learning case presented to first-year medical students conveyed 12 "Population Health Competencies for Medical Students," as recommended by the Association of American Medical Colleges and the Regional Medicine-Public Health Education Centers. A public health-oriented Problem-Based Learning case guided by the ecological model paradigm was developed and implemented among two groups of 8 students at the University of California, Berkeley-UCSF Joint Medical Program, in the Fall of 2010. Using directed content analysis, student-generated written reports were coded for the presence of the 12 population health content areas. Students generated a total of 29 reports, of which 20 (69%) contained information relevant to at least one of the 12 population health competencies. Each of the 12 content areas was addressed by at least one report. As physicians-in-training prepare to confront the challenges of integrating prevention and population health with clinical practice, Problem-Based Learning is a promising tool to enhance medical students' engagement with public health.

Training Young Russian Physicians in Uganda: A Unique Program for Introducing Global Health Education in Russia.

PubMed

Ziganshin, Bulat A; Yausheva, Liliya M; Sadigh, Mitra; Ziganshina, Anna P; Pichugin, Arseniy A; Ziganshin, Ayrat U; Sadigh, Majid

2015-01-01

Global health is a new concept in Russia. There has been an ongoing academic collaboration between the Yale School of Medicine in the United States and Makerere University College of Health Sciences in Uganda since 2010, and the US Western Connecticut Health Network/University of Vermont College of Medicine since 2012, to introduce global health concepts to Kazan State Medical University (KSMU) in Russia. The purpose was to educate Russian physicians and medical trainees about the practice of clinical medicine and medical education, as well as the general practice of global health in culturally diverse, resource-limited settings. The aim of this study was to evaluate the initial outcomes of this multi-institutional partnership and to assess the impact of the global health elective on the participants and on KSMU. Participants were selected to attend a 6-week elective in global health at Mulago Hospital in Kampala, Uganda. The elective consisted of clinical experience, education about Uganda's common diseases, and region-specific sociocultural classes. It included a predeparture orientation and, upon return, completion of a standard questionnaire to assess the program's impact. Since 2010, there have been 20 KSMU members (4 medical students, 4 interns, 9 residents, 2 fellows, and 1 faculty member) who have participated in the program. As a result of the elective, the participants reported increased knowledge of tropical medicine (70%) and HIV/AIDS (75%), and 95% reported increased cultural sensitivity and desire to work with the underserved. The majority noted a very positive impact of their careers (90%) and personal life (80%). KSMU established the first successful collaborative program in global health education in Russia, leading to the integration of tropical medicine and global health courses in medical school curriculum. This elective has proven highly effective in introducing the concept of global health to faculty, fellows, residents, and medical students at KSMU. It trained these participants to address the challenges faced by physicians in culturally diverse and resource-limited countries. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

78 FR 19725 - Merchant Mariner Medical Evaluation Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... Examiners program, could be applied by the Coast Guard in making medical fitness determinations for issuance... Designated Aviation Medical Examiners program, could be applied by the Coast Guard in making medical fitness... ultimate determination of medical fitness rests with the Coast Guard, mariners may have any authorized...

Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey.

PubMed

Kruse, Gina R; Rigotti, Nancy A; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2017-12-01

There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

PubMed

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

10 CFR 850.36 - Medical consent.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Medical consent. 850.36 Section 850.36 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.36 Medical... medical surveillance program established in § 850.34 at least one week before the first medical evaluation...

10 CFR 850.36 - Medical consent.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Medical consent. 850.36 Section 850.36 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.36 Medical... medical surveillance program established in § 850.34 at least one week before the first medical evaluation...

10 CFR 850.36 - Medical consent.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Medical consent. 850.36 Section 850.36 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.36 Medical... medical surveillance program established in § 850.34 at least one week before the first medical evaluation...

10 CFR 850.36 - Medical consent.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Medical consent. 850.36 Section 850.36 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.36 Medical... medical surveillance program established in § 850.34 at least one week before the first medical evaluation...

10 CFR 850.36 - Medical consent.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Medical consent. 850.36 Section 850.36 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.36 Medical... medical surveillance program established in § 850.34 at least one week before the first medical evaluation...

Highway Safety Program Manual: Volume 11: Emergency Medical Services.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

Volume 11 of the 19-volume Highway Safety Program Manual (which provides guidance to State and local governments on preferred highway safety practices) concentrates on emergency medical services. The purpose of the program, Federal authority in the area of medical services, and policies related to an emergency medical services (EMS) program are…

Designing Anatomy Program in Modern Medical Curriculum: Matter of Balance

PubMed Central

Grković, Ivica; Marinović Guić, Maja; Košta, Vana; Poljičanin, Ana; Čarić, Ana; Vilović, Katarina

2009-01-01

Aim To evaluate the structure of the anatomy program in the first year medical curriculum of University of Split School of Medicine by comparing it with the recommendations by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) and the Terminologia Anatomica (TA); we also quantitatively evaluated the organization of teaching material in contemporary topographical anatomy textbooks and matched them with the AACA recommendations, TA, and the curriculum of the anatomy course taught at Medical School in Split, Croatia. Methods TA, official recommendations of the AACA, 6 contemporary anatomy textbooks, and the structure of the anatomy course were analyzed for the proportion of the terms or text devoted to standard topographical regions of the body. The findings were correlated using Spearman ρ test. Results The curriculum outline correlated both with the AACA recommendations (Spearman ρ = 0.83, P = 0.015) and TA (Spearman ρ = 0.73, P = 0.046). Textbooks contained 8 distinct sections, 7 allocated to topographic anatomy regions and 1 to general anatomy concepts and principles. The structure of all textbooks correlated significantly with the course curriculum. However, 4 out of 6 textbooks did not correlate with TA and only a single textbook showed significant correlation with the AACA recommendations. Conclusion Anatomy textbooks vary in the amount of text dedicated to different parts of topographical anatomy and are not quite concordant with curriculum recommendations and standard anatomical terminology. Planning the structure of an anatomy course should not be based on a single book or recommendation but on evidence. PMID:19260144

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

[Telemedicine and dementia: a need for the 21st century].

PubMed

Vilalta-Franch, J; Garre-Olmo, J; López-Pousa, S; Coll-De Tuero, G; Monserrat-Vila, S

The ongoing process of information and communication technologies in health services implies a change in the conception, organization and management of these services. Telemedicine is a working method that allows health professionals to explore and/or treat a patient from an off-site location. In this review we provide a historical background on telemedicine, the evolution of its bibliometric impact, and its application for people with dementia. Telemedicine's applications have been developed in order to provide greater availability and easier access to healthcare to underserved people. The bibliometric study of telemedicine literature shows an increase in the number of bibliographic references related to telemedicine since 1995. During the last few years in Spain the research and development of telemedicine programs have increased significantly and at present there are telemedicine programs in all regions of the country. Although some of the needs of the patients with dementia may be unsuitable for communication and information technologies, their application could offer an added value to health services. This technology does not attempt to replace face-to-face medical consultations but rather to prevent some difficulties this kind of patients can present and improve their quality of life. Dementia could be an appropriate field in order to implement some telemedicine programs that may improve patient medical care, and reduce medical and management expenses for social and healthcare services.

A model to begin to use clinical outcomes in medical education.

PubMed

Haan, Constance K; Edwards, Fred H; Poole, Betty; Godley, Melissa; Genuardi, Frank J; Zenni, Elisa A

2008-06-01

The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.

HPCC and the National Information Infrastructure: an overview.

PubMed Central

Lindberg, D A

1995-01-01

The National Information Infrastructure (NII) or "information superhighway" is a high-priority federal initiative to combine communications networks, computers, databases, and consumer electronics to deliver information services to all U.S. citizens. The NII will be used to improve government and social services while cutting administrative costs. Operated by the private sector, the NII will rely on advanced technologies developed under the direction of the federal High Performance Computing and Communications (HPCC) Program. These include computing systems capable of performing trillions of operations (teraops) per second and networks capable of transmitting billions of bits (gigabits) per second. Among other activities, the HPCC Program supports the national supercomputer research centers, the federal portion of the Internet, and the development of interface software, such as Mosaic, that facilitates access to network information services. Health care has been identified as a critical demonstration area for HPCC technology and an important application area for the NII. As an HPCC participant, the National Library of Medicine (NLM) assists hospitals and medical centers to connect to the Internet through projects directed by the Regional Medical Libraries and through an Internet Connections Program cosponsored by the National Science Foundation. In addition to using the Internet to provide enhanced access to its own information services, NLM sponsors health-related applications of HPCC technology. Examples include the "Visible Human" project and recently awarded contracts for test-bed networks to share patient data and medical images, telemedicine projects to provide consultation and medical care to patients in rural areas, and advanced computer simulations of human anatomy for training in "virtual surgery." PMID:7703935

A study of photon interaction in some hormones

NASA Astrophysics Data System (ADS)

Manjunatha, H. C.

2013-05-01

The effective atomic numbers (Z eff) and electron density (N el) of some hormones such as testosterone, methandienone, estradiol and rogesterone for total and partial photon interactions have been computed in the wide energy region 1 keV-100 GeV using an accurate database of photon-interaction cross sections and the WinXCom program. The computed Z eff and N el are compared with the values generated by XMuDat program. The computer tomography (CT) numbers and kerma values relative to air are also calculated and the computed data of CT numbers in the low-energy region help in visualizing the image of the biological samples and to obtain precise accuracy in treating the inhomogenity of them in medical radiology. In view of dosimetric interest, the photon absorbed dose rates of some commonly used gamma sources (Na-21, Cs-137, Mn-52, Co-60 and Na-22) are also estimated.

Mobile surgical skills education unit: a new concept in surgical training.

PubMed

Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

2011-08-01

Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

MD/MBA Students: An Analysis of Medical Student Career Choice.

PubMed

Sherrill, Windsor Westbrook

2004-12-01

An increasing number of medical schools are offering dual degree MD/MBA programs. Career choices and factors influencing students to enter these programs provide an indicator of the roles in which dual degree students will serve in health care as well as the future of dual degree programs. Using career choice theory as a conceptual framework, career goals and factors influencing decisions to enter dual degree programs were assessed among dual degree medical students. Students enrolled at dual degree programs at six medical schools were surveyed and interviewed. A control group of traditional medical students was also surveyed. Factors influencing students to seek both medical and business training are varied but are often related to a desire for leadership opportunities, concerns about change in medicine and job security and personal career goals. Most students expect to combine clinical and administrative roles. Students entering these programs do so for a variety of reasons and plan diverse careers. These findings can provide guidance for program development and recruitment for dual degree medical education programs.

Experience with a pharmacy technician medication history program.

PubMed

Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

2014-09-15

The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[Analysis of qualifications of medical and health institutions and certified doctors for providing occupational disease diagnosis in China].

PubMed

Wang, Huan-qiang; Li, Tao; Qi, Fang; Wu, Rui; Nie, Wu; Yu, Chen

2013-10-01

To investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies. Work reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%. By the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year. A national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified doctors.

Are Michigan State University medical school (MSU-CHM) alumni more likely to practice in the region of their graduate medical education primary care program compared to non-MSU-CHM alumni?

PubMed

Switzer, Richard; VandeZande, Luke; Davis, Alan T; Koehler, Tracy J

2018-05-24

Over the past 10 years, three new MD schools have been created in the state of Michigan, while the Michigan State University College of Human Medicine (MSU-CHM) has increased their class size to 850 students. The aim of this study was to determine if MSU-CHM alumni who graduate from an MSU-affiliated primary care residency from a single graduate medical education (GME) training program in Michigan are more likely to go on to practice in close proximity to the location of their training program immediately after graduation compared to non MSU-CHM alumni. Changes over time in the proportion of primary care graduates who received fellowship training immediately following residency were also compared between these groups. A review of historical data was performed for all 2000-2016 primary care (Family Medicine, FM; Internal Medicine, IM; Internal Medicine-Pediatrics, IMP; Pediatrics, Peds) program graduates sponsored by Grand Rapids Medical Education Partners (GRMEP). Study variables included primary care program, gender, age at graduation, fellowship training, practice location immediately after graduation and undergraduate medical education location. Summary statistics were calculated for the data. Comparisons were made using the chi-square test or Fisher's Exact test when appropriate. Significance was assessed at p < 0.05. There were 478 primary care program graduates who went into practice immediately following graduation, 102 of whom also graduated from MSU-CHM. Just over half of the graduates were female and the average age at graduation was 32 years. There were 152 FM, 150 IM, 50 IMP and 126 Peds graduates. Those that graduated from both MSU-CHM and GRMEP were more likely to practice in Michigan immediately after residency training (79.4% vs 52.0%; p < 0.001), as well as within 100 miles of GRMEP (71.6% vs 46.4%; p < 0.001). There were 8% of MSU-CHM primary care graduates who went on to fellowship training from 2000 to 2009, increasing to 34% from 2010 to 2016 (p < 0.001). Medical school graduates of MSU-CHM who receive GME training in primary care are more likely to practice medicine within close proximity to their training site than non MSU-CHM graduates. However, plans for fellowship after training may add one caveat to this finding.

Summer anesthesiology externship: Demonstrating the ability of early clinical involvement to educate and increase specialty interest.

PubMed

Baker, Kevin S; Cormican, Daniel; Seidman, Peggy A

2012-01-01

We describe the influence of a 6-week "Summer Anesthesiology Externship" featuring didactic, procedure, and simulation education on formation of medical students' specialty choice. Eighteen months after externship completion, externs were sent a questionnaire with Likert scale agreement ratings of subspecialties/simulations and yes/no questions about student career interests before/after the program, stipend importance, and procedural skill performance during/after the program. General anesthesiology had the highest subspecialty approval rating (9.0). Externs strongly agreed that simulations successfully progressed at first year student understanding levels (9.2 mean agreement rating), increased confidence in being part of a care team (9.4 mean agreement rating), and provided personal/interpersonal development. Externs unanimously agreed that the program introduced them to the breadth of anesthesiology, and that practicing clinical/procedural skills improved confidence when performing the procedures later in medical school. Four of 14 students applied for the externship with some focus on anesthesiology as a career choice. After the externship, a significantly higher number of students (12 of 14) were strongly considering applying to the field (p<0.0001). Eleven of 14 ultimately entered anesthesiology residencies, a significantly higher rate than our general medical student classes (p<0.0001). Both CA1 and CA3 resident post-test scores improved at the end of the ultrasound guided regional workshop. Our study showed a 68% improvement in test scores, which is larger than the 50% improvement previously reported. These results show that fast learning can occur in this type of setting. Furthermore, knowledge acquired during the workshop was retained when CA1 residents were re-tested one year after the workshop. The ultrasound-guided regional anesthesia workshop will become part of the didactic series for our CA1 residents and will be a required learning activity. Additional work still needs to be done to find out the best way to test knowledge and skill outcomes in residents learning new technology and techniques.

A global network for the control of snail-borne disease using satellite surveillance and geographic information systems.

PubMed

Malone, J B; Bergquist, N R; Huh, O K; Bavia, M E; Bernardi, M; El Bahy, M M; Fuentes, M V; Kristensen, T K; McCarroll, J C; Yilma, J M; Zhou, X N

2001-04-27

At a team residency sponsored by the Rockefeller Foundation in Bellagio, Italy, 10-14 April 2000 an organizational plan was conceived to create a global network of collaborating health workers and earth scientists dedicated to the development of computer-based models that can be used for improved control programs for schistosomiasis and other snail-borne diseases of medical and veterinary importance. The models will be assembled using GIS methods, global climate model data, sensor data from earth observing satellites, disease prevalence data, the distribution and abundance of snail hosts, and digital maps of key environmental factors that affect development and propagation of snail-borne disease agents. A work plan was developed for research collaboration and data sharing, recruitment of new contributing researchers, and means of access of other medical scientists and national control program managers to GIS models that may be used for more effective control of snail-borne disease. Agreement was reached on the use of compatible GIS formats, software, methods and data resources, including the definition of a 'minimum medical database' to enable seamless incorporation of results from each regional GIS project into a global model. The collaboration plan calls for linking a 'central resource group' at the World Health Organization, the Food and Agriculture Organization, Louisiana State University and the Danish Bilharziasis Laboratory with regional GIS networks to be initiated in Eastern Africa, Southern Africa, West Africa, Latin America and Southern Asia. An Internet site, www.gnosisGIS.org, (GIS Network On Snail-borne Infections with special reference to Schistosomiasis), has been initiated to allow interaction of team members as a 'virtual research group'. When completed, the site will point users to a toolbox of common resources resident on computers at member organizations, provide assistance on routine use of GIS health maps in selected national disease control programs and provide a forum for development of GIS models to predict the health impacts of water development projects and climate variation.

Supporting medical education research quality: the Association of American Medical Colleges' Medical Education Research Certificate program.

PubMed

Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian

2011-01-01

The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.

Evaluation of a clinical medical librarianship program at a university Health Sciences Library.

PubMed Central

Schnall, J G; Wilson, J W

1976-01-01

An evaluation of the clinical medical librarianship program at the University of Washington Health Sciences Library was undertaken to determine the benefits of the program to patient care and to the education of the recipients of the service. Results of a questionnaire reflected overwhelming acceptance of the clinical medical librarianship program. Guidelines for the establishment of a limited clinical medical librarianship program are described. A statistical cost analysis of the program is included. PMID:938773

42 CFR 415.152 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subpart— Approved graduate medical education (GME) program means one of the following: (1) A residency program approved by the Accreditation Council for Graduate Medical Education, by the American Osteopathic... on Podiatric Medical Education of the American Podiatric Medical Association. (2) A program otherwise...

Advancing Health Professions Education Research by Creating a Network of Networks.

PubMed

Carney, Patricia A; Brandt, Barbara; Dekhtyar, Michael; Holmboe, Eric S

2018-02-27

Producing the best evidence to show educational outcomes, such as competency achievement and credentialing effectiveness, across the health professions education continuum will require large multisite research projects and longitudinal studies. Current limitations that must be overcome to reach this goal include the prevalence of single-institution study designs, assessments of a single curricular component, and cross-sectional study designs that provide only a snapshot in time of a program or initiative rather than a longitudinal perspective.One solution to overcoming these limitations is to develop a network of networks that collaborates, using longitudinal approaches, across health professions and regions of the United States. Currently, individual networks are advancing educational innovation toward understanding the effectiveness of educational and credentialing programs. Examples of such networks include: (1) the American Medical Association's Accelerating Change in Medical Education initiative, (2) the National Center for Interprofessional Practice and Education, and (3) the Accreditation Council for Graduate Medical Education's Accreditation System. In this Invited Commentary, the authors briefly profile these existing networks, identify their progress and the challenges they have encountered, and propose a vigorous way forward toward creating a national network of networks designed to determine the effectiveness of health professions education and credentialing.

Enhancing US-Japan Cooperation to Combat Antimicrobial Resistance

PubMed Central

2014-01-01

The Global Health Security Agenda (GHSA) is aimed at preventing, detecting, and responding to infectious disease threats. To move toward these goals, the United States has committed to partner with at least 30 countries around the world. One of the objectives of the GHSA includes “[p]reventing the emergence and spread of antimicrobial drug resistant organisms.” Antimicrobial resistance (AMR) has become a growing global health security problem, with inappropriate use of antimicrobial medications in humans and animals and a lack of new antimicrobial medications contributing to this problem. While AMR is a growing global concern, working on it regionally can make this multifaceted problem more manageable. The United States and Japan, both world leaders in the life sciences, are close allies that have established cooperative programs in medical research and global health that can be used to work on combating AMR and advance the GHSA. Although the United States and Japan have cooperated on health issues in the past, their cooperation on the growing problem of AMR has been limited. Their existing networks, cooperative programs, and close relationships can and should be used to work on combating this expanding problem. PMID:25470465

Developing an active implementation model for a chronic disease management program.

PubMed

Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

2013-04-01

Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council's model for complex interventions and the Chronic Care Model. We used the Medical Research Council's five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council's model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council's model added transparency to the design phase which further facilitated the process of implementing the program. http://www.clinicaltrials.gov/(NCT01228708).

National variation of ADHD diagnostic prevalence and medication use: health care providers and education policies.

PubMed

Fulton, Brent D; Scheffler, Richard M; Hinshaw, Stephen P; Levine, Peter; Stone, Susan; Brown, Timothy T; Modrek, Sepideh

2009-08-01

Attention-deficit hyperactivity disorder (ADHD) diagnostic prevalence and medication use vary across U.S. census regions, but little is known about state-level variation. The purpose of this study was to estimate this variation across states and examine whether a state's health care provider characteristics and education policies are associated with this variation. Logistic regression models were estimated with 69,505 children aged four to 17 from the state-stratified and nationally representative 2003 National Survey of Children's Health, conducted by the Centers for Disease Control and Prevention. Diagnostic prevalence was higher in the South (odds ratio [OR]=1.42, p<.001) than in the West; among children with ADHD diagnoses, medication use was higher in the South (OR=1.60, p<.01) and the Midwest (OR=1.53, p<.01) versus the West. On these measures, several states differed from the U.S. averages, including some states that, on the basis of the regional patterns found above, would not be expected to differ: Michigan had a high diagnostic prevalence; Vermont, South Dakota, and Nebraska had low diagnostic prevalences; and Connecticut, New Jersey, and Kentucky had low medication rates. Both diagnosis and medication status were associated with the number, age, and type of physicians within a state, particularly pediatricians. However, state education policies were not significantly associated with either diagnostic prevalence or medication rates. To better understand the association between a state's health care provider characteristics and both diagnostic prevalence and medication use, it may be fruitful to examine the content of provider continuing education programs, including the recommendations of major health professional organization guidelines to treat ADHD.

Local, Regional and National Responses for Medical Management of a Radiological/Nuclear Incident

PubMed Central

Dainiak, Nicholas; Skudlarska, Beata; Albanese, Joseph

2013-01-01

Radiological and nuclear devices may be used by terrorists or may be the source of accidental exposure. A tiered approach has been recommended for response to a terrorist event wherein local, regional, state and federal assets become involved sequentially, as the magnitude in severity of the incident increases. State-wide hospital plans have been developed and published for Connecticut, New York and California. These plans address delineation of responsibilities of various categories of health professionals, protection of healthcare providers, identification and classification of individuals who might have been exposed to and/or contaminated by radiation and, in the case of Connecticut response plan, early management of victims. Regional response programs such as the New England Regional Health Compact (consisting of 6 member states) have been developed to manage consequences of radiation injury. The Department of Homeland Security is ultimately responsible for managing both health consequences and the crisis. Multiple US national response assets may be called upon for use in radiological incidents. These include agencies and programs that have been developed by the Department of Energy, the Environmental Protection Agency and the Department of Defense. Coordination of national, regional and state assets with local response efforts is necessary to provide a timely and efficient response. PMID:23447742

Local, regional and national responses for medical management of a radiological/nuclear incident.

PubMed

Dainiak, Nicholas; Skudlarska, Beata; Albanese, Joseph

2013-01-01

Radiological and nuclear devices may be used by terrorists or may be the source of accidental exposure. A tiered approach has been recommended for response to a terrorist event wherein local, regional, state and federal assets become involved sequentially, as the magnitude in severity of the incident increases. State-wide hospital plans have been developed and published for Connecticut, New York and California. These plans address delineation of responsibilities of various categories of health professionals, protection of healthcare providers, identification and classification of individuals who might have been exposed to and/or contaminated by radiation and, in the case of Connecticut response plan, early management of victims. Regional response programs such as the New England Regional Health Compact (consisting of 6 member states) have been developed to manage consequences of radiation injury. The Department of Homeland Security is ultimately responsible for managing both health consequences and the crisis. Multiple US national response assets may be called upon for use in radiological incidents. These include agencies and programs that have been developed by the Department of Energy, the Environmental Protection Agency and the Department of Defense. Coordination of national, regional and state assets with local response efforts is necessary to provide a timely and efficient response.

More mentoring needed? A cross-sectional study of mentoring programs for medical students in Germany.

PubMed

Meinel, Felix G; Dimitriadis, Konstantinos; von der Borch, Philip; Störmann, Sylvère; Niedermaier, Sophie; Fischer, Martin R

2011-09-24

Despite increasing recognition that mentoring is essential early in medical careers, little is known about the prevalence of mentoring programs for medical students. We conducted this study to survey all medical schools in Germany regarding the prevalence of mentoring programs for medical students as well as the characteristics, goals and effectiveness of these programs. A definition of mentoring was established and program inclusion criteria were determined based on a review of the literature. The literature defined mentoring as a steady, long-lasting relationship designed to promote the mentee's overall development. We developed a questionnaire to assess key characteristics of mentoring programs: the advocated mentoring model, the number of participating mentees and mentors, funding and staff, and characteristics of mentees and mentors (e.g., level of training). In addition, the survey characterized the mentee-mentor relationship regarding the frequency of meetings, forms of communication, incentives for mentors, the mode of matching mentors and mentees, and results of program evaluations. Furthermore, participants were asked to characterize the aims of their programs. The questionnaire consisted of 34 questions total, in multiple-choice (17), numeric (7) and free-text (10) format. This questionnaire was sent to deans and medical education faculty in Germany between June and September 2009. For numeric answers, mean, median, and standard deviation were determined. For free-text items, responses were coded into categories using qualitative free text analysis. We received responses from all 36 medical schools in Germany. We found that 20 out of 36 medical schools in Germany offer 22 active mentoring programs with a median of 125 and a total of 5,843 medical students (6.9 - 7.4% of all German medical students) enrolled as mentees at the time of the survey. 14 out of 22 programs (63%) have been established within the last 2 years. Six programs (27%) offer mentoring in a one-on-one setting. 18 programs (82%) feature faculty physicians as mentors. Nine programs (41%) involve students as mentors in a peer-mentoring setting. The most commonly reported goals of the mentoring programs include: establishing the mentee's professional network (13 programs, 59%), enhancement of academic performance (11 programs, 50%) and counseling students in difficulties (10 programs, 45%). Despite a clear upsurge of mentoring programs for German medical students over recent years, the overall availability of mentoring is still limited. The mentoring models and goals of the existing programs vary considerably. Outcome data from controlled studies are needed to compare the efficiency and effectiveness of different forms of mentoring for medical students.

More mentoring needed? A cross-sectional study of mentoring programs for medical students in Germany

PubMed Central

2011-01-01

Background Despite increasing recognition that mentoring is essential early in medical careers, little is known about the prevalence of mentoring programs for medical students. We conducted this study to survey all medical schools in Germany regarding the prevalence of mentoring programs for medical students as well as the characteristics, goals and effectiveness of these programs. Methods A definition of mentoring was established and program inclusion criteria were determined based on a review of the literature. The literature defined mentoring as a steady, long-lasting relationship designed to promote the mentee's overall development. We developed a questionnaire to assess key characteristics of mentoring programs: the advocated mentoring model, the number of participating mentees and mentors, funding and staff, and characteristics of mentees and mentors (e.g., level of training). In addition, the survey characterized the mentee-mentor relationship regarding the frequency of meetings, forms of communication, incentives for mentors, the mode of matching mentors and mentees, and results of program evaluations. Furthermore, participants were asked to characterize the aims of their programs. The questionnaire consisted of 34 questions total, in multiple-choice (17), numeric (7) and free-text (10) format. This questionnaire was sent to deans and medical education faculty in Germany between June and September 2009. For numeric answers, mean, median, and standard deviation were determined. For free-text items, responses were coded into categories using qualitative free text analysis. Results We received responses from all 36 medical schools in Germany. We found that 20 out of 36 medical schools in Germany offer 22 active mentoring programs with a median of 125 and a total of 5,843 medical students (6.9 - 7.4% of all German medical students) enrolled as mentees at the time of the survey. 14 out of 22 programs (63%) have been established within the last 2 years. Six programs (27%) offer mentoring in a one-on-one setting. 18 programs (82%) feature faculty physicians as mentors. Nine programs (41%) involve students as mentors in a peer-mentoring setting. The most commonly reported goals of the mentoring programs include: establishing the mentee's professional network (13 programs, 59%), enhancement of academic performance (11 programs, 50%) and counseling students in difficulties (10 programs, 45%). Conclusions Despite a clear upsurge of mentoring programs for German medical students over recent years, the overall availability of mentoring is still limited. The mentoring models and goals of the existing programs vary considerably. Outcome data from controlled studies are needed to compare the efficiency and effectiveness of different forms of mentoring for medical students. PMID:21943281

[Evaluation of a medication self-management education program for elders with hypertension living in the community].

PubMed

Lee, Jong Kyung

2013-04-01

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Comprehensive geriatric intervention program with and without weekly class-style exercise: research protocol of a cluster randomized controlled trial in Kyoto-Kameoka Study

PubMed Central

Yoshida, Tsukasa; Yoshinaka, Yasuko; Yoshimoto, Mie; Tanaka, Yoko; Itoi, Aya; Yamagata, Emi; Ebine, Naoyuki; Ishikawa-Takata, Kazuko; Kimura, Misaka

2018-01-01

Objective The number of long-term care (LTC) users and the associated expenditures in Japan are increasing dramatically. The national government recommends LTC prevention through activation of communities. However, there is no clear evidence of the effect of population-based comprehensive geriatric intervention program (CGIP) for restraints of LTC users and the associated expenditures in the future. The aims of the current paper are to describe the study protocol and progress of a cluster randomized controlled trial (RCT) with a CGIP in Kameoka City. Methods The cluster RCT involved random allocation of regions as intervention (n=4,859) and nonintervention (n=7,195). Participants were elderly persons aged ≥65 years without LTC certification who had responded to a mailing survey. The residents living in intervention regions were invited to a physical check-up, and 1,463 people participated (30.3%). These individuals were invited to the CGIP, and 526 accepted. The CGIP comprised instructions on: 1) low-load resistance training using bodyweight, ankle weights, and elastic bands; 2) increasing daily physical activity; 3) oral motor exercise and care; and 4) a well-balanced diet based on a program from Ministry of Health, Labour and Welfare. We allocated the intervention regions randomly into home-based self-care program alone (HB group, 5 regions, n=275) and home-based program+weekly class-style session (CS group, 5 regions, n=251). We evaluated the effects of the CGIP at 12 weeks and at 12 or 15 months on physical function, and are conducting follow-up data collection for an indefinite period regarding LTC certification, medical costs, and mortality. Results and discussion The study was launched with good response rates in each phase. Participants of both groups significantly increased their step counts by ~1,000 per day from the baseline during the CGIP. This RCT will provide valuable information and evidence about effectiveness of a community-based CGIP. PMID:29872280

Clinician scientist training program: a proposal for training medical students in clinical research.

PubMed

Mark, A L; Kelch, R P

2001-11-01

There is national alarm about a decline in the number of clinician scientists. Most of the proposed solutions have focused on housestaff and junior faculty. We propose a new national program for training medical students in clinical research. This program, coined "Clinician Scientist Training Program" (CSTP), would consist of a combined degree program in medicine (MD) and clinical research (eg, masters in translational research or masters in clinical epidemiology). Students could enroll in the program at any stage during medical school. After 3 years of medical school, students would spend at least 2 years in a combined didactic and mentored clinical research training program and then complete medical school. Students could elect to pursue more prolonged clinical research training toward a combined PhD and MD. The CSTP is designed to meet six critical challenges: 1) engage students early in clinical research training; 2) provide a didactic clinical research curriculum; 3) expose students to several years of mentored clinical research training; 4) promote debt prevention by providing tuition payments during medical education and a stipend during clinical research training; 5) facilitate prolonged exposure to a community of peers and mentors in a program with national and institutional identity and respect; and 6) permit enrollment in the program as students enter medical school or at any stage during medical school. If the success of the Medical Scientist Training Program in training medical students in basic research is a guide, the CSTP could become a linchpin for training future generations of clinician scientists.

Inventory Management in a United States Air Force Regional Medical Center Pharmacy

DTIC Science & Technology

1989-09-01

Data bases used by Paradox are maintained in table format. Each row is a record and each column is a field. The program uses artificial intelligence ...system. Bair and Lee urge pharmacists to understand the operation of the purchasing systems that support them, and be prepared to participate in their...advocates ABC analysis and Economic Order Quantities. He further supports active pharmacist interaction with vendors. McAllister states that hospital

Blast/Fire Interactions. Program Information

DTIC Science & Technology

1978-10-01

for shelter identification and for emergency food and medical stockpiles. This vigorous effort was largely completed by the end of 1963. On April 1...transportation, food supplies, etc.) can be exercised and tested to some degree. (The need for local’or regional autonomy is less in the peacetimeS...Corporation 7125 Saltsburg Road P.O Box 235 Pittsburgh, PA 15235 Buffalo, New York 14221i • Dr. Franch • E. Fendell National Fire Protection Association

Exploring the Readability of Consent Forms in Human Research in the United States Army

DTIC Science & Technology

2005-03-01

subjects: autonomy (respect for persons), beneficence, and justice. Readability of consent forms 12 The report also defined how these principles apply to...Regional Medical Command, Fort Sam Houston, Texas CPT Heidi P. Mon) U.S. Army-Baylor University Graduate Program in Health Care Administration March...United States v. Karl Brandt, 1947). The opinion in that case included 10 basic principles for human research, called the Nuremberg Code

Regionalisation of general practice training--are we meeting the needs of rural Australia?

PubMed

Campbell, David G; Greacen, Jane H; Giddings, Patrick H; Skinner, Lesley P

2011-06-06

The concept of "social accountability" has underpinned the development of many medical education programs over the past decade. Success of the regionalisation of the general practice training program in Australia will ultimately be measured by the ability of the program to deliver a sufficient rural general practice workforce to meet the health needs of rural communities. Regionalisation of general practice training in Australia arose from the 1998 recommendations of the Ministerial Review of General Practice Training. The resultant competitive structure adopted by government was not the preferred option of the Review Committee, and may be a negative influence on rural workforce, as the competitive corporate structure of regional training providers has created barriers to meaningful vertical integration. Available data suggest that the regionalised training program is not yet providing a sustainable general practice workforce to rural Australia. The current increase in medical student and general practice training places provides an opportunity to address some of these issues. In particular, it is recommended that changes be made to registrar selection processes, the rural pipeline and vertical integration of training, and training for procedural rural practice. To achieve these goals, perhaps it is time for another comprehensive ministerial review of general practice training in Australia.

Special Programs in Medical Library Education, 1957-1971: Part I: Definition of the Problem and Research Design *

PubMed Central

Roper, Fred W.

1973-01-01

This report discusses the background and design of a study on special programs of education for medical librarianship in the United States. Between 1957 and 1971, 238 persons completed special programs in medical librarianship. Since little information has been available concerning the occupational success of these individuals, the study was undertaken (1) to determine the nature and distinguishing characteristics of the special programs of education for medical librarianship in the United States and (2) to provide some quantitative evidence of the value of those programs by studying a group of professional medical librarians who have had specialized training and a group of practicing medical librarians who have not had specialized training and comparing and correlating the data with regard to selected characteristics. The findings of the study will be presented in three future reports: (1) a descriptive analysis of the programs; (2) a description of the characteristics of all former trainees in medical librarianship who responded to a questionnaire and a discussion of their reactions to their training programs; and (3) a comparison, based on selected characteristics, of a group of former trainees who are currently employed in medical libraries with a group of medical librarians who did not go through special training programs. PMID:4702806

Surgeons' attitude toward a competency-based training and assessment program: results of a multicenter survey.

PubMed

Hopmans, Cornelis J; den Hoed, Pieter T; Wallenburg, Iris; van der Laan, Lijkckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; van Lanschot, Jan J B; Ijzermans, Jan N M

2013-01-01

Currently, most surgical training programs are focused on the development and evaluation of professional competencies. Also in the Netherlands, competency-based training and assessment programs were introduced to restructure postgraduate medical training. The current surgical residency program is based on the Canadian Medical Education Directives for Specialists (CanMEDS) competencies and uses assessment tools to evaluate residents' competence progression. In this study, we examined the attitude of surgical residents and attending surgeons toward a competency-based training and assessment program used to restructure general surgical training in the Netherlands in 2009. In 2011, all residents (n = 51) and attending surgeons (n = 108) in 1 training region, consisting of 7 hospitals, were surveyed. Participants were asked to rate the importance of the CanMEDS competencies and the suitability of the adopted assessment tools. Items were rated on a 5-point Likert scale and considered relevant when at least 80% of the respondents rated an item with a score of 4 or 5 (indicating a positive attitude). Reliability was evaluated by calculating the Cronbach's α, and the Mann-Whitney test was applied to assess differences between groups. The response rate was 88% (n = 140). The CanMEDS framework demonstrated good reliability (Cronbach's α = 0.87). However, the importance of the competencies 'Manager' (78%) and 'Health Advocate' (70%) was undervalued. The assessment tools failed to achieve an acceptable reliability (Cronbach's α = 0.55), and individual tools were predominantly considered unsuitable for assessment. Exceptions were the tools 'in-training evaluation report' (91%) and 'objective structured assessment of technical skill' (82%). No significant differences were found between the residents and the attending surgeons. This study has demonstrated that, 2 years after the reform of the general surgical residency program, residents and attending surgeons in a large training region in the Netherlands do not acknowledge the importance of all CanMEDS competencies and consider the assessment tools generally unsuitable for competence evaluation. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Regional cost and experience, not size or hospital inclusion, helps predict ACO success.

PubMed

Schulz, John; DeCamp, Matthew; Berkowitz, Scott A

2017-06-01

The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date. We used a cross-sectional analysis to examine all ACOs and used a multivariate logistic model to predict probability of achieving shared savings.Experience, as measured by years in the MSSP program, was associated with success and the ability to earn shared savings varied regionally. This variation was strongly associated with differences in regional Medicare fee-for-service per capita costs: ACOs in high cost regions were more likely to earn savings. In the multivariate model, the number of ACO beneficiaries, inclusion of a hospital or involvement of an academic medical center, was not associated with likelihood of earning shared savings, after accounting for regional baseline cost variation.These results suggest ACOs are learning and improving from their experience. Additionally, the results highlight regional differences in ACO success and the strong association with variation in regional per capita costs, which can inform CMS policy to help promote ACO success nationwide.

The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

PubMed Central

2013-01-01

Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (p<0.05 for t statistics) in generating the community patient’s life satisfaction. Among major aspects of the community patient’s trust in community health delivery system, trust in doctor (particularly in underdeveloped regions), trust in prescription (particularly in underdeveloped regions), and trust in recommended medical examination (particularly in underdeveloped regions) were all important considerations (p<0.10 for t statistics) in generating the community patient’s life satisfaction. Conclusion The reduction of medical cost (particularly in developed regions), the improvement of doctor-patient communication (particularly in developed regions), the promotion of medical facility and hospital environment (particularly in developed regions), the improvement of medical treatment process (particularly in underdeveloped regions), the promotion of trust in doctor (particularly in underdeveloped regions), the promotion of trust in prescription (particularly in underdeveloped regions), and the promotion of trust in recommended medical examination (particularly in underdeveloped regions) could help promote the community patient’s life satisfaction. PMID:23406216

An Insurer's Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs.

PubMed

Polinski, Jennifer M; Moore, Janice M; Kyrychenko, Pavlo; Gagnon, Michael; Matlin, Olga S; Fredell, Joshua W; Brennan, Troyen A; Shrank, William H

2016-07-01

Adverse drug events and the challenges of clarifying and adhering to complex medication regimens are central drivers of hospital readmissions. Medication reconciliation programs can reduce the incidence of adverse drug events after discharge, but evidence regarding the impact of medication reconciliation on readmission rates and health care costs is less clear. We studied an insurer-initiated care transition program based on medication reconciliation delivered by pharmacists via home visits and telephone and explored its effects on high-risk patients. We examined whether voluntary program participation was associated with improved medication use, reduced readmissions, and savings net of program costs. Program participants had a 50 percent reduced relative risk of readmission within thirty days of discharge and an absolute risk reduction of 11.1 percent. The program saved $2 for every $1 spent. These results represent real-world evidence that insurer-initiated, pharmacist-led care transition programs, focused on but not limited to medication reconciliation, have the potential to both improve clinical outcomes and reduce total costs of care. Project HOPE—The People-to-People Health Foundation, Inc.

Clerkship maturity: Does the idea of training clinical skills work?

PubMed Central

Stosch, Christoph; Joachim, Alexander; Ascher, Johannes

2011-01-01

Background: With the reformed curriculum “4C”, the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated. Materials and methods: Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the concept of Clerkship Maturity. Results and discussion: The Cologne training program Clerkship Maturity can be validated empirically overall through the activities of the students awaiting the clerkship framework and through the evaluation by the medical staff providing the training. The subjective ratings of the advantages of the training by the students leave room for improvement. Apart from minor improvements to the program, the most likely solution providing sustainable results will involve an over-regional strategy for establishing skills training planned as part of the curriculum. PMID:21866243

The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India

PubMed Central

Sikka, Veronica; Gautam, V.; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P.; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R. P.; Rana, B. K.; Batra, Bipin; Kalra, OP.; Aggarwal, P.; Bhoi, Sanjeev; Krishnan, S. Vimal

2017-01-01

The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India. PMID:28855780

Recent trends in psychiatry residency workforce with special reference to international medical graduates.

PubMed

Rao, Nyapati R

2003-01-01

This study examines trends in the supply, distribution, and demographics of psychiatry residents during the 1990s. It evaluates the extent to which the predicted downsizing of psychiatry residency training programs actually occurred and how it affected training programs of different sizes and locations. Data for this study were obtained from the American Medical Association's (AMA) Annual Survey of Graduate Medical Education (GME) Programs, the AMA GME directory, and the APA Graduate Medical Census. The study compares the roles played by international medical graduates (IMGs) in contrast to U.S. medical graduates (USMGs) in these trends. There was a significant decline in the number of residents during the years studied. The median training program size also decreased. International medical graduates found broad acceptance in training programs of all locations and sizes, including medical school based programs. Implications of the findings are discussed regarding the impact of current graduate medical education (GME) and immigration policies on future workforce patterns. The field will have to decide whether it can afford anymore residency downsizing in light of emerging evidence of a shortage of psychiatrists.

Law Panel in action.

PubMed

Odulana, J

In September 1976 the Africa Regional Council (ARC) of IPPF created a Law Panel to 1) advise the ARC on the emphasis of laws and parenthood programs in the region, 2) investigate legal obstacles to family planning and ways of removing them, 3) institute a monitoring service on laws and court decisions affecting planned parenthood, and 4) prepare a list of lawyers and legal reformers by country. The panel has 1) recommended adoption of an IPPF Central Medical Committee and Central Law Panel statement on sterilization, adolescent fertility control, and the use of medical and auxiliary personnel in family planning services with guidelines for Africa; 2) appointed National Legal Correspondents to carry on the monitoring service mentioned above in 18 countries; and 3) discussed solutions to problems in delivering family planning services with family planning associations in Tanzania, Zambia, Mauritius, Madagascar, and Kenya. Laws governing family planning education and services, marriage, divorce, and maternity benefits in these countries are summarized. In 1978 the panel will hold 2 workshops on law and the status of women.

Setting priorities for teaching and learning: an innovative needs assessment for a new family medicine program in Lao PDR.

PubMed

Kanashiro, Jeanie; Hollaar, Gwen; Wright, Bruce; Nammavongmixay, Khamphong; Roff, Sue

2007-03-01

Lao People's Democratic Republic (Lao PDR) is a small, tropical, landlocked country in southeast Asia. It is one of the least developed countries in the region, and its socioeconomic indicators are among the lowest 25% in the world. The World Health Organization has long called for increased equity in primary health care access around the world. To meet this need in Lao PDR, the Family Medicine Specialist Program was developed, a Lao-generated postgraduate training program designed to produce community-oriented primary care practitioners to serve the rural, remote areas of Lao PDR, where 80% of the population lives. An innovative method of needs assessment was required to determine the health care priorities to be met by this new program. Through the use of a modified Delphi technique, local key leaders in medical education, clinical specialists, and teachers were consulted to develop prioritized objectives for the hospital-based curriculum of the program. By setting priorities for teaching and learning in the unique and needy circumstances of Lao PDR, a novel approach to curriculum planning in a low-income country was explored and ultimately formed the foundation of the new curriculum. This process served to direct the allocation of scarce resources during implementation of this groundbreaking program. More importantly, this model of needs assessment could potentially be used to customize medical curricula in other low-income countries facing challenges similar to those in Lao PDR.

Implementation of a pharmacy residency in a Veterans Affairs community-based outpatient clinic.

PubMed

Phillips, Beth Bryles; Williams, Kim C

2012-05-15

The implementation of an innovative ambulatory care pharmacy residency program at a Veterans Affairs (VA) outpatient clinic is described. Community-based outpatient clinics (CBOCs) are a largely underutilized resource for pharmacy residency training. Through a collaboration of the University of Georgia College of Pharmacy in Athens and Charlie Norwood VA Medical Center in Augusta, a postgraduate year 2 (PGY2) pharmacy residency program was established at the CBOC in Athens. The program graduated its first resident in 2009; components of training included (1) disease state management at an anticoagulation clinic and a newly created disease state-focused pharmacotherapy clinic, (2) participation in the planning and implementation of a new lipid management service, (3) a variety of didactic, laboratory, and experiential teaching activities at the college of pharmacy, and (4) management experiences such as completing requests for nonformulary medications, management of drug shortages, adverse drug reaction reporting, and participation in meetings of local and regional VA pharmacy and therapeutics committees. The demonstrated value of the ongoing program led to position upgrades for two CBOC clinical pharmacists and the addition of a clinical faculty member, enabling the program to offer additional learning experiences and preceptorship opportunities. A PGY2 ambulatory care residency program established in a CBOC provided a novel practice setting for the resident, helped improve patient care and pharmacy student education, and assisted in the professional development of preceptors and providers at the training site.

Assessment of medical occupational radiation doses in Costa Rica.

PubMed

Mora, P; Acuña, M

2011-09-01

Participation of the University of Costa Rica (UCR) in activities in an IAEA Regional Project RLA/9/066 through training, equipment and expert missions, has enabled to setting up of a national personal monitoring laboratory. Since 2007, the UCR has been in charge of monitoring around 1800 medical radiation workers of the Social Security System. Individual external doses are measured with thermoluminescent dosemeter using a Harshaw 6600 Plus reader. The service has accreditation with ISO/IEC 17025:2005. Distribution of monitored medical personnel is as follows: 83 % in diagnostic radiology, 6 % in nuclear medicine and 6 % in radiotherapy. Preliminary values for the 75 percentile of annual H(p)(10) in mSv are: radiology 0.37; interventional radiology 0.41; radiotherapy 0.53 and nuclear medicine 1.55. The service provided by the UCR in a steady and reliable way can help to implement actions to limit the doses received by the medical workers and optimise their radiation protection programs.

Unité de Coordination Clinique des Services Préhospitaliers d'Urgence: A clinical telemedicine platform that improves prehospital and community health care for rural citizens.

PubMed

Bussières, Sylvain; Tanguay, Alain; Hébert, Denise; Fleet, Richard

2017-01-01

Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results.

[Occupational brucellosis in the veterinary service of the Local Health Service in the Abruzzo Region (Italy)].

PubMed

Cieri, D; Turchi, C; Torzi, G

2007-01-01

During the health surveillance of the employees in the veterinary service of a Local Sanitary Service, we came across a medical case of occupational brucellosis in a veterinarian, identified by seriological data (Wright' seriological diagnosis + brucellosis specific test with identification of IgM and IgG), in a lack of significant anamnesis, anamnestic negativity of dangerous behaviours. Two medical cases of the sole seriological positivity have been identified in a veterinarian and in a health vigililant. In our Local Health Service the medical cases stated across the population have been 6 (in the period from 2000 to August 2007). The epidemiological flow of the animal brucellosis in the regional area, and in particular in our territory, shows one low incidence of positive stock farms, low incidence of oxes, sheep and goats infected. In Italy the medical cases of brucellosis denounced and approved from the National Institute for work-related Injury Insurance have been 38 out of 41, in the period from 1996 to 2006. This zoonosis represents a problem of relief in the sector the breeding of the animals and the butchery of the meats in all countries; the occupational health physician, within the area of prevention, has to exercise a specific health surveillance of biological risk and take part in specific programs of information and formation, in particular on the use of individual protection devices and correct behavioural rules.

The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

PubMed

Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

2018-05-09

Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

IAEA support to medical physics in nuclear medicine.

PubMed

Meghzifene, Ahmed; Sgouros, George

2013-05-01

Through its programmatic efforts and its publications, the International Atomic Energy Agency (IAEA) has helped define the role and responsibilities of the nuclear medicine physicist in the practice of nuclear medicine. This paper describes the initiatives that the IAEA has undertaken to support medical physics in nuclear medicine. In 1984, the IAEA provided guidance on how to ensure that the equipment used for detecting, imaging, and quantifying radioactivity is functioning properly (Technical Document [TECDOC]-137, "Quality Control of Nuclear Medicine Instruments"). An updated version of IAEA-TECDOC-137 was issued in 1991 as IAEA-TECDOC-602, and this included new chapters on scanner-computer systems and single-photon emission computed tomography systems. Nuclear medicine physics was introduced as a part of a project on radiation imaging and radioactivity measurements in the 2002-2003 IAEA biennium program in Dosimetry and Medical Radiation Physics. Ten years later, IAEA activities in this field have expanded to cover quality assurance (QA) and quality control (QC) of nuclear medicine equipment, education and clinical training, professional recognition of the role of medical physicists in nuclear medicine physics, and finally, the coordination of research and development activities in internal dosimetry. As a result of these activities, the IAEA has received numerous requests to support the development and implementation of QA or QC programs for radioactivity measurements in nuclear medicine in many Member States. During the last 5 years, support was provided to 20 Member States through the IAEA's technical cooperation programme. The IAEA has also supported education and clinical training of medical physicists. This type of support has been essential for the development and expansion of the Medical Physics profession, especially in low- and middle-income countries. The need for basic as well as specialized clinical training in medical physics was identified as a priority for healthcare providers in many countries. The IAEA's response to meet the increasing needs for training has been 2-folds. Through its regular program, a priority is given to the development of standardized syllabi and education and clinical training guides. Through its technical cooperation programme, support is given for setting up national medical physics education and clinical training programs in countries. In addition, fellowships are granted for professionals working in the field for specialized training, and workshops are organized at the national and regional level in specialized topics of nuclear medicine physics. So as to support on-the-job training, the IAEA has also setup a gamma camera laboratory in Seibersdorf, Austria. The laboratory is also equipped with QC tools and equipments, and radioisotopes are procured when training events are held. About 2-3 specialized courses are held every year for medical physicists at the IAEA gamma camera laboratory. In the area of research and development, the IAEA supports, through its coordinated research projects, new initiatives in quantitative nuclear medicine and internal dosimetry. The future of nuclear medicine is driven by advances in instrumentation, by the ever increasing availability of computing power and data storage, and by the development of new radiopharmaceuticals for molecular imaging and therapy. Future developments in nuclear medicine are partially driven by, and will influence, nuclear medicine physics and medical physics. To summarize, the IAEA has established a number of programs to support nuclear medicine physics and will continue to do so through its coordinated research activities, education and training in clinical medical physics, and through programs and meetings to promote standardization and harmonization of QA or QC procedures for imaging and treatment of patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence of Malaria Parasitemia and Purchase of Artemisinin-Based Combination Therapies (ACTs) among Drug Shop Clients in Two Regions in Tanzania with ACT Subsidies

PubMed Central

Briggs, Melissa A.; Kalolella, Admirabilis; Bruxvoort, Katia; Wiegand, Ryan; Lopez, Gerard; Festo, Charles; Lyaruu, Pierre; Kenani, Mitya; Abdulla, Salim; Goodman, Catherine; Kachur, S. Patrick

2014-01-01

Background Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. Method and Findings A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6–18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was <5 years old (aOR: 6.6; 95% CI: 3.9–11.0) or the shop attendant had >5 years, experience (aOR: 2.8; 95% CI: 1.2–6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5–7.4). Conclusion Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives ACTs in these drug shops. PMID:24732258

Prevalence of malaria parasitemia and purchase of artemisinin-based combination therapies (ACTs) among drug shop clients in two regions in Tanzania with ACT subsidies.

PubMed

Briggs, Melissa A; Kalolella, Admirabilis; Bruxvoort, Katia; Wiegand, Ryan; Lopez, Gerard; Festo, Charles; Lyaruu, Pierre; Kenani, Mitya; Abdulla, Salim; Goodman, Catherine; Kachur, S Patrick

2014-01-01

Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6-18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was <5 years old (aOR: 6.6; 95% CI: 3.9-11.0) or the shop attendant had >5 years, experience (aOR: 2.8; 95% CI: 1.2-6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5-7.4). Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives ACTs in these drug shops.

Visiting medical student elective and clerkship programs: a survey of US and Puerto Rico allopathic medical schools

PubMed Central

2010-01-01

Background No published reports of studies have provided aggregate data on visiting medical student (VMS) programs at allopathic medical schools. Methods During 2006, a paper survey was mailed to all 129 allopathic medical schools in the United States and Puerto Rico using a list obtained from the Association of American Medical Colleges. Contents of the survey items were based on existing literature and expert opinion and addressed various topics related to VMS programs, including organizational aspects, program objectives, and practical issues. Responses to the survey items were yes-or-no, multiple-choice, fill-in-the-blank, and free-text responses. Data related to the survey responses were summarized using descriptive statistics. Results Representatives of 76 schools (59%) responded to the survey. Of these, 73 (96%) reported their schools had VMS programs. The most common reason for having a VMS program was "recruitment for residency programs" (90%). "Desire to do a residency at our institution" was ranked as the leading reason visiting medical students choose to do electives or clerkships. In descending order, the most popular rotations were in internal medicine, orthopedic surgery, emergency medicine, and pediatrics. All VMS programs allowed fourth-year medical students, and approximately half (58%) allowed international medical students. The most common eligibility requirements were documentation of immunizations (92%), previous clinical experience (85%), and successful completion of United States Medical Licensing Examination Step 1 (51%). Of the programs that required clinical experience, 82% required 33 weeks or more. Most institutions (96%) gave priority for electives and clerkships to their own students over visiting students, and a majority (78%) reported that visiting students were evaluated no differently than their own students. During academic year 2006-2007, the number of new resident physicians who were former visiting medical students ranged widely among the responding institutions (range, 0-76). Conclusions Medical schools' leading reason for having VMS programs is recruitment into residency programs and the most commonly cited reason students participate in these programs is to secure residency positions. However, further research is needed regarding factors that determine the effectiveness of VMS programs in residency program recruitment and the development of more universal standards for VMS eligibility requirements and assessment. PMID:20529301

The influence of international medical electives on career preference for primary care and rural practice.

PubMed

Law, Iain R; Walters, Lucie

2015-11-11

Previous studies have demonstrated a correlation between medical students who undertake international medical electives (IMEs) in resource poor settings and their reported career preference for primary care in underserved areas such as rural practice. This study examines whether a similar correlation exists in the Australian medical school context. Data was extracted from the Medical Schools Outcomes Database (MSOD) of Australian medical students that completed commencing student and exit questionnaires between 2006 and 2011. Student responses were categorized according to preferred training program and preferred region of practice at commencement. The reported preferences at exit of students completing IMEs in low and middle income countries (LMIC) were compared to those completing electives in high income countries (HIC). The effect of elective experience for students expressing a preference for primary care at commencement was non-significant, with 40.32 % of LMIC and 42.11 % of HIC students maintaining a preference for primary care. Similarly there were no significant changes following LMIC electives for students expressing a preference for specialist training at commencement with 11.81 % of LMIC and 10.23 % of HIC students preferring primary care at exit. The effect of elective experience for students expressing a preference for rural practice at commencement was non-significant, with 41.51 % of LMIC and 49.09 % of HIC students preferring rural practice at exit. Similarly there were no significant changes following LMIC electives for students expressing a preference for urban practice at commencement, with 7.84 % of LMIC and 6.70 % of HIC students preferring rural practice at exit. This study did not demonstrate an association between elective experience in resource poor settings and a preference for primary care or rural practice. This suggests that the previously observed correlation between LMIC electives and interest in primary care in disadvantaged communities is likely dependent on student and elective program characteristics and supports the need for further research and critical examination of elective programs at Australian medical schools.

Medical Assisting Program Guide.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Dept. of Vocational Education.

This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a medical assisting program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the medical assisting field, such as medical law and ethics, typing,…

Students’ psychological distress in an English program embedded in a medical school in a non-English speaking country

PubMed Central

Loureiro, Elizabete; Klugar, Miloslav; Tancred, Adam; Ivanova, Katerina; Oborna, Ivana

2013-01-01

Objectives To clarify if medical students in an English program in a non-English speaking country are exposed to a higher risk of psychological distress compared to comparable local medical students. Methods An online survey was conducted for all medical students both in the English program exclusively for international students (n=235) and in the local program (n=1043) at the Palacky University in the Czech Republic. The Medical Student Well-Being Index (MSWBI) was used to define the student’s psychological distress. Logistic regressions were conducted to find an effect of the study program on the students’ psychological distress, adjusted by age, study year, marital status, residential status, and frequency of contact with significant others, stratified by gender. Results 44% (n=68) of the respondents in the English program screened positive for psychological distress, and 53% (n=221) in the local program. There was an interaction between gender and program in the association with psychological distress. The higher prevalence of psychological distress in the local program was likely attributed to female students who had frequent contacts with their significant others. Conclusions Psychological distress was highly prevalent in a Czech medical school, but there was no overall difference between the international students in the English program and the comparable local medical students.

A pilot study of the utility of a laboratory-based spinal fixation training program for neurosurgical residents.

PubMed

Sundar, Swetha J; Healy, Andrew T; Kshettry, Varun R; Mroz, Thomas E; Schlenk, Richard; Benzel, Edward C

2016-05-01

OBJECTIVE Pedicle and lateral mass screw placement is technically demanding due to complex 3D spinal anatomy that is not easily visualized. Neurosurgical and orthopedic surgery residents must be properly trained in such procedures, which can be associated with significant complications and associated morbidity. Current training in pedicle and lateral mass screw placement involves didactic teaching and supervised placement in the operating room. The objective of this study was to assess whether teaching residents to place pedicle and lateral mass screws using navigation software, combined with practice using cadaveric specimens and Sawbones models, would improve screw placement accuracy. METHODS This was a single-blinded, prospective, randomized pilot study with 8 junior neurosurgical residents and 2 senior medical students with prior neurosurgery exposure. Both the study group and the level of training-matched control group (each group with 4 level of training-matched residents and 1 senior medical student) were exposed to a standardized didactic education regarding spinal anatomy and screw placement techniques. The study group was exposed to an additional pilot program that included a training session using navigation software combined with cadaveric specimens and accessibility to Sawbones models. RESULTS A statistically significant reduction in overall surgical error was observed in the study group compared with the control group (p = 0.04). Analysis by spinal region demonstrated a significant reduction in surgical error in the thoracic and lumbar regions in the study group compared with controls (p = 0.02 and p = 0.04, respectively). The study group also was observed to place screws more optimally in the cervical, thoracic, and lumbar regions (p = 0.02, p = 0.04, and p = 0.04, respectively). CONCLUSIONS Surgical resident education in pedicle and lateral mass screw placement is a priority for training programs. This study demonstrated that compared with a didactic-only training model, using navigation simulation with cadavers and Sawbones models significantly reduced the number of screw placement errors in a laboratory setting.

Effect of special diabetes program for Indians funding on system changes in diabetes care and outcomes among American Indian/Alaska Native people 1994-2004.

PubMed

Ramesh, Meera; Schraer, Cynthia; Mayer, Ann Marie; Asay, Elvin; Koller, Kathryn

2008-06-01

The Alaska Native Medical Center diabetes program analysed Diabetes Care and Outcomes Audit data from 1994-2004 to evaluate the impact of the Special Diabetes Program for Indians (SDPI) funding on process and intermediate outcomes. We conducted a retrospective analysis of data from standardized medical records reviews conducted between 1994 and 2004 from regional sites in Alaska. We analysed 7,735 randomly selected records for trends over three time periods (pre-SDPI, transition and SDPI). Hemoglobin A1c, total and LDL cholesterol, triglycerides and blood pressure significantly improved from the pre-SDPI to the SDPI period. However, as the number of people with diabetes increased, the percentage of patients receiving foot, eye and dental exams decreased, as did the percentage receiving nutrition, exercise and diabetes education. SDPI funding provided resources for interventions necessary to improve the effectiveness of diabetes care. This was associated with improved intermediate outcomes in American Indian/Alaska Native patients with diabetes. Further observations are needed to evaluate whether or not intermediate outcomes result in decreased cardiovascular disease, amputations, dialysis and retinopathy.

A program to enhance k-12 science education in ten rural New York school districts.

PubMed

Goodell, E; Visco, R; Pollock, P

1999-04-01

The Rural Partnership for Science Education, designed by educators and scientists in 1991 with funding from the National Institutes of Health, works in two rural New York State counties with students and their teachers from kindergarten through grade 12 to improve pre-college science education. The Partnership is an alliance among ten rural New York school districts and several New York State institutions (e.g., a regional academic medical center; the New York Academy of Sciences; and others), and has activities that involve around 4,800 students and 240 teachers each year. The authors describe the program's activities (e.g., summer workshops for teachers; science exploration camps for elementary and middle-school students; enrichment activities for high school students). A certified science education specialist directs classroom demonstrations throughout the academic year to support teachers' efforts to integrate hands-on activities into the science curriculum. A variety of evaluations over the years provides strong evidence of the program's effectiveness in promoting students' and teachers' interest in science. The long-term goal of the Partnership is to inspire more rural students to work hard, learn science, and enter the medical professions.

Use of fictional medical television in health sciences education: a systematic review.

PubMed

Hoffman, Beth L; Hoffman, Robert; Wessel, Charles B; Shensa, Ariel; Woods, Michelle S; Primack, Brian A

2018-03-01

While medical television programs are popular among health profession trainees, it is not clear to what extent these programs affect their knowledge, perceptions, and/or behaviors. Therefore, we conducted a systematic review of research evaluating associations between program exposure and outcomes. We conducted systematic literature searches in Pubmed, CINAHL, and PsycINFO. Selected studies were required to be scholarly research, involve exposure to fictionalized medical television programming by health professional students, and assess associations between exposure and outcomes. Studies were classified according to quality and factors related to population, exposure, and outcomes. Of 3541 studies identified, 13 met selection criteria. Six studies involved undergraduate medical students, one involved nursing students, two involved both medical and nursing students, two involved medical residents, one involved medical students, residents and attending physicians, and one involved graduate epidemiology students. Mean study quality according to the MERSQI was 8.27. The most commonly assessed television programs were ER and Grey's Anatomy (six each). Five studies assessed regular viewing habits, and found that fictional medical programs are popular among students and that students recall health topics from episodes. The eight studies that assessed the association with outcomes when using clips as educational tools reported high satisfaction and increased knowledge of the presented health topics. While relatively few published studies have explored influences of fictional medical television on health professional students, those conducted suggest that students often view these television programs independently and that integration of this programming into medical education is feasible and acceptable.

Trained simulated ultrasound patients: medical students as models, learners, and teachers.

PubMed

Blickendorf, J Matthew; Adkins, Eric J; Boulger, Creagh; Bahner, David P

2014-01-01

Medical educators must develop ultrasound education programs to ensure that future physicians are prepared to face the changing demands of clinical practice. It can be challenging to find human models for hands-on scanning sessions. This article outlines an educational model from a large university medical center that uses medical students to fulfill the need for human models. During the 2011-2012 academic year, medical students from The Ohio State University College of Medicine served as trained simulated ultrasound patients (TSUP) for hands-on scanning sessions held by the college and many residency programs. The extracurricular program is voluntary and coordinated by medical students with faculty supervision. Students receive a longitudinal didactic and hands-on ultrasound education program as an incentive for serving as a TSUP. The College of Medicine and 7 residency programs used the program, which included 47 second-year and 7 first-year student volunteers. Participation has increased annually because of the program's ease, reliability, and cost savings in providing normal anatomic models for ultrasound education programs. A key success of this program is its inherent reproducibility, as a new class of eager students constitutes the volunteer pool each year. The TSUP program is a feasible and sustainable method of fulfilling the need for normal anatomic ultrasound models while serving as a valuable extracurricular ultrasound education program for medical students. The program facilitates the coordination of ultrasound education programs by educators at the undergraduate and graduate levels.

Health region development from the perspective of system theory - an empirical cross-regional case study.

PubMed

Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

2015-01-01

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

A discrete choice experiment studying students' preferences for scholarships to private medical schools in Japan.

PubMed

Goto, Rei; Kakihara, Hiroaki

2016-02-09

The shortage of physicians in rural areas and in some specialties is a societal problem in Japan. Expensive tuition in private medical schools limits access to them particularly for students from middle- and low-income families. One way to reduce this barrier and lessen maldistribution is to offer conditional scholarships to private medical schools. A discrete choice experiment is carried out on a total of 374 students considering application to medical schools. The willingness to receive a conditional scholarship program to private medical schools is analyzed. The probability of attending private medical schools significantly decreased because of high tuition, a postgraduate obligation to provide a service in specific specialty areas, and the length of time of this obligation. An obligation to provide a service in rural regions had no significant effect on this probability. To motivate non-applicants to private medical schools to enroll in such schools, a decrease in tuition to around 1.2 million yen (US$ 12,000) or less, which is twice that of public schools, was found to be necessary. Further, it was found that non-applicants to private medical schools choose to apply to such schools even with restrictions if they have tuition support at the public school level. Conditional scholarships for private medical schools may widen access to medical education and simultaneously provide incentives to work in insufficiently served areas.

Medical center farmers markets: a strategic partner in the patient-centered medical home.

PubMed

George, Daniel R; Rovniak, Liza S; Kraschnewski, Jennifer L; Morrison, Kathy J; Dillon, Judith F; Bates, Beth Y

2013-08-01

The number of medical center-based farmers markets has increased in the past decade, but little is known about how such organizations contribute to the preventive health goals of the patient-centered medical home. In 2010, we started a seasonal farmers market at Penn State Hershey Medical Center to help support the institution's commitment to the medical home. We obtained descriptive data on the farmers market from hospital and market records and tracking information on the market's Facebook and Twitter sites. We computed summary measures to characterize how the market has begun to meet the 6 standards of the 2011 National Committee for Quality Assurance's report on the medical home. During the 2010 and 2011 seasons, 146 medical center volunteers from 40 departments formed 23 interprofessional teams that spent an average of 551 volunteer hours per season at the market, providing health screenings (n = 695) and speaking to customers (n = 636) about preventive health. Fifty-five nonmedical community health partners provided 208 hours of service at the market alongside medical center staff. Market programming contributed to 5 regional preventive health partnerships and created opportunities for interprofessional mentoring, student leadership, data management, development of social media skills, and grant-writing experience. The market contributed to all 6 medical home standards outlined by the National Committee for Quality Assurance. Medical center markets can support medical home standards. With systematic tracking of the health effects and integration with electronic medical health records, markets hold potential to contribute to comprehensive patient-centered care.

Blended learning on medication administration for new nurses: integration of e-learning and face-to-face instruction in the classroom.

PubMed

Sung, Young Hee; Kwon, In Gak; Ryu, Eunjung

2008-11-01

This study analyzed the effects of a blended learning program on medication administration by new nurses using a non-equivalent groups design. A medication education program using blended learning (including e-learning) was administered to 26 new nurses, while face-to-face instruction in the classroom was given to 24 new nurses. The following dependent variables were compared: degree of knowledge of medication, self-efficacy of medication administration, medication-administration ability, and satisfaction with the learning program. The experimental, blended learning group showed a significantly higher level of knowledge of medication and satisfaction with the comprehensiveness of their medication learning, but the self-efficacy of medication administration, medication-administration ability, and other items related to their learning satisfaction did not differ significantly from that in the control group. These results suggest that blended learning integrating e-learning and face-to-face instruction in the classroom is useful for enhancing medication knowledge. An e-learning program can reduce the lecturing time and cost of repeated topics such as medication, suggesting that it can be an effective component in nurse education programs.

Medical Transport of Children with Complex Chronic Conditions

PubMed Central

Lerner, Carlos F.; Kelly, Robert B.; Hamilton, Leslie J.; Klitzner, Thomas S.

2012-01-01

One of the most notable trends in child health has been the increase in the number of children with special health care needs, including those with complex chronic conditions. Care of these children accounts for a growing fraction of health care resources. We examine recent developments in health care, especially with regard to medical transport and prehospital care, that have emerged to adapt to this remarkable demographic trend. One such development is the focus on care coordination, including the dissemination of the patient-centered medical home concept. In the prehospital setting, the need for greater coordination has catalyzed the development of the emergency information form. Training programs for prehospital providers now incorporate specific modules for children with complex conditions. Another notable trend is the shift to a family-centered model of care. We explore efforts toward regionalization of care, including the development of specialized pediatric transport teams, and conclude with recommendations for a research agenda. PMID:22315689

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

ERIC Educational Resources Information Center

Kromrei, Heidi T.

2014-01-01

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

Clinical Oncology Assistantship Program for Medical Students.

ERIC Educational Resources Information Center

Neilan, Barbara A.; And Others

1985-01-01

The Clinical Oncology Assistantship Program at the University of Arkansas for Medical Sciences is described, along with student reactions to the program. The summer elective program involves cancer lectures (one week) and clinical exposure (nine weeks) in medical, surgical, and pediatric oncology services, as well as self-directed learning…

Basis of Accreditation for Educational Programs in Allied Medical Disciplines.

ERIC Educational Resources Information Center

Canadian Medical Association, Ottawa (Ontario).

Designed as a guide to accreditation for educational programs in the allied medical disciplines in Canada, this report provides educators with guidelines, general requirements and requirements for specific programs. Following information on the organization, structure, goals and terminology of accreditation of allied medical programs in Canada,…

Java-based browsing, visualization and processing of heterogeneous medical data from remote repositories.

PubMed

Masseroli, M; Bonacina, S; Pinciroli, F

2004-01-01

The actual development of distributed information technologies and Java programming enables employing them also in the medical arena to support the retrieval, integration and evaluation of heterogeneous data and multimodal images in a web browser environment. With this aim, we used them to implement a client-server architecture based on software agents. The client side is a Java applet running in a web browser and providing a friendly medical user interface to browse and visualize different patient and medical test data, integrating them properly. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. Based on the Java Advanced Imaging API, processing and analysis tools were developed to support the evaluation of remotely retrieved bioimages through the quantification of their features in different regions of interest. The Java platform-independence allows the centralized management of the implemented prototype and its deployment to each site where an intranet or internet connection is available. Giving healthcare providers effective support for comprehensively browsing, visualizing and evaluating medical images and records located in different remote repositories, the developed prototype can represent an important aid in providing more efficient diagnoses and medical treatments.

Fifteen years of community organization for health in Panama: an assessment of current progress and problems.

PubMed

La Forgia, G M

1985-01-01

Since the late 1970s the WHO and other international agencies have placed much emphasis on strategies of community organization in order to improve preventive health services and facilities in rural areas. Many countries have recently set out to reform their rural health systems by means of a community-based approach. Panama's 15 years of experience in 'community health' provide insight into the constraints to program continuity at the national level and to maintenance of participatory mechanisms (health committees) at the village level. This paper focuses on the present status of the Community Health Program and level of activity of the health committees. This study is based on in-depth interviewing of key program participants at three contexts: central ministry, district/regional health institutions and rural communities. It sought to discover how interactions among and within these contexts affected program services and community participation. Inconsistent outcomes are evident. In some areas the Community Health Program thrives and the health committees are active, while in most areas the program functions at a minimal level and most health committees are inactive. Several factors are identified which affect a 'successful' or 'unsuccessful' program environment. These include: degree of support from medical directors of district and regional health centers, existence of 'federations of health committees', the extent of political interference, the presence of a functional 'technical health team' and degree of community confidence in health committee officers.

Teaching evidence-based medicine: a regional dissemination model.

PubMed

Leipzig, Rosanne M; Wallace, Eleanor Z; Smith, Lawrence G; Sullivant, Jean; Dunn, Kathel; McGinn, Thomas

2003-01-01

Evidence-based medicine (EBM) is a framework for critically appraising medical literature and applying it to the care of individual patients. Lack of faculty skilled in practicing and teaching EBM limits the ability to train residents in this area. A 31/2-day interactive course, called Teaching Evidence-Based Medicine, was given in 1996, 1998, and 1999. The goal of the course was to create a cadre of faculty within New York State's internal medicine residency programs educated in EBM knowledge and skills who could integrate EBM into their training program. Thirty (58.8%) of 51 metropolitan New York internal medicine residency programs and three of 12 upstate programs sent participants. The postcourse ratings showed increased self-rated knowledge and a willingness to apply the teaching methods at their home institutions. There is a high demand for the opportunity to learn EBM skills and in turn to implement EBM at home institutions

Peace in the Clinic: Rethinking "Global Health Diplomacy" in the Somali Region of Ethiopia.

PubMed

Carruth, Lauren

2016-06-01

Drawing on ethnographic research with Somalis, within aid organizations, and within health care facilities in the Somali Region of Ethiopia, this article argues that what is called "global health diplomacy," despite its origins and articulations in interstate politics, is fundamentally local and interpersonal. As evidence, I outline two very different health programs in the Somali Region of Ethiopia, and how, in each, existing animosities and political grievances were either reinforced or undermined. I argue that the provision of health care in politically insecure and post-conflict settings like the Somali Region of Ethiopia is precarious but pivotal: medical encounters have the potential to either worsen the conditions in which conflicts and crises recur, or build new interpersonal and governmental relations of trust. Effective global health diplomacy, therefore, cannot be limited to building clinics and donating medicine, but must also explicitly include building positive relationships of trust between oppositional groups within clinical spaces.

Medication safety programs in primary care: a scoping review.

PubMed

Khalil, Hanan; Shahid, Monica; Roughead, Libby

2017-10-01

Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry. This scoping review sought to map the current medication safety programs used in primary care. The current scoping review sought to examine the characteristics of medication safety programs in the primary care setting and to map evidence on the outcome measures used to assess the effectiveness of medication safety programs in improving patient safety. The current review considered participants of any age and any condition using care obtained from any primary care services. We considered studies that focussed on the characteristics of medication safety programs and the outcome measures used to measure the effectiveness of these programs on patient safety in the primary care setting. The context of this review was primary care settings, primary healthcare organizations, general practitioner clinics, outpatient clinics and any other clinics that do not classify patients as inpatients. We considered all quantitative studied published in English. A three-step search strategy was utilized in this review. Data were extracted from the included studies to address the review question. The data extracted included type of medication safety program, author, country of origin, aims and purpose of the study, study population, method, comparator, context, main findings and outcome measures. The objectives, inclusion criteria and methods for this scoping review were specified in advance and documented in a protocol that was previously published. This scoping review included nine studies published over an eight-year period that investigated or described the effects of medication safety programs in primary care settings. We classified each of the nine included studies into three main sections according to whether they included an organizational, professional or patient component. The organizational component is aimed at changing the structure of the organization to implement the intervention, the professional component is aimed at the healthcare professionals involved in implementing the interventions, and the patient component is aimed at counseling and education of the patient. All of the included studies had different types of medication safety programs. The programs ranged from complex interventions including pharmacists and teams of healthcare professionals to educational packages for patients and computerized system interventions. The outcome measures described in the included studies were medication error incidence, adverse events and number of drug-related problems. Multi-faceted medication safety programs are likely to vary in characteristics. They include educational training, quality improvement tools, informatics, patient education and feedback provision. The most likely outcome measure for these programs is the incidence of medication errors and reported adverse events or drug-related problems.

The multiple mini-interview for selecting medical residents: first experience in the Middle East region.

PubMed

Ahmed, Ashraf; Qayed, Khalil Ibrahim; Abdulrahman, Mahera; Tavares, Walter; Rosenfeld, Jack

2014-08-01

Numerous studies have shown that multiple mini-interviews (MMI) provides a standard, fair, and more reliable method for assessing applicants. This article presents the first MMI experience for selection of medical residents in the Middle East culture and an Arab country. In 2012, we started using the MMI in interviewing applicants to the residency program of Dubai Health Authority. This interview process consisted of eight, eight-minute structured interview scenarios. Applicants rotated through the stations, each with its own interviewer and scenario. They read the scenario and were requested to discuss the issues with the interviewers. Sociodemographic and station assessment data provided for each applicant were analyzed to determine whether the MMI was a reliable assessment of the non-clinical attributes in the present setting of an Arab country. One hundred and eighty-seven candidates from 27 different countries were interviewed for Dubai Residency Training Program using MMI. They were graduates of 5 medical universities within United Arab Emirates (UAE) and 60 different universities outside UAE. With this applicant's pool, a MMI with eight stations, produced absolute and relative reliability of 0.8 and 0.81, respectively. The person × station interaction contributed 63% of the variance components, the person contributed 34% of the variance components, and the station contributed 2% of the variance components. The MMI has been used in numerous universities in English speaking countries. The MMI evaluates non-clinical attributes and this study provides further evidence for its reliability but in a different country and culture. The MMI offers a fair and more reliable assessment of applicants to medical residency programs. The present data show that this assessment technique applied in a non-western country and Arab culture still produced reliable results.

Metropolitan Spokane Region Water Resources Study. Appendix H. Volume 1. Plan Formulation and Evaluation

DTIC Science & Technology

1976-01-01

Trickling Filter Fairchild A.F.B. Trickling Filter Town of Medical Lake Lagoon Town of Fairfield Lagoon Town of Millwood Activated Sludge (Extended Aeration...sewer system is subject to high levels of in- filtration. The treatment plant has ice problems in winter, trickling filter spreading arm clogging...lagoons. There is need of a routine effluent quan- tity/quality monitoring program. Tekoa. The trickling filter plant is poorly maintained to the point

The Readmission Reduction Program of Kaiser Permanente Southern California—Knowledge Transfer and Performance Improvement

PubMed Central

Tuso, Philip; Huynh, Dan Ngoc; Garofalo, Lynn; Lindsay, Gail; Watson, Heather L; Lenaburg, Douglas L; Lau, Helen; Florence, Brandy; Jones, Jason; Harvey, Patti; Kanter, Michael H

2013-01-01

In 2011, Kaiser Permanente Northwest Region (KPNW) won the Lawrence Patient Safety Award for its innovative work in reducing hospital readmission rates. In 2012, Kaiser Permanente Southern California (KPSC) won the Transfer Projects Lawrence Safety Award for the successful implementation of the KPNW Region’s “transitional care” bundle to a Region that was almost 8 times the size of KPNW. The KPSC Transition in Care Program consists of 6 KPNW bundle elements and 2 additional bundle elements added by the KPSC team. The 6 KPNW bundle elements were risk stratification, standardized discharge summary, medication reconciliation, a postdischarge phone call, timely follow-up with a primary care physician, and a special transition phone number on discharge instructions. The 2 additional bundle elements added by KPSC were palliative care consult if indicated and a complex-case conference. KPSC has implemented most of the KPNW and KPSC bundle elements during the first quarter of 2012 for our Medicare risk population at all of our 13 medical centers. Each year, KPSC discharges approximately 40,000 Medicare risk patients. After implementation of bundle elements, KPSC Medicare risk all-cause 30-day Healthcare Effectiveness Data and Information Set readmissions observed-over-expected ratio and readmission rates from December 2010 to November 2012 decreased from approximately 1.0 to 0.80 and 12.8% to 11%, respectively. PMID:24355891

State regulation of medical discount programs: a new frontier.

PubMed

Rich, J Peter

2006-01-01

Over the past several years, discount medical programs have flourished as a result of double digit increases in health insurance premiums. Given the rapid growth and sometimes questionable practices of such programs, several states have taken notice and have begun to regulate discount medical programs. This article summarizes the laws of several states that have chosen to oversee these programs.

Mississippi Curriculum Framework for Emergency Medical Technology--Basic (Program CIP: 51.0904). Emergency Medical Technology--Paramedic (Program CIP: 51.0904). Postsecondary Programs.

ERIC Educational Resources Information Center

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the emergency medical technology (EMT) programs cluster. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline…

Opioid Prescribing Practices of Neurosurgeons: Analysis of Medicare Part D.

PubMed

Khalid, Syed I; Adogwa, Owoicho; Lilly, Daniel T; Desai, Shyam A; Vuong, Victoria D; Mehta, Ankit I; Cheng, Joseph

2018-04-01

The Centers for Disease Control have declared that the United States is amidst a continuing opioid epidemic, with drug overdose-related death tripling between 1999 and 2014. Among the 47,055 overdose-related deaths that occurred in 2014, 28,647 (60.9%) of them involved an opioid. The Part D Prescriber Public Use File, which is based on beneficiaries enrolled in the Medicare Part D prescription drug program, was used to query information on prescription drug events incurred by Medicare beneficiaries with a Part D prescription drug plan from 31 June 2014 to 30 June 2015. Only those providers with the specialty description of neurosurgeon, as reported on the provider's Part B claims, were included in this study. A total of 271,502 beneficiaries, accounting for 971,581 claims and 22,152,689 day supplies of medication, accounted for the $52,956,428.40 paid by the Centers for Medicare and Medicaid Services for medication that the 4085 neurosurgeons submitted to the Centers for Medicare and Medicaid Services Part D program in the 2014 calendar year. During the same year, 402,767 (41.45%) claims for 158,749 (58.47%) beneficiaries accounted for 6,458,624 (29.16%) of the day supplies of medications and $13,962,630.11 (26.37%) of the total money spent by the Centers for Medicare and Medicaid Services Part D that year. Nationwide, the ratio of opioid claims to total Medicare Part D beneficiaries was 1.48. No statistically significant regional differences were found. The opioid misuse epidemic is a complex and national issue with patterns of prescription not significantly different between regions. All neurosurgeons must be cognizant of their prescribing practices so as to best support the resolution of this public health crisis. Copyright © 2017. Published by Elsevier Inc.

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

PubMed

Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

2018-01-01

Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Courses in Physics in Medical Colleges

ERIC Educational Resources Information Center

Physics Education, 1975

1975-01-01

Provides information concerning programs in medical physics, radiation biology, and radiation physics at eight British medical colleges. Each institution is separately listed, and the provided information typically includes program descriptions, graduate programs, and main branches of research. (MLH)

Medical students' views on thoracic surgery residency programs in a Japanese medical school.

PubMed

Morishita, Kiyofumi; Naraoka, Shu-ichi; Miyajima, Masahiro; Uzuka, Takeshi; Saito, Tatsuya; Abe, Tomio

2003-09-01

There has been a decline in the number of medical students applying for thoracic surgery training programs. We obtained knowledge of medical students' views on thoracic surgery residency programs. After completion of thoracic surgery clerkship, 17 students were asked to fill out questionnaires on first-year thoracic surgery residency programs. The majority of students considered thoracic surgery to be held in high regard by the general public, and felt that the salary was sufficient. However, only one student chose a thoracic surgery training program. The main reason for not applying for thoracic surgery residency was lifestyle issues. The factors in determining career choice included quality of education and work hours. Medical students are likely to select specialties other than thoracic surgery. Since the main factor influencing medical students' career is the quality of education in a residency program, efforts should be made to improve the quality of education.

Training Medical Students for Rural, Underserved Areas: A Rural Medical Education Program in California.

PubMed

Eidson-Ton, W Suzanne; Rainwater, Julie; Hilty, Donald; Henderson, Stuart; Hancock, Christine; Nation, Cathryn L; Nesbitt, Thomas

2016-01-01

The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies. Long-term outcomes, such as graduates entering rural practice, are still unknown, but will be monitored to assess the impact and sustainability of the rural program. This article illustrates the opportunities and challenges of training medical students for rural practice and provides lessons learned to inform newly-established and long standing rural medical education programs.

LEADER Program Results for 2009: an Activity and Spectrum Analysis of Linezolid Using 6,414 Clinical Isolates from 56 Medical Centers in the United States▿†

PubMed Central

Farrell, David J.; Mendes, Rodrigo E.; Ross, James E.; Sader, Helio S.; Jones, Ronald N.

2011-01-01

The LEADER Program monitors the in vitro activity of linezolid in sampled U.S. medical centers using reference broth microdilution methods with supporting molecular investigations in a central laboratory design. This report summarizes data obtained in 2009, the 6th consecutive year of this longitudinal study. A total of 6,414 isolates from 56 medical centers in all nine Census regions across the United States participated in 2009. For the six leading species/groups, the following linezolid MIC90 values were observed: Staphylococcus aureus, 2 μg/ml; coagulase-negative staphylococci (CoNS), 1 μg/ml; Enterococcus spp., 2 μg/ml; Streptococcus pneumoniae, 1 μg/ml; viridans group streptococci, 1 μg/ml; and beta-hemolytic streptococci, 1 μg/ml. Linezolid resistance was only 0.34% overall, with no evidence of significant increase in the LEADER Program since 2006. The predominant linezolid resistant mechanism found was a G2576T mutation in the 23S rRNA. L3/L4 riboprotein mutations were also found. The mobile multidrug-resistant cfr gene was found in four strains (two S. aureus strains and one strain each of S. epidermidis and S. capitis) from four different states, suggesting persistence but a lack of dissemination. Linezolid continues to exhibit excellent activity and spectrum, and this study documents the need for continued monitoring of emerging mechanisms of resistance over a wide geographic area. PMID:21670176

Contextual considerations in implementing problem-based learning approaches in a Brazilian medical curriculum: the UNAERP experience

PubMed Central

Bestetti, Reinaldo Bulgarelli; Couto, Lucélio Bernardes; Romão, Gustavo Salata; Araújo, Guilherme Teixeira; Restini, Carolina Baraldi A.

2014-01-01

Background Despite being a well-established pedagogical approach in medical education, the implementation of problem-based learning (PBL) approaches hinges not only on educational aspects of the medical curriculum but also on the characteristics and necessities of the health system and the medical labor market within which it is situated. Aim To report our experiences implementing a PBL-based approach in a region of Brazil where: 1) all pre-university education and the vast majority of medical courses are based on traditional, lecture-based instructions; and 2) students’ career interests in primary care, arguably the prototypical PBL trainee, are heavily disfavored because of economics. Results Brazilian guidelines require that clinical training take place during the last 2 years of the medical program and include intensive, supervised, inpatient and outpatient rotations in pediatrics, family medicine, obstetrics and gynecology, internal medicine, and surgery. Throughout the pre-clinical curriculum, then, students learn to deal with progressively more difficult and complex cases – typically through the use of PBL tutors in a primary care context. However, because of curricular time constraints in the clerkships, and students’ general preoccupation with specialty practice, the continuation of PBL-based approaches in the pre-clinical years – and the expansion of PBL into the clerkships – has become exceedingly difficult. Discussion and conclusion Our experience illustrates the importance of context (both cultural and structural) in implementing certain pedagogies within one Brazilian training program. We plan to address these barriers by: 1) integrating units, whenever possible, within a spiral curriculum; 2) introducing real patients earlier in students’ pre-clinical coursework (primarily in a primary care setting); and 3) using subject experts as PBL tutors to better motivate students. PMID:24931596

Group dynamics and social interaction in a South Asian online learning forum for faculty development of medical teachers.

PubMed

Anshu; Sharma, M; Burdick, W P; Singh, T

2010-04-01

Group dynamics of online medical faculty development programs have not been analyzed and reported in literature. Knowledge of the types of content of posted messages will help to understand group dynamics and promote participation in an asynchronous learning environment. This paper assesses group dynamics and social interactivity in an online learning environment for medical teachers in the South Asian context. Participants of a medical education fellowship program conducted by the Foundation for Advancement of International Medical Education and Research (FAIMER) Regional Institute at Christian Medical College, Ludhiana (CMCL) in India interact on a listserv called the Mentoring-Learning Web (ML-Web). Monthly topics for online discussion are chosen by fellows through a standard tool called "multi-voting". Fellows volunteer to moderate sessions and direct the pace of the discussion. We analyzed the content and process of the discussion of one particular month. The emails were categorized as those that reflected cognitive presence (dealing with construction and exploration of knowledge), teacher presence (dealing with instructional material and learning resources), and social presence, or were administrative in nature. Social emails were further classified as: affective, cohesive and interactive. Social emails constituted one-third of the total emails. Another one-quarter of the emails dealt with sharing of resources and teacher presence, while cognitive emails comprised 36.2% of the total. More than half of the social emails were affective, while a little less than one-third were cohesive. Social posts are an inevitable part of online learning. These posts promote bonding between learners and contribute to better interaction and collaboration in online learning. Moderators should be aware of their presence and use them as tools to promote interactivity.

Building the Capacity to Build Capacity in e-Health in Sub-Saharan Africa: The KwaZulu-Natal Experience

PubMed Central

2012-01-01

Abstract Background: Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workers. There are already too few doctors to train doctors in specialities and sub-specialties. E-health is seen as a possible solution through distance education, telemedicine, and computerized health information systems but there are few people trained in e-health. We describe 12 years of experience at the University of KwaZulu-Natal (UKZ-N) in education and training in postgraduate medical disciplines, medical informatics, and telemedicine. Medical Education: Videoconferencing of seminars and grand rounds to regional training hospitals commenced in 2001 and has grown to 40 h of interactive conferencing taking place weekly during academic terms involving over 33,000 participants in 2010. Videoconferenced sessions are directly recorded to DVD and DVDs are sent to other medical schools in Africa that do not have the infrastructure to directly connect. E-health Education: Students and academic staff were initially sent to the United States for training in medical informatics and workshops were held in South Africa for people from sub-Saharan Africa. This led to the development of postgraduate academic programs in medical informatics and telemedicine at UKZ-N. African students were then brought to UKZ-N for training. The model was changed from UKZ-N to students and staff based at their home universities with the aim of building capacity in the staff at partner institutions so that they can in time offer their own e-health academic programs. Conclusions: The need for capacity development in all aspects of e-health in sub-Saharan Africa is great and innovative solutions are required. PMID:22150714

Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

DTIC Science & Technology

2016-04-28

L 2 8 , 2 0 1 6 Report No. DODIG-2016-079 Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management...Department of Defense F r a u d , W a s t e & A b u s e DODIG-2016-079 (Project No. D2015-D000CL-0214.000) │ i Results in Brief Delinquent Medical...objective was to determine whether Landstuhl Regional Medical Center (LRMC) effectively managed accounts delinquent over 120 days by properly

Accelerating the commercialization of university technologies for military healthcare applications: the role of the proof of concept process

NASA Astrophysics Data System (ADS)

Ochoa, Rosibel; DeLong, Hal; Kenyon, Jessica; Wilson, Eli

2011-06-01

The von Liebig Center for Entrepreneurism and Technology Advancement at UC San Diego (vonliebig.ucsd.edu) is focused on accelerating technology transfer and commercialization through programs and education on entrepreneurism. Technology Acceleration Projects (TAPs) that offer pre-venture grants and extensive mentoring on technology commercialization are a key component of its model which has been developed over the past ten years with the support of a grant from the von Liebig Foundation. In 2010, the von Liebig Entrepreneurism Center partnered with the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC), to develop a regional model of Technology Acceleration Program initially focused on military research to be deployed across the nation to increase awareness of military medical needs and to accelerate the commercialization of novel technologies to treat the patient. Participants to these challenges are multi-disciplinary teams of graduate students and faculty in engineering, medicine and business representing universities and research institutes in a region, selected via a competitive process, who receive commercialization assistance and funding grants to support translation of their research discoveries into products or services. To validate this model, a pilot program focused on commercialization of wireless healthcare technologies targeting campuses in Southern California has been conducted with the additional support of Qualcomm, Inc. Three projects representing three different universities in Southern California were selected out of forty five applications from ten different universities and research institutes. Over the next twelve months, these teams will conduct proof of concept studies, technology development and preliminary market research to determine the commercial feasibility of their technologies. This first regional program will help build the needed tools and processes to adapt and replicate this model across other regions in the Country.

WE-D-204-00: Session in Memory of Franca Kuchnir: Excellence in Medical Physics Residency Education

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

NONE

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

Attributions, Influences and Outcomes for Underrepresented and Disadvantaged Participants of a Medical Sciences Enrichment Pipeline Program

ERIC Educational Resources Information Center

Pinckney, Charlyene Carol

2014-01-01

The current study was undertaken to examine the effectiveness of the Rowan University-School of Osteopathic Medicine - Summer Pre-Medical Research and Education Program (Summer PREP), a postsecondary medical sciences enrichment pipeline program for under-represented and disadvantaged students. Thirty-four former program participants were surveyed…

Mississippi Curriculum Framework for Medical Assisting Technology Programs (CIP: 51.0801--Medical Assistant). Postsecondary Programs.

ERIC Educational Resources Information Center

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the medical assisting technology program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and…

Using Contemporary Leadership Skills in Medication Safety Programs.

PubMed

Hertig, John B; Hultgren, Kyle E; Weber, Robert J

2016-04-01

The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes - and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach - one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article.

Using Contemporary Leadership Skills in Medication Safety Programs

PubMed Central

Hertig, John B.; Hultgren, Kyle E.; Weber, Robert J.

2016-01-01

The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes – and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach – one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article. PMID:27303083

Support programs for minority students at Ohio University College of Osteopathic Medicine.

PubMed

Thompson, H C; Weiser, M A

1999-04-01

The Ohio University College of Osteopathic Medicine ranks high among the nation's 19 osteopathic medical schools with respect to the percentage of underrepresented minorities (URMs) in the entering class. The college has strong recruitment and retention programs for URM and disadvantaged students. URM enrollment rose steadily from 11% in 1982-83 to 22% in 1997-98, despite the school's location in a rural, residential public university with few minorities as students or town residents. The college has six programs to support minority students through both undergraduate and medical school: the Summer Scholars Program (1983 to present), an intensive six-week summer program to prepare rising under-graduate seniors and recent graduates to apply to medical school; Academic Enrichment (1987 to present), to support first- and second-year medical students; the Prematriculation Program (1988 to present), an intensive six-week summer program for students who will matriculate in the college; Program ExCEL (1993 to present), a four-year program for undergraduates at Ohio University; the Summer Enrichment Program (1993 to present), an optional six-week program for students who will enter the premedical course at Ohio University; and the Post-baccalaureate Program (1993 to present), a year-long, individually tailored program for URM students who have applied to the medical college but have been rejected. The medical college first focused on supporting students already in the medical school curriculum, then expanded logically back through the undergraduate premedical programs, always targeting learning strategies and survival strategies, peer and faculty support, and mastery of the basic science content. The college plans to create an on-site MCAT preparation program and perhaps expand into secondary education.

Student Perceptions of an Online Medical Dosimetry Program

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

Lenards, Nishele, E-mail: lenards.nish@uwlax.ed

2011-07-01

The University of Wisconsin-La Crosse offers the first online medical dosimetry program in the nation. There is no data to research a program of this type. This research consisted of the evaluation of other distance education programs including health profession programs in addition to face-to-face medical dosimetry programs. There was a need to collect and analyze student perceptions of online learning in medical dosimetry. This research provided a guide for future implementation by other programs as well as validated the University of Wisconsin-La Crosse program. Methodology used consisted of an electronic survey sent to all previous and currently enrolled studentsmore » in the University of Wisconsin-La Crosse medical dosimetry program. The survey was both quantitative and qualitative in demonstrating attitudinal perceptions of students in the program. Quantitative data was collected and analyzed using a 5-point Likert scale. Qualitative data was gathered based on the open-ended responses and the identifying themes from the responses. The results demonstrated an overall satisfaction with this program, the instructor, and the online courses. Students felt a sense of belonging to the courses and the program. Considering that a majority of the students had never taken an online course previously, the students felt there were no technology issues. Future research should include an evaluation of board exam statistics for students enrolled in the online and face-to-face medical dosimetry programs.« less

Planning and Decision Making for Medical Education: An Analysis of Costs and Benefits.

ERIC Educational Resources Information Center

Wing, Paul

This paper clarifies the role of medical education in the large health care system, estimates the resources required to carry on medical education programs and the benefits that accrue from medical education, and answers a few fundamental policy questions. Cost estimates are developed on a program-by-program basis, using empirical economic…

Emergency health planning.

PubMed

HARDMAN, A C

1962-12-01

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine

PubMed Central

2014-01-01

Background There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students’ perspectives on specialization training in Malawi. Methods We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an “editing approach” to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. Results We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Conclusions Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country’s healthcare workforce and the needs of their graduating medical students to be able to match opportunities and retain graduating students. PMID:24393278

Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine.

PubMed

Sawatsky, Adam P; Parekh, Natasha; Muula, Adamson S; Bui, Thuy

2014-01-06

There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students' perspectives on specialization training in Malawi. We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an "editing approach" to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country's healthcare workforce and the needs of their graduating medical students to be able to match opportunities and retain graduating students.

Residency training in physiatry during a time of change: funding of graduate medical education and other issues.

PubMed

DeLisa, J A; Jain, S S; Kirshblum, S

1998-01-01

Decision makers at the federal and state level are considering, and some states have enacted, a reduction in total United States residency positions, a shift in emphasis from specialist to generalist training, a need for programs to join together in training consortia to determine local residency position allocation strategy, a reduction in funding of international medical graduates, and a reduction in funding beyond the first certificate or a total of five years. A 5-page, 24-item questionnaire was sent to all physiatry residency training directors. The objective was to discern a descriptive database of physiatry training programs and how their institutions might respond to cuts in graduate medical education funding. Fifty-eight (73%) of the questionnaires were returned. Most training directors believe that their primary mission is to train general physiatrists and, to a much lesser extent, to train subspecialty or research fellows. Directors were asked how they might handle reductions in house staff such as using physician extenders, shifting clinical workload to faculty, hiring additional faculty, and funding physiatry residents from practice plans and endowments. Physiatry has had little experience (29%; 17/58) with voluntary graduate medical education consortiums, but most (67%; 34/58) seem to feel that if a consortium system is mandated, they would favor a local or regional over a national body because they do not believe the specialty has a strong enough national stature. The major barriers to a consortium for graduate medical education allocation were governance, academic, fiscal, bureaucratic, and competition.

49 CFR 390.105 - Medical examiner training programs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... nationally recognized medical profession accrediting organization to provide continuing education units; and... diagnostic tests or medical opinion from a medical specialist or treating physician. (6) Informing and... 49 Transportation 5 2014-10-01 2014-10-01 false Medical examiner training programs. 390.105...

Mentoring needs of distributed medical education faculty at a Canadian medical school: a mixed-methods descriptive study.

PubMed

Krishnan, Rohin J; Uruthiramoorthy, Lavanya; Jawaid, Noor; Steele, Margaret; Jones, Douglas L

2018-01-01

The Schulich School of Medicine & Dentistry in London, Ontario, has a mentorship program for all full-time faculty. The school would like to expand its outreach to physician faculty located in distributed medical education sites. The purpose of this study was to determine what, if any, mentorship distributed physician faculty currently have, to gauge their interest in expanding the mentorship program to distributed physician faculty and to determine their vision of the most appropriate design of a mentorship program that would address their needs. We conducted a mixed-methods study. The quantitative phase consisted of surveys sent to all distributed faculty members that elicited information on basic demographic characteristics and mentorship experiences/needs. The qualitative phase consisted of 4 focus groups of distributed faculty administered in 2 large and 2 small centres in both regions of the school's distributed education network: Sarnia, Leamington, Stratford and Hanover. Interviews were 90 minutes long and involved standardized semistructured questions. Of the 678 surveys sent, 210 (31.0%) were returned. Most respondents (136 [64.8%]) were men, and almost half (96 [45.7%]) were family physicians. Most respondents (197 [93.8%]) were not formal mentors to Schulich faculty, and 178 (84.8%) were not currently being formally mentored. Qualitative analysis suggested that many respondents were involved in informal mentoring. In addition, about half of the respondents (96 [45.7%]) wished to be formally mentored in the future, but they may be inhibited owing to time constraints and geographical isolation. Consistently, respondents wished to have mentoring by a colleague in a similar practice, with the most practical being one-on-one mentoring. Our analysis suggests that the school's current formal mentoring program may not be applicable and will require modification to address the needs of distributed faculty.

Educational Programs in the Health Field.

ERIC Educational Resources Information Center

Hospitals, 1971

1971-01-01

This document lists by location educational programs in the health field in the United States and Canada. Areas covered include Certified Laboratory Assistant Programs, Cytotechnology, Dental Hygiene, Dentistry, Dietetics, Hospital Administration, Inhalation Therapy, Library Science, Medical Illustration, Medical Records, Medical Technology,…

Family, Community, and Health System Considerations for Reducing the Burden of Pediatric Sickle Cell Disease in Uganda Through Newborn Screening

PubMed Central

Green, Nancy S.; Mathur, Sanyukta; Kiguli, Sarah; Makani, Julie; Fashakin, Victoria; LaRussa, Philip; Lyimo, Magdalena; Abrams, Elaine J.; Mulumba, Lukia; Mupere, Ezekiel

2016-01-01

Sickle cell disease (SCD) is associated with high mortality for children under 5 years of age in sub-Saharan Africa. Newborn sickle screening program and enhanced capacity for SCD treatment are under development to reduce disease burden in Uganda and elsewhere in the region. Based on an international stakeholder meeting and a family-directed conference on SCD in Kampala in 2015, and interviews with parents, multinational experts, and other key informants, we describe health care, community, and family perspectives in support of these initiatives. Key stakeholder meetings, discussions, and interviews were held to understand perspectives of public health and multinational leadership, patients and families, as well as national progress, resource needs, medical and social barriers to program success, and resources leveraged from HIV/AIDS. Partnering with program leadership, professionals, patients and families, multinational stakeholders, and leveraging resources from existing programs are needed for building successful programs in Uganda and elsewhere in sub-Saharan Africa. PMID:27336011

Fogarty research ethics training programs in the Asia-Pacific: the merging of cultures.

PubMed

Pratt, Bridget; Van, Cassandra; Trevorrow, Emily; Loff, Bebe

2014-04-01

In-depth interviews were undertaken with nine principal investigators and 16 former trainees from eight FIC programs recruiting trainees from the Asia-Pacific to assess the impact of training. Incorporation of new knowledge into teaching, research, and medical practice; advanced training; and ethics committee participation were the most common outcomes identified. When attempting to implement ethics activities posttraining, trainees often had to contend with opposition from more senior staff. Approaches that enhanced the cultural relevance of program content were identified as necessary, including comparing/contrasting non-Western principles and religions with Western bioethics, using region-specific case studies, and integrating clinical and research ethics. Best practices associated with program and trainee success included selecting more senior trainees clustered within Asia-Pacific institutions, offering a variety of degree and nondegree options, and post-training mentorship and networking support. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.

The Kaiser Permanente Northwest Cardiovascular Risk Factor Management Program: A Model for All

PubMed Central

Joyce, Jodi S; Fetter, Martina M; Klopfenstein, Dean H; Nash, Michael K

2005-01-01

Proof of the effectiveness of preventive measures that reduce established risk traits for atherothrombotic disorders has spurred attempts to systematically apply these interventions among susceptible populations. One such attempt is the Cardiovascular Risk Factor Management (CVRFM) Program, launched in 2003 to optimize clinical management and outcomes for 75,000 Kaiser Permanente Northwest Region (KPNW) members with atherosclerotic cardiovascular disease (CVD) or hypertension. The CVRFM Program is a centralized, multidisciplinary, proactive telephone-based clinical management intervention consisting of an “outreach” call, an interview, a mailed individualized care plan and information packet, regular follow-up (including protocolized medication management) and—when “goal status” is achieved—transfer of the patient to a maintenance plan. Quarterly evaluation of effectiveness entailed measurement of a range of clinical, utilization, and member satisfaction outcomes. Results by the fourth quarter were outstanding: For example, >98% of participants with coronary disease or diabetes had LDL cholesterol testing, >90% of coronary patients received aspirin or statin treatment, 99% were “extremely” or “very” satisfied with the program, and reductions were observed in the number of hospitalizations and visits to the emergency department and clinic. Mathematical models predict a decrease in myocardial infarctions and cardiovascular mortality within two years after implementing the program, the underlying principles of which should yield similar improvement in other Kaiser Permanente (KP) Regions and in other health care organizations. PMID:21660155

Health systems and noncommunicable diseases in the Asia-Pacific region: a review of the published literature.

PubMed

Mannava, Priya; Abdullah, Asnawi; James, Chris; Dodd, Rebecca; Annear, Peter Leslie

2015-03-01

Addressing the growing burden of noncommunicable diseases (NCDs) in countries of the Asia-Pacific region requires well-functioning health systems. In low- and middle-income countries (LMICs), however, health systems are generally characterized by inadequate financial and human resources, unsuitable service delivery models, and weak information systems. The aims of this review were to identify (a) health systems interventions being implemented to deliver NCD programs and services and their outcomes and (b) the health systems bottlenecks impeding access to or delivery of these programs and services in LMICs of the Asia-Pacific region. A search of 4 databases for literature published between 1990 and 2010 retrieved 36 relevant studies. For each study, information on basic characteristics, type of health systems bottleneck/intervention, and outcome was extracted, and methodological quality appraised. Health systems interventions and bottlenecks were classified as per the World Health Organization health systems building blocks framework. The review identified interventions and bottlenecks in the building blocks of service delivery, health workforce, financing, health information systems, and medical products, vaccines, and technologies. Studies, however, were heterogeneous in methodologies used, and the overall quality was generally low. There are several gaps in the evidence base around NCDs in the Asia-Pacific region that require further investigation. © 2013 APJPH.

The scope and variety of combined baccalaureate-MD programs in the United States.

PubMed

Eaglen, Robert H; Arnold, Louise; Girotti, Jorge A; Cosgrove, Ellen M; Green, Marianne M; Kollisch, Donald O; McBeth, Dani L; Penn, Mark A; Tracy, Sarah W

2012-11-01

The landscape of combined baccalaureate-MD programs has changed substantially in the last two decades but has not been documented in detail. The authors review the current state of these programs and discuss opportunities for future study of their evolving role and potential impact.In 2011, using a definition of baccalaureate-MD program built on prior research, the authors reviewed Association of American Medical Colleges sources and medical school Web sites to identify and characterize 81 active programs. In addition, they surveyed the 57 medical schools offering those programs; 31 schools with 39 programs responded. The resulting database inventories the number and distribution of programs; institutional affiliations; missions or goals; length; size; admissions criteria; curricula; and retention requirements.Since the inception of combined programs in 1961, their number and curricular length have increased. Pressures that spurred earlier programs remain evident in the goals of today's programs: attract talented high school or early college students, especially from diverse backgrounds; prepare physicians to meet societal needs; and offer an enriched premedical environment. Baccalaureate educational activities achieve program goals through special courses, medical experiences, community service, and learning communities tailored to students' needs. Admission and retention criteria are comparable to those of traditional medical schools.Combined baccalaureate-MD programs have evolved along several paths during the last half century and have enriched the baccalaureate experiences of medical students. Shifting expectations for the selection and education of future physicians warrant focused research on these programs to document their effectiveness in addressing those expectations.

Lack of Emphasis on Nutrition in Medical School Curriculum.

ERIC Educational Resources Information Center

Friedman, Suanne

The need and concern for the apparent lack of nutrition education provided in training programs for physicians was the impetus for begining a 10-session nutrition lecture series program. The program was developed and implemented in a large teaching medical center hospital and given to 16 third-year medical students. The program's purpose was to…

Mississippi Curriculum Framework for Medical Laboratory Technology Programs (CIP: 51.1004--Medical Laboratory Technology). Postsecondary Programs.

ERIC Educational Resources Information Center

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the medical laboratory technology program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and…

The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives.

PubMed

Martel, John; Oteng, Rockefeller; Mould-Millman, Nee-Kofi; Bell, Sue Anne; Zakariah, Ahmed; Oduro, George; Kowalenko, Terry; Donkor, Peter

2014-10-01

Ghana's first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. We describe the history and status of novel postgraduate emergency physician, nurse, and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist-level emergency physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national Emergency Medical Service. This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled health care workers in Ghana and may serve as a model for similar developing nations. Copyright © 2014 Elsevier Inc. All rights reserved.

Pay for performance in commercial HMOs.

PubMed

Rosenthal, Meredith B; Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard G; Epstein, Arnold M

2006-11-02

Pay for performance has increasingly become the subject of intense interest and debate, both of which have been heightened as the Centers for Medicare and Medicaid Services moves closer to adopting this approach for Medicare. Although many claims have been made for the effectiveness of this approach, the extent of its national penetration remains unknown. We surveyed a sample of 252 health maintenance organizations (HMOs) (response rate, 96%) drawn from 41 metropolitan areas across the nation about use of pay for performance. We determined the prevalence of pay-for-performance programs, detailed the features of such programs, and examined the adoption of pay for performance as a function of the characteristics of both the health plans and markets. More than half the HMOs, representing more than 80% of persons enrolled, use pay for performance in their provider contracts. Of the 126 health plans with pay-for-performance programs, nearly 90% had programs for physicians and 38% had programs for hospitals. Use of pay for performance was statistically associated with geographic region, use of primary care providers (PCPs) as gatekeepers, use of capitation to pay PCPs, and whether the plans themselves received bonuses or penalties according to performance. Pay for performance is now commonly used by HMOs, especially those that are situated to assign responsibility for a particular patient to a PCP or medical group. As the design of Medicare with pay for performance moves forward, it will be important to leverage the early experience of pay for performance in the commercial market. Copyright 2006 Massachusetts Medical Society.

Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.

PubMed

Helmons, Pieter J; Dalton, Ashley J; Daniels, Charles E

2012-10-01

The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form. ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p < 0.0001). The predominant error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program. A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.

Guide for Program Planning: Medical Laboratory Technician.

ERIC Educational Resources Information Center

Kahler, Carol, Ed.; And Others

Prepared by the American Association of Junior Colleges and the National Council on Medical Technology Education, this guide discusses programs for career-entry supportive medical laboratory personnel which have been cooperatively planned by junior college personnel and the medical community, particularly pathologists and medical technologists.…

The network of Shanghai Stroke Service System (4S): A public health-care web-based database using automatic extraction of electronic medical records.

PubMed

Dong, Yi; Fang, Kun; Wang, Xin; Chen, Shengdi; Liu, Xueyuan; Zhao, Yuwu; Guan, Yangtai; Cai, Dingfang; Li, Gang; Liu, Jianmin; Liu, Jianren; Zhuang, Jianhua; Wang, Panshi; Chen, Xin; Shen, Haipeng; Wang, David Z; Xian, Ying; Feng, Wuwei; Campbell, Bruce Cv; Parsons, Mark; Dong, Qiang

2018-07-01

Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area. The 4S registry uses a web-based database that automatically extracts data from structured electronic medical records. Site-specific education and training program will be designed and administrated according to their baseline characteristics. Both acute reperfusion therapies including thrombectomy and thrombolysis in the acute phase and subsequent care were measured and monitored with feedback. Primary outcome is to evaluate the differences in quality metrics between baseline characteristics (including rate of thrombolysis in acute stroke and key performance indicators in secondary prevention) and post-intervention. Conclusions The 4S system is a regional stroke network that monitors the ongoing stroke care quality in Shanghai. This project will provide the opportunity to evaluate the spectrum of acute stroke care and design quality improvement processes for better stroke care. A regional stroke network model for quality improvement will be explored and might be expanded to other large cities in China. Clinical Trial Registration-URL http://www.clinicaltrials.gov . Unique identifier: NCT02735226.

SU-B-213-03: Evaluation of Graduate Programs

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

Clark, B.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

SU-B-213-04: Evaluation of Residency Programs

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

Reft, C.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

Report on the American Association of Medical Physics Undergraduate Fellowship Programs

PubMed Central

Avery, Stephen; Gueye, Paul; Sandison, George A.

2013-01-01

The American Association of Physicists in Medicine (AAPM) sponsors two summer undergraduate research programs to attract top performing undergraduate students into graduate studies in medical physics: the Summer Undergraduate Fellowship Program (SUFP) and the Minority Undergraduate Summer Experience (MUSE). Undergraduate research experience (URE) is an effective tool to encourage students to pursue graduate degrees. The SUFP and MUSE are the only medical physics URE programs. From 2001 to 2012, 148 fellowships have been awarded and a total of $608,000 has been dispersed to fellows. This paper reports on the history, participation, and status of the programs. A review of surveys of past fellows is presented. Overall, the fellows and mentors are very satisfied with the program. The efficacy of the programs is assessed by four metrics: entry into a medical physics graduate program, board certification, publications, and AAPM involvement. Sixty‐five percent of past fellow respondents decided to pursue a graduate degree in medical physics as a result of their participation in the program. Seventy percent of respondents are currently involved in some educational or professional aspect of medical physics. Suggestions for future enhancements to better track and maintain contact with past fellows, expand funding sources, and potentially combine the programs are presented. PACS number: 01.10.Hx PMID:23318397

Teaching health-care trainees empathy and homelessness IQ through service learning, reflective practice, and altruistic attribution.

PubMed

Chrisman-Khawam, Leanne; Abdullah, Neelab; Dhoopar, Arjun

2017-05-01

This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness. Participants across all disciplines and specialties have shown greater empathy and helper behavior as determined by qualitative measures. Learners have also developed a greater understanding of health-care systems allowing them to more consistently address social determinants of health identified by the authors as their Disparity Information Quotient. This article outlines the process of initiating a homeless service program, a curriculum for addressing common myths about homelessness and the effective use of narrative methods, relational connections, and reflective practice to enable trainees to process their experience and decrease burnout by focusing on the value of altruism and finding meaning in their work.

[Results of Monitoring of the Plan of Measures Directed to Reduction of Ischemic Heart Disease in North Caucasus Republics. Analysis of Dynamics of Cardio-Vascular Mortality].

PubMed

Mamedov, M N

2016-05-01

Comparative analysis of dynamics of cardiovascular mortality in Russia and foreign countries as well as main directions of development of cardiological service in Russia are presented in this review article. Plan of measures for reduction of mortality from ischemic heart disease (IHD) was created in 2015. This plan comprises 4 blocks of assessment of the following measures: directed at improvement of primary IHD prevention (1), directed at secondary prevention of complications of IHD (2); directed at improvement of efficacy of medical care of patients with IHD (3), and directed at monitoring of some demographic parameters (4). The article also contains results of monitoring of realization of the plan of IHD reduction in republics of North Caucasus. Realization of the program on healthy life style (HLS) lacks coordination between ministries. Mass information media are not sufficiently involved in propaganda of HLS. Mean achievement of target levels of main risk factors does not exceed 30-35%. First stage of prophylactic medical examination (dispanserization) has been fulfilled in 65%. High technology care is available both in federal and regional centers. Organization of effective urgent medical service, drug supply, and rehabilitation of patients with IHD are important aspects of improvement of secondary prevention in the region.

Medical Diplomacy: A Tool for Enabling National Security Strategy Objectives

DTIC Science & Technology

2012-04-06

Traditional HSS Engagement Programs Medical, dental and veterinarian civic health engagement programs aimed to aid disadvantage people in isolated...worker shortages and build support for existing medical education programs. “Through this exciting new partnership, the Peace Corps will supply

Professional Medical Library Education in the United States in Relation to the Qualifications of Medical Library Manpower in Ohio *

PubMed Central

Rees, Alan M.; Rothenberg, Lesliebeth; Denison, Barbara

1968-01-01

The present system of education for medical library practice in the United States consists of four major components: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice. The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel. PMID:5702318

Development of a systematic career coaching program for medical students.

PubMed

Hur, Yera; Cho, A Ra; Kwon, Mihye

2018-03-01

This study aimed to develop a systematic career-coaching program (SCCP) that can be used by medical teaching schools to address a growing need for career-coaching. The program objectives were to help students (1) develop a comprehensive self-understanding of their aptitudes, interests, and personality traits; (2) explore possible career choices and decide on a career path; and (3) develop the competencies needed to prepare for their future careers. The SCCP was based on the ADDIE (analysis, design, development, implementation, and evaluation) model and decision-making questioning model. Medical professionals, medical education and career counseling experts, and students participated in designing the program. The SCCP describes coaching content, tools, operational methods, and appropriate timing, and identifies the professionals and specialists who can offer their expertise in the different coaching phases. It is designed to allow medical schools to offer the program in segments or in its entirety, depending on the curriculum and environment. The SCCP represents a viable career-coaching program for medical students that can be applied in part or in its entirety, depending on a medical school's curriculum and educational environment.

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

PubMed

Bitterman, Noemi; Shalev, Ilana

2005-05-01

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

Metropolis revisited: the evolving role of librarians in informatics education for the health professions

PubMed Central

King, Samuel B.; Lapidus, Mariana

2015-01-01

Objective: The authors' goal was to assess changes in the role of librarians in informatics education from 2004 to 2013. This is a follow-up to “Metropolis Redux: The Unique Importance of Library Skills in Informatics,” a 2004 survey of informatics programs. Methods: An electronic survey was conducted in January 2013 and sent to librarians via the MEDLIB-L email discussion list, the library section of the American Association of Colleges of Pharmacy, the Medical Informatics Section of the Medical Library Association, the Information Technology Interest Group of the Association of College and Research Libraries/New England Region, and various library directors across the country. Results: Librarians from fifty-five institutions responded to the survey. Of these respondents, thirty-four included librarians in nonlibrary aspects of informatics training. Fifteen institutions have librarians participating in leadership positions in their informatics programs. Compared to the earlier survey, the role of librarians has evolved. Conclusions: Librarians possess skills that enable them to participate in informatics programs beyond a narrow library focus. Librarians currently perform significant leadership roles in informatics education. There are opportunities for librarian interdisciplinary collaboration in informatics programs. Implications: Informatics is much more than the study of technology. The information skills that librarians bring to the table enrich and broaden the study of informatics in addition to adding value to the library profession itself. PMID:25552939

Metropolis revisited: the evolving role of librarians in informatics education for the health professions.

PubMed

King, Samuel B; Lapidus, Mariana

2015-01-01

The authors' goal was to assess changes in the role of librarians in informatics education from 2004 to 2013. This is a follow-up to "Metropolis Redux: The Unique Importance of Library Skills in Informatics," a 2004 survey of informatics programs. An electronic survey was conducted in January 2013 and sent to librarians via the MEDLIB-L email discussion list, the library section of the American Association of Colleges of Pharmacy, the Medical Informatics Section of the Medical Library Association, the Information Technology Interest Group of the Association of College and Research Libraries/New England Region, and various library directors across the country. Librarians from fifty-five institutions responded to the survey. Of these respondents, thirty-four included librarians in nonlibrary aspects of informatics training. Fifteen institutions have librarians participating in leadership positions in their informatics programs. Compared to the earlier survey, the role of librarians has evolved. Librarians possess skills that enable them to participate in informatics programs beyond a narrow library focus. Librarians currently perform significant leadership roles in informatics education. There are opportunities for librarian interdisciplinary collaboration in informatics programs. Informatics is much more than the study of technology. The information skills that librarians bring to the table enrich and broaden the study of informatics in addition to adding value to the library profession itself.

Community resiliency through recovery resource supply chain planning.

PubMed

Franklin, Charlotte; Todt, Kiersten

2014-01-01

Information in this paper is the result of recommendations and remedies developed at 'Local Supply Chain Capacity in a Crisis Summit Exercise' held in Arlington, VA on 30th-31st January,2013. At the event, which was funded through the Regional Catastrophic Preparedness Grant Program, national private sector and not-for-profit essential resource provider experts in sectors such as transportation, communication systems, energy/power, financial resources, medical supplies and other vital supplies, together with emergency managers, discussed best practices, major challenges and exchanged remedy recommendations.

Morphological, Molecular, and Chromosomal Discrimination of Cryptic Anopheles (Nyssorhynchus) (Diptera: Culicidae) from South America

DTIC Science & Technology

1998-09-01

sunk An. trinkae as its junior synonym. Recent regional keys for identifying anopheline species have followed Peyton (1993) and regarded An. trinkae...as a synonym of An. dunhami ( Calderon-Falero 1994). In recent publications we also accepted Peyton’s (1993) use of An. dunhumi as a senior synonym...1995)) and a 1-S distance matrix was generated using the similarity option in the RAPDPLOT program 832 JOURNAL OF MEDICAL ENTOMOLOGY Vol. 35, no. 5

Medical Image Tamper Detection Based on Passive Image Authentication.

PubMed

Ulutas, Guzin; Ustubioglu, Arda; Ustubioglu, Beste; V Nabiyev, Vasif; Ulutas, Mustafa

2017-12-01

Telemedicine has gained popularity in recent years. Medical images can be transferred over the Internet to enable the telediagnosis between medical staffs and to make the patient's history accessible to medical staff from anywhere. Therefore, integrity protection of the medical image is a serious concern due to the broadcast nature of the Internet. Some watermarking techniques are proposed to control the integrity of medical images. However, they require embedding of extra information (watermark) into image before transmission. It decreases visual quality of the medical image and can cause false diagnosis. The proposed method uses passive image authentication mechanism to detect the tampered regions on medical images. Structural texture information is obtained from the medical image by using local binary pattern rotation invariant (LBPROT) to make the keypoint extraction techniques more successful. Keypoints on the texture image are obtained with scale invariant feature transform (SIFT). Tampered regions are detected by the method by matching the keypoints. The method improves the keypoint-based passive image authentication mechanism (they do not detect tampering when the smooth region is used for covering an object) by using LBPROT before keypoint extraction because smooth regions also have texture information. Experimental results show that the method detects tampered regions on the medical images even if the forged image has undergone some attacks (Gaussian blurring/additive white Gaussian noise) or the forged regions are scaled/rotated before pasting.

Secretarial Administration: Medical Terminology: Building Block of the Medical Secretary Program.

ERIC Educational Resources Information Center

Sormunen, Carolee

1980-01-01

With the growing number of employment opportunities available in the medical field, business educators need to reevaluate existing medical secretary programs. Areas that need special attention are medical terminology (anatomy, laboratory language, etc.), report formats, and the importance of confidentiality of patient information. (CT)

Knowledge, attitudes, and behaviour regarding breast cancer screening among women from different socio-economic regions in southwest China: a cross-sectional study.

PubMed

Huang, Yuan; Zhou, Ke; Li, Hui; Wang, Anrong; Li, Jiayuan; Pang, Yi; Wang, Qiong; Huang, Rong; Fu, Liang; Kang, Min; Ning, Ping; Yuan, Ping

2011-01-01

In most developed countries, breast cancer screening (BCS) is a well-established practice which is widely accepted by women. In contrast, national BCS projects in China were only launched in the last two years, so little is known about their public response. We surveyed 1,162 Chinese women from different socio-economic regions in Sichuan Province to assess participants' knowledge, attitudes, and behaviour regarding BCS. ANOVA/t-test, Chi-square test, SNK test, and covariance analyses were used to compare subgroups and a multinomial logistic regression model was adopted to examine factors associated with BCS attendance. Statistically significant differences in scores of BCS knowledge were seen across regions. Most women from all four regions were interested in knowing the risk factors for (1,053, 90.6%) and means of prevention (912, 78.5%) of breast cancer. Eight hundred thirty-seven (72.0%) women expressed willingness to pay extra insurance fees when young in exchange for reimbursement for cancer screening when they reached the age at which screening is recommended. Approval of primary medical institutions was generally low. Regional socio-economic level, work status, and education were strong predictors of BCS attendance. To eliminate geographic disparities and raise the participation rate of BCS, future health education should be adjusted to local conditions and strengthened for women in under-developed regions. Incorporating BCS into a regular program of community-based prevention of chronic non-communicable diseases, and increasing medical insurance funds to cover BCS, especially in rural areas, may be effective means to increase BCS attendance.

Implementation of a Regional Virtual Tumor Board: A Prospective Study Evaluating Feasibility and Provider Acceptance

PubMed Central

Marshall, Christy L.; Petersen, Nancy J.; Naik, Aanand D.; Velde, Nancy Vander; Artinyan, Avo; Albo, Daniel; Berger, David H.

2014-01-01

Abstract Background: Tumor board (TB) conferences facilitate multidisciplinary cancer care and are associated with overall improved outcomes. Because of shortages of the oncology workforce and limited access to TB conferences, multidisciplinary care is not available at every institution. This pilot study assessed the feasibility and acceptance of using telemedicine to implement a virtual TB (VTB) program within a regional healthcare network. Materials and Methods: The VTB program was implemented through videoconference technology and electronic medical records between the Houston (TX) Veterans Affairs Medical Center (VAMC) (referral center) and the New Orleans (LA) VAMC (referring center). Feasibility was assessed as the proportion of completed VTB encounters, rate of technological failures/mishaps, and presentation duration. Validated surveys for confidence and satisfaction were administered to 36 TB participants to assess acceptance (1–5 point Likert scale). Secondary outcomes included preliminary data on VTB utilization and its effectiveness in providing access to quality cancer care within the region. Results: Ninety TB case presentations occurred during the study period, of which 14 (15%) were VTB cases. Although one VTB encounter had a technical mishap during presentation, all scheduled encounters were completed (100% completion rate). Case presentations took longer for VTB than for regular TB cases (p=0.0004). However, VTB was highly accepted with mean scores for satisfaction and confidence of 4.6. Utilization rate of VTB was 75%, and its effectiveness was equivalent to that observed for non-VTB cases. Conclusions: Implementation of VTB is feasible and highly accepted by its participants. Future studies should focus on widespread implementation and validating the effectiveness of this model. PMID:24845366

Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

PubMed

Knudsen, Hannah K; Abraham, Amanda J

2012-01-01

Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

Perceptions of the State Policy Environment and Adoption of Medications in the Treatment of Substance Use Disorders

PubMed Central

Knudsen, Hannah K.; Abraham, Amanda J.

2012-01-01

Objective Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Methods Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. Results A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state’s Medicaid formulary and that state-contract funding permitted the purchase of medications. Conclusions States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment. PMID:22227755

A preliminary assessment of the fifth-year chiropractic students' knowledge of anatomy.

PubMed

Strkalj, Goran; Schroder, Tania; Pather, Nalini; Solyali, Veli

2011-01-01

Anatomy has been at the foundation of medical students' training. In recent decades, medical programs in many countries have undergone major reform in both pedagogy and content. These reforms generated intense debates, focusing mainly on the way the new programs affected medical graduates' knowledge of anatomy and their clinical capabilities. Anatomy, however, is not only core to medicine, but also to a number of allied and complementary health disciplines. While the evaluation of anatomy teaching and learning in the medical programs has been heavily scrutinized, anatomy education in the complementary and alternative medicine (CAM) professions, including those, such as chiropractic, in which anatomy has traditionally been one of the main preclinical subjects, has been less frequently evaluated. The study aimed to make a preliminary assessment of the final year chiropractic students' knowledge of anatomy using the "carpal bone test." The testing was conducted on the final-year chiropractic students at Macquarie University in 2009. In this test, the students were given 5 minutes to label an illustration of the bony skeleton of the carpal region. The results of this assessment were then compared to results of previously published surveys using the "carpal bone test." A total of 84 students participated in the study. Thirty-eight percent (38%) of students identified all eight bones, while 60% of students identified five or more carpal bones. The most frequent correctly identified bone was the pisiform, followed by the scaphoid bone (82% and 74% of students, respectively). The trapezium and trapezoid bones were least frequently identified: both by 52% of students each. These results were generally better than those of the previously tested final-year medical students. The importance of anatomy in chiropractors' education has been generally acknowledged. This study suggests that the comparatively high number of hours devoted to anatomy in Macquarie University chiropractic curriculum and underpinning of clinical skills to anatomy knowledge in the senior year have increased retention of anatomy knowledge. The study, preliminary in nature, has also recognized the need for more detailed assessment of teaching and learning of the basic medical sciences in chiropractic and other CAM disciplines.

Patient participation in a clinic-based community pharmacy medication take-back program.

PubMed

Lystlund, Stefanie; Stevens, Eric; Planas, Lourdes G; Marcy, Todd R

2014-01-01

To describe patient interest and involvement in participating in a clinic-based community pharmacy drug take-back program to dispose of unused, unwanted, or expired (UUE) medications and to identify patients' reasons for participating in the program. A convenience sample of patients at the University of Oklahoma Family Medicine Pharmacy was recruited to complete a needs assessment survey regarding interest in drug take-back programs and current practices for handling UUE medications. Participants who purchased a postage-paid drug disposal envelope were asked to complete a program survey identifying sources of UUE medications, experience with drug take-back programs, and reasons for participation. These participants were later contacted for a follow-up telephone survey regarding their experience with the program and medications sent back. 62 needs assessment surveys were collected. 61% of patients reported interest in a drug take-back program. 57% reported having no UUE medications at home. Commonly reported UUE handling practices included disposal in the garbage (53.2%) or sewer (29.0%) and home storage (17.7%). 15 disposal envelopes were sold to 10 participants whose most common reasons for participation included concern about the safety of household members, accidental or intentional ingestion, and environmental impact. For 4 patients who returned a median of 9.5 prescriptions, the most common class of returned drugs was antibiotics (19.0%). Interest in drug take-back programs exists, but awareness and availability of continuous programs is limited. Programs may be more successful if offered at no cost to patients. Future studies are needed on the types of medications sent back and specific reasons for accumulation.

Dual and parallel postdoctoral training programs: implications for the osteopathic medical profession.

PubMed

Burkhart, Diane N; Lischka, Terri A

2011-04-01

Students in colleges of osteopathic medicine have several options when considering postdoctoral training programs. In addition to training programs approved solely by the American Osteopathic Association or accredited solely by the Accreditation Council for Graduate Medical Education (ACGME), students can pursue programs accredited by both organizations (ie, dually accredited programs) or osteopathic programs that occur side-by-side with ACGME programs (ie, parallel programs). In the present article, we report on the availability and growth of these 2 training options and describe their benefits and drawbacks for trainees and the osteopathic medical profession as a whole.

Medical Center Farmers Markets: A Strategic Partner in the Patient-Centered Medical Home

PubMed Central

Rovniak, Liza S.; Kraschnewski, Jennifer L.; Morrison, Kathy J.; Dillon, Judith F.; Bates, Beth Y.

2013-01-01

Background The number of medical center–based farmers markets has increased in the past decade, but little is known about how such organizations contribute to the preventive health goals of the patient-centered medical home. Community Context In 2010, we started a seasonal farmers market at Penn State Hershey Medical Center to help support the institution’s commitment to the medical home. Methods We obtained descriptive data on the farmers market from hospital and market records and tracking information on the market’s Facebook and Twitter sites. We computed summary measures to characterize how the market has begun to meet the 6 standards of the 2011 National Committee for Quality Assurance’s report on the medical home. Outcome During the 2010 and 2011 seasons, 146 medical center volunteers from 40 departments formed 23 interprofessional teams that spent an average of 551 volunteer hours per season at the market, providing health screenings (n = 695) and speaking to customers (n = 636) about preventive health. Fifty-five nonmedical community health partners provided 208 hours of service at the market alongside medical center staff. Market programming contributed to 5 regional preventive health partnerships and created opportunities for interprofessional mentoring, student leadership, data management, development of social media skills, and grant-writing experience. The market contributed to all 6 medical home standards outlined by the National Committee for Quality Assurance. Interpretation Medical center markets can support medical home standards. With systematic tracking of the health effects and integration with electronic medical health records, markets hold potential to contribute to comprehensive patient-centered care. PMID:23906327

Career development for the clinician-educator. Optimizing impact and maximizing success.

PubMed

Roberts, David H; Schwartzstein, Richard M; Weinberger, Steven E

2014-02-01

Health care professionals in pulmonary, critical care, and sleep medicine play key roles as teachers for learners of all levels in both clinical care and scientific investigation. Teaching excellence requires training in principles of adult learning and the acquisition and practice of key professional skills including assessment and feedback techniques, curriculum development, and strategies for effective teaching across venues ranging from the bedside to the lecture hall. Those interested in pursuing teaching as the focus of their academic career and basis for promotion should invest in professional development as a teacher and educator. Professional development activities include obtaining additional training as a teacher in dedicated medical education fellowships or serving as a peer observer or being observed by a fellow teacher. Numerous additional options for training as a teacher and educator are now available including resource repositories, continuing medical education courses, and online training modules. Those with an interest in medical education research may benefit from enrollment in masters or other advanced degree programs focused on the qualitative and quantitative methods and other key research skills. Aspiring clinician-educators should also seek out opportunities to participate in a community of medical educators locally, regionally, nationally, and internationally. At each of these levels, there exist opportunities to contribute to course or program design, development, and evaluation. Finally, for those interested in promotion as an academic clinician-educator, there are increasing requirements to produce academic scholarship ranging from curricular materials to journal articles focused on education and education research.

The UNAM M. Sc. program in Medical Physics enters its teen years

NASA Astrophysics Data System (ADS)

Brandan, María-Ester

2010-12-01

The M.Sc. (Medical Physics) program at the National Autonomous University of Mexico UNAM, created in 1997, has graduated a substantial number of medical physicists who constitute today about 30% of the medical physics clinical workforce in the country. Up to present date (May 2010) more than 60 students have graduated, 60% of them hold clinical jobs, 20% have completed or study a Ph.D., and 15% perform activities related to this specialization. In addition to strengthening the clinical practice of medical physics, the program has served as an incentive for medical physics research in UNAM and other centers. We report the circumstances of the program origin, the evolution of its curriculum, the main achievements, and the next challenges.

Definition of "Rural" Determines the Placement Outcomes of a Rural Medical Education Program: Analysis of Jichi Medical University Graduates

ERIC Educational Resources Information Center

Matsumoto, Masatoshi; Inoue, Kazuo; Kajii, Eiji

2010-01-01

Purpose: To show the impact of changing the definition of what is "rural" on the outcomes of a rural medical education program. Methods: A cross-sectional sample of 643 graduates under obligatory rural service and 1,699 graduates after serving their obligation, all from Jichi Medical University (JMU), a binding rural education program in…

Medical technology advances from space research.

NASA Technical Reports Server (NTRS)

Pool, S. L.

1971-01-01

NASA-sponsored medical R & D programs for space applications are reviewed with particular attention to the benefits of these programs to earthbound medical services and to the general public. Notable among the results of these NASA programs is an integrated medical laboratory equipped with numerous advanced systems such as digital biotelemetry and automatic visual field mapping systems, sponge electrode caps for electroencephalograms, and sophisticated respiratory analysis equipment.

Developing an active implementation model for a chronic disease management program

PubMed Central

Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

2013-01-01

Background Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model. Methods We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. Results The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). Conclusion The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council’s model added transparency to the design phase which further facilitated the process of implementing the program. Trial registration: http://www.clinicaltrials.gov/(NCT01228708). PMID:23882169

WE-D-204-04: Learning the Ropes: Clinical Immersion in the First Month of Residency

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

Dieterich, S.

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-03: CAMPEP Residencies in a Canadian Context: Comprehensive Cancer Centers and Integrated Learning Environments

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

Parker, W.

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-02: Errors and Process Improvements in Radiation Therapy

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

Fontenla, D.

2016-06-15

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists

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

Hendrickson, K.

2016-06-15

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

Essentials of an Acceptable School for Medical Record Technicians.

ERIC Educational Resources Information Center

American Medical Association, Chicago, IL. Council on Medical Education.

The Council on Medical Education of the American Medical Association in collaboration with the American Association of Medical Record Librarians establishes standards for medical record technician education, surveys and approves educational programs, and publishes lists of approved programs. The standards presented are intended as a guide for…

32 CFR 199.26 - TRICARE Young Adult.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.26 TRICARE Young Adult. (a) Establishment. The TRICARE Young Adult (TYA) program offers the medical benefits provided... sponsors who do not otherwise have eligibility for medical coverage under a TRICARE Program at age 21 (23...

32 CFR 199.26 - TRICARE Young Adult.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.26 TRICARE Young Adult. (a) Establishment. The TRICARE Young Adult (TYA) program offers the medical benefits provided... sponsors who do not otherwise have eligibility for medical coverage under a TRICARE Program at age 21 (23...

75 FR 76471 - Medicare Program; Renewal of the Medicare Evidence Development & Coverage Advisory Committee...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... economics of health care, medical ethics and other related professions such as epidemiology and... basis. The MEDCAC--(1) Hears public testimony; (2) reviews medical literature, technology assessments... Federal Domestic Assistance Program No. 93.774, Medicare--Supplementary Medical Insurance Program). Dated...

Developing a Community Based Pre-College Medical Science Collaborative.

ERIC Educational Resources Information Center

Shagam, Janet Yagoda

Designed to assist secondary and post-secondary educators develop community interactive science programs, this manual describes steps undertaken at New Mexico's Albuquerque Technical Vocational Institute to develop pre-college medical science programs that encourage local high school students to consider the college's medical technology program.…

The implementation of medical monitoring programs following potentially hazardous exposures: a medico-legal perspective.

PubMed

Vearrier, David; Greenberg, Michael I

2017-11-01

Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. We searched the MEDLINE database using the Ovid ® search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance"). The titles and abstracts of the resulted articles were reviewed for relevance. We expanded our search to include non-peer-reviewed publications and gray literature and resources using the same terms as utilized in the MEDLINE search. There were a total of 48 relevant peer-reviewed and non-peer-reviewed publications. Publications excluded contained no information relevant to medical monitoring following potentially harmful toxicologic exposures, discussed only worker screening/surveillance and/or population biomonitoring, contained redundant information, or were superseded by more recent information. Approaches to medical monitoring: A consensus exists in the peer-reviewed medical literature, legal literature, and government publications that for medical monitoring to be a beneficial public health activity, careful consideration must be given to potential benefits and harms of the program. Characteristics of the exposure, the adverse human health effect, the screening test, and the natural history of the disease are important in determining whether an exposed population will reap a net benefit or harm from a proposed monitoring program. Broader interpretations of medical monitoring: Some have argued that medical monitoring programs should not be limited to exposure-related outcomes but should duplicate general preventive medicine efforts to improve public health outcomes although an overall reduction of morbidity, mortality and disability by modifying correctable risk factors and disease conditions. This broader approach is inconsistent with the targeted approach advocated by the Agency for Toxic Substances and Disease Registry and the United States Preventive Services Task Force and the bulk of the peer-reviewed medical literature. Medical monitoring in legal contexts: Numerous medical monitoring actions have been litigated. Legal rationales for allowing medical monitoring claims often incorporate some of the scientific criteria for the appropriateness of monitoring programs. In the majority of cases in which plaintiffs were awarded medical monitoring relief, plaintiffs were required to demonstrate both that the condition for which medical monitoring was sought could be detected early, and that early detection and treatment will improve morbidity and mortality. However, the treatment of medical monitoring claims varies significantly depending upon jurisdiction. Examples of large-scale, comprehensive medical monitoring programs: Large-scale, comprehensive medical monitoring programs have been implemented, such as the Fernald Medical Monitoring Program and the World Trade Center Health Program, both of which exceeded the scope of medical monitoring typically recommended in the peer-reviewed medical literature and the courts. The Fernald program sought to prevent death and disability due to non-exposure-related conditions in a manner similar to general preventive medicine. The World Trade Center Health Program provides comprehensive medical care for World Trade Center responders and may be viewed as a large-scale, federally--funded research effort, which distinguishes it from medical monitoring in a medico-legal context. Synthesis of public health approaches to medical monitoring: Medical monitoring may be indicated following a hazardous exposure in limited circumstances. General causation for a specific adverse health effect must be either established by scientific consensus through a formal causal analysis using a framework such as the Bradford-Hill criteria. The exposure must be characterized and must be of sufficient severity that the exposed population has a significantly elevated risk of an adverse health effect. Monitoring must result in earlier detection of the condition than would otherwise occur and must confer a benefit in the form of primary, secondary or tertiary prevention. Outcome tables may be of use in describing the potential benefits and harms of a proposed monitoring program. In the context of litigation, plaintiffs may seek medical monitoring programs after documented or putative exposures. The role of the clinical toxicologist, in this setting, is to evaluate the scientific justifications and medical risks and assist the courts in determining whether monitoring would be expected to result in a net public health benefit.

A survey of Sub-Saharan African medical schools

PubMed Central

2012-01-01

Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to infrastructure and faculty limitations, respectively. Significant correlations were seen between schools implementing increased faculty salaries and bonuses, and lower percentage loss of faculty over the previous five years (P = 0.018); strengthened institutional research tools (P = 0.00015) and funded faculty research time (P = 0.045) and greater faculty involvement in research; and country compulsory service requirements (P = 0.039), a moderate number (1-5) of post-graduate medical education programs (P = 0.016) and francophone schools (P = 0.016) and greater rural general practice after graduation. Conclusions The results of the SAMSS survey increases the level of data and understanding of medical schools in Sub-Saharan Africa. This data serves as a baseline for future research, policies and investment in the health care workforce in the region which will be necessary for improving health. PMID:22364206

Long-term outcomes of regional variations in intensity of invasive vs medical management of Medicare Patients with acute myocardial infarction.

PubMed

Stukel, Therese A; Lucas, F Lee; Wennberg, David E

2005-03-16

The health and policy implications of the marked regional variations in intensity of invasive compared with medical management of patients with acute myocardial infarction (AMI) are unknown. To evaluate patient clinical characteristics associated with receiving more intensive treatment; and to assess whether AMI patients residing in regions with more intensive invasive treatment and management strategies have better long-term survival than those residing in regions with more intensive medical management strategies. National cohort study of 158,831 elderly Medicare patients hospitalized with first episode of confirmed AMI in 1994-1995, followed up for 7 years (mean, 3.6 years), according to the intensity of invasive management (performance of cardiac catheterization within 30 days) and medical management (prescription of beta-blockers to appropriate patients at discharge) in their region of residence. Baseline chart reviews were drawn from the Cooperative Cardiovascular Project and linked to Medicare health administrative data. Long-term survival over 7 years of follow-up. Patient baseline AMI severity was similar across regions. In all regions, younger and healthier patients were more likely than older high-risk patients to receive invasive treatment and medical therapy. Regions with more invasive treatment practice styles had more cardiac catheterization laboratory capacity; patients in these regions were more likely to receive interventional treatment, regardless of age, clinical indication, or risk profile. The absolute unadjusted difference in 7-year survival between regions providing the highest rates of both invasive and medical management strategies and those providing the lowest rates of both was 6.2%. For both ST- and non-ST-segment elevation AMI patients, survival improved with regional intensity of both invasive and medical management. In areas with higher rates of medical management, there appeared to be little or no improvement in survival associated with increased invasive treatment. In elderly Medicare patients with AMI, more intensive medical treatment provides population survival benefits. However, routine use of more costly and invasive treatment strategies may not be associated with an overall population benefit beyond that seen with excellent medical management. Efforts should focus on directing invasive clinical resources to patients with the greatest expected benefit.

A Faculty Development Program can result in an improvement of the quality and output in medical education, basic sciences and clinical research and patient care.

PubMed

Dieter, Peter Erich

2009-07-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International.The traditional teacher- and discipline-centred curriculum was displaced by a student-centred, interdisciplinary and integrative curriculum, which has been named Dresden Integrative Patient/Problem-Oriented Learning (DIPOL). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany.The students play a very important strategic role in all processes. They are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. The Faculty Development program, including a reform in medical education, the establishment of the Quality Management program and the certification, resulted in an improvement of the quality and output of medical education and was accompanied in an improvement of the quality and output of basic sciences and clinical research and interdisciplinary patient care.

The Academic Support Program at the University of Michigan School of Medicine.

PubMed

Segal, S S; Giordani, B; Gillum, L H; Johnson, N

1999-04-01

The University of Michigan has a support program aimed at early identification, remedial plans, and appropriate academic accommodations for at-risk students in under-graduate colleges and graduate and professional schools. Since 1994, the medical school has formally taken part in this program. Medical students at risk for academic failure (e.g., repeated failure in academic course work, licensure examinations, clinical examinations) are automatically referred to their academic counselors in the Student Programs Office of the medical school. Once a referral is made, the student is evaluated at the Office of Services for Students with Disabilities to identify problem areas. The office makes appropriate recommendations for interventions or accommodation. Tutoring, academic assistance, and other services are available through the medical school, specific divisions of the medical center, and the community. The Student Programs Office acts as a liaison between community and university assistance programs and between the student and the medical school. During the first four years of the program, 28 medical students were identified through it; of these, 24 (86%) were underrepresented minorities. Most (21) were referred during the first and third years of the curriculum. After a range of services for a variety of problems, 26 (93%) of the 28 students either graduated or continued to progress in their studies; the other two left the medical school for academic reasons.

The Medical Academic Advancement Program at the University of Virginia School of Medicine.

PubMed

Fang, W L; Woode, M K; Carey, R M; Apprey, M; Schuyler, J M; Atkins-Brady, T L

1999-04-01

Since 1984 the University of Virginia School of Medicine has conducted the Medical Academic Advancement Program for minority and disadvantaged students interested in careers in medicine. The program is a six-week residential program for approximately 130 undergraduate and post-baccalaureate students per year. It emphasizes academic course work--biology, chemistry, physics, and essay writing--to prepare the participants for the Medical College Admission Test. Non-graded activities, such as a clinical medicine lecture series, clinical experiences, and a special lecture series, and special workshops are also offered. The participants take two simulated MCAT exams. Between 1984 and 1998, 1,497 students have participated in the program, with complete follow-up information available for 690 (46%). Of the 1,487 participants, 80 (5%) have graduated from the University of Virginia School of Medicine and 174 (12%) from other medical schools; 44 (3%) are attending the medical school now, and 237 (16%) are at other medical schools; 44 (3%) have graduated from other health professions schools, and 54 (3%) are attending such schools. The retention rate for participants at the University of Virginia School of Medicine is 91% (that is, all but seven of the 80 who matriculated have been retained past the first year). The Medical Academic Advancement Program has been successful in increasing the number of underrepresented minority students matriculating into and continuing in medical education. Such programs warrant continued support and encouragement.

A program using medical students to teach high school students about AIDS.

PubMed

Johnson, J A; Sellew, J F; Campbell, A E; Haskell, E G; Gay, A A; Bell, B J

1988-07-01

In the spring of 1987, 20 medical students from the Eastern Virginia Medical School of the Medical College of Hampton Roads were involved in a pilot program to teach about the acquired immune deficiency syndrome (AIDS) to high school senior students in Norfolk, Virginia. The medical students received instruction about AIDS from basic science and clinical faculty members at the medical school in preparation for the project. All participating high school seniors completed a 15-item knowledge test about AIDS prior to the intervention and an equivalent posttest one week after the program was completed. T-test analysis revealed a significant increase in knowledge by students at all five high schools. Responses to 10 subjective posttest questions indicated that the high school students were interested in learning about AIDS and having medical students as their teachers. This program provides an example of how medical institutions can develop a collaborative community education project that contributes to the education of medical students.

[Patient education: state of the art of the programs in the region of Provence-Alpes-Côte d'Azur in 2008 before the publication of official documents relative to the authorizations of the Regional Health Agency (ARS)].

PubMed

Parron, S; Gentile, S; Enel, P; Benhaïm, L; Ferrandino, J; Bentz, L; Sambuc, R

2013-02-01

At the request of the Hospitalization Regional Agency (ARH)--in the context of the 2007-2011 plan aimed at improving the quality of life for patients affected by chronic diseases--the purpose of this work was to draw up a clear assessment of the 2008 Therapeutic Education programmes in the Provence-Alpes-Côte d'Azur (PACA) region. The study was carried out before the publication of the therapeutic education statutory orders and ARS (regional health agency) authorizations. Cross-sectional study, carried out in the three sectors of medical management in the region--namely health-care institutions, ambulatory structures and health networks--made it possible to identify, first, which structures had actually launched therapeutic education programmes and then, how the procedures had been designed and set up. Among all the medical structures investigated, the study has listed 491 programmes, heterogeneously located throughout the PACA region. These programmes primarily target diabetes, respiratory and cardiovascular diseases. Their main objectives are the patients' quality of life, adherence to treatment and protective health behaviour (health improvement). The hospitalization sector programmes preferentially target the 30 to 60 years old, whereas the ambulatory and health networks programmes are more inclined to target the over 60 years old part of the population. More than 50% of the professionals involved in the programmes have never benefited from a specific training concerning the patients' therapeutic education. This study has pointed out a great number of important aspects which need drastic improvement in terms of therapeutic education organization - the involvement and training of health professionals, for instance. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

A review of emergency medical services events in US national parks from 2007 to 2011.

PubMed

Declerck, Matthieu P; Atterton, Laurie M; Seibert, Thomas; Cushing, Tracy A

2013-09-01

Outdoor recreation is growing in the United States, with more than 279 million annual visitors to areas controlled by the National Park Service (NPS). Emergency medical needs in these parks are overseen by the National Park's rangers within the NPS Emergency Medical Services (EMS) system. This study examines medical and traumatic emergencies throughout the NPS over a 5-year period to better understand the types of events and fatalities rangers encounter, both regionally and on a national scale. This is a retrospective review of the annual EMS reports published by the 7 NPS regions from 2007 to 2011. The following were compared and examined at a regional and national level: medical versus traumatic versus first aid events, cardiac events and outcomes, use of automated external defibrillators, and medical versus traumatic fatalities. The national incidence of EMS events was 45.9 events per 1 million visitors. Medical, traumatic, and first aid events composed 29%, 28%, and 43% of reports, respectively. Of medical episodes, 1.8% were cardiac arrests, of which 64.2% received automated external defibrillator treatment; 29.1% of cardiac arrests survived to hospital discharge. Of fatalities, 61.4% were traumatic in nature and the remaining 38.5% were nontraumatic (medical). Regional differences were found for all variables. On a national level, the NPS experiences an equal number of medical and traumatic EMS events. This differs from past observed trends that reported a higher incidence of traumatic events than medical events in wilderness settings. Cardiac events and automated external defibrillator usage are relatively infrequent. Traumatic fatalities are more common than medical fatalities in the NPS. Regional variations in events likely reflect differences in terrain, common activities, proximity to urban areas, and access to definitive care between regions. These data can assist the NPS in targeting the regions with the greatest number of incidents and fatalities for prevention, ranger training, and visitor education. Copyright © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Initiation of a medical toxicology consult service at a tertiary care children's hospital.

PubMed

Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J

2015-05-01

Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children < 6 years, poisoning continues to be a common pediatric diagnosis and bedside toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.

The effectiveness of an e-learning program on pediatric medication safety for undergraduate students: a pretest-post-test intervention study.

PubMed

Lee, Tzu-Ying; Lin, Fang-Yi

2013-04-01

Safe medication management is a major competency taught in the nursing curriculum. However, administering pediatric medications is considered a common clinical stressor for Taiwanese students. A supplemental e-learning program that helps students fill the gap between basic nursing skills and pediatric knowledge on medication safety was developed. To evaluate the effectiveness of an e-learning program to increase pediatric medication management among students who take pediatric nursing courses. This intervention study used a historical comparison design. A university in Northern Taiwan. A total of 349 undergraduate nursing students who took pediatric nursing courses participated. Eighty students in the comparison group received regular pediatric courses, including the lectures and clinical practicum; 269 students in the intervention group received an e-learning program, in addition to the standard pediatric courses. Between February 2011 and July 2012 pediatric medication management, including pediatric medication knowledge and calculation ability, was measured at the beginning of the first class, at the completion of the lectures, and at the completion of the clinical practicum. The program was evaluated qualitatively and quantitatively. The intervention group had significantly higher pediatric medication management scores at completion of the lecture course and at the completion of the clinical practicum than the comparison group based on the first day of the lecture course, after adjusting for age, nursing program, and having graduated from a junior college in nursing. Overall, the students appreciated the program that included various teaching modalities content that related to the administration of medication. Using an e-learning program on pediatric medication management is an effective learning method in addition to sitting in a regular lecture course. The different emphases in each module, provided by experienced instructors, enabled the students to be more aware of their role in pediatric medication safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Humanistic Medicine program at the Karolinska Institute, Stockholm, Sweden.

PubMed

Ahlzén, Rolf; Stolt, Carl-Magnus

2003-10-01

In 1998, the Humanistic Medicine program was established at the Karolinska Institute, Stockholm, Sweden. A fundamental element of the program is to promote medical humanities within clinical practice. The program's design focuses on three interconnected areas of study, the history of medicine, philosophy of medical science and practice, and aspects of the clinical encounter. The program offers undergraduate and postgraduate studies. The program's humanities content is bolstered in the medical curriculum by The Doctor School, a line of teaching medical students follow through their first four semesters. From this parallel series of lectures and seminars, students are exposed to further humanities and medical training. Students also have the option to select from humanities courses for their 17 eligible weeks of electives. It is hoped that the Karolinska Institute will continue to develop the humanities content of its curriculum, intertwining scientific exploration and humanistic understanding.

Accreditation of Allied Medical Education Programs.

ERIC Educational Resources Information Center

American Medical Association, Chicago, IL. Council on Medical Education.

Prepared by the Council on Medical Education of the American Medical Association with the cooperation of collaborating organizations, this document is a collection of guidelines for accredited programs for medical assistants, nuclear medicine technology, orthopedic assistants, radiation therapy technology, and radiologic technologists. The…

Legacy of Operational Space Medicine During the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Stepaniakm, P.; Gilmore, S.; Johnston, S.; Chandler, M.; Beven, G.

2011-01-01

The Johnson Space Center s Medical Science Division branches were involved in preparing astronauts for space flight during the 30 year period of the Space Shuttle Program. These branches included the Flight Medicine Clinic, Medical Operations and the Behavioral Health Program. The components of each facet of these support services were: the Flight Medicine Clinic s medical selection process and medical care; the Medical Operations equipment, training, procedures and emergency medical services; and the Behavioral Health and Performance operations. Each presenter will discuss the evolution of its operations, implementations, lessons learned and recommendations for future vehicles and short duration space missions.

Financial and Time Burdens for Medical Students Interviewing for Residency.

PubMed

Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

2017-02-01

Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

Using a Quasi-Experimental Research Design to Assess Knowledge in Continuing Medical Education Programs

ERIC Educational Resources Information Center

Markert, Ronald J.; O'Neill, Sally C.; Bhatia, Subhash C.

2003-01-01

Introduction: The objectives of continuing medical education (CME) programs include knowledge acquisition, skill development, clinical reasoning and decision making, and health care outcomes. We conducted a yearlong medical education research study in which knowledge acquisition in our CME programs was assessed. Method: A randomized…

Building Faculty Community: Fellowship in Graduate Medical Education Administration

PubMed Central

Edler, Alice A.; Dohn, Ann; Davidson, Heather A.; Grewal, Daisy; Behravesh, Bardia; Piro, Nancy

2009-01-01

Introduction The Department of Graduate Medical Education at Stanford Hospital and Clinics has developed a professional training program for program directors. This paper outlines the goals, structure, and expected outcomes for the one-year Fellowship in Graduate Medical Education Administration program. Background The skills necessary for leading a successful Accreditation Council for Graduate Medical Education (ACGME) training program require an increased level of curricular and administrative expertise. To meet the ACGME Outcome Project goals, program directors must demonstrate not only sophisticated understanding of curricular design but also competency-based performance assessment, resource management, and employment law. Few faculty-development efforts adequately address the complexities of educational administration. As part of an institutional-needs assessment, 41% of Stanford program directors indicated that they wanted more training from the Department of Graduate Medical Education. Intervention To address this need, the Fellowship in Graduate Medical Education Administration program will provide a curriculum that includes (1) readings and discussions in 9 topic areas, (2) regular mentoring by the director of Graduate Medical Education (GME), (3) completion of a service project that helps improve GME across the institution, and (4) completion of an individual scholarly project that focuses on education. Results The first fellow was accepted during the 2008–2009 academic year. Outcomes for the project include presentation of a project at a national meeting, internal workshops geared towards disseminating learning to peer program directors, and the completion of a GME service project. The paper also discusses lessons learned for improving the program. PMID:21975722

Medical knowledge related to Rocky Mountain spotted fever in Sonora, Mexico.

PubMed

Alvarez-Hernandez, Gerardo; Ernst, Kacey; Acuña-Melendrez, Natalia Haydee; Vargas-Ortega, Anabel Patricia; Candia-Plata, Maria Del Carmen

2018-03-01

Rocky Mountain spotted fever (RMSF) is a tick-borne disease with a high case-fatality rate unless diagnosed promptly and treated timely with doxycycline. Physician knowledge about presentation and treatment can improve outcomes of RMSF in endemic regions, such as Sonora in northern Mexico, where RMSF has caused 1348 non-fatal cases and 247 deaths from 2003 to 2016. A cross-sectional study was conducted with 343 physicians working in medical facilities in Sonora, Mexico. A 25-item questionnaire explored physician knowledge of clinical, epidemiological and preventive aspects of RMSF. Only 62% of physicians agreed that doxycycline should be used as the first choice treatment for children under 8 years with suspected RMSF. Additionally, 40% of primary care physicians correctly identified the time to initiate doxycycline, and 32% correctly identified the case-fatality rate of untreated RMSF in all patients. Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.

Social environment, bases social markers and health care system in Shida Kartli region.

PubMed

Raminashvili, D; Gvanceladze, T; Kajrishvili, M; Zarnadze, I; Zarnadze, Sh

2009-10-01

Difficult social conditions are accompanied by poor health status and limited access to quality social services. Accessibility to the health care is one of the important patient right universally. Although formally in place, health services are deprived of any means to assist the population. From 1600 respondents 58,8% paid for medical bills on their own, and 8.7% of respondents had health insurance that covered medical and health expenses. Almost every fifth respondent (18.5%) had access to supplemental financial support from friends and relatives. The vast majority of respondents considered the care received from medical services providers as being positive. 17.8% of respondents evaluated it as having been "very good", and every second out of five respondents (42.7%) evaluated it as having been "good". Every twentieth patient (5.2%) evaluated it as "poor" and 3.7% -"very bad", 29% of respondents are affiliated with various governmental programs. Social-economic situation influenced on the accessibility to the medical care. An effective of social policy is the system of prevention of risk factors.

Advancing the understanding of progression in multiple sclerosis: an interview with Shibeshih Belachew.

PubMed

Belachew, Shibeshih

2018-02-01

Shibeshih Belachew speaks to Laura Dormer, Commissioning Editor: Dr Shibeshih Belachew, MD, PhD, is a Senior Medical Director for Multiple Sclerosis (MS) Disease Area in Global Product Development Medical Affairs at Roche (Basel, Switzerland). Prior to joining Roche in January 2016, he was Director of MS Franchise and Head of Medical Director's office for Biogen Region Europe and Canada. Previously at Biogen he also served as a Director in Global Neurology for the natalizumab program in Cambridge (MA, USA). Prior to joining industry, he was a Clinical Professor of Neurology at the University of Liège in Belgium. Shibeshih completed neurology postgraduate training at the University of Liège and has a PhD in Biomedical Science in the field of Developmental Neurobiology. Shibeshih has been a post-doctoral fellow in the Laboratory of Cellular and Synaptic Neurophysiology at the National Institutes of Health (Bethesda, MD, USA) and later at the Center for Neuroscience Research of Children's National Medical Center in Washington DC. He is a member of the Belgian Neurological Society.

Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder.

PubMed

Williams, Arthur Robin; Santaella-Tenorio, Julian; Mauro, Christine M; Levin, Frances R; Martins, Silvia S

2017-11-01

Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n ~ 67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) marijuana use; (2) heavy use (> 300 days/year); and (3) cannabis use disorder diagnosis, based on DSM-IV criteria. Covariates included program type, age group and state-level characteristics throughout the study period. Adults 26+ years of age living in states with non-medical MML programs increased past-month marijuana use 1.46% (from 4.13 to 6.59%, P = 0.01), skewing towards greater heavy marijuana by 2.36% (from 14.94 to 17.30, P = 0.09) after MMLs were enacted. However, no associated increase in the prevalence of cannabis use disorder was found during the study period. Our findings do not show increases in prevalence of marijuana use among adults in states with medicalized MML programs. Additionally, there were no increases in adolescent or young adult marijuana outcomes following MML passage, irrespective of program type. Non-medical marijuana laws enacted in US states are associated with increased marijuana use, but only among adults aged 26+ years. Researchers and policymakers should consider program regulation and subgroup characteristics (i.e. demographics) when assessing for population level outcomes. Researchers and policymakers should consider program regulation and subgroup characteristics (i.e. demographics) when assessing for population level outcomes. © 2017 Society for the Study of Addiction.

[Are medical students being properly cared for? A question for the current student advisory program].

PubMed

Hur, Yera; Lee, Keumho

2013-09-01

Medical students need close care and systematic management of their mental and emotional health during their academic tenure. This study examined the status of the current student advisory program and counseling office, the satisfaction of the current student advisory program, the core content of an advisory program, and the quality of a good advisor. We asked 64 faculties that were in charge of the student advisory program and medical education and 774 medical students from 41 medical schools in Korea to answer a survey. Statistical analysis, chi-square test, and ordered multiple response analysis were performed. A significant number of faculty members (63.5%) and students (53.4%) indicated the existence of problems with the current advisory program. 'Deviations from the content (27.3%)' was the faculty's predominant complaint versus 'too formal (31.3%)' for students. A total of 55.5% of faculty members replied that the counseling program was helpful, but students were somewhat skeptical (13.9%). The core content of the advisory program was 'school life & academic counseling (28.3%)' by the faculty versus 'life as a medical doctor (22.3%)' for students. Both faculty and students replied that the quality of a good advisor is having 'concerns about students.' Current student advisory and counseling programs are not much help to students. A differentiated program for specific academic years should be considered to provide a tailored and valuable service.

The transition to medication adoption in publicly funded substance use disorder treatment programs: organizational structure, culture, and resources.

PubMed

Knudsen, Hannah K; Roman, Paul M

2014-05-01

Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.

[Thoughts on the Witnessed Audit in Medical Device Single Audit Program].

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-02-08

Medical Device Single Audit Program is one of the key projects in International Medical Device Regulators Forum, which has much experience to be used for reference. This paper briefly describes the procedures and contents of the Witnessed Audit in Medical Device Single Audit Program. Some revelations about the work of Witnessed Audit have been discussed, for reference by the Regulatory Authorities and the Auditing Organizations.

Resident Empowerment as a Driving Theme of Graduate Medical Education Reform.

PubMed

Thibault, George E

2018-03-01

Through a series of six recent conferences, the Josiah Macy Jr. Foundation wanted to try to change the discussion about graduate medical education (GME) reform to one that is about the innovations needed to better prepare residents for the changing world of practice they will be entering and for meeting the needs of the patient population they will serve. These conferences featured some of the encouraging innovations in GME that are occurring at local and regional levels. An ongoing theme from many of these reforms is the empowerment of residents. The author examines what it would mean for health care systems, residency programs, and residents themselves to pursue empowerment for this significant portion of the health care workforce. Residents should be seen as a valuable component of the health care workforce with the ability to contribute to institutional and societal goals. The author highlights examples of existing programs that use residents in this way, but to accomplish this more broadly will require culture change and greater flexibility on the part of GME and institutional leadership.

Interdisciplinary multiinstitutional alliances in support of educational programs for health sciences librarians.

PubMed Central

Smith, L C

1996-01-01

This project responds to the need to identify the knowledge, skills, and expertise required by health sciences librarians in the future and to devise mechanisms for providing this requisite training. The approach involves interdisciplinary multiinstitutional alliances with collaborators drawn from two graduate schools of library and information science (University of Illinois at Urbana-Champaign and Indiana University) and two medical schools (University of Illinois at Chicago and Washington University). The project encompasses six specific aims: (1) investigate the evolving role of the health sciences librarian; (2) analyze existing programs of study in library and information science at all levels at Illinois and Indiana; (3) develop opportunities for practicums, internships, and residencies; (4) explore the possibilities of computing and communication technologies to enhance instruction; (5) identify mechanisms to encourage faculty and graduate students to participate in medical informatics research projects; and (6) create recruitment strategies to achieve better representation of currently underrepresented groups. The project can serve as a model for other institutions interested in regional collaboration to enhance graduate education for health sciences librarianship. PMID:8913560

School Administration Handbook for Approved Schools for Medical Record Technicians. Revised April 66.

ERIC Educational Resources Information Center

American Association of Medical Record Librarians, Chicago, IL.

These guidelines are for the development and operation of approved programs to prepare medical record technicians. "School Approval" discusses the cooperative roles of the American Medical Association (AMA) Council on Medical Education and the American Association of Medical Record Librarians (AAMRL) in connection with program approval,…

Quality management of medical education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany.

PubMed

Dieter, Peter Erich

2008-12-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.

Development of a systematic career coaching program for medical students

PubMed Central

2018-01-01

Purpose This study aimed to develop a systematic career-coaching program (SCCP) that can be used by medical teaching schools to address a growing need for career-coaching. The program objectives were to help students (1) develop a comprehensive self-understanding of their aptitudes, interests, and personality traits; (2) explore possible career choices and decide on a career path; and (3) develop the competencies needed to prepare for their future careers. Methods The SCCP was based on the ADDIE (analysis, design, development, implementation, and evaluation) model and decision-making questioning model. Medical professionals, medical education and career counseling experts, and students participated in designing the program. Results The SCCP describes coaching content, tools, operational methods, and appropriate timing, and identifies the professionals and specialists who can offer their expertise in the different coaching phases. It is designed to allow medical schools to offer the program in segments or in its entirety, depending on the curriculum and environment. Conclusion The SCCP represents a viable career-coaching program for medical students that can be applied in part or in its entirety, depending on a medical school’s curriculum and educational environment. PMID:29510607

The University of Oklahoma College of Medicine summer medical program for high school students.

PubMed

Larson, Jerome; Atkins, R Matthew; Tucker, Phebe; Monson, Angela; Corpening, Brian; Baker, Sherri

2011-06-01

To enhance diversity of applicants to University of Oklahoma College of Medicine, a Summer Medical Program for High School Students was started in 2009. This comprehensive pipeline program included sessions on applying to medical school, interaction with a panel of minority physicians and health care professionals role models, clinically oriented didactics taught by physician faculty, shadowing experiences in clinics and hospitals, and presentation of student research reports. Students' assessments in 2009 showed increased understanding of the medical school application process, the medical curriculum and the medical field, and an increase in students'likeliness to choose a medical career. Importance of long-term mentoring and follow-up with students to sustain their medical interests is discussed.

Enrolling in Medicaid through the National School Lunch Program: outcome of a pilot project in California schools.

PubMed

Cousineau, Michael R; Wada, Eriko O; Hogan, Laura

2007-01-01

California has several health insurance programs for children. However, the system for enrolling into these programs is complex and difficult to manage for many families. Express Lane Eligibility is designed to streamline the Medicaid (called Medi-Cal in California) enrollment process by linking it to the National School Lunch Program. If a child is eligible for free lunch and the parents consent, the program provides two months of presumptive eligibility for Medi-Cal and a simplified application process for continuation in Medi-Cal. For those who are ineligible, it provides a referral to other programs. An evaluation of Express Lane shows that while many children were presumptively enrolled, nearly half of the applicants were already enrolled in Medi-Cal. Many Express Enrolled children failed to complete the full Medi-Cal enrollment process. Few were referred to the State Children's Health Insurance Program or county programs. Express Lane is less useful as a broad screening strategy, but can be one of many tools that communities use to enroll children in health insurance.

Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article

PubMed Central

French, Dustin D.; Dixon, Brian E.; Perkins, Susan M.; Myers, Laura J.; Weiner, Michael; Zillich, Allan J.; Haggstrom, David A.

2016-01-01

Abstract The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans’ electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers. The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs. A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation. Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office. VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment. There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807–1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees. Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons. PMID:26765453

Faculty Diversity Programs in U.S. Medical Schools and Characteristics Associated with Higher Faculty Diversity

PubMed Central

Page, Kathleen Raquel; Castillo-Page, Laura; Wright, Scott M.

2011-01-01

Purpose To describe diversity programs for racial and ethnic minority faculty in U.S. medical schools and identify characteristics associated with higher faculty diversity. Method The authors conducted a cross-sectional survey study of leaders of diversity programs at 106 U.S. MD-granting medical schools in 2010. Main outcome measures included African American and Latino faculty representation, with correlations to diversity program characteristics, minority medical student representation, and state demographics. Results Responses were obtained from 82 of the 106 institutions (77.4%). The majority of the respondents were deans, associate and assistant deans (68.3%), members of minority ethnic/racial background (65.9% African American, 14.7% Latino), and women (63.4%). The average time in the current position was 6.7 years, with approximately 50% effort devoted to the diversity program. Most programs targeted medical trainees and faculty (63.4%). A majority of programs received monetary support from their institutions (82.9%). In bivariate analysis, none of the program characteristics measured were associated with higher than the mean minority faculty representation in 2008 (3% African American and 4.2% Latino faculty). However, minority state demographics in 2008, and proportion of minority medical students a decade earlier, were significantly associated with minority faculty representation. Conclusions Medical student diversity ten years earlier was the strongest modifiable factor associated with faculty diversity. Our results support intervening early to strengthen the minority medical student pipeline to improve faculty diversity. Schools located in states with low minority representation may need to commit additional effort to realize institutional diversity. PMID:21869663

Training the next generation of physician researchers - Vanderbilt Medical Scholars Program.

PubMed

Brown, Abigail M; Chipps, Teresa M; Gebretsadik, Tebeb; Ware, Lorraine B; Islam, Jessica Y; Finck, Luke R; Barnett, Joey; Hartert, Tina V

2018-01-04

As highlighted in recent reports published by the Physician-Scientist Workforce Working Group at the National Institutes of Health, the percentage of physicians conducting research has declined over the past decade. Various programs have been put in place to support and develop current medical student interest in research to alleviate this shortage, including The Vanderbilt University School of Medicine Medical Scholars Program (MSP). This report outlines the long-term program goals and short-term outcomes on career development of MSP alumni, to shed light on the effectiveness of research training programs during undergraduate medical training to inform similar programs in the United States. MSP alumni were asked to complete an extensive survey assessing demographics, accomplishments, career progress, future career plans, and MSP program evaluation. Fifty-five (81%) MSP alumni responded, among whom 12 had completed all clinical training. The demographics of MSP alumni survey respondents are similar to those of all Vanderbilt medical students and medical students at all other Association of American Medical College (AAMC) medical schools. MSP alumni published a mean of 1.9 peer-reviewed manuscripts (95% CI:1.2, 2.5), and 51% presented at national meetings. Fifty-eight percent of respondents reported that MSP participation either changed their career goals or helped to confirm or refine their career goals. Results suggest that the MSP program both prepares students for careers in academic medicine and influences their career choices at an early juncture in their training. A longer follow-up period is needed to fully evaluate the long-term outcomes of some participants.

Effective use of the web to expand a summer predoctoral program: the St. Jude experience.

PubMed

Gronemeyer, S A

2000-01-01

Since 1978, the St. Jude Children's Research Hospital has oncology education (POE) program for medical and other health professional students to do two-to-four-month clinical and/or basic research rotations in pediatric oncology. Limitations in funding, recruitment capability, and faculty interest held student numbers to 0-18 per year. In early 1997, the program announcement and an on-line application were put on the Web site, . An applicant's online submission is delivered immediately to the program director's e-mail inbox, promptly acknowledged via e-mail, transferred to a digital database, and forwarded electronically to prospective institutional preceptors. The program accepted 36 of 61 applicants (56% minority) in 1997. A supplemental funding award enabled expansion of the program to include students preparing for health professions or biomedical sciences careers. In 1999, 75 of 139 applicants were accepted (47% minority) from 39 schools in 18 states, the District of Columbia, Puerto Rico, Mexico, and Ireland. Effective use of the Web and e-mail made it possible to inform students effectively about the institution and program, match students with preceptors, increase the number of minority participants, and expand the regional program into a national one.

Development of a community-based participatory colorectal cancer screening intervention to address disparities, Arkansas, 2008-2009.

PubMed

Yeary, Karen; Flowers, Eric; Ford, Gemessia; Burroughs, Desiree; Burton, Jackie; Woods, Delores; Stewart, Chara; Mehta, Paulette; Greene, Paul; Henry-Tillman, Ronda

2011-03-01

The death rate from colorectal cancer is high and affects poor and medically underserved populations disproportionately. In the United States, health disparities are particularly acute in the Lower Mississippi River Delta region. Because many in the region have limited access to basic health care resources, they are not screened for cancer, even though screening is one of the most effective strategies to prevent colorectal cancer. Community-based participatory research is a promising approach to prevent colorectal cancer in this population. The Empowering Communities for Life program was implemented in 2 underserved counties in the Arkansas Lower Mississippi River Delta. The program arose from a 9-year partnership between the University of Arkansas for Medical Sciences and 9 cancer councils across Arkansas. Empowering Communities for Life is a community-based participatory intervention designed to increase colorectal cancer screening in rural, underserved communities through fecal occult blood testing. Community and academic partners collaborated to develop research infrastructure, intervention materials and methods, and the assessment instrument. Project outcomes were strengthened community-academic partnerships, certification of community partners in conducting human subjects research, development of a randomized controlled design to test the intervention's efficacy, an interactive PowerPoint presentation, an informational pamphlet, the certification of 6 lay health advisors and 22 role models to provide the intervention, and an assessment tool using an audience response system. Lessons learned in working collaboratively with diverse groups include the importance of meeting face to face and listening.

SU-E-E-07: An Adaptable Approach for Education On Medical Physics at Undergraduate and Postgraduate Levels

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

Miller-Clemente, R; Universidad de Oriente, Santiago De Cuba, Santiago de Cuba; Mendez-Perez, L

Purpose: To contribute to the professional profile of future medical physicists, technologists and physicians, and implement an adaptable educational strategy at both undergraduate and postgraduate levels. Methods: The Medical Physics Block of Electives (MPBE) designed was adapted to the Program of B.S. in Physics. The conferences and practical activities were developed with participatory methods, with interdisciplinary collaboration from research institutions and hospitals engaged on projects of Research, Development and Innovation (RDI). The scientific education was implemented by means of critical analysis of scientific papers and seminars where students debated on solutions for real research problems faced by medical physicists. Thismore » approach included courses for graduates not associated to educational programs of Medical Physics (MP). Results: The implementation of the MPBE began in September 2014, with the electives of Radiation MP and Introduction to Nuclear Magnetic Resonance. The students of second year received an Introduction to MP. This initiative was validated by the departmental Methodological Workshop, which promoted the full implementation of the MPBE. Both postgraduated and undergraduate trainees participated in practices with our DICOM viewer system, a local prototype for photoplethysmography and a home-made interface for ROC analysis, built with MATLAB. All these tools were designed and constructed in previous RDI projects. The collaborative supervision of University’s researchers with clinical medical physicists will allow to overcome the limitations of residency in hospitals, to reduce the workload for clinical supervisors and develop appropriate educational activities. Conclusion: We demonstrated the feasibility of adaptable educational strategies, considering available resources. This provides an innovative way for prospective medical physicists, technologists and radiation oncologists. This strategy can be implemented in several regions without formal programs of MP, like most of developing countries. Starting with undergraduate students would allow to reach appropriate certification faster than most of traditional or alternative approaches for education on MP. The authors acknowledge Radiation Consulting Group, LLC, an Arizona Corporation which promotes the use of ionizing radiation in the healing arts, for the “Oscar Luis Caballero” travel grant. The authors thanks to professors Meisbel Daudinot, David Adame and Alexander Pascau for the practices through imagis, imageROC and ANGIODIN PD3000 respectively.« less

Research Productivity of Sports Medicine Fellowship Faculty.

PubMed

Cvetanovich, Gregory L; Saltzman, Bryan M; Chalmers, Peter N; Frank, Rachel M; Cole, Brian J; Bach, Bernard R

2016-12-01

Research productivity is considered an important factor in academic advancement in sports medicine. No study to date has evaluated academic productivity and correlates of academic rank for sports medicine fellowship faculty. To describe the academic productivity of American Orthopaedic Society for Sports Medicine (AOSSM) fellowship program faculty and to determine the association between academic productivity, fellowship characteristics, and academic rank. Descriptive epidemiology study. Characteristics of orthopaedic sports medicine fellowship programs were obtained from the AOSSM and program websites. Metrics of academic productivity (Hirsch index [ h index], I-10 index, publications, citations, and number of publications in several journals) were obtained from Scopus. Statistical analyses were conducted to determine whether academic productivity differs with fellowship attributes and academic rank. A total of 90 AOSSM sports medicine fellowship programs with 610 associated faculty members were identified. Faculty were predominantly male (94%), at academic medical centers (74%), members of AOSSM (71%), and sports medicine-fellowship trained (84%). Faculty had a median of 18 (range, 0-684) publications overall, including a median of 3 (range, 0-161) publications since 2012. All measures of academic productivity were significantly higher among faculty employed at academic medical centers compared with those not employed at academic centers ( P < .05 in all cases). On multivariate ordinal regression analysis, the best correlates of higher academic rank were higher cumulative h index (1.22; P < .001) and longer time in practice since fellowship (1.14; P < .001), which predicted 63.8% of the variance in academic rank. Fellowships with a larger number of fellows had more publications and citations per faculty member, higher faculty cumulative h index, and more publications in the American Journal of Sports Medicine and Arthroscopy per faculty member ( P < .017). Regional differences were present, with the Northeast fellowship faculty the most productive, followed by the Midwest. Higher cumulative h index and more years in practice were the best correlates of higher academic rank among AOSSM sports medicine fellowship faculty. Research productivity was higher among faculty employed at academic centers in the Northeast and Midwest regions and at programs with a larger number of fellows.

Uncovering the Role of BMP Signaling in Melanocyte Development and Melanoma Tumorigenesis

DTIC Science & Technology

2015-06-01

Graduate Program Nicola Kearns, UMass Medical School, Interdisciplinary Graduate Program Qualifying examination committees: Christopher Clark, UMass...Dutta, UMass Medical School, Interdisciplinary Graduate Program Nicola Kearns, UMass Medical School, Interdisciplinary Graduate Program Hsi-Ju Chen...Pigment Cell Melanoma Research, 24, 378-81. 13. Lian, C.G., Xu. Y., Ceol, C.J., Wu, F., Larson, A., Dresser, K., Xu, W., Tan , L., Zhan, Q., Lee, C., Hu, D

Army Medical Research and Materiel Command Resident Research Associateship Program

DTIC Science & Technology

2017-05-01

Award Number: W81XWH-12-2-0033 TITLE: Army Medical Research & Materiel Command Resident Research Associateship Program PRINCIPAL INVESTIGATOR...PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public...SUBTITLE NRC/AMRMC Resident Research Associateship Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-2-0033 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

Emergency Medical Services Program Guide.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Dept. of Vocational Education.

This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

10 CFR 850.35 - Medical removal.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Medical removal. 850.35 Section 850.35 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.35 Medical removal. (a) Medical removal protection. The responsible employer must offer a beryllium-associated worker...

10 CFR 850.35 - Medical removal.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Medical removal. 850.35 Section 850.35 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.35 Medical removal. (a) Medical removal protection. The responsible employer must offer a beryllium-associated worker...

10 CFR 850.35 - Medical removal.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Medical removal. 850.35 Section 850.35 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.35 Medical removal. (a) Medical removal protection. The responsible employer must offer a beryllium-associated worker...

42 CFR 413.75 - Direct GME payments: General requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... physicians' salaries and fringe benefits attributable to direct graduate medical education (GME); and (2... publications: (i) The Directory of Graduate Medical Education Programs published by the American Medical... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a...

10 CFR 850.35 - Medical removal.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Medical removal. 850.35 Section 850.35 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.35 Medical removal. (a) Medical removal protection. The responsible employer must offer a beryllium-associated worker...

10 CFR 850.35 - Medical removal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Medical removal. 850.35 Section 850.35 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.35 Medical removal. (a) Medical removal protection. The responsible employer must offer a beryllium-associated worker...

MEDICAL LABORATORY ASSISTANT, A SUGGESTED GUIDE FOR A TRAINING PROGRAM.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

INFORMATION IS GIVEN TO ASSIST IN ORGANIZING AND ADMINISTERING A TRAINING PROGRAM FOR MEDICAL LABORATORY ASSISTANTS IN A VARIETY OF SETTINGS AND TO PROVIDE GUIDANCE IN ESTABLISHING NEW PROGRAMS AND IN EVALUATING EXISTING ONES. THE MATERIAL WAS PREPARED UNDER THE DIRECTION OF THE NATIONAL COMMITTEE FOR CAREERS IN MEDICAL TECHNOLOGY. PATHOLOGISTS…

Survey of Clinical Pharmacology Programs in U.S. and Canadian Medical Schools.

ERIC Educational Resources Information Center

And Others; Fisher, James W.

1980-01-01

A survey is reported that was undertaken by the Association for Medical School Pharmacology to assess the status of developing clinical pharmacology programs in medical schools in the United States and Canada and to determine why some schools have been unable to mount such programs. Survey questions are included. (Author/JMD)

Exploration Medical Capability (ExMC) Program

NASA Technical Reports Server (NTRS)

Kalla, Elizabeth

2006-01-01

This document reviews NASA's Exploration Medical Capability (ExMC) program. The new space exploration program, outlined by the President will present new challenges to the crew's health. The project goals are to develop and validate requirements for reliable, efficient, and robust medical systems and treatments for space exploration to maximize crew performance for mission objectives.

Exposure to Fictional Medical Television and Health: A Systematic Review

ERIC Educational Resources Information Center

Hoffman, Beth L.; Shensa, Ariel; Wessel, Charles; Hoffman, Robert; Primack, Brian A.

2017-01-01

Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly…

Durable medical equipment recycling: a pilot program.

PubMed

Wright, Aaron J

2012-01-01

Our unfunded trauma patients often lack the access to adequate health care services and equipment after hospital discharge. We have developed and implemented a pilot program to provide reclaimed durable medical equipment to medically indigent trauma patients. Our program includes the reuse of items such as front-wheeled walkers, bedside commodes, shower chairs, crutches, and canes.

The short-term and long-term impact of a brief aging research training program for medical students.

PubMed

Barron, Jeremy S; Bragg, Elizabeth; Cayea, Danelle; Durso, Samuel C; Fedarko, Neal S

2015-01-01

Summer training in aging research for medical students is a strategy for improving the pipeline of medical students into research careers in aging and clinical care of older adults. Johns Hopkins University has been offering medical students a summer experience of mentored research, research training, and clinical shadowing since 1994. Long-term outcomes of this program have not been described. The authors surveyed all 191 participants who had been in the program from 1994-2010 (60% female and 27% underrepresented minorities) and received a 65.8% (N = 125) response rate. The authors also conducted Google and other online searches to supplement study findings. Thirty-seven percent of those who have completed training are now in academic medicine, and program participants have authored or coauthored 582 manuscripts. Among survey respondents, 95.1% reported that participation in the Medical Student Training in Aging Research program increased their sensitivity to the needs of older adults. This program may help to build commitment among medical students to choose careers in aging.

The current medical education system in the world.

PubMed

Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji

2011-07-04

To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.

Skylab medical experiments program. [for in-flight human physiological adaptive processes

NASA Technical Reports Server (NTRS)

Hessberg, R. R.

1973-01-01

With the completion of the historic Apollo Program, the significant medical findings will be reviewed and the medical results summarized. The medical objectives of Skylab will be presented. The medical experiments which will be conducted and their relationship to the Apollo medical findings and Skylab objectives will be discussed. The interrelationship of the Skylab medical experiments will be described and the anticipated information to be obtained will be postulated.

Learning strategies of first year nursing and medical students: a comparative study.

PubMed

Salamonson, Yenna; Everett, Bronwyn; Koch, Jane; Wilson, Ian; Davidson, Patricia M

2009-12-01

Interprofessional education (IPE), where two or more professions learn with, from, and about each other to improve collaboration and the quality of care, has been proposed as a curriculum strategy to promote mutual understanding between professions, thus helping to prepare health professionals to work in challenging contemporary health systems. Although there is support for IPE initiatives within health professional education, differences in student motivation and learning strategies are likely to contribute to the success of these initiatives. To explore self-regulated learning strategies used by first year medical and nursing students, and to determine if these strategies were different among nursing students who were high achievers. A comparative survey design. Nursing and medical nursing schools in a large university in the western region of Sydney, Australia. Six hundred and sixty-five first year nursing (n=565) and medical (n=100) students in a large university in the western region of Sydney were surveyed to assess motivational and learning strategies using The Motivated Strategies for Learning Questionnaire (MSLQ). Data relating to sociodemographic characteristics and academic performance were also collected. Nursing students were significantly older than medical students (mean age: 24.4 years versus 19.4 years; p<0.001), and there were also more females in the nursing student group (82% versus 56%; p<0.001). Although nursing students had a higher mean score for extrinsic goal orientation compared to medical students (p<0.001), medical students had higher mean scores for the other four learning strategies measured: peer learning (p=0.003), help seeking (p=0.008), critical thinking (p=0.058), and time and study environment management (p<0.001). Similarly, the grade point average (GPA) of medical students at the end of their first year was significantly higher (4.5, S.D. 1.4 versus 3.6, S.D. 1.3; p<0.001) compared to that of nursing students. While interprofessional education is seen to have many benefits for students, this study demonstrates differences in motivational and learning strategies between nursing and medical students that may impact on the success of interprofessional programs.

Physical deterioration in an acute mental health unit: A quantitative retrospective analysis of medical emergencies.

PubMed

Porter, Joanne E; Cant, Robyn; Missen, Karen; Raymond, Anita; Churchill, Anne

2018-04-27

Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011-2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals' quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the 'Worried' category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the 'Worried' category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am-12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration. © 2018 Australian College of Mental Health Nurses Inc.

Building the capacity to build capacity in e-health in sub-Saharan Africa: the KwaZulu-Natal experience.

PubMed

Mars, Maurice

2012-01-01

Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workers. There are already too few doctors to train doctors in specialities and sub-specialties. E-health is seen as a possible solution through distance education, telemedicine, and computerized health information systems but there are few people trained in e-health. We describe 12 years of experience at the University of KwaZulu-Natal (UKZ-N) in education and training in postgraduate medical disciplines, medical informatics, and telemedicine. Videoconferencing of seminars and grand rounds to regional training hospitals commenced in 2001 and has grown to 40 h of interactive conferencing taking place weekly during academic terms involving over 33,000 participants in 2010. Videoconferenced sessions are directly recorded to DVD and DVDs are sent to other medical schools in Africa that do not have the infrastructure to directly connect. E-HEALTH EDUCATION: Students and academic staff were initially sent to the United States for training in medical informatics and workshops were held in South Africa for people from sub-Saharan Africa. This led to the development of postgraduate academic programs in medical informatics and telemedicine at UKZ-N. African students were then brought to UKZ-N for training. The model was changed from UKZ-N to students and staff based at their home universities with the aim of building capacity in the staff at partner institutions so that they can in time offer their own e-health academic programs. The need for capacity development in all aspects of e-health in sub-Saharan Africa is great and innovative solutions are required.

The Perry Initiative's Medical Student Outreach Program Recruits Women Into Orthopaedic Residency.

PubMed

Lattanza, Lisa L; Meszaros-Dearolf, Laurie; O'Connor, Mary I; Ladd, Amy; Bucha, Amy; Trauth-Nare, Amy; Buckley, Jenni M

2016-09-01

Orthopaedic surgery lags behind other surgical specialties in terms of gender diversity. The percentage of women entering orthopaedic residency persistently remains at 14% despite near equal ratios of women to men in medical school classes. This trend has been attributed to negative perceptions among women medical students of workplace culture and lifestyle in orthopaedics as well as lack of exposure, particularly during medical school when most women decide to enter the field. Since 2012, The Perry Initiative, a nonprofit organization that is focused on recruiting and retaining women in orthopaedics, had conducted extracurricular outreach programs for first- and second-year female medical students to provide exposure and mentoring opportunities specific to orthopaedics. This program, called the Medical Student Outreach Program (MSOP), is ongoing at medical centers nationwide and has reached over 300 medical students in its first 3 program years (2012-2014). (1) What percentage of MSOP participants eventually match into orthopaedic surgery residency? (2) Does MSOP impact participants' perceptions of the orthopaedics profession as well as intellectual interest in the field? The percentage of program alumnae who matched into orthopaedics was determined by annual followup for our first two cohorts who graduated from medical school. All program participants completed a survey immediately before and after the program that assessed the impact of MSOP on the student's intention to pursue orthopaedics as well as perceptions of the field and intellectual interest in the discipline. The orthopaedic surgery match rate for program participants was 31% in our first graduating class (five of 16 participants in 2015) and 28% in our second class (20 of 72 participants in 2016). Pre/post program comparisons showed that the MSOP influenced students' perceptions of the orthopaedics profession as well as overall intellectual interest in the field. The results of our study suggest that The Perry Initiative's MSOP positively influences women to choose orthopaedic surgery as a profession. The match rate for program alumnae is twice the percentage of females in current orthopaedic residency classes. Given these positive results, MSOP can serve as a model, both in its curricular content and logistic framework, for other diversity initiatives in the field.

Medical Student Service Learning Program Teaches Secondary Students about Career Opportunities in Health and Medical Fields

ERIC Educational Resources Information Center

Karpa, Kelly; Vakharia, Kavita; Caruso, Catherine A.; Vechery, Colin; Sipple, Lanette; Wang, Adrian

2015-01-01

Engagement of academic medical centers in community outreach provides the public with a better understanding of basic terms and concepts used in biomedical sciences and increases awareness of important health information. Medical students at one academic medical center initiated an educational outreach program, called PULSE, that targets secondary…

Developing medical students as teachers: an anatomy-based student-as-teacher program with emphasis on core teaching competencies.

PubMed

Andrew Jay, Erie; Starkman, Sidney J; Pawlina, Wojciech; Lachman, Nirusha

2013-01-01

Teaching is an increasingly recognized responsibility of the resident physician. Residents, however, often assume teaching responsibilities without adequate preparation. Consequently, many medical schools have implemented student-as-teacher (SAT) programs that provide near-peer teaching opportunities to senior medical students. Near-peer teaching is widely regarded as an effective teaching modality; however, whether near-peer teaching experiences in medical school prepare students for the teaching demands of residency is less understood. We explored whether the anatomy-based SAT program through the Human Structure didactic block at Mayo Medical School addressed the core teaching competencies of a medical educator and prepared its participants for further teaching roles in their medical careers. A web-based survey was sent to all teaching assistants in the anatomy-based SAT program over the past five years (2007-2011). Survey questions were constructed based on previously published competencies in seven teaching domains--course development, course organization, teaching execution, student coaching, student assessment, teacher evaluation, and scholarship. Results of the survey indicate that participants in the anatomy-based SAT program achieved core competencies of a medical educator and felt prepared for the teaching demands of residency. Copyright © 2013 American Association of Anatomists.

SU-B-213-06: Development of ABR Examination Questions

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

Allison, J.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

SU-B-213-02: Development of CAMPEP Standards

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

Beckham, W.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

SU-B-213-01: Introduction

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

Starkschall, G.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

SU-B-213-07: Panel Discussion

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

Starkschall, G.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

SU-B-213-05: Development of ABR Certification Standards

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

Seibert, J.

2015-06-15

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization.more » In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.« less

Special Programs in Medical Library Education, 1957-1971: Part III. The Trainees *†

PubMed Central

Roper, Fred W.

1974-01-01

This report describes the personal characteristics of the former trainees and their opinions about their training program experiences. More of the degree program trainees were under thirty (71%) than was the case with the internship program trainees (45%). The male-female ratio for each of the two groups is approximately 1:4. Approximately 60% of the degree program trainees entered their training with majors in the natural or health sciences, while less than 50% of the total group hold degrees in the natural or health sciences. Slightly less than 60% of the total group of trainees were employed in medical libraries in 1971. However, 68.5% of the internship program trainees as compared to 46.0% of the degree program trainees held positions in medical libraries. The reasons cited most often for leaving medical librarianship were the lack of available positions and student status. The major reasons indicated by the former trainees for entering the medical library education programs were an interest in the biomedical subject fields, the availability of funds, and the desire to gain experience. The reactions of the former trainees to their training program experiences were favorable. PMID:4462687

Sexual and gender minority identity disclosure during undergraduate medical education: "in the closet" in medical school.

PubMed

Mansh, Matthew; White, William; Gee-Tong, Lea; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Goldsmith, Elizabeth; Brenman, Stephanie; Tran, Eric; Wells, Maggie; Fetterman, David; Garcia, Gabriel

2015-05-01

To assess identity disclosure among sexual and gender minority (SGM) students pursuing undergraduate medical training in the United States and Canada. From 2009 to 2010, a survey was made available to all medical students enrolled in the 176 MD- and DO-granting medical schools in the United States and Canada. Respondents were asked about their sexual and gender identity, whether they were "out" (i.e., had publicly disclosed their identity), and, if they were not, their reasons for concealing their identity. The authors used a mixed-methods approach and analyzed quantitative and qualitative survey data. Of 5,812 completed responses (of 101,473 eligible respondents; response rate 5.7%), 920 (15.8%) students from 152 (of 176; 86.4%) institutions identified as SGMs. Of the 912 sexual minorities, 269 (29.5%) concealed their sexual identity in medical school. Factors associated with sexual identity concealment included sexual minority identity other than lesbian or gay, male gender, East Asian race, and medical school enrollment in the South or Central regions of North America. The most common reasons for concealing one's sexual identity were "nobody's business" (165/269; 61.3%), fear of discrimination in medical school (117/269; 43.5%), and social or cultural norms (110/269; 40.9%). Of the 35 gender minorities, 21 (60.0%) concealed their gender identity, citing fear of discrimination in medical school (9/21; 42.9%) and lack of support (9/21; 42.9%). SGM students continue to conceal their identity during undergraduate medical training. Medical institutions should adopt targeted policies and programs to better support these individuals.

Special Forces Medical Sergeants' perceptions and beliefs regarding their current medical sustainment program: implications for the field.

PubMed

Wilson, Ramey L; DeZee, Kent J

2014-01-01

Special Forces Medical Sergeants (SFMS) are trained to provide trauma and medical care in support of military operations and diplomatic missions throughout the world with indirect physician oversight. This study assessed their perceptions of the current program designed to sustain their medical skills. An Internet-based survey was developed using the constructs of the Theory of Reasoned Action/Planned Behavior and validated through survey best practices. Of the 334 respondents, 92.8% had deployed at least once as an SFMS. Respondents reported spending 4 hours per week sustaining their medical skills and were highly confident that they could perform their duties on a no-notice deployment. On a 5-point, Likert-type response scale, SFMS felt that only slight change is needed to the Special Operations Medical Skills Sustainment Course (mean: 2.17; standard deviation [SD]: 1.05), while moderate change is needed to the Medical Proficiency Training (mean: 2.82; SD: 1.21) and nontrauma modules (mean: 3.02; SD: 1.22). Respondents desire a medical sustainment program that is provided by subject matter experts, involves actual patient care, incorporates new technology, uses hands-on simulation, and is always available. SFMS are challenged to sustain their medical skills in the current operational environment, and barriers to medical training should be minimized to facilitate sustainment training. Changes to the current medical sustainment program should incorporate operator-level perspectives to ensure acceptability and utility but must be balanced with organizational realities. Improving the medical sustainment program will prepare SFMS for the challenges of future missions. 2014.

77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2013 AGENCY: U.S. Office of Personnel Management. ACTION: Notice of Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health...